Malnutrition, a serious condition that happens when diet does not contain the right amount of nutrient, is a public health issue all over the world and it persists in all its forms, including undernutrition, micronutrient deficiencies and overweight, with children paying a high price.
In 2020, over 149 million under-fives worldwide are estimated to have been stunted, or too short for their age; more than 45 million, wasted, or too thin for their height; and nearly 39 million, overweight, according to United Nations’ report.
While the State of Food Security and Nutrition in the World (SOFI) 2021 report indicates that progress has been made for some forms of malnutrition, the world is not on track to achieve any global nutrition targets by 2030.
Based on a conservative scenario, the SOFI report projected that an additional 22 million children in low and middle-income countries will be stunted and an additional 40 million will be wasted between 2020 and 2030 due to the COVID-19 pandemic.
Malnutrition endemic in Nigeria
In Nigeria, the situation of malnutrition is dire. Currently, the United Nations Children’s Fund (UNICEF) says five in 10 children under five years old in Nigeria suffer from the effects of being malnourished.
According to the 2018 Nigeria Demography and Health Survey (NDHS), malnutrition is largely concentrated in Nigeria’s northern states, the proportion of stunted children is highest in the North-West at 57 per cent and lowest in the South-East at 18 per cent.
By state, NDHS report stated that stunting is most prevalent in Kebbi at 66 per cent, Jigawa at 64 per cent and Katsina at 61 per cent and these are all North-West states.
Malnutrition is least prevalent in the South-East states of Anambra at 14 per cent and Enugu at 14.8 per cent, the proportion of children who are wasted is approximately twice as high in the North-East at 10 per cent and North-West at 9 per cent, and In the other zones, the percentage is at 4 per cent to 6 per cent, the survey revealed.
Tackling malnutrition through Breastfeeding
The importance of breastfeeding cannot be over emphasized as it has been identified by experts as an effective tools to tackle malnutrition among children.
Initiation of breastfeeding within the first hour of birth, followed by exclusive breastfeeding for six months and continued breastfeeding for up to two years or beyond, offer a powerful line of defence against all forms of child malnutrition, including wasting and obesity, says UNICEF.
According to UNICEF executive director, Henrietta Fore, breastfeeding also acts as babies’ first vaccine, protecting them against many common childhood illnesses. In Nigeria, where one in eight children do not reach their fifth birthday and three in 10 children are stunted, optimal breastfeeding practices are known to reduce neonatal and child morbidities and mortality rates as well as stunting reduction, Fore added.
She said optimal nutrition provided by breastfeeding along with nurturing, care, and stimulation, strengthens a child’s brain development with positive impacts that endure over a lifetime.
Nigerian government’s commitment
With the huge benefits of breastfeeding to the development of a child, available statistics in Nigeria revealed that the average duration of exclusive breastfeeding is approximately three months and only three out of every 10 children under six months of age were exclusively breastfed (29 per cent).
For instance, the NDHS 2013 and 2018 show improvement of breastfeeding from 17 per cent in 2013 to 29 per cent in 2018. However, this still falls significantly below the target of 50 per cent set by the World Health Assembly to be achieved in 2025 and the SDG target for 2030.
According to Fore, the percentage of children who were breastfed within one hour of birth (42 per cent) remains less than 50 per cent, adding that “Breastfeeding rates in Nigeria reduce with age, as 83 per cent of the children are breastfed up to one year, while 28 per cent are breastfeeding till two years. Furthermore, the proportion of children who are not breastfeeding increases with age.”
To change the narrative in Nigeria, the Nigerian Government has launched the National Guidelines on Baby Friendly Initiatives in commemoration of World Breastfeeding Week 2021, starting August 1st to August 7th, 2021.
The minister of health, Dr. Osagie Ehanire who disclosed this at the launch and flag of activities for the 2021 breastfeeding week said the country’s breastfeeding indices are still below optimal as only 42 per cent of babies in Nigeria are put to breast within one year of birth, adding that 29 per cent of Children zero to six months are exclusively breastfed and 97 per cent of them are only breastfed at one point and the other.
To advance Nigeria’s response to breastfeeding, Ehanire said the ministry of health in collaboration with other stakeholders, reviewed the baby friendly initiative to include the revised WHO ten steps to successful breastfeeding towards improving the support, promotion and protection of breastfeeding practices and services in communities and workplaces in line with global best practices.
The minister said this will help to improve breastfeeding indices in Nigeria and also stem the high rates of malnutrition in the country.
He disclosed that the ministry of health will collaborate with the National Agency for Food and drugs Administration and control (NAFDAC) and other stakeholders to enforce the code for marketing of breast milk substitutes by unwholesome marketing of breast milk substitutes, which pose as a threat to breastfeeding in the country.
In the same vein, the minister of Women affairs, Mrs Pauline Tallen elaborated on the importance of exclusive breastfeeding and promised better advocacy to communities for the good of babies and mothers.
WHO, UNICEF Recommendations
The theme for the 2021 World breastfeeding week is “Protect Breastfeeding, A shared responsibility.” To achieve the commitments made by the Nigerian government, organisations like WHO and UNICEF have called on the Nigerian government, health workers and industry to protect mothers from aggressive marketing practices by the baby food industry.
They called on the government and other stakeholders to ensure health care workers have the resources and information they need to effectively support mothers to breastfeed, including through global efforts such as the Baby-friendly Hospital Initiative, and guidelines on breastfeeding counselling.
Government should ensure employers allow women the time and space they need to breastfeed; including paid parental leave with longer maternity leave; safe places for breastfeeding in the workplace; access to affordable and good-quality childcare; and universal child benefits and adequate wages.
There is a need to further demonstrate commitments and shared responsibility towards improving by all stakeholders, government, donors, civil society groups and private sector, to increase funding to reach the 2025 World Health Assembly Target to raise the rate of exclusive breastfeeding in the first six months to at least 50 percent.
Government should implement the 10 Steps to Successful Breastfeeding in maternity facilities; improve access to skilled lactation counselling and create monitoring systems that track the progress of policies, programmes and funds toward achieving both national and global breastfeeding targets.
“As we approach the UN Food Systems Summit in September and the Tokyo Nutrition for Growth Summit in December, governments, donors, civil society and the private sector all have an opportunity to make smart investments and commitments to tackle the global malnutrition crisis, including protecting, promoting and supporting breastfeeding, through stronger policies, programmes and actions.
“Now is not the time to lower our ambitions. Now is the time to aim high. We are committed to making the Nutrition for Growth Year of Action a success by ensuring that every child’s right to nutritious, safe and affordable food and adequate nutrition is realized from the beginning of life, starting with breastfeeding,” they advised.