Exclusive breast feeding: Changing the narrative

Sat Mar 21st, 2020 - Ekiti

Kindly Share This Story: By Evelyn Usman

Breast milk is considered the best nutrient for babies, as it contains live ingredients, including stem cells, white blood cells and beneficial bacteria as well as other bioactive components such as antibodies, enzymes and hormones which help fight infection, prevent disease and contribute to normal healthy development in new born.

Owing to its attributive advantages, the World Health Organisation, WHO recommends breastfeeding for at least, six months for new born babies because it is one of the most effective ways to ensure child’s health. When scaled up to near-universal levels, about 820,000 children lives would be saved every year through effective breastfeeding.

This is because exclusively breastfed babies in the first six months of existence are believed to rarely suffer from diarrhea and other sicknesses such as flu and cold. They are also less likely to be victims of Sudden Infant Death and Syndrome (SIDS) , when compared to formula-fed infants. Breastfeeding is a common way to soothe babies that are sick or upset, as well as reduces crying and providing relief when babies are having vaccinations. Its benefits are numerous.

Brain development

One vital benefit of breastfeeding is brain development. A baby’s first six months are a busy time for his rapidly growing brain, as its mass almost doubles during this crucial period. A US study showed that toddlers and preschoolers who’d been exclusively breastfed for at least three months had brains with 20 to 30% more white matter – which connects different regions of the brain and transmits signals between them – than those who’d had no breast milk.

READ ALSO: 71% of Nigerian children not breastfed exclusively — REPORT

The importance of breastfeeding for baby brain development is reflected in research across the globe. In a UK study, 16-year-olds who had been breastfed for six months or more as babies were more likely to get higher grades in their school exams. And Brazilian researchers found people who’d been breastfed for at least a year tended to earn more money by the time they were 30.

Brick wall
According to research, optimal breastfeeding practices is capable of preventing 103,742 child deaths, an advantage that contributes to reducing overall under-five child mortality.

It is against this backdrop that the campaign for optimal breastfeeding practices is being championed in Nigeria. Unfortunately, record shows that a minimal percentage of children under six months are deprived of the advantages that come with exclusive breastfeeding.

Statistics show that an estimated 5.4 million children in Nigeria are deprived of the powerful health and immunological benefits of breastfeeding each year. This is as a result of the introduction of milk formula, immediately they are born. Unfortunately, these children become susceptible to different decease.

This deprivation is mainly caused by inability of mothers who form a good percentage of the workforce in Nigeria to have six months maternity leave. Though the International Labour Organisation, ILO convention 183 and recommendation 191, recommended that women should be provided with daily breaks or a reduction of work hours to breastfeed their babies as well as provision of breastfeeding facilities under adequate hygienic conditions at or near the workplaces.

Unfortunately, in Nigeria, only Lagos, Enugu and Ekiti states have approved a six-month maternal leave, to avail nursing mothers the opportunity to practice exclusive breastfeeding. Other states, including private outfits, only approve three months maternity leave to their employees and those who decide to extend theirs, would be without pay.

However, aside from the challenge of the workforce factor, some women in Nigeria, introduce babies below six months to formular and local foods, with the belief that such would sustain the baby more.

Other women, subject their babies to all kinds of concoctions during birth, while others apply Holy water or wash Arabic inscriptions on slates, into water for their new borns to drink

‘Alive and Thrive’ campaign

In order to drive home the economic, social and developmental benefits of exclusive breastfeeding for the first six months of a baby’s existence ‘Alive and Thrive’, a global nutrition initiative and Non-Governmental Organisation, funded by Bill and Belinda Gates Foundation has been in the forefront of its campaign in Nigeria, with a view to saving lives and improving healthy growth of both mother and child.

To achieve its mandate, it embarked on a three years programme in Nigeria, specifically to reach out, not just to mothers both in the urban and rural areas but health workers with a view to vigorously support the campaign on Infant and Young Child Feeding, IYCF and by extension, to address the rate of malnutrition in children.

So far, it has worked with 490 hospitals for two years in Nigeria, by training Health Care Providers and supporting health sectors in training and equipping them with knowledge-based techniques to counsel mothers, especially the pregnant ones on the benefits of exclusive breastfeeding , whenever they come for anti-natal.

Pregnant women are taken through sections of right feeding practices which has three components: early initiation, which entails introducing the baby to its mother’s breast immediately after birth, proper way of positioning the baby; exclusive breastfeeding within the first six months, with emphasis on no water, infant formula or any other food.

The third component is the counsel on introduction of appropriate complImentary feeding , after six months. This campaign which is aimed at improving infant and child feeding practices is also geared towards addressing the rate of malnutrition in Nigeria.

READ ALSO: Quota system: Why is Nigeria still breastfeeding the North?

After delivery, nursing mothers are reminded of the infant feeding practices, when they take their children for immunization.

Changing the narrative

Highlighting the benefits and impact of Alive and Thrive, in its exclusive breastfeeding campaign, during a two-day field trip to beneficiary stakeholders and some selected venues in Lagos, the State’s Health Education Coordinator, Mrs Shola Hassan, said the clarion call for exclusive breastfeeding has been overwhelmingly impressive in the state. But she was quick to add that some mothers were still of the view that breast milk alone, would not be enough for their babies, hence the introduction of baby formula. She also blamed some health workers who she accused of urging mothers to introduce baby formula.

Attributing their attitudes as ignorance, she, therefore, called for the need to changing the narrative. She said, “This is why we are focusing on behavioural change on the part of women so as to overcome these challenges.

We have recorded a lot of success working with Alive and Thrive in delivering and nurturing healthy babies. We always ask them to come to the clinic to know how to take care of their children at every stage as the baby grows.

“Sometimes, lactating mothers are not patient enough to allow their babies suck very well before jumping into conclusion that breast milk is not enough for the sucking baby. The baby should be allowed to suckle on both breasts for as long as possible. Sadly, a lot of mothers are always in a hurry, which leads them to patronise breast milk substitutes.”

On her part, the Chief Nutrition Officer, Lagos State Ministry of health, , Mrs Taiwo Fadairo, stated that the campaign for exclusive breastfeeding had witnessed a drop in cases of stunted children.
She said,” For the number of stunted children, which is an irreversible situation, the state dropped from 11.4 as it was as in 2013 to 6.6 per cent in 2018. This is a huge success, though we are not yet there; there is still a lot of work to do.

“In the area of awareness creation, nursing mothers are now more aware of the benefits of exclusive breastfeeding and adequate dietary”.

She, however, lamented that some women who would have loved to practice exclusive breastfeeding were constrained by the three months leave. She, therefore, advised such women to take their babies to crèches close to their places of work, where they would visit intermittently to breastfeed them.

At the Dopemu Primary Health Care Centre, the Medical Officer of Ministry of Health, Agege Local Government Area, Akinayo Akintoba Adebayo, also lauded the efforts of Alive and Thrive, saying “ with the help of Alive and Thrive, the centre was able to raise ambassadors for best breastfeeding and other nutrition practices.

Private hospitals

From the tour, it was evident that the training of health workers by ‘Alive and Thrive was not limited to a government hospital but private as well. The next port of call was one of the private hospitals- Soteria Maternity and Hospital, located in Omole area of Lagos.

Its Matron, Mrs. Margaret Oluwafumilayo Giwa, who asserted that some staff of the medical centre had benefitted from Alive and Thrive training, gave a nod of approval to the exclusive breastfeeding campaign, noting that breast milk contains all the water and nutrients a baby needed in the first six months of life.

Like her counterparts in the public sector, she stated that giving baby water before the age of six months; hinders absorption of nutrients from breast milk; and increases the risk of illness from contaminated water and feeding bottles, especially in emergency situations.

She said: “Breast milk is 88 per cent water, which is clean, safe, and designed specifically to meet the needs of the baby. Giving the baby water is exposing it to harm because that water could be contaminated. Replacing breast milk with another fluid can negatively impact an infant’s nutritional status, survival, growth, and development” she said.

Community leaders

Community leaders were not left out in the awareness campaign. The idea of including them was to take the information back to their respective communities. These leaders who are also described as community influencers were not only informed of the benefits of the exclusive breastfeeding but majority of them were discovered to be men. During the training, they were informed on the need to encourage their wives during the breastfeeding period, by being around them and by extension, assist them to shun the temptation of giving up on time.

One of them, Mr. Chinedu Nwoadazie, Immunity facilitator and influencer at Sango Primary Health Care Centre, Agege, showered accolades on Alive and Thrive, stating that knowledge gained through its training programmes had gone a long way to disabusing some wrong notions in the community.

For instance, he said, “In the course of taking back knowledge gained from Alive and Thrive, we have been able to correct some misconceptions among them. Some of them attributed having more than one wife, especially when they give birth, to the belief that children would suck their semen while being breastfed.

” But today, they have come to know that having sexual intercourse with their wives while they (wives) are breastfeeding enhances family planning.

Traditional Birth Attendants

Traditional Birth Attendants, TBA are not left out in the training either. This is because most child delivery in remote areas is done by TBAs.

During a visit to one of the TBAs facilities in Agege Local Government area, Kofoworola Clinic, the Managing Director , Mr. Jimoh Bashir, revealed that trainings by Alive and Thrive has eradicated some superstitious believe and ignorance hinged on culture.

According to him: “ We came in contact with Alive and two years ago. I have undergone training sections on how to help women on exclusive breastfeeding, most especially the importance of colostrum. They trained us on exclusive breastfeeding from day zero to the sixth month without water.

Before we met Alive and Thrive , several practices that were not proper, were carried out by nursing mothers. An example is the introduction of glucose mixed with water , to babies.

“ Also, some mothers would wash verses of the Quran written on slate , in water and give to new born babies to drink, immediately after delivery, in our facilities. Some Christians also give Holy water to their newly born babies to drink. We thought these were spiritual protections for the baby. We never bothered about colostrum which is the first immunization for the baby.

“I have 69 TBAs under me and I have made it a point of duty to impact the knowledge gained from Alive and Thrive , on them. that way, it has reduced infant deaths in our facilities.

At the end of the visit to the stakeholders visited, it was evident that the initiative taken by Alive and Thrive has changed the narrative positively, in children breastfeeding.




source: Vanguard