Dismantling Barriers to Exclusive Breastfeeding

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From 1 to 7 August, Nigeria joined the rest of the world to mark World Breastfeeding Week (WBW). The annual commemoration is organised to raise awareness on the importance of breastfeeding to children’s health. It is particularly aimed at encouraging exclusive breastfeeding, with the ultimate goal of improving the wellbeing of babies around the world.

With the official commemoration period over, it is imperative to again reflect on the theme of this year’s event, “Step Up for Breastfeeding—Educate and Support,” which aims at addressing bottlenecks against exclusive breastfeeding of infants. Exclusive breastfeeding is the practice of giving an infant only breast milk, without mixing it with water, other liquids, tea, herbal preparations or food, in the first six months of life (with the exception of medicines).

Health experts and nutritionists unanimously affirm that exclusive breastfeeding for the first six months, followed by continued breastfeeding with appropriate complementary foods for up to two years and beyond, provides an infant the best start possible to life. According to the World Health Organisation (WHO) “breast milk is safe and clean, and provides the energy and nutrients an infant needs for the first few months of life; and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year.” Most importantly, early initiation of breastfeeding, within one hour of birth, protects the new-born from infectious and chronic diseases, and reduces new-born mortality.

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Research has also found that exclusively breastfed children perform better on intelligence tests, are less likely to be overweight or obese and less prone to diabetes and other diseases later in life. Moreover, women who breastfeed have been found to have a reduced risk of breast and ovarian cancers.

Considering these numerous benefits of breastfeeding to babies and their mothers, it is deeply disturbing that reports continue to show that the rate of exclusive breastfeeding in Nigeria is still abysmally low. Figures from UNICEF and the WHO cite 29 per cent, meaning that over 70 per cent of infants in Nigeria are denied the aforementioned benefits of breast milk in their formative years. Indeed, the figure is as low as 21 per cent in some states. The results are often malnutrition and preventable diseases.

Factors responsible for this appalling rate of breastfeeding, according to experts, include widespread ignorance about the benefits and appropriate methods of breastfeeding among women, the misconception that breast milk could be inadequate for a baby or that  baby formula is equivalent to  breast milk, lack of family and social support, embarrassment about feeding in public, lactation problems, returning to work and accessing supportive childcare, bad policies and practices in health services by health workers as well as bad policies and practices in health services.

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It is for these reasons and more that that the theme of this year’s edition of WBW is particularly important for Nigeria. Evidence has shown that all the above barriers to exclusive breastfeeding can be decisively resolved with the firm commitment of stakeholders to adequate education and support. As the WHO has rightly noted, “Breastfeeding is not a one-woman job. Mothers need support from their husbands, family members, community, health workers and governments to give their children the healthiest possible start of life.”

To this end, government, health workers and other key players in the health sector must be committed to creating awareness for women to know that the first 1,000 days of life are the most important in brain growth and other health development indices for their babies, and the best and only food for this critical period is breast milk. They must also be enlightened that breast milk contains all that an infant needs for healthy survival and development.  Government should also ensure that adverts and campaigns about breast milk substitutes are duly censored. Most importantly, government must heed the call of both UNICEF and WHO to allocate increased resources to protect, promote, and support breastfeeding policies and programmes, especially for the most vulnerable families living in emergency settings.

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It is laudable that the National Policy on Infant and Young Child Feeding in Nigeria, (2005) takes cognizance of the importance of exclusive breastfeeding to the health of the child and to the overall socio-economic wellbeing of the nation. However, the stipulations of the policy must be revisited for proper implementation and compliance. One good way to begin is to ensure that employers of labour provide mothers with the time, space, and support they need to breastfeed.

We also call on health workers to help with teaching, encouraging, counselling and guiding mothers on exclusive breastfeeding. These will help to allay their fears and address their common challenges.  Beyond this, health professionals must also support mothers to initiate breastfeeding as soon as possible after birth, within the first hour after delivery. Knowing the importance of colostrum in preventing life-threatening infection and diseases, they should put babies to their mothers’ breasts immediately after birth, even in cases of caesarean births.

In the same vein, husbands and family members must provide the encouragement, support and enabling environment for mothers to exclusively breastfeed their babies. When mothers are provided with good nutrition and assisted with chores, they get the energy and nutrients to properly and adequately breastfeed their infants, and the entire family enjoy the ultimate benefits.

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