Efforts to checkmate the rising
cases of infant and child malnutrition across Nigeria are yet to achieve the
goal.
Nigeria Natural Health Online gathered that although gradual progress is being made towards
the goal, much remains to be done as indicators show that many Nigerian mothers
are yet to understand the primary role of exclusive breastfeeding within the
first six months of life in the bid to break the vicious cycle of malnutrition
and poverty in the country.
According to the 2016-2017 Multiple Indicator
Cluster Survey 2016/17, MICS, Nigeria’s breastfeeding rate remains low overall
with only 23.7 per cent of babies born in the country being breastfed
exclusively.
It would be recalled that the World
Health Organisation, WHO, and the United Nations Children’s Fund, UNICEF,
recommend that infants should be breastfed within one hour of birth.
WHO and
UNICEF also say infants should be breastfed exclusively for the first six
months of life and be breastfed continuously for up to two years of age and
beyond. Based on the 2016/17 MICS, women in Northern Nigeria rank lowest in
breastfeeding their children exclusively while women in the South-West zone
lead in exclusive breastfeeding.
Health watchers are of the view that although
the percentage of mothers exclusively breastfeeding their babies aged under six
months, increased from 15.1 per cent to 23.7 per cent, it remains a major crack
in the country’s efforts to stop malnutrition in children.
South-West leads
A
further breakdown of the MICS showed that the South-West has the highest number
of exclusively breastfed children with 43.9 per cent and 70.5 per cent
predominantly breastfed while the North-West zone has the lowest number of
children breastfed exclusively with only 18.5 per cent. About 56.6 per cent
were predominantly breastfed.
The South-South zone followed with 27.2 per cent
and 52.5 per cent exclusively and predominantly breastfed; South-East, 25.3 per
cent and 47.8 per cent exclusively/predominantly breastfed; North-Central, 24.9
per cent and 45.8 per cent; North-East, 21.3 per cent and 50.4 per cent
respectively.
The survey also found that out of the 60 per cent child deaths
attributed directly and indirectly to undernutrition, two thirds of child
deaths have been attributed to improper feeding during the first year of
existence.
A comparative analysis of data from the MICS, conducted in 2007,
2011 and 2016/17, revealed that exclusive breastfeeding under six months has
gradually improved consistently over the years in all states in the South- West
zone and Edo State.
In a presentation entitled: The Situation of Children &
Women in South-West States based on MICS data in the last 10 years (2007 –
2017), UNICEF’s Planning, Monitoring & Evaluation, Specialist, Mr Niyi
Olaleye, observed that exclusive breastfeeding is positively related with
mother’s education, wealth status and is now practised more in urban areas.
According to Olaleye, data from the MICS showed that in the South- West zone,
Ogun and Ondo states recorded the lowest rates over the years while Osun
recorded the most improvement rising from 12.5 per cent in 2007, 40.7 per cent
(2011) to 55.3 per cent (2016/17).
In the South-West zone, according to the
2016/17 MICS, the average rate of infants under six months old who are
exclusively breastfed is 43.9 per cent, with the highest rate occurring in
Lagos at 51.8 per cent, and lowest in Ondo at 23.5 per cent.
From the 2007 and
2011 MICS, average rates of infants under six months old exclusively breastfed
were 17.1 per cent, and 27.0 per cent, respectively. Rates for Lagos were 20.0
per cent (2007) and 28.1 per cent (2011), while corresponding rates for Ondo
were 14.3 per cent, (2007) and 8.6 per cent (2011).
Quoting the MICS, Olaleye
said more women with a live birth in the last two years across the South- West
zone are putting their last newborn to the breast within one hour of birth,
especially in Ogun. He said early initiation of breastfeeding is practised more
in Edo and improved consistently in Ondo.
WHO recommendation
According to the
WHO, breastfeeding is vital to a child’s lifelong health and reduces costs for
health facilities, families, and governments. Breastfeeding within the first
hour of birth protects newborn babies from infections and saves lives.
WHO
maintains that infants are at greater risk of death due to diarrhoea and other
infections when they are only partially breastfed or not breastfed at all.
Breastfeeding also improves IQ, school readiness and attendance, and is
associated with higher income in adult life. It also reduces the risk of breast
cancer in the mother.
The world health body also found that breastfeeding all
babies for the first two years would save the lives of more than 820,000 children
under age five annually.
In the views of UNICEF Evaluation expert, Maureen
Zubie-Okolo, during a media dialogue on MICS 5 2017 and Data- Driven Reporting,
education is one of the most important tool in encouraging and promoting the
campaign for 100 per cent attainment of exclusive breastfeeding by all mothers
in Nigeria.
She said a key finding in the survey showed that 41.0 per cent of
children under five in the country were exclusively breastfed by mothers who
had attained one form of higher education or the other.
Zubie-Okolo said the
survey found that 30.6 per centof the children were exclusively breastfed by
mothers who completed their secondary school education, 20.8 per cent was
attributed to mothers who only attended primary school, 16.9 per cent of the
children were born to women who had non-formal education and 19.6 per cent were
breastfed by mothers who had no access to any form of education.
She noted that
a mother’s education has a great impact on the nutritional status of the child,
as children born by mothers who were either unable to attain any form of
education or only had access to lower education, were the ones mostly faced
with issues of malnutrition.
“The survey proves that with more number of
educated mothers in the country, the higher the chances of an increased
percentage of children exclusively breastfed as a result of access to adequate
information and a better understanding of the benefits of feeding a child with
only breast milk within the first six months after birth. She said exclusive
breastfeeding is key to fighting child malnutrition as it is more resilient in
fighting malnutrition.
What breastfeeding is UNICEF Nutrition Specialist, Mrs.
Ada Ezeogu said breastfeeding simply means feeding of an infant or young child
with breast milk rather than using infant formula or any other milk from baby
bottle while exclusive breastfeeding means giving the baby only breast milk for
the first six months of his life without water or any form of liquid.
Ezeogu
regretted that achieving exclusive breastfeeding has remained a challenge in
the country because of the practice of adding water to breastfeeding. “Most
parents see breast like any other food that you eat and drink water at the end
but the breast milk has enough water to meet the needs of the child. It
contains all the nutrients that a child needs to grow and survive and, in fact,
over 88 per cent of the breast milk is water.
So you don’t need to add any
water for the baby, otherwise, you will be taking the space of the nutrients
from the milk in the baby’s stomach.”
She encouraged mothers to ensure that
babies that are less than six months do not take water, adding that, “if you
give water, the baby will not be able to get sufficient milk and nutrient
requirements and he will be malnourished. “In addition to water, breast milk
contains nutrients such as protein, vitamins, iron, minerals and fats, etc.
What stands breast milk out? Of the eight major preventive interventions for
child development and survival, analysis showed that exclusive breastfeeding
has the most impact. Ezeogu who noted that breastfeeding alone could contribute
13 per cent reduction in child mortality, added that breastfeeding is at the
very top of interventions for child survival.
“Babies who are exclusively
breastfed for the first six months of their lives have lower risk of
respiratory infection, urinary tract infections, ear infections (acute otitis
media), fewer bouts of diarrhoea and sudden infant death syndrome. Sudden
infant death is unexplainable death of children.
“Breastfeeding also protects
the baby from chronic diseases such as obesity and diabetes mellitus. Also, the
breast milk contains antibodies that are transferred to the baby. The benefits
are not only pronounced in childhood but also in adulthood.
It has been proven
that children that are exclusively breastfed has higher IQ than those not
breastfed. The longer you breastfeed the child, the less chances of his
suffering from depression and attention issues when he becomes an adult.”