Tackling Malnutrition through Exclusive Breastfeeding

While over two million Nigerian children are suffering from malnutrition across the country, stakeholders believe exclusive breastfeeding for the first six months of life can help reduce the prevalence. Ayodeji Ake writes

Breastfeeding is essential, it saves lives, improves women’s and children’s health and boosts intelligence and lifelong productivity. Exclusive breastfeeding for the first six months of life without water, infant formula, or any other liquid or food, keeps the child healthier and stronger.

According to the 2017 United Nations International Children’s Emergency Fund (UNICEF) report, early moments matter for every child, with particular reference to promotion of exclusive breastfeeding, and the call on employers to provide six months of paid maternity leave, which a lot of private organisations are yet to comply.

However, the International Labour Organisation (ILO) convention 183 and recommendation 191 also recommended that women should be provided with daily breaks or a reduction of work hours to breastfeed their children. It also calls for the provision of breastfeeding facilities under adequate hygienic conditions at or near the workplaces.

While noncompliance of this recommendations and report shot-up malnutrition cases in the country, Alive and Thrive, a global nutrition initiative, managed by Family Health International (FHI 360), designed to save lives, prevent illness and ensure healthy growth of mothers and children, embarked on a-three-years programme designed to demonstrate rapid improvements in Infant and Young Child Feeding (IYCF), sponsored by the Bill and Melinda Gates Foundation.

Recently the Alive and Thrive team embarked on a two-days field trip in accompany of the media to meet with key stakeholders at some selected project venues in Lagos State.

Speaking during the visitation to the Lagos State Secretariat, Alausa, the State Health Education Coordinator, Mrs. Shola Hassan noted that exclusive breastfeeding should be observed in the first six months of life, and that after which, nutritional supplements can be given along with breast milk.

She said: “Most of the challenges that we encounter are on the part of the mothers and health workers. Sometimes, they feel the breast milk will not be enough for the child. We have a lot of sensitisation to do for people to change their behavior so that we can overcome all those challenges.

“After six months, we always want them to give their babies diet that will be rich in protein for the baby to grow, because in as much as they are still going to be giving the breast milk, the complimentary diet also has to be adequate. Sometimes mothers don’t give them the required nutritional supplements that they are supposed to take along with breast milk.

“That is why we have asked them to visit the clinic so that the health workers can take them on demonstration classes to know what to give the babies after six months. More so, awareness is ongoing to overcome the challenges,” she said.

The Chief Nutrition Officer, Lagos State Ministry of Health, Mrs. Taiwo Fadairo, confirmed the IYCF initiative has gone a long way in reducing cases of malnutrition in the state. Although, according to her, most career women who work in private organisations do not practice exclusive breastfeeding.

She said some learned mothers claim they do not have the time for exclusive breastfeeding. “Those who work in the bank do not have the three months leave, not to mention six months that the state has acknowledged. With that, a lot of them do not practice exclusive breastfeeding. Aside that, when they start complimentary feeding, they go for tin foods and at times, leave the children in the care of housemaids and nannies who are not knowledgeable able healthy feeding for babies,” she said.

Visit to the Traditional Birth Attendant

In Agege Local Government area, Kofoworola Clinic is a household Traditional Birth Attendant facility. During the team’s visitation to the facility, the Director of the facility, Mr. Jimoh Bashir who doubles as the Secretary General of TBAs in the local government, expressed enthusiasm to be part of the drive against malnutrition.

He noted that as a trainee under Alive and Thrive IYCF imitative, he has had wide knowledge of colostrum (first breast milk immediately after birth) and six months of exclusive breastfeeding without water.

He said: “We have been working with Alive and Thrive for two years now. We have been trained on how to help women on exclusive breastfeeding, most especially the importance of colostrum.

“Before we joined Alive and Thrive initiative, we have been doing a lot of things that are not proper. But when we were trained we have heard a broad knowledge of exclusive breastfeeding. They trained us on exclusive breastfeeding from zero day to the sixth month without water. Before now, when a mother gives birth, we immediately put glucose in water and give to the baby.

“Some uses the Islamic recitation written on a plank into water and give to the baby, Christians brings their ‘Holy water’ and we give to the baby. We thought all these are spiritual protections for the baby. We never bothered about colostrum which is the first immunisation for the baby,” she said.

Visit to a private facility

In another visitation to Christ Living Spring Apostolic Ministry (CLAM)’s Soteria Hospital, one out of the 490 private hospitals registered under Alive and Thrive, Matron Margret Olufunmilayo said IYCF can curb malnutrition in Nigeria.

“We started this hospital in May 2015. The vision was about mother and child nutrition. We have been trained and as a midwife, when a child is been giving birth to, within the first hour we ensure they take colostrum. We ensure they feed on breast milk unless the mother is sick and on admission.

“Right from antenatal we prepare our mothers. We give them breast and nipple massage to ensure the baby grips well. We made the mothers know that the colostrum comes out between the first and the third days. We have a WhatsApp platform for the mothers where they can ask questions and we also check on them to know how they are faring.

“So far so good, the response has been good because the mothers are doing well. We teach them to mind what they take when breastfeeding because excess sugar intake is not good. We teach them different diet. One main challenge is the relatives. They may mislead the woman to give their baby water instead of breast milk,” she said.

Visit to a government facility

Also at the Dopemu Primary Health Centre, its representative, Dr. Akintayo Akintoba said the facility has recorded successes on exclusive breastfeeding, which was achieved through two-steps communication using traditional leaders, market women and community leaders as a point of contact to an achievable grassroot campaigns.

One of the community influencers, Mrs. Adetutu Ogunniyi, a volunteer, also told the team that educating mothers on exclusive breastfeeding was important.

She said: “We have been training about breastfeeding guidance. we go to pregnant women to teach them what to do during pregnancy and after delivery what they should do immediately they give.”

Speaking on challenges, she said some mothers ignore exclusive breastfeeding as a result of poverty, and not having enough to eat for themselves.

“Some mothers complain they don’t have money to prepare food. When you see some children, it will be obvious they are not feeding well. It is when a mother feeds well she will be able to breastfeed a child well. Some just clamour that they want the government to give them food and money. But we make them realise the government isn’t the one that impregnated them. We educate them that before they get pregnant they must plan very well. At times, I give them stipend to work things out,” she said.

A nursing mother in the community, Mrs. Yusuf Rofiat, who gave birth to twins explained it wasn’t easy to practice exclusive breastfeeding but that with determination and assistance of her husband, it was achievable.

Another nursing mother, Mrs. Victoria David, also testified that exclusive breastfeeding has helped in ensuring her children were healthy.

“I have three children. I did exclusive breastfeeding for them. When I was told exclusive breastfeeding helps babies a lot, I then decided to give it a try. And today, I am enjoying the benefit,” she said.