… Kenya, South Africa lead in WHO compliance in Africa
ANTHONIA OBOKOH
Toyosi Jane, 30, a single parent of one, feels less qualified as a mother, not because she can’t afford her new-born the joy of being cradled and raised under the unity of a loving couple. She believes her inability to breastfeed her daughter eliminates her from the category of tier-A mothers who can.
Jane dearly wished her baby could gulp abundantly from her chest for the first six months as recommended by the World Health Organisation (WHO). She longed to see that expression of utter fulfilment, bliss and laughter from the countenance of a well-breastfed child. But the HIV-positive condition of the Lagos-based mother condemns her breast milk to waste.
There is no respite for mother-child such as Jane and her daughter currently in Nigeria as breast milk banks- a depot of alternative natural milk which is sourced from the donation of other mothers – are unavailable.
Although WHO recommends donated breast milk as the next preferred option where a mother is unable to breastfeed, cultural barriers, religious bias, individual beliefs, attitude and lack of institutional support stand in the way.
Poor awareness among gynaecologists and mothers also grossly limit the adoption of this feeding method.
“When I gave birth to my daughter, two months ago as a preterm baby, she could not be breastfed because I am HIV positive. Whenever I remember that I cannot breastfeed my baby, I feel less proud as a mother. I cannot even afford the HIV drugs,” Jane said with a gloomy tone.
“My baby was losing almost 10 percent of her body weight because I couldn’t breastfeed her. I would feed her with formula milk.”
28-year-old Doris almost perfectly understands the pain of Jane. After giving birth to her baby seven weeks earlier at 34 weeks, she couldn’t lactate until after seven days.
“I had severe pains; my breast was aching and the breast milk was not flowing. My baby did not suck for those days. I was worried that my baby could not eat and I was in so much pain,” Doris explained.
“If Nigeria had a breast milk bank, I do not think there is anything wrong. In that case, I could go to ask the hospital to supply me some of the milk,” Doris said.
Breastfeeding challenges highlight Nigeria’s need for breast milk. Of the estimated seven million children born every year, only about 25 percent are exclusively breastfed from age 0 to 6 months.
The strong belief influenced by culture and religious practices has set Nigeria back and slowed progress in people’s attitude towards breast milk banks as an intervention for breastfeeding. There is no breast milk bank or specific regulatory frameworks instituted in the country, experts say.
Breastfeeding is the most natural and best way to feed new-borns. Many babies lack access to their mother’s milk due to the mother’s sickness, temporary health challenge or death.
Larne Yusuf, a Lagos-based medical practitioner, ranked cultural belief top among reasons breast milk banking may not work in Nigeria.
He fears that without mass sensitisation on breast milk donation, banking in Nigeria might lack people to supply milk.
“We have strong cultural and religious beliefs that see as taboo any move to consider breast milk from another woman. It is only in a few exceptional cases that someone will take someone else’s child to breastfeed,” Yusuf said.
Kenya is the second, after South Africa to have established a human milk bank in sub-Saharan Africa, upon WHO’s recommendation.
Breast milk banks are growing rapidly in South Africa, combating a climate where breastfeeding rates are low, formula is fashionable and premature babies die every 20 minutes. The government is introducing the banks at public hospitals and hopes that a shift in attitudes and mindset will follow. At present, only eight percent of South African women, exclusively breastfeed their babies during the first six months of their lives.
Similarly, Kenya recently launched a breast milk bank which is meant to help make a dent in Nairobi’s neonatal deaths during the first 28 days of life, which stand at 38 deaths per every 1,000 live births – the highest in the country. It does this by providing life-saving breast milk to babies who are born premature, those born underweight or severely malnourished, those who are orphaned, and those who otherwise, have no access to their mother’s milk.
Uzoma Onuoha, a gynaecologist at the Federal Medical Centre Keffi, said culture has a question already for any woman in Nigeria who fails to breastfeed her own baby. She notes that some illnesses are also hindrances that prevent some mothers to breastfeed.
“In the cases of HIV patient, especially of a woman who is not on drugs, active tuberculosis infection, breast cancer, breast abscess and women with psychosis (puerperal psychosis) might have challenges of breastfeeding their babies,” he said.
HIV patients, for instance, are commonly advised against breastfeeding except on their drugs.
Breast milk, established as the most optimal source of nutrient for infants, contains bioactive substances that are essential to the development of the newborn’s immature immune system.
Thompson Kobata, public health nutritionist at the Federal Ministry of Health told BDSUNDAY that adequate nutrition during infancy and early childhood was fundamental to a child’s survival, growth, and development to full potential.
“Inadequate nutritional practices beginning with poor universal breastfeeding practices result in 33 percent of deaths of the newborns due to initiation of breastfeeding within two to 23 hours of birth. In Nigeria, malnutrition contributes more than 50 per cent of death and occurs in the first years of life,” he said.
“Breast milk substitute poses the risk of not having breast milk’s protective qualities through the high risk of contamination that can lead to life-threatening infections in young infants,” Kobata further explained.
The World Health Assembly (WHA) adopted the Code in 1981 as a global health public strategy to protect breastfeeding from aggressive promotional campaigns by milk formula manufacturers.
The Code recommends restrictions on the marketing of breast milk substitutes, such as infant formula, to ensure that mothers are not discouraged from breastfeeding and that substitutes are used safely.
According to the United Nations Children’s Fund (UNICEF), improving breastfeeding can help Nigeria reach its full human and economic potentials, preventing 10 million cases of childhood diarrhoea and pneumonia, saving 103, 742 children’s lives each year and reducing the cost to the health care system by $22 million a year.
