Introduction:
Exclusive breastfeeding (EBF) is the feeding an infant only breast milk for the first six months of life, without any additional food or drink, not even water, except for oral rehydration solution, drops, or syrups (vitamins, minerals, medicines) as prescribe by a medical practitioner. It is recognized globally as one of the most effective ways to ensure child health and survival. In Nigeria, where malnutrition remains a significant public health challenge, promoting EBF is crucial.
The World Health Organization (WHO), Federal Ministry of Health and Social Development (FMOH&SD) and UNICEF recommend EBF for the first six months of life, followed by continued breastfeeding with appropriate complementary foods up to two years of age or beyond to achieve optimal growth, development and health and thereafter to meet their evolving nutritional requirements.
Exclusive breastfeeding benefits both infants and mothers. For infants, it provides essential nutrients and antibodies that protect against common childhood illnesses such as diarrhea and pneumonia, which are leading causes of child mortality and also contributes to gestational weight management s Furthermore, EBF aids in postpartum recovery, reduces the risk of certain cancers, and strengthens the bond with their child.
Watch CS-SUNN Video “EBF: Changing the Nigerian Story”
Importance of Exclusive Breastfeeding:
Nutritional Benefits: Breast milk provides all the necessary nutrients in the right proportions and is easily digestible for infants. It contains antibodies that help protect infants from common childhood illnesses.
Health Benefits: EBF reduces infant mortality rates by preventing infections such as diarrhea and pneumonia, two major causes of infant death. It also lowers the risk of chronic conditions like obesity, type 2 diabetes, and cardiovascular diseases later in life.
Maternal Health: EBF helps in quicker postpartum recovery for mothers, reducing the risk of postpartum haemorrhage and breast and ovarian cancers.
Learn more about the benefits of Exclusive Breastfeeding… Click and watch
Factors affecting the uptake of EBF:
According to the Nigeria Demographic and Health Survey (NDHS) 2018, the prevalence of exclusive breastfeeding among infants aged 0-5 months is 29% in Nigeria. This is significantly below the global target of 50% set by WHO for 2025. The NDHS indicates a slight improvement from previous years; with the survey in 2013 reporting an EBF rate of 17%, showing a positive trend but still indicating that much work needs to be done.
Regional disparities exist across Nigeria according to this survey indicating that EBF rates tend to be higher in rural areas at 32% compared to urban areas at 26%. It further showed the North West region has the highest EBF rate at 40%, while the South East has the lowest at 17%. These disparities could be attributed to differences in education, cultural practices, and access to healthcare services.
Several key factors influence the practice of exclusive breastfeeding (EBF) in Nigeria, shaping the decisions and experiences of mothers across the country. Below are the critical factors that have been identified as significant determinants of EBF success or challenges.
Cultural Practices: Traditional beliefs and practices sometimes discourage EBF. For instance, some communities introduce water and herbal concoctions early due to cultural beliefs. Others believe that the colostrum is bad milk and should be discarded.
Watch to learn some of the factors affecting EBF in Nigeria
Maternal Education: Higher levels of maternal education correlate with higher rates of EBF. Educated mothers are more likely to be aware of the benefits and practice EBF.
Healthcare Access: Access to quality healthcare services and breastfeeding support can significantly impact EBF rates. Health workers play a crucial role in educating and supporting mothers to practice EBF.
Economic Factors: Mothers who need to return to work shortly after childbirth may find it challenging to practice EBF. Lack of maternity leave policies and breastfeeding-friendly workplaces contribute to lower EBF rates.
Several initiatives and research efforts are ongoing to improve EBF rates in Nigeria like the Baby-Friendly Hospital Initiative (BFHI), a WHO and UNICEF initiative in collaboration with the federal government of Nigeria aimed to support breastfeeding by ensuring that hospitals and maternity facilities adopt practices that promote and support breastfeeding.
The Civil Society-Scaling Up Nutrition in Nigeria (CS-SUNN) has played a vital role in supporting the federal government’s efforts to eradicate malnutrition through EBF.
CS-SUNN’s Role in Promoting Exclusive Breastfeeding:
CS-SUNN has been at the forefront of advocating for EBF in Nigeria. The alliance supports the federal government in executing the World Breastfeeding Week (WBW) annually. WBW is celebrated in the first week of August to raise awareness about the benefits of breastfeeding and mobilize action to support breastfeeding practices. CS-SUNN’s involvement includes supporting high-level flag-offs and community engagements, disseminating Strategic Behaivour Change materials, and engaging with the media to amplify breastfeeding messages.
Another critical area where CS-SUNN has made significant contributions is in the review and domestication of nutrition policies. The alliance has been instrumental in ensuring that national policies align with international best practices and are tailored to the Nigerian context. For example, CS-SUNN supported the review and domestication (at state levels) of the National Strategic Plan of Action for Nutrition (NSPAN) and the National Multisectoral Plan of Action for Food and Nutrition (NMSPAFN), advocating for the inclusion of specific targets and strategies to promote EBF. This involvement ensured that the policies were comprehensive and actionable to advance positive nutrition outcomes through MIYCN. . In the words of Director Aid Corporation, Kaduna State Ministry of Budget and Planning, Salisu Baba Lawal during one of CS-SUNN’s pre-budget meetings, “Our policy was developed in 2017 but it was not printed. CS-SUNN supported the state to develop the multi sectoral plan. They supported us to print these two documents. They supported the states to launch these documents. We express our deep appreciation to CS-SUNN for this support. It will go a long way to improve implementation of nutrition strategies in Kaduna state”.
CS-SUNN advocacy efforts with support from and in collaboration with nutrition partners in Nigeria like UNICEF, Alive & Thrive, GAIN, Nutrition International and others extend to pushing for policy changes that support EBF. One of the notable achievements in this regard is the advocacy for the approval of six months paid maternity leave for working mothers. CS-SUNN has consistently highlighted the importance of extended maternity leave creating an enabling environment for mothers to practice EBF. Prior to 2024, CS-SUNN’s partnerships with nutrition stakeholders in Nigeria in joint advocacy efforts in Lagos, Kaduna, Enugu states bore fruits when the state government approved six months of maternity leave for female employees in the public service. Only recently, the alliance’s advocacy efforts have yielded positive results and endorsement of 6 months paid maternity leave by the government of Cross River State under a UNICEF supported project. This policy change is a significant step towards creating an enabling environment for EBF.
At the community level, CS-SUNN state chapters implement various interventions to promote EBF. In several states, the alliance conducts community sensitization programs, working with traditional leaders, healthcare workers, and women’s groups to raise awareness about the benefits of EBF. These programs often include practical food demonstrations, distribution of educational materials, and support groups for breastfeeding mothers. Such grassroots efforts are crucial in changing attitudes and behaviors towards EBF. Village Head, Narayi Bayan Dutse, Kakuri Musa who had spoken through his secretary, Emmanuel Adamu at a town hall meeting at Narayi Bayan Dutse during the 2022 WBW said “This exclusive breastfeeding sensitisation you people have brought down to our community is a plus to us and you can hear our lactating mothers asking important questions as applicable to them as breastfeeding mothers. The good thing is that these women here are ambassadors to others who could not make it here. They will spread the message within their houses and even at the health facility here in Bayan Dutse. We thank the CS-SUNN team and government officials for this important programme in our community”.
The efforts of the Civil Society Scaling Up Nutrition in Nigeria (CS-SUNN) in promoting Exclusive Breastfeeding (EBF) have yielded promising results, significantly contributing to improved maternal and child health across the country. Through extensive community engagement, educational campaigns, and advocacy engagements, CS-SUNN has made substantial progress in raising awareness about the importance of EBF for the first six months of an infant’s life. Looking ahead, the continued advocacy, education, and support from CS-SUNN promise a future where exclusive breastfeeding becomes the norm, significantly enhancing the overall well-being and human capital outcomes for Nigeria. By ensuring that more mothers receive the necessary support and education to practice exclusive breastfeeding, CS-SUNN is helping to pave the way for healthier future generations, ultimately contributing to the nation’s overall development and well-being.
