Sufficient nutrition at birth and infancy is crucial in promoting maximal growth and behavioral development. Breast milk contains ingredients for perfect nourishment of infants. In this report, DOOSUUR IWAMBE examined workplace activities that may affect the practice of exclusive breast among working class mothers.

33-year-old Mrs. Loveline Okafor had the intention of exclusively breastfeeding her baby, Amaka who is now 9 months old in the first six months. However, her job as a banker left her with no other alternative than to introduce other food to her baby.

“Amaka is my first baby and when I was attending antenatal clinics, I was told by the nurses to ensure that I practice exclusive breastfeeding for optimal development of my baby.

“She was healthy when I gave birth to her. I started exclusive breastfeeding but months after; I was done with my maternity leave. After I resumed, dropping her at the crèche was the only option.

‘’Since I was not sure how neat they were to handle the breast extract milk, I was left with the option of introducing other food to her’’, she said.

Another nursing mother simply identified as Simi works as a secretary in one of a very big law firm in Abuja. She told the Daily Times that her office did not make provision for a crèche and therefore, could not bring her baby with her to the office.

She said, I know the health benefits that come with exclusive breastfeeding. I did that for my baby who is 10 months old now for only three months because I had to resume work.

‘’I could not continue because we had no crèche in the office and there was none around my office either’’. She said.

For her part, Anabel Nnochiri a mother of two said that she could not do exclusive breastfeeding for her children because her job involves travelling.

“I can’t be travelling with my baby all over the country. My organization does not want to know whether you are doing exclusive breastfeeding or not three months after your maternity leave when you are expected to resume work’’, she added.

Breastfeeding provides all the nutrition, including water, which a child needs for growth and good health for the first six months of life. It helps protect children from infection and helps them recover faster from illness. Breast milk is easy for children to digest and is always the right temperature.

However, in many countries including Nigeria, the importance of breastfeeding is often not widely understood and poor feeding practices are common. In poor countries, infants under two months of age who are not breastfed are 25 times more likely to die of diarrhea than infants who are exclusively breastfed.

According to the Minister of Health, Dr. Osagie Ehanire, about 20,000 women die annually from poor breastfeeding practices. Ehanire, who was speaking during an event to commemorate the 2020 Breastfeeding Week with the theme; “Support Breastfeeding for a Healthier Planet,” in Abuja, said the benefit of breastfeeding to both mother and baby had been well documented to, among others, give babies stronger immunity, reduce the risk of suffering many childhood illnesses and infections.

Ehanire lamented that despite the benefits that comes with breastfeeding, Nigeria had fallen below optimal.

He cited the National Demographic and Health Survey 2018, which indicated that 97 percent of children were breastfed at one point or the other, while only 42 percent are put to the breast within 1 hour of birth and the proportion of children 0 to 6 months who are exclusively breastfed stood a pt just 29 percent.

He revealed that the Federal Ministry of Health developed the national social and behavioral change strategy for infant and young child feeding as part of measures to increase optimal breastfeeding practices.

Ehanire said a major barrier to its proper implementation “is the practice by mothers and caregivers, on giving water to babies from birth to the age of six months.”

To address the problem, he said the FMOH launched the National Zero Water Campaign, which is now ongoing in several states during the 2019 World Breastfeeding Week celebration, to educate Nigerians on the need to give babies only breast milk only, and no other liquids in the first six months of life.

Ehanire, who said the National Guidelines on the Baby-Friendly Initiative “is currently being reviewed”, stressed that it encompassed baby-friendly services in the hospital, community, and workplace, saying its goal is to incorporate programming breastfeeding as an integrated delivery in routine services.

The theme of World Breastfeeding Week 2020 is “Support breastfeeding for a healthier planet”. In line with this theme, The World Health Organization (WHO) and the United Nations Children Fund (UNICEF) are calling on governments to protect and promote women’s access to skilled breastfeeding counseling, a critical component of breastfeeding support.

The international bodies said that breastfeeding provides every child with the best possible start in life and delivers health, nutritional and emotional benefits to both children and mothers.

The WHO also revealed that exclusive breastfeeding could save the lives of 820,000 children every year, generating $302bn in additional income adding that it can provides every child with the best possible start in life.

“It delivers health, nutritional and emotional benefits to both children and mothers. In addition, it forms part of a sustainable food system. However, while breastfeeding is a natural process, it is not always easy. Mothers need support – both to get started and to sustain breastfeeding,” it said.

According to the UN agency, “Skilled counseling services can ensure that mothers and families receive this support, along with the information, the advice, and the reassurance they need to nourish their babies optimally.

“Breastfeeding counseling can help mothers to build confidence while respecting their individual circumstances and choices.

“Counseling can empower women to overcome challenges and prevent feeding and care practices that may interfere with optimal breastfeeding, such as the provision of unnecessary liquids, foods, and breast milk substitutes to infants and young children.”

The world health body added that improving access to skilled counseling for breastfeeding can extend the duration of breastfeeding and promote exclusive breastfeeding, with benefits for babies, families and economies.

“Indeed, analysis indicates that increasing rates of exclusive breastfeeding could save the lives of 820,000 children every year, generating US $302 billion in additional income.

“Skilled breastfeeding counseling can be provided by different actors including health care professionals, lactation counselors and peer support providers, and in a variety of settings– in health facilities or clinics, through home visits or community programmes, in person or remotely.

“During the COVID-19 pandemic, it is even more important to find innovative solutions to ensure that access to these essential services is not disrupted and that families continue to receive the breastfeeding counselling they need,” it said.

WHO however urged governments to protect and promote women’s access to skilled breastfeeding counselling, a critical component of breastfeeding support.

Breastfeeding strengthens the economy

Beyond health, the new Series presents a strong economic case for investing in promoting and protecting breastfeeding worldwide. The findings from WHO and partners estimate that global economic losses from lower cognition associated with not breastfeeding reached more than US$ 300 billion in 2012, equivalent to 0.49% of the world’s gross national income.

Boosting breastfeeding rates for infants below 6 months of age to 90% in Brazil, China, and the United States of America, and to 45% in the United Kingdom would cut treatment costs of common childhood illnesses, such as pneumonia, diarrhoea and asthma, and save healthcare systems at least US$ 2.45 billion in the United States, US$ 29.5 million in the United Kingdom, US$ 223.6 million in China, and US$ 6.0 million in Brazil.

Yet, worldwide low levels of optimal breastfeeding affect both high- and low-income countries. Fewer than 1 in 5 infants are breastfed for 12 months in high-income countries and only 2 out of 3 children between 6 months and 2 years receive any breast milk in low- and middle-income countries.

Protecting and promoting breastfeeding

Although the World Health Assembly adopted the International Code of Marketing of Breast milk Substitutes in 1981 to protect the public from inappropriate marketing strategies, it has been weakly enforced by countries. As a result, aggressive marketing of breast-milk substitutes is undermining efforts to improve breastfeeding rates, with global sales expected to reach US$ 70.6 billion by 2019.

To address this issue, the Global Breastfeeding Advocacy Initiative, led by UNICEF and WHO in collaboration with international partners, will be providing leadership to improve breastfeeding rates. As a first step, WHO and UNICEF have created a Network for Global Monitoring and Support for Implementation of the International Code (NetCode) with the purpose of strengthening capacity for Code monitoring, adherence and implementation.

Beyond combating marketing of breast-milk substitutes, countries need to invest in policies and programmes that support women’s breastfeeding. Supportive health-care systems, adequate maternity leave entitlements, workplace interventions, counseling and educational programmes can all help to improve breastfeeding rates.

Breastfeeding has also been identified as a high impact intervention to achieve the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030), which was launched alongside the Sustainable Development Goals as a roadmap for ending preventable deaths in a generation. Breastfeeding is important to child survival in all settings, but also to ensuring that children can thrive and reach their full cognitive and developmental potentials throughout their lives.

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