Making a case for exclusive breastfeeding.

Source :WHO

Breastfeeding is a norm in Nigeria, but exclusive breastfeeding is not. Babies below six months of age most times are given other foods or liquids. Exclusive breastfeeding; feeding an infant on breast milk alone, is the gold standard for babies below six months old as it not only contains all the nutritional needs of babies that age but also protects them from several types of diseases. It has repeatedly been described as the safest and healthiest option for feeding infants. Experts recommend it should start from the first hour of a baby's life as this not only gives the baby good supply of the nutrient-rich colostrum which safeguards infants from dying during the most vulnerable time of their life,  but also helps establish and increase the supply of the more mature breast milk.

Today, the evidence on the power of exclusive breastfeeding is stronger than ever. 

Many mothers choose to practice this form of infant feeding  but get discouraged at some point either by the opinions of family members or the advice of poorly trained health workers,or even by several myths surrounding exclusive breastfeeding. 

Breast milk is said to be a potent medicine for disease prevention that is tailored to fit the needs of a baby, it has been described as the perfect elixir of immunity for infants. Feeding a baby below six months on breast milk alone gives the baby a complete dosage of this potent medicine; this also keeps the baby safe from contaminants in food and water that can cause diarrhea. It also makes makes the baby less susceptible to ear infections, pneumonia and several other childhood illnesses. 

A recent document published by the World Health Organization titled "From the first hour of life: making the case for improved infant and young child feeding everywhere" described breast milk as 'the most personalized form of medicine that any of us will receive in our lifetime'; this is largely because antibodies are produced to combat specific infections a baby is exposed to- a mother's body writes a prescription for illnesses unique to her baby's needs and environment. Human milk apart from being an excellent source of nutrients for an infant also contains a variety of immune components such as antibodies, growth factors, cytokines, antimicrobial compounds and specific immune cells. Feeding infants the recommended way gives the infant the recommended dosage of this highly personalized medicine.

Source:WHO

Exclusive breastfeeding has been described as a high-impact, cost-effective solution for saving children's lives. As infants breastfeed, the immune composition of breast milk adjusts to the properties of their saliva. If the mother's body detects pathogens, it produces antibodies to fight them. There is the risk of contamination from non-breast milk feedings which can expose vulnerable newborns to life-threatening pathogens; besides they can take up valuable space in the newborn's stomach, leaving little room for complete breast milk . 

Exclusive breastfeeding guarantees infants a food source that is uniquely adapted to their needs while being safe, clean, healthy and accessible. According to the WHO document quoted above, feeding a baby below six months of age other things except breast milk makes the baby 2.8 times more likely to die than those who were exclusively  breastfed; exclusive breastfeeding can prevent 53% of hospital admissions for diarrhea and 27% of hospitalizations for lower respiratory infections each month. Research also suggests increases in a child's long-term heart capacity and shape in exclusively breastfed babies than those fed with infant formula. 

For a child six months and below, other foods are at best unnecessary and at worst life-threatening. Let us therefore join hands to promote this great infant feeding practice which has the potential to save countless lives.

Refuting some myths surrounding Exclusive breastfeeding in Nigeria

Today, more than ever, evidence abound on the immense benefits of exclusively breastfeeding a baby

below six months old. Like many practices, there are also myths surrounding Exclusive Breastfeeding (EBF) among which are;

Source: www.Malaysianparenting.com

1.  Exclusive breastfeeding could make a child dehydrated, so a baby needs water: Breast milk is said to be about 88% water, especially the first milk that comes out in each feeding session. Thus, breast milk contains as much water as a baby below 6 months of age needs. Babies on EBF should simply be offered breast milk when it is suspected that they are thirsty. Giving water to babies comes with a lot of concerns especially in our part of the world where safe, drinking water is hardly assured.
2.  EBF is stressful: Motherhood and all it entails can be really stressful but when it comes to ranking stressful activities, putting a baby to one's breasts for feeding can hardly be compared to preparing formula (or in fact any other baby food) as the latter is much more stressful.
3. Exclusive breastfeeding must last up to 6 months.While six months is the standard length of time for practising EBF, it is nowhere etched in stone that it must last that long. Many Pediatricians recommend 6 months as the maximum length of time and 4 months the minimum. That is, complementary feeding can be introduced when a baby is four months of age, but not before then if the mother for one reason or the other feels there is need to do so. Some babies start showing interest in other foods before 6 months, some pediatricians recommend such babies should be introduced to other foods to sustain their interest in foods besides breast milk. 
4.  You need to drink milk/tea always to keep up your milk supply: There is absolutely no scientific evidence to back this up. In fact, milk and other dairy products are linked to infant gas pain. EBF mums should simply take enough water to keep themselves hydrated. 
5. Not every woman can produce enough milk to EBF: Research suggests that above 90% of women can produce enough milk to exclusively breastfeed an infant. Milk supply can only be affected when the mother does not eat well or when she doesn't frequently put the baby to her breasts.
6.  Breast milk alone does not sustain some babies below 6 months: Breast milk is more than enough to satisfy any baby aged 6 months and below. Giving a baby that young any other thing is unnecessary at best and very risky at worst as it could expose your baby to contaminants in food and water at that vulnerable stage of your baby's life.
7.  Exclusively breastfed babies tend to be picky-eaters once weaned. This is absolutely untrue and has been proven so. Picky eating is a trait found in many babies both mix-fed and exclusively breastfed.
8.  Exclusive breastfeeding is only for mums who cannot afford quality formula or those who cannot assure the safety of their drinking water. This is also absolutely untrue. EBF is for every woman who knows its advantages and can practice it; rich and poor alike.

Breastfeeding: A key to Sustainable development

For the past 25 years, August 1 to 7 each year is celebrated as World Breastfeeding Week in many countries the world over. This year's theme is "Breastfeeding: a key to sustainable development". The activities mapped out for this year's celebrations hopes to highlight the links between breastfeeding and nutrition, food security, health, development, survival, achieving full educational potential and economic productivity.

The objectives this year are:

1. To inform people about the new Sustainable Development Goals (SDGs) and how they relate to breastfeeding and Infant and Young Child Feeding (IYCF). 
2. To firmly anchor breastfeeding as a key component of sustainable development.
3. To galvanize a variety of actions at all levels on breastfeeding and IYCF in the new era of the SDGs.
4. To engage and collaborate with a wider range of actors around the promotion, protection and support of breastfeeding.  

Each of the 17 SDGs has an individual link with breastfeeding. The links are outlined below as culled from   www.worldbreastfeedingweek.org. 

1.   No poverty: Breastfeeding is a natural and low-cost way of feeding babies and children. It is affordable for everyone and does not burden household budgets compared to artificial feeding. Breastfeeding contributes to poverty reduction.
2.  Zero hunger: Exclusive breastfeeding and continued breastfeeding for two years and beyond provide high quality nutrients and adequate energy and can help prevent hunger, under-nutrition and obesity. Breastfeeding also means food security for infants.
3.   Good health and well being: Breastfeeding significantly improves the health, development and survival of infants and children. It also contributes to improved health and well-being of mothers, both in the short and long term.
4. Quality education: Breastfeeding and adequate complimentary feeding are fundamentals for readiness to learn. Breastfeeding and good quality complementary foods significantly contribute to mental and cognitive development and thus promote learning.
5. Gender equality: Breastfeeding is a great equalizer, giving every child a fair and best start in life. Breastfeeding is uniquely a right of women and they should be supported by women to breastfeed optimally. The breastfeeding experience can be satisfying and empowering for the mother as she would be in control of how she feeds her baby.
6. Clean water and sanitation: Breastfeeding on demand provides all the water a baby needs even in hot weather. On the other hand, formula feeding requires access to clean water, hygiene and sanitation.
7. Affordable and clean energy: Breastfeeding entails less energy when compared to formula production industries. It also reduces the need for water, firewood and fossil fuels in the home.
8.  Decent work and economic growth: Breastfeeding women who are supported by their employers are more productive and loyal. Maternity protection and other workplace policies can enable women to combine breastfeeding and their work. Decent jobs should cater to the needs of breastfeeding women especially those in precarious situations.
9. Industry, innovation and infrastructure:  With industrialization and urbanization, the time and space challenges become more prominent. Breastfeeding mothers who work outside the home need to manage these challenges and be supported by employers, their own families and communities. Crèches near their workplace, lactation rooms and breastfeeding breaks can make a big difference.
10. Reduced inequalities: Breastfeeding practices differ across the globe. Breastfeeding needs to be protected, promoted and supported among all, but in particular among poor and vulnerable groups. This will help to reduce inequalities.
11. Sustainable cities and communities: In the bustle of big cities, breastfeeding mothers and their babies need to feel safe and welcome in all public spaces. When disaster and humanitarian crises strike, women and their children are affected disproportionately. Pregnant and lactating mothers need particular support during such times.
12.  Responsible consumption and production: Breastfeeding provides a healthy, viable, non-polluting, non-resource intensive, sustainable and natural source of nutrition and sustenance.
13.  Climate action: Breastfeeding safeguards infant health and nutrition in times of adversity and weather-related disasters due to global warming.
14.   Life below water: Breastfeeding entails less waste compared to formula feeding. Industrial formula production and distribution lead to waste that pollutes the seas and affects marine life.
15.  Life on land: Breastfeeding is ecological compared to formula feeding. Formula production implies dairy farming that often puts pressure on natural resources and contributes to carbon emissions and climate change.
16.  Peace and justice strong institutions: Breastfeeding is enshrined in many human rights frameworks and conventions. National legislations and policies to protect and support breastfeeding mothers and babies are needed to ensure that their rights are upheld.
17. Partnerships for the goals: The global strategy for infant and young child feeding (GSIYCF) fosters multi-sectoral collaboration, and can  build upon various partnerships for support of development through breastfeeding programs and initiatives.   

As we mark the week-long celebration, let us make conscious efforts to encourage breastfeeding mothers to keep up the good work of contributing towards achieving the SDGs come 2030. 

Memoirs of a Nigerian Mum; breastfeeding

A breastfeeding mum is a common sight in Nigeria. In fact hardly would your baby start crying than people around you say things like "ah, ah, breast feed that child na". Stories abound of women who were handed over to the police for refusing to breastfeed. A crying baby and a mum unwilling to breastfeed raises eyebrows as to whether the child wasn't kidnapped.

When I became pregnant, I naively expected breastfeeding to only involve sitting down and putting the baby to my breast. I didn't envisage the sore nipples, the engorged and painful breasts, the night feeds and even the feeds during the day when I'd rather be sleeping or doing something else. I also didn't envisage the times my baby would rather play than suckle my breasts.

I had read and learnt a lot about exclusive breastfeeding by the time my baby was due for delivery that I made up my mind to practice exclusive breastfeeding. Shortly after he was born I put him to my breasts and worried like most mums do if the yellowish fluid coming out of my breasts was enough. My nutritionist sister and the dietitian in the hospital assured me of that and encouraged me to put the baby frequently to my breasts as that would help the more mature milk to come in faster.By the second day of breast feeding, I cringed whenever I was to put my baby to my breasts. My breasts had become so sore, painful and cracked. I was later to learn that I wasn't latching the baby on correctly.

Source:www.slideshare.net

Breastfeeding was moving smoothly till sometime around my baby's fifth month when he would easily get distracted and I had to go to quiet places to breastfeed him. I had more episodes of painfully engorged breasts at this time than any other period. My breasts always seemed to leak milk. Whoever discovered breast pads deserves an award.

Then came the seventh month and my baby completely refused to breastfeed. I almost gave up on trying. He would only breastfeed without a fight when he was feeling sleepy. I held on to those times and ensured I breastfed him then. That episode lasted for about two weeks. Suffice it to say he was already eating other meals by then. He repeated it sometime around his eleventh month.


My baby is 13 months old now and still breastfeeding with no end in sight. Our target is age two.

Colostrum; baby's first vaccine

Colostrum is the first milk produced by the mammary glands. The World Health Organization describes it as "the perfect food for newborns" . In humans, it is produced from about the fourth month of pregnancy. It's colour could be anything from clear fluid to yellow  and provides all the nutrients a child needs the few days before breast milk comes in. It is also known to contain many immunoglobulins and antibodies that protect a baby from infections hence some people refer to it as "a baby's first vaccine " . Colostrum also has a laxative effect which helps newborns pass out that tar-like poo called 'meconium'.

Source:www.pinterest.com

Compared to more matured human breast milk, colostrum is said to have a higher protein content and lower sugar and fat contents; exactly as needed by newborns. Experts suggest that the breasts produce enough colostrum to nourish a newborn baby till the more mature breast milk comes in after a few days; they also suggest that babies be introduced to the breasts within the first hour of life which they say has several advantages including stimulating milk production. The more your baby suckles, the faster your milk comes in. This is because the activity of  prolactin (the hormone which causes milk production) increases with frequent breastfeeding .

 A newborn's stomach capacity is said to be about (5ml) one teaspoonful and thus easily satiated by colostrum; this capacity increases to above 30ml by the fifth day during which the mum's milk would have "come in". Colostrum gives way to the more mature breast milk after about 2-4 days post delivery   It is therefore more important to frequently make newborns suckle the breasts than make each  session last long. It is best to put the newborn to the breast at least 8-12 times everyday.

Antibiotics Abuse, Resistance and the threat of a post-antibiotics era

photocredit:www.slideshare.net

You have cough or sore throat you take Septrin; having running stomach or going to a place whose food you aren't so sure of you take Flagyl; having slight or persistent headache you take Amoxicillin; you give your new born baby Ampiclox drops to "flush" all infections the baby could have gotten from you; Your doctor prescribes malaria drugs as well as antibiotics after he sent you for malaria test alone to which you tested positive. These among many others are the ways we abuse antibiotics in our part of the world.  What makes matters so terrible is the ease with which we can source antibiotics in every drug shop around. It is not only wrong to self-prescribe antibiotics it also does not always help our case.

Sometimes the cough or cold one is self-treating with antibiotics is actually caused by a virus, thus antibiotics would have no effect.

Poultry and fish farmers also indiscriminately use antibiotics for varied reasons. Even our medical practitioners are guilty. They tend to prescribe antibiotics at almost every visit to the hospital; medical test or none. Our over-exposure to antibiotics has made microorganisms resistant to them.

Photocredit:www.medicaldaily.com

When you misuse antibiotics, some microorganisms toughen, learn to strive, thrive and multiply even in the presence of the antibiotics; then they can be said to be resistant to that antibiotic.  Antibiotics resistance is the reason why drugs like Penicillin, Ampiclox and Tetracyclin hardly are effective these days. It is part of the reasons infections hardly get treated these days, often leading to both human and economic losses.

credit:www.iapindia.org

Antibiotics resistance has been described as a pressing public health problem world over. There seems to be a prevalence of organisms resistant to the current antibiotics.  Even  the  World Health Organization (WHO), said "we are gradually getting to a post-antibiotics era when minor infections and injuries  will once again start to kill". It has also been estimated that "one in four deaths in Nigeria will be attributable to antibiotics resistance by 2050", and that "resistant microorganisms will kill more than cancer by 2050". For those who know what these imply, they are very scary. To worsen the already bad situation is the case of fake and substandard drugs in the market.


We do not always need to take antibiotics.

Solution: take antibiotics only when prescribed and as prescribed by a qualified and "informed" medical practitioner , do not share or transfer medications and do not take left-overs.
Health practitioners should avoid indiscriminate antibiotics prescriptions. Tests should be conducted and the actual cause of infection determined before antibiotics is prescribed. Nevertheless, your doctor can use his/her discretion to prescribe drugs pending when your test result is ready.
Government and drug regulatory agencies should tighten the laws surrounding antibiotics prescription, availability and ease of purchase. One should not be able to walk into any drug shop and buy antibiotics  without a doctor's prescription.

 We need to be aware of what we could be causing or exacerbating when we indiscriminately take antibiotics. Antibiotics save lives. Let us not allow its indiscriminate use lead to loss of lives. I dread the post-antibiotics era. I dread the Superbug. You should too.

Therefore let us all say no to antibiotics  abuse and all forms of drug abuse.

Memoirs of a Nigerian Mum; Acid reflux

Motherhood is a challenging task filled with emotional highs and lows. It could get confusing sometimes. At points when you do not know what to do you find out there are myriads of advice which are often conflicting and leaves you confused. If you are Internet savvy you could try searching the challenging issue on the internet ; this could leave you even more confused. If it is a health-related issue, the best person to consult is your medical practitioner.

That said, I would love to share a then-scary experience I had. As a first-time mum, there were too many things I did not know and was wary of picking up advice easily. I cross-checked time and again before taking an advice especially when it had to to with my baby. My mum was (and is still) such a solid rock. She was always my first port of call. When she wasn't sure of the solution she always told me. I have never had any reason to doubt her solutions.

My baby was somewhere between one to four weeks old then; I had just breastfed and put him back to sleep when he cried out. I rushed to him and noticed he was gasping for breath, arching his back and foaming at the mouth. I panicked. I carried him in my arms, woke his dad up and we tried all we could, from rocking to trying to breastfeed, to praying and in fact everything we could think of. That was probably the longest one or two minutes of our lives as parents. I later found out our baby had what is called "acid reflux". Because I was feeling sleepy I didn't bother burping him  after breast feeding and I put him back to sleep, on his back. The air he swallowed during breastfeeding, the breast milk and his stomach acid refluxed back up towards his mouth leading to what I saw. Holding him upright helped ease the discomfort. I learnt and put into practice the following which ensured my baby never experienced such again.

(1) I made sure I burped him after each feed by keeping him upright with his head on my chest or on my shoulders.

(2) When it was almost impossible to burp him, like after those midnight feeds when I could barely keep my eyes open I lay him down on his left side; that ensures the stomach is positioned in such a way to keep food down as the inlet is higher than the outlet. Considering how young he was, I placed a folded wrapper at his back to hold him in that position.

(3) I cut off milk and other dairy products as well as gas-producing foods like beans and cabbage from my diet. This was largely because I noticed he had so much infant gas pain each time I ate food containing the  aforementioned.

My baby never had that experience again.