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Tuesday, April 16, 2024
Breast feeding

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One in seven pregnancies worldwide ends in miscarriage, and eleven percent of women endure a failed pregnancy at least once in their lifetime, experts said Tuesday.

Some 23 million miscarriages occur every year, according to data pieced together from around the globe by an international team of 31 researchers.

But the actual tally is sure to be “substantially higher” due to underreporting, they said in a trio of studies published in The Lancet.

Two percent of women — one in 50 — have experienced two miscarriages, while less that one percent have been through three or more.

Levels of care for women suffering miscarriage is highly uneven across countries, and even within many wealthy nations, the data showed.

“A new system is needed to ensure miscarriages are better recognised and women are given the physical and mental health care they need,” the researchers said in a statement.

Misconceptions about miscarriage are widespread.

Many women believe they occur only rarely, for example, or that they can be caused by lifting heavy objects or previous contraceptive use.

They may also think that there’s no effective treatments to prevent a miscarriage, especially in women at high risk.

Such misconceptions can be damaging, leaving women and their partners feeling at fault and discouraging them from seeking treatment and support, the authors note.

Miscarriage can also lead to isolation, since many women might not tell their family, close friends, or even their partner about the loss of a pregnancy.

“Silence around miscarriage remains not only for women who experience it, but also among health care providers, policymakers and research funders,” said co-lead author Siobhan Quenby, a professor at the University of Warwick and director of Tommy’s National Centre for Miscarriage Research.

A miscarriage is widely defined as the loss of a pregnancy before 20 to 24 weeks of gestation, with the exact time period varying from country to country.

Unrecognised trauma
A review of published academic literature up to mid-May 2020 identified many causes for miscarriages, including a more advanced maternal age, previous miscarriages, and a father older than 40.

Other risk factors correlating with pregnancies that end spontaneously are being extremely under- or over-weight, smoking, alcohol consumption, persistent stress, working night shifts, and constant exposure to air pollution or pesticides.

Health consequences can be severe, especially for women who experience a second or multiple miscarriages.

“Recurrent miscarriage is a devastating experience for most women, but the mental health impact is rarely acknowledged or addressed in medical care,” said co-lead author Arri Coomarasamy, from the University of Birmingham.

“Women can experience trauma and bereavement, which may have no obvious sign and can go unrecognised.”

There is also a link with anxiety, depression and — for about 20 percent of women — post-traumatic stress disorder nine months after a miscarriage.

The authors of the three studies noted that most data comes from wealthier nations, but that the “silence around miscarriage” is found everywhere.

They recommended that national health authorities strengthen miscarriage care services, improve research in prevention, and identify women at high risk.

“For too long miscarriage has been minimised and often dismissed,” The Lancet said in an companion editorial.

“The lack of medical progress should be shocking — instead, there is pervasive acceptance.”

“The era of telling women to ‘just try again’ is over,” The Lancet said.

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In recognition of World Breastfeeding Week, Medela breast pump announced its new partnership with The Wellbeing Foundation Africa (WBFA) to improve breastfeeding support and resources in Neonatal Intensive Care Units (NICUs) in Nigeria. Medela is one of the breast pumps recommended by doctors and used in hospitals.

As part of this partnership, Medela and The Wellbeing Foundation Africa will work together to improve the support offered to new mothers in Nigeria by delivering NICU-specific education and training on the value of human milk and how to build sufficient milk supply for long-term breastfeeding. This work will involve frontline healthcare workers, nonprofit organisations and government agencies.

Founder and president of Wellbeing Foundation Africa, Toyin Ojora Saraki, said: “Medela’s long history as a global player in breastfeeding research, products, technology and innovation is the perfect partner for Wellbeing Foundation Africa in our quest to improve Nigeria’s prevalence of breastfeeding and our focus on NICU support.

“Ensuring new mothers are wholly supported to breastfeed is not only critical for the health and wellbeing of the baby: it can be linked to all 17 of the United Nations Sustainable Development Goals.”

Nigeria ranks 6th worst country in the world for infant mortality and complications due to prematurity, which is the leading cause of death. In children younger than five years, 47 per cent of deaths occur in the first 28 days of life, many of them are preventable and can be addressed through improved nutrition with mother’s milk. Today Nigeria has one of the lowest breastfeeding rates in the world with only 17 per cent of mothers exclusively breastfeeding their children through six months. To improve these statistics, the United Nations set a global goal to improve breastfeeding rates to 50 per cent by the year 2030. Medela hopes to contribute to the solution through this partnership with the WBFA. As a supporting member of the Global UN Compact and the UN’s Every Woman, Every Child initiative, Medela is committed to partnering with organisations to improve breastfeeding rates globally to meet the 2030 Breastfeeding goals. Medela’s new global corporate social responsibility program, Medela Cares, is dedicated to improving the lives of moms, babies and patients through education and support, as well as through technologies, research and services.

“Research shows us that breast milk is critical for growth and overall health for newborns and is a low-cost and highly effective intervention that can prevent infant death,” said Annette Brüls, CEO of Medela worldwide. “We are thrilled to partner with The Wellbeing Foundation Africa as part of our commitment to the UN’s Every Woman, Every Child movement to better the lactation care provided to mothers and ultimately improve the infant feeding and health outcomes in Nigeria.”

The partnership will commence with a webinar on August 7, 2020 about Breastfeeding in High Risk Countries, a panel discussion with Her Excellency Toyin Saraki, Founder WBFA, Annette Brüls, CEO of Medela, Dr. Prof. Diane Spatz, PhD, RN-BC, FAAN, and Rita Momoh, lead midwife at WBFA, moderated by Tolu Adeleke, founder of Tolu The Midwife Healthcare Solutions and CEO of Maternity Hub (Nigeria). This group will discuss the need to address infant mortality and share how midwives and mothers can be supported to champion breastfeeding efforts in high-risk countries such as Nigeria.

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A study in mice has found that scientists can switch off a gene responsible for an aggressive form of breast cancer. Silencing the gene not only shrinks tumors but also prevents their spread around the body.

Around one in eight females in the United States will develop breast cancer, according to the American Cancer Society.

In 2019, doctors diagnosed an estimated 268,600 new cases of invasive breast cancer in females in the U.S., while around 41,760 individuals died from the disease.

Up to a fifth of breast cancers are a more aggressive form known as triple-negative breast cancer that is difficult to treat.

Unlike the majority of breast cancers, estrogen and progesterone do not fuel the growth of triple-negative tumors, so drugs, such as tamoxifen, that block these hormones are ineffective.

A molecule that switches off a particular gene in triple-negative tumors could be a promising alternative treatment, according to research at Tulane University School of Medicine in New Orleans, LA.

The scientists report their discovery in the Nature journal Scientific Reports.

The effect of gene silencing

The research combined in vitro studies of cells growing in dishes with in vivo studies involving mice.

The team began by working with cultures of a triple-negative cancer cell line that originally came from a patient treated in 1973 at the M. D. Anderson Cancer Center in Houston, TX.

The researchers compared the effects of switching off two known breast cancer genes, one called Rab27a and the other TRAF3IP2.

To deactivate or “silence” the genes, they targeted them with molecules of short hairpin RNAs called lentiviral-TRAF3IP2-shRNA. These are strands of RNA twisted back on themselves like a hairpin that prevent a specific gene from being read or “transcribed” to make a protein.

The researchers discovered that switching off TRAF3IP2 had a more disruptive effect on cancer-associated metabolic pathways in the cells than switching off Rab27a.

They confirmed this by switching off the genes individually in a mouse model of breast cancer.

Switching off Rab27a did slow down tumor growth in the mice, but a very small number of cancer cells spread, or “micrometastasized.”

When the researchers switched off TRAF3IP2, however, this not only suppressed new tumor growth but also prevented metastasis for up to 1 year. Better still, the treatment shrank existing tumors until they were undetectable.

“This exciting discovery has revealed that TRAF3IP2 can play a role as a novel therapeutic target in breast cancer treatment,” says Dr. Reza Izadpanah, assistant professor of medicine at Tulane University School of Medicine, who led the research.

Future studies ‘to further validate’ findings

The scientists are now seeking approval from the Food and Drug Administration (FDA) to start clinical trials as soon as possible.

They write that, first, they will need to confirm their results by transplanting breast cancer cells from human patients into mice, in a process known as ‘xenotransplantation.’

“A limitation of the present study is that we used a single breast cancer cell line to investigate potential roles of silencing Rab27a and TRAF3IP2 on tumor growth. Our future studies will involve the use of patient-derived xenotransplants to further validate these fundamental first in vivo and in vitro results.”

– Eckhard U. Alt et al.

Silencing TRAF3IP2 may turn out to be an effective treatment in several cancers and even heart failure.

The gene is known to activate various cellular pathways that promote inflammation, which plays an important role not only in cancer but also in heart failure.

In their breast cancer research, the team at Tulane School of Medicine collaborated with Dr. Chandrasekar Bysani at the University of Missouri School of Medicine in Columbia, who identified the part played by TRAF3IP2 in promoting inflammation in heart failure.

Dr. Bysani also took part in recent research that found that switching off TRAF3IP2 could be an effective strategy for treating glioblastoma, a malignant type of brain cancer.

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Itchy breasts are a common occurrence, but if there is no rash, the cause may be difficult to pinpoint.

Various conditions, including yeast infections, eczema, and psoriasis, often cause itching, but they also produce a rash.

There are several reasons why the breasts may feel itchy without an accompanying rash, however. Although most causes are benign, people should pay attention to their symptoms, as breast itchiness can also be an early sign of a rare form of inflammatory breast cancer.

In this article, we provide more information on the possible causes of itchy breasts with no rash.

1. Dry skin

Dry skin on the breasts can cause itchiness and irritation. The skin typically appears flaky or scaly when it is dry.

Some people have naturally dry skin, but other possible causes include:

  • the use of harsh skin care products
  • sun exposure
  • sweating

Using moisturizers and sunscreen may help prevent dry skin. Keeping creams in the fridge and applying them to the breasts can help cool the skin and ease itching.

2. Breast growth

Whenever the breasts grow, the skin around them stretches, and this may cause itchiness and discomfort. The breasts may grow due to:

  • puberty
  • pregnancy
  • weight gain
  • hormonal changes, such as those that occur during the menstrual cycle

3. Heat rash

Heat rash is a common occurrence in hot climates or when a person exercises in high temperatures.

Contrary to its name, heat rash can sometimes occur without any visual symptoms. However, many people also develop small, pin-like bumps or blisters in addition to the itching.

Heat rash can affect any part of the body with sweat glands, and it can often appear on, between, or under the breasts. Other names for it include “prickly heat” and “miliaria.”

4. Allergens

Allergic reactions are another common cause of itchiness. Allergic reactions can sometimes cause a rash, but this is not always the case.

Products that may cause an allergic reaction include:

  • soaps
  • laundry detergents
  • cosmetic products
  • perfume

5. Breast cancer

In rare cases, itchiness of the breasts can be a symptom of breast cancer.

The National Breast Cancer Foundation list itchy breasts as a symptom of a rare form of breast cancer called inflammatory breast cancer.

In addition to experiencing itchiness, people with inflammatory breast cancer may see a rash and feel that the breast is warm and swollen.

If either the nipple or areolar region is itchy, this could be a symptom of a rare form of breast cancer called Paget’s disease of the breast.

When to see a doctor

Dry skin and growing breasts are two of the more common reasons for itchy breasts, and they do not usually require a doctor’s examination.

However, a person should talk to a doctor if they experience the following symptoms:

  • itchiness lasting for more than a week
  • intense itchiness
  • an itchy nipple or areolar area, especially if the area is also flaky
  • tenderness, pain, or swelling alongside the itching
  • the appearance of a rash on, between, or under the breasts
  • itchiness that does not go away with home remedies

Treatments and prevention

People can often treat and prevent breast itchiness at home.

For example, if dry skin is the cause of the itchiness, a person can try:

  • using sunscreen
  • using moisturizers that are not oil based
  • staying hydrated
  • keeping the breasts clean and dry
  • using only nonscented products, including creams and detergents

If an allergic reaction causes the itchiness, a person can try to identify the source of the irritation and avoid exposure to it.

Other treatments for itchy breasts may include ointments such as pramoxine, which numbs the skin, or hydrocortisone, which reduces itchiness and swelling.

Antihistamines are another possible treatment option. Some examples include:

  • diphenhydramine (Benadryl)
  • cetirizine (Zyrtec)
  • loratadine (Claritin)
  • fexofenadine (Allegra)

Antihistamines can help suppress the immune system’s response to the allergen. People can take these orally or use them in the form of a cream or ointment.

Summary

Breast itchiness without a rash has many possible causes, including dry skin or growing breasts due to puberty, weight gain, or pregnancy.

In some cases, allergic reactions or other underlying conditions may be responsible for the itchiness.

In very rare cases, itchiness of the breast, nipple, or areolar region can be a sign of some types of breast cancer.

People should speak to a doctor if the itchiness is intense, does not respond to treatment, lasts for a long time, or occurs alongside other symptoms.

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Urinary tract infections, or UTIs, are common, and women can often experience them during pregnancy. Left untreated, a UTI can pose a serious health risk to a pregnant woman and a developing fetus.

This article outlines the possible causes of a UTI in pregnancy, as well as the potential risks. We also provide information on how to prevent and treat UTIs.

Is it common?

A UTI is an infection in any part of the urinary system, including the bladder and kidneys. Research suggests it is commonTrusted Source for pregnant women to get UTIs.

According to one study from the Centers for Disease Control and Prevention (CDC), 8%Trusted Source of pregnant women experience a UTI.

Causes

During pregnancy, the uterus expands for the growing fetus. This expansion puts pressure on the bladder and the ureters. The ureters are the tubes that carry urine from the kidneys to the bladder.

The urine is also less acidic and contains more proteins, sugars, and hormones during pregnancy. This combination of factors increases the risk of a UTI occurring.

Women are also susceptible to UTIs during and after giving birth. During labor, there is an increased risk of bacteria entering the urinary tract. After giving birth, a woman may experience bladder sensitivity and swelling, which can make a UTI more likelyTrusted Source.

Symptoms

A person who has a UTI may experience the following symptoms:

  • urgent or frequent need to urinate
  • burning sensation when urinating
  • cloudy or strong smelling urine
  • blood in the urine
  • pain in the lower back, abdomen, and sides

People should tell their doctor straight away if they have blood in their urine, as this can be a sign of another condition.

In some cases, the bacterial infection causing a UTI can spread to the kidneys. A person who has a kidney infection may experience the following symptoms:

  • back pain
  • fever
  • chills
  • nausea and vomiting

If people have these symptoms, they should see their doctor immediately. Kidney infections can be serious and require immediate medical treatment.

Treatments

Pregnant women should see their doctor if they have any symptoms of a UTI. Without treatment, a UTI can cause serious complications.

A 3-dayTrusted Source course of antibiotics may be necessary to treat a UTI during pregnancy. A doctor may prescribe one of the followingTrusted Source antibiotics:

  • amoxicillin
  • ampicillin
  • cephalosporins
  • nitrofurantoin
  • trimethoprim-sulfamethoxazole

The American College of Obstetricians and Gynecologists (ACOG) advise that pregnant women avoid nitrofurantoin and trimethoprim-sulfamethoxazoleTrusted Source during the first trimester. These antibiotics can cause birth abnormalities if a person takes them at this stage of their pregnancy.

According to a 2015 reviewTrusted Source, studies show that both nitrofurantoin and trimethoprim-sulfamethoxazole are generally safe during the second and third trimesters. However, taking either antibiotic in the final weekTrusted Source before delivery may increase the risk of jaundice in newborns.

If pregnant women develop a kidney infection during pregnancy, they will need treatment in the hospital. This treatment will involve antibiotics and intravenous fluids.

A short course of antibiotics is unlikelyTrusted Source to cause any harm to a developing fetus. Research suggests that the benefits of taking antibiotics to treat a UTI far outweighTrusted Source the risks of leaving a UTI without treatment.

Home remedies

Women who are pregnant and have symptoms of a UTI should see a doctor. As well as medical treatment, they may also wish to try the following at home to help speed up recovery:

  • Drinking plenty of water: Water dilutes urine and helps flush bacteria out of the urinary tract.
  • Drinking cranberry juice: According to a 2012 reviewTrusted Source, cranberries contain compounds that may help to stop bacteria from attaching to the lining of the urinary tract. This action helps to prevent and eliminate infection.
  • Urinating when the urge arises: This helps bacteria pass out of the urinary tract more quickly.
  • Taking certain supplements: A 2016 studyTrusted Source found that a combination of vitamin C, cranberries, and probiotics may help to treat recurrent UTIs in women.

Some women may choose the above treatments as an alternative to antibiotics. However, they should always consult their doctor before doing so. A doctor will monitor a pregnancy regularly to check the effectiveness of natural treatments and ensure a UTI does not worsen.

Complications

Without treatment, UTIs can cause serious complications during pregnancy. Complications may include:

  • kidney infection
  • premature birth
  • sepsis

A baby born to a woman with an untreated UTI may also have a low birth weight at delivery.

If a UTI spreads to the kidneys, this can cause further complications, such as:

  • anaemia
  • high blood pressure, or hypertension
  • preeclampsia
  • breakdown of red blood cells, or hemolysis
  • low blood platelet count, or thrombocytopenia
  • bacteria in the bloodstream, or bacteremia
  • acute respiratory distress syndrome

In some cases, an infection may pass on to the newborn baby, causing a rare but severe complication. Attending screenings for UTIs during pregnancy and getting prompt treatment when one occurs can help prevent these complications.

Prevention

The following tips may help to reduce a person’s likelihood of getting a UTI:

  • drink plenty of water
  • drink unsweetened cranberry juice or take cranberry pills
  • wash carefully around the genitals and anus
  • pass urine whenever the urge arises, and at least every 2–3 hours
  • urinate before and after having sex

Pregnant women will usually attend a screening to check for UTIs in their early pregnancy. These checks are an important step in helping to prevent UTI infections or detecting them early.

Summary

UTIs are common, and some women may experience them during pregnancy.

Women who have symptoms of a UTI during pregnancy should see their doctor immediately. Without treatment, UTIs can cause serious complications for a pregnant woman and the developing fetus. Prompt intervention can help to prevent these complications.

Routine pregnancy checks help detect the early signs of a UTI.

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Experts have emphasised on the need for Nigerians to embrace family planning fully as part of measures to curb maternal and infant mortality in the country.

They lamented that despite the drop in the fertility rate from 5.5 percent in 2013 to 5.3 percent in 2018, according to the Nigeria Demographic Health Survey (NDHS), with a two-percent increase in the total contraceptive prevalence rate (CPR) from 15 percent to 17 percent, the acceptance rate of family planning in some communities still remain low due to several barriers such as religion, culture and fear of the unknown among others. The implications, they said, remain multiple pregnancies and births, population explosion that puts pressure of the nation resources, as well as unsafe abortions, which increases the risk of maternal and infant mortality in Nigeria.

Speaking at a two-day media workshop on sexual reproductive health and rights, organised by Marie Stopes International Organisation Nigeria (MSION) in Ibadan, Oyo Sate, the Director Programme Operation, Emmanuel Ajah lamented that religion, sociocultural inhibitions and stigma, especially in rural communities, are discouraging women to demand for reproductive health care services. He said these pose great danger to the women and the society, as maternal mortality would be very high, especially with the belief held against birth control and population explosion regarded as a blessing by the communities.

Ajah said most of the women, in a bid to reduce childbearing, eventually engage in unsafe abortion, which end up costing their lives, as they fail to embrace contraceptive/family-planning commodities. “Unsafe abortions is the third leading cause of maternal deaths in Nigeria, and an overwhelming health problem in the country, yet it has not generated enough policy attention. Women who die from unsafe abortion are all pregnancy related, as millions of women have unmet need for family planning

“Other reasons for seeking abortion are too many frequent pregnancies, lack of awareness on fertility management, contraception failure, lack of access to quality family planning information and/or services,” he said.

Also speaking, the Head, Marketing and Strategic Communication, Ogechi Onuoha said Nigeria as country is very complex with different religious and ethnic backgrounds, which require massive awareness and sensitisation movement in certain states that are yet to accept family planning as a means of reducing maternal mortality. She said all stakeholders including the government must work together to address the socio-cultural norms such as, religious tenets, and women’s lack of decision-making power related to sexual and reproductive health to improve maternal survival in the country.

Onuoha said there must also be improvement in the family planning programmes in communities, as well as the availability of and access to services and commodities to slow the rate of population growth, which would put the country on a path to a healthier future for women and families.

“The focus is on dispelling myths and misconceptions about family planning, expanding the provision of family planning services and supplies to the last mile, and enabling an environment in which women and girls make informed choices on their health,” she added.

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A woman’s breasts are primarily for breastfeeding the young but despite the fact that many Nigerian women are blessed with a sizeable chest, millions of babies in the country are yearning for breastmilk. According to scientists, all sizes of breasts can produce enough breastmilk for the baby even as it is no longer news that breastmilk is the optimal food for the developing infant.
But while almost all women can breastfeed, there are some who for one reason or another, decide not to breastfeed exclusively for the first six months even though breastfeeding is also the first line of prevention for some childhood diseases and obesity.
According to the World Health Organisation, WHO, exclusive breastfeeding means that the infant receives only breast milk and no other liquids or solids are given – not even water – with the exception of oral rehydration solution, or drops/syrups of vitamins, minerals or medicines.
According to experts, breastmilk provides a host of other health benefits for mother and child. Sadly, according to the United Nations Children’s Fund, UNICEF, more than 5 million newborns in Nigeria are deprived of essential nutrients and antibodies that protect them from disease and death as they are not being exclusively breastfed. The 2014 National Nutrition and Health Survey report showed that out of 7 million children born every year in the country, only 1.75 million are breastfed.
Efforts by the federal government and other stakeholders to improve the breastfeeding rate have not yielded the desired result. The 2016/2017 Multiple Indicator Cluster Survey, MICS, revealed that only 1.66 million children were exclusively breastfed (23.7 percent) of newborn babies are exclusively breastfed.
While many countries are boosting their exclusive breastfeeding rate, Nigeria keeps dropping. Ghana and Nigeria had exclusive breastfeeding rates of 7.4, but, by 2013, Ghana had moved up to 63 per cent.
The attitude of Nigerian women to shun breastfeeding contributed largely to the country’s inability to make significant progress in exclusive breastfeeding. However, investigations by Good Health Weekly showed that many mothers no longer breastfeed their children.
Some of them confessed that breastfeeding has become more of a burden than a joy.  Several of them who are working mothers claimed that the fact that they have to return to work soon after giving birth makes breastfeeding inconvenient and tasking.
A mother who works in a corporate organization said: “I would have loved to breastfeed but I intend to keep my breast firm.” Although many women like her have jettisoned the role of exclusive breastfeeding to keep their breasts firm, experts say worrying about breasts sagging or become unattractive is a waste of time as the only way to keep firm, upright breasts throughout your lifetime is to never get pregnant and never get old.
However, other women like Sade Ogun who have developed apathy for breastfeeding identified urbanisation, globalisation and work-life imbalance as factors discouraging women from breastfeeding.
Health watchers worry that if the trend continues, the unacceptable level of malnutrition among Nigerian children will worsen. Currently, Nigeria is home to 11 million stunted children and second highest stunting burden in the world. Preliminary data from MICS 2011 showed stunting as 35 percent while MICS 2016-17 showed stunting to have increased to 44 percent.
In the views of a Nutritionist, with Alive & Thrive, a project of FHI360, Dr. Sylvester Igbedioh the increasing calls for urgent action. Igbedioh, said: “Infants and young children need the right foods at the right time to grow and develop to their full potential. “The most critical time for good nutrition is in the first 1,000 days from the start of a woman’s pregnancy until a child’s second birthday. “Breastmilk is a crucial food for children’s health and development during this critical window.
“It provides all of the vitamins, minerals, enzymes and antibodies that children need to grow and thrive in the first 6 months of life, and continues to be a pivotal part of their diet up to the age of 2 or beyond.”
Igbedioh while quoting from 2003 Lancet study said exclusive breastfeeding is one of the interventions that can reduce child mortality by 13 percent. Arguing why women should embrace exclusive breastfeeding, he said breastfed children have at least 6 times greater chance of survival in the early months than non-breastfed children.
“An exclusively breastfed child is 14 times less likely to die in the first six months than a non-breastfed child. If 90 percent of mothers exclusively breastfed their infants for the first six months of life, an estimated 13 percent of child deaths could be averted,” he added.
Continuing, he added that if the same proportion of mothers provided adequate and timely complementary feeding for their infants from 6 to 24 months, a further 6 percent of child deaths could be prevented. He maintained that investing in breastfeeding saves lives and provides a high return on investment.
On steps to a successful breastfeeding, the Technical Advisor, Policy and Advocacy, Alive& Thrive, Mrs. Toyin Adewale-Gabriel advised that pregnant women and their families should be counseled about the benefits of breastfeeding during an antenatal clinic visit.
Adewale-Gabriel added that there is need to establish uninterrupted skin-to-skin contact between mothers and infants immediately after birth. Continuing, she said: “Health workers should ensure that all mothers are supported to initiate breastfeeding immediately (within the first hour) after delivery.
“Mothers should be discouraged from giving any food or fluids other than breast milk, unless medically indicated.” She argued that every maternity facility providing newborn care services should practice “rooming – in” throughout after delivery, day and night.

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Efforts to checkmate the rising cases of infant and child malnutrition across Nigeria are yet to achieve the goal.

Indicators reveal that although gradual progress is being made towards the goal, much remains to be done as indicators show that many Nigerian mothers are yet to understand the primary role of exclusive breastfeeding within the first six months of life in the bid to break the vicious cycle of malnutrition and poverty in the country.

According to the 2016- 2017 Multiple Indicator Cluster Survey 2016/17, MICS, Nigeria’s breastfeeding rate remains low overall with only 23.7 per cent of babies born in the country being breastfed exclusively.

It would be recalled that the World Health Organisation, WHO, and the United Nations Children’s Fund, UNICEF, recommend that infants should be breastfed within one hour of birth.

WHO and UNICEF also say infants should be breastfed exclusively for the first six months of life and be breastfed continuously for up to two years of age and beyond.

Based on the 2016/17 MICS, women in Northern Nigeria rank lowest in breastfeeding their children exclusively while women in the South-West zone lead in exclusive breastfeeding.

Health watchers are of the view that although the percentage of mothers exclusively breastfeeding their babies aged under six months, increased from 15.1 per cent to 23.7 per cent, it remains a major crack in the country’s efforts to stop malnutrition in children.

South-West leads

A further breakdown of the MICS showed that the South-West has the highest number of exclusively breastfed children with 43.9 per cent and 70.5 per cent predominantly breastfed while the North-West zone has the lowest number of children breastfed exclusively with only 18.5 per cent. About 56.6 per cent were predominantly breastfed.

The South-South zone followed with 27.2 per cent and 52.5 per cent exclusively and predominantly breastfed; South-East, 25.3 per cent and 47.8 per cent exclusively/predominantly breastfed; North-Central, 24.9 per cent and 45.8 per cent; North-East, 21.3 per cent and 50.4 per cent respectively.

The survey also found that out of the 60 per cent child deaths attributed directly and indirectly to undernutrition, two thirds of child deaths have been attributed to improper feeding during the first year of existence.

A comparative analysis of data from the MICS, conducted in 2007, 2011 and 2016/17, revealed that exclusive breastfeeding under six months has gradually improved consistently over the years in all states in the South- West zone and Edo State.

In a presentation entitled: The Situation of Children & Women in South-West States based on MICS data in the last 10 years (2007 – 2017), UNICEF’s Planning, Monitoring & Evaluation, Specialist, Mr Niyi Olaleye, observed that exclusive breastfeeding is positively related with mother’s education, wealth status and is now practised more in urban areas.

According to Olaleye, data from the MICS showed that in the South- West zone, Ogun and Ondo states recorded the lowest rates over the years while Osun recorded the most improvement rising from 12.5 per cent in 2007, 40.7 per cent (2011) to 55.3 per cent (2016/17).

In the South-West zone, according to the 2016/17 MICS, the average rate of infants under six months old who are exclusively breastfed is 43.9 per cent, with the highest rate occurring in Lagos at 51.8 per cent, and lowest in Ondo at 23.5 per cent.

From the 2007 and 2011 MICS, average rates of infants under six months old exclusively breastfed were 17.1 per cent, and 27.0 per cent, respectively. Rates for Lagos were 20.0 per cent (2007) and 28.1 per cent (2011), while corresponding rates for Ondo were 14.3 per cent, (2007) and 8.6 per cent (2011).

Quoting the MICS, Olaleye said more women with a live birth in the last two years across the South- West zone are putting their last newborn to the breast within one hour of birth, especially in Ogun. He said early initiation of breastfeeding is practised more in Edo and improved consistently in Ondo.

WHO recommendation

According to the WHO, breastfeeding is vital to a child’s lifelong health and reduces costs for health facilities, families, and governments. Breastfeeding within the first hour of birth protects newborn babies from infections and saves lives.

WHO maintains that infants are at greater risk of death due to diarrhoea and other infections when they are only partially breastfed or not breastfed at all.

Breastfeeding also improves IQ, school readiness and attendance, and is associated with higher income in adult life. It also reduces the risk of breast cancer in the mother.

The world health body also found that breastfeeding all babies for the first two years would save the lives of more than 820,000 children under age five annually.

In the views of UNICEF Evaluation expert, Maureen Zubie-Okolo, during a media dialogue on MICS 5 2017 and Data- Driven Reporting, education is one of the most important tool in encouraging and promoting the campaign for 100 per cent attainment of exclusive breastfeeding by all mothers in Nigeria.

She said a key finding in the survey showed that 41.0 per cent of children under five in the country were exclusively breastfed by mothers who had attained one form of higher education or the other.

Zubie-Okolo said the survey found that 30.6 per centof the children were exclusively breastfed by mothers who completed their secondary school education, 20.8 per cent was attributed to mothers who only attended primary school, 16.9 per cent of the children were born to women who had non-formal education and 19.6 per cent were breastfed by mothers who had no access to any form of education.

She noted that a mother’s education has a great impact on the nutritional status of the child, as children born by mothers who were either unable to attain any form of education or only had access to lower education, were the ones mostly faced with issues of malnutrition.

“The survey proves that with more number of educated mothers in the country, the higher the chances of an increased percentage of children exclusively breastfed as a result of access to adequate information and a better understanding of the benefits of feeding a child with only breast milk within the first six months after birth.

She said exclusive breastfeeding is key to fighting child malnutrition as it is more resilient in fighting malnutrition.

What breastfeeding is

UNICEF Nutrition Specialist, Mrs. Ada Ezeogu said breastfeeding simply means feeding of an infant or young child with breast milk rather than using infant formula or any other milk from baby bottle while exclusive breastfeeding means giving the baby only breast milk for the first six months of his life without water or any form of liquid.

Ezeogu regretted that achieving exclusive breastfeeding has remained a challenge in the country because of the practice of adding water to breastfeeding. “Most parents see breast like any other food that you eat and drink water at the end but the breast milk has enough water to meet the needs of the child. It contains all the nutrients that a child needs to grow and survive and, in fact, over 88 per cent of the breast milk is water. So you don’t need to add any water for the baby, otherwise, you will be taking the space of the nutrients from the milk in the baby’s stomach.”

She encouraged mothers to ensure that babies that are less than six months do not take water, adding that, “if you give water, the baby will not be able to get sufficient milk and nutrient requirements and he will be malnourished.

“In addition to water, breast milk contains nutrients such as protein, vitamins, iron, minerals and fats, etc. What stands breast milk out? Of the eight major preventive interventions for child development and survival, analysis showed that exclusive breastfeeding has the most impact.

Ezeogu who noted that breastfeeding alone could contribute 13 per cent reduction in child mortality, added that breastfeeding is at the very top of interventions for child survival.

“Babies who are exclusively breastfed for the first six months of their lives have lower risk of respiratory infection, urinary tract infections, ear infections (acute otitis media), fewer bouts of diarrhoea and sudden infant death syndrome. Sudden infant death is unexplainable death of children.

“Breastfeeding also protects the baby from chronic diseases such as obesity and diabetes mellitus. Also, the breast milk contains antibodies that are transferred to the baby. The benefits are not only pronounced in childhood but also in adulthood. It has been proven that children that are exclusively breastfed has higher IQ than those not breastfed. The longer you breastfeed the child, the less chances of his suffering from depression and attention issues when he becomes an adult.”

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