From Juliana Taiwo-Obalonye
Nigeria, on Tuesday, August 1, 2023, joined the rest of the world to observe the World Breastfeeding Week, ending on Monday, August 7, 2023. Representative of United Nations Children’s Fund (UNICEF) in Nigeria, Cristian Munduate, in this interview, shares how breastfeeding her second son exclusively saved her from frequent hospital visits she had with her first son, among other issues.
Excerpts:
Why do we celebrate breastfeeding week?
Breastfeeding week is an annual event aiming to raise awareness through a week-long series of activities promoting breastfeeding. The goal is for stakeholders across society to actively support and facilitate breastfeeding following each awareness week.
Each year, a specific theme is chosen to guide the discussions and initiatives of breastfeeding week. This year’s theme is “Let’s make breastfeeding at work, work,” focusing on how to empower and assist working women in breastfeeding while in their workplaces.
Although Nigeria has made progress over the past two decades, increasing exclusive breastfeeding rates from 17 per cent to 34 per cent, we are still below the global target. To achieve the World Health Assembly (WHA) target of 50 per cent by 2025 and the Sustainable Development Goal (SDG) target of 70 per cent by 2030, we must address the barriers faced by women and families in achieving their breastfeeding goals. Creating family-friendly workplace policies such as paid parental leave, breastfeeding breaks, and lactation rooms benefits not only working women and their families but also employers and the entire country.
In some states, the government is taking positive actions to support breastfeeding. They are providing necessary time for maternity leave, which typically extends to around six months, and are establishing breastfeeding facilities in workplaces. Currently, around seven states have made significant changes in this regard, implementing designated breastfeeding rooms. It is crucial to emphasize that these rooms are not nurseries where any milk can be provided to the child. Their primary purpose is to support exclusive breastfeeding for six months, after which complementary feeding begins. This phase involves introducing mashed foods such as vegetables and meat while continuing to breastfeed, though less frequently than in the first six months.
The ultimate desire is for all actors in society to demonstrate a strong commitment to promoting, facilitating, and providing opportunities for breastfeeding following each breastfeeding week. By working together, we can create a supportive environment that empowers mothers to breastfeed their children and fosters the health and well-being of both mothers and infants.
What about fathers who work? Do they contribute in any way to promoting breastfeeding?
There are commendable initiatives to support paternity leave, with UNICEF endorsing a four-month paternity leave policy. Currently, the Nigerian government has implemented 12 weeks of paid paternity leave, which is a positive step in the right direction.
However, it is important to emphasise the ethical aspect of paternity leave. The intention is for fathers to fully commit to being present with their children during those crucial initial months. This time is pivotal to a child’s development, including their emotional, psychological, and intellectual capacity.
Creating an environment of love and care within the home is crucial. The four months of paternity leave should not be seen as an opportunity for men to engage in other activities; rather, it should be a time for them to be actively involved in caring for their children. Similarly, women should be encouraged to make use of the six months of maternity leave to prioritise breastfeeding and nurturing their child.
Promoting these policies and practices is not only the responsibility of the government but also the private sector. Providing breastfeeding rooms is important, but it is essential to first raise awareness among mothers about the significant advantages of breastfeeding and the importance of maintaining these rooms as dedicated breastfeeding spaces.
By encouraging active parental involvement and providing the necessary support and resources, both the government and private sector can contribute to creating an environment that prioritises the well-being and development of children, encourages breastfeeding, and fosters a loving and nurturing home environment.
What are the benefits of breastfeeding for those who do not know the importance?
I think that there are hundreds of thousands of mothers. Because here in Nigeria, we speak about hundreds of thousands, who on a yearly basis, many of them have children, right. And they should know why breastfeeding is important. First, because a child that has been exclusively breastfed for six months, is healthier, and has a better immune system compared to others. And that is scientifically proven.
Secondly, because this also develops the healthy, psychological and emotional ties between the child and the mother, and it helps the child as it grows, to be healthy, with a better immune system and to cope with stress which shocks it, violent behaviours, etc. Thirdly, because when a woman does the six-month breastfeeding, it helps all her reproductive organs to go back to their place, and in a way prevents things related to breast cancer.
There are reliable studies indicating that breastfeeding lowers the risk of breast cancer compared to not breastfeeding. When women visit health care providers or gynaecologists, they are often asked about their menstrual history and breastfeeding practices. This line of questioning stems from the fact that women who do not breastfeed are more likely to develop tumours. It is crucial for women to be aware of this information. Additionally, the economic implications within households must be considered. The cost of substitute milk for feeding infants in the first six months is high, and many women prioritize providing this expensive powdered milk to their children, going to great lengths to afford it.
If a thorough calculation is conducted, it becomes evident that the expenses incurred in purchasing milk substitutes for a six-month period are quite significant. Many women, due to the high cost, resort to diluting the milk with excessive water once their children begin growing. This practice not only leads to malnourishment in children but also represents a wastage of money. Therefore, from an economic standpoint, it is crucial to consider the impact of such practices.
This issue not only affects women who have the financial means to purchase milk substitutes but also impacts a significant portion of the population who cannot afford such luxuries. For those who lack resources, they resort to giving water or other juices to their children prematurely. Unfortunately, this practice leads to malnourishment as the child’s digestive system is not yet developed to handle anything other than breast milk. The long-term consequences of this can be observed later on. It is important to acknowledge that a child who has been breastfed tends to be healthier compared to a child denied this nourishment.
In rural areas, when women give water to their children, it often comes from unreliable sources and is not safe for consumption. This is further compounded by the prevalent practice of open defecation in the country, which leads to water contamination with fecal matter. Consequently, children who consume this contaminated water are at a higher risk of developing diarrhea. The stomach of a baby is not yet fully developed to process anything other than breast milk, making them more susceptible to weakness and illness when exposed to unsuitable liquids, solutions, or soups.
The lack of breastfeeding contributes to negative health outcomes for children, including sickness, diarrhoea, and undernourishment. In severe cases, this can lead to acute malnutrition, where children become dangerously thin and weak, on the brink of death. Consequently, child mortality rates in the country are influenced by the absence of breastfeeding.
It is important to address cultural beliefs in certain regions that discourage breastfeeding. It is a misconception that children should not be breastfed. Historically, breastfeeding was the norm and widely practised. The perception that using milk substitutes demonstrates higher economic status or purchasing power is inaccurate. The true significance lies in understanding the importance of breastfeeding for the health and well-being of children.
Introducing powdered milk to infants prematurely may result in childhood obesity. Unfortunately, some mothers mistakenly believe that a larger, overweight child is a sign of good health. However, this belief can have negative consequences in the future, as the child may develop conditions like diabetes and high blood pressure. On the contrary, a breastfed child tends to have a healthy weight and is less susceptible to future health implications.
Earlier you said seven states have set up breastfeeding rooms for women at work. I would like to know those states and what effort is UNICEF doing to get others to do the same?
We offer technical assistance to states in developing laws and policies that support breastfeeding and provide maternity leave. This ensures that there is legal backing for promoting breastfeeding practices. We collaborate with organizations like the International Labour Organization (ILO) and UNICEF to provide technical guidance in this regard. Another area where our technical support is offered is in the design of breastfeeding rooms. These rooms are meant to support the recommended breastfeeding duration of six months, during which mothers are encouraged to breastfeed their infants three to four times a day. As the child grows, the feeding intervals may be adjusted accordingly. It is important to note that if breastfeeding is ceased, the mother’s milk supply may diminish.
Therefore, it is beneficial for mothers to learn techniques for expressing and storing breast milk safely. Breast milk can be refrigerated or even frozen for later use. The milk can be defrosted by placing it at room temperature or warming it using hot water in a pot or bowl. By disseminating such information and educating mothers, we help promote and sustain breastfeeding practices.
While breastfeeding and the care of newborns may seem straightforward, many people lack sufficient knowledge in these areas. Therefore, alongside our training and capacity building efforts, we also aim to address this gap by providing further education. We support states in sensitizing women and explaining to them the significance of breastfeeding and proper newborn care. Through these initiatives, we strive to ensure that women understand the importance of these practices and can make informed decisions for the well-being of themselves and their children.
What are some of the challenges working mothers face in continuing breastfeeding while at work?
It is important to recognize and appreciate the significant role that women play in various aspects of life. Women are often engaged in multitasking, balancing work, childcare, household responsibilities, caring for their parents and other children, and much more. Managing all these responsibilities can be overwhelming, which is why paternity leave is crucial.
Having a child is a transformative experience for a woman, and it is essential to acknowledge that she is not a machine. It is necessary to provide support and assistance during the postpartum period as her body goes through recovery. This means that men should step in and contribute by taking on household chores and other responsibilities, allowing the mother to have the necessary time and space with the child.
Implementing paternity leave can be challenging, especially considering existing societal practices and the absence of men in many cases. However, the purpose of paternity leave is precisely to provide support and ensure that women can breastfeed their children while balancing their numerous responsibilities. It is crucial to break traditional norms and encourage men to actively participate in childcare, ultimately fostering a more inclusive and supportive environment for women and their families.
It is important to acknowledge that not every household in Nigeria is able to facilitate breastfeeding due to various circumstances. Many families face the reality of having both parents unemployed or engaged in informal jobs. In such cases, it becomes essential to find ways to support women in breastfeeding their children.
In many countries, women often have activities they can engage in at home. This situation allows for breastfeeding to take place, as the mother is present. However, challenges arise when women are required to work outside the home, such as in the field, creating significant barriers to breastfeeding. This is where the need to sensitize men comes into play. The work can be postponed or adjusted so that it aligns with the timing of breastfeeding, providing the child with the opportunity for bonding with the mother.
Understanding the cultural practices in Nigeria is crucial to address this issue effectively. After delivery, it is important to determine if mothers are expected to resume work immediately or if they have the opportunity to stay and breastfeed their child. Breastfeeding fosters a natural bond between mother and baby, which makes it difficult to stop once initiated. Speaking from personal experience, I can attest to the strong connection formed through breastfeeding, which makes supporting women in this aspect even more crucial.
Do you mind sharing your breastfeeding experience so others can learn from you?
I am a firm believer in the importance of breastfeeding because I have personally experienced its effects with my two boys, who are now grown. Unfortunately, with my first son, I was not aware of the significance of breastfeeding as I was not working with UNICEF at the time. When I was leaving the hospital after giving birth, I was given a can of milk, and without knowing any better, I continued feeding my child with it. As a result, he faced numerous health challenges. By the age of two, he was diagnosed with asthma and continued to have frequent illnesses. He also developed rhinitis and experienced episodes of dermatitis. It was evident that his immune system was not functioning properly.
However, with my second son, things were different. By that time, I had joined UNICEF and had acquired knowledge on breastfeeding. He was exclusively breastfed for the first six months and gradually introduced to complementary meals afterwards. From the time he was born until he turned 18, the only reason we visited the hospital was for dental check-ups. The stark contrast between my two sons’ health outcomes made it clear that breastfeeding played a crucial role.
Reflecting on these experiences, I now understand the vital impact breastfeeding can have on a child’s health and well-being. It has not only enriched the bond between me and my children but also significantly contributed to their overall wellness.
I have witnessed the remarkable impact of breastfeeding through my sister’s experience with her three children. All of them were exclusively breastfed and have enjoyed good health as a result. In contrast, children who are not breastfed face a weakened immune system, making them susceptible to illnesses such as diarrhea and infections. These health challenges can potentially lead to severe acute malnutrition or even death. If they do survive, there is a risk of long-term consequences that can impact their cognitive abilities and hinder their developmental milestones.
I vividly remember encountering a nine-month-old child who appeared to be significantly underdeveloped, resembling a three-month-old. It was an incredibly heart-wrenching sight, and it prompted a determined response to save the child’s life and provide whatever support and treatment was necessary. Despite our efforts, it was clear that the child’s brain and internal organs might have already been compromised. It served as a poignant reminder of the heartbreaking consequences that can result from inadequate nourishment and the urgent need to address this issue.
What resources are available for working parents who wish to continue breastfeeding while working?
The level of commitment and involvement from both the public and private sectors is crucial in making investments that support breastfeeding practices. One such investment is the provision of breastfeeding rooms at workplaces, enabling women to bring their babies with them. However, it’s important to acknowledge that working women cannot be in the breastfeeding room all the time, as they must return to work. In such situations, the involvement of caregivers becomes essential. Collaborative efforts among mothers themselves are also valuable in contributing to these initiatives and promoting breastfeeding.
It is worth noting that sometimes women are unable to breastfeed because they are working, while in other cases, misinformation may prevent them from breastfeeding even when they have the opportunity to do so. This is why it is crucial to provide evidence-based information, highlighting the importance of breastfeeding not just for the child’s health but also for the mother’s well-being and the potential economic implications that may arise if the child falls ill.
By considering the health of both the child and the mother, and by recognizing the potential economic consequences of illness, we can collectively strive to foster an environment that supports breastfeeding and enables women to make informed choices for themselves and their children.
Do you have figures to back up the implications of not breastfeeding?
The impact of not breastfeeding is significant, with an estimated 100,000 lives of children lost due to this reason. It is challenging to quantify the financial cost in terms of millions or billions of naira or dollars because the focus should be on saving the lives of these children. When a child is not breastfed, there is often a need for costly curative healthcare interventions to address the resulting health issues.
To address this issue, we are proposing measures that focus on preventing child mortality resulting from the lack of breastfeeding. Currently, out of every 10 children in the age group where exclusive breastfeeding is recommended, only four are being breastfed. These numbers highlight the urgency to promote and encourage the practice of breastfeeding, rather than focusing solely on statistical figures. By prioritizing the practice of breastfeeding, we can significantly reduce child mortality rates and provide a healthier future for children.
What final call to action would you like to make during World Breastfeeding Week?
My call to action is for both public and private institutions to recognize the interconnected benefits associated with breastfeeding. When a child is breastfed, it not only has a positive impact on health but also holds great economic implications. By investing in breastfeeding, millions and billions of Naira that would have been allocated for curative healthcare expenses can be saved.
From the government’s perspective, it becomes evident that budget allocation is necessary to address the structural costs incurred when children are not breastfed and fall sick easily, resulting in increased healthcare expenses. On the other hand, the private sector also bears financial consequences due to increased absenteeism of working mothers tending to their sick children. In order to mitigate these costs, it is in the private sector’s best interest to invest in breastfeeding support such as creating breastfeeding rooms in workplaces or offering adequate maternity leave.
This investment pays off in multiple ways. Providing breastfeeding facilities not only facilitates employee retention but also leads to a more committed, productive, and ultimately happier workforce of working mothers. It becomes a win-win situation for the employer, the mother, and most importantly, the child. By understanding the economic benefits and the improved well-being of both mothers and children, public and private institutions can join hands in promoting and supporting breastfeeding, thereby creating a healthier and more prosperous future for all.
What is UNICEF doing to celebrate this year’s breastfeeding week?
UNICEF, in collaboration with the Nigeria Governors Wives Forum, is actively supporting their initiatives focused on addressing critical issues related to breastfeeding, breast cancer, and uterine cancer. These concerns are strongly intertwined with breastfeeding practices.
As an organization committed to making a difference, UNICEF recognizes the significance of collective action. Rather than hosting standalone events, our approach is to work alongside partners who share our commitment. By doing so, we aim to create a multiplier effect, encouraging others to take action, while also fostering a sense of accountability among all stakeholders involved.
Through this collaborative effort with the Nigeria Governors Wives Forum, we strive to bring about meaningful change and promote the well-being of women and children in Nigeria. By addressing these interconnected issues, we seek to create lasting impact and advocate for widespread awareness and action.
