CHAI proposes childcare allowance for nursing mothers

TO ensure optimal nutrition and exclusive breastfeeding for infants, the Chief Executive Officer (CEO)/Director of Child Health Advocacy Initiative (CHAI), Mrs. Lola Alonge, has recommended among other things: six months paid maternity leave for mother and two weeks paternity leave for fathers for the first two children; childcare allowance for nursing mothers zero months for the first two children; and long lunch breaks and short working hours for breastfeeding mothers.

Other recommendations include: award for family and mother friendly organizations; better training of mothers on skills and techniques of breastfeeding; provision of adequate information materials for breastfeeding mothers; availability of breastfeeding counseling lines for mothers; and more sensitization and awareness campaign by the media.

CHAI is an initiative of BASICS 11 United States Agency for International development (USAID). The focus of the Organization is to promote child survival in Nigeria.

They work with the federal, states, local governments and international Agencies. Alonge told The Guardian that child’s early nutrition would affect his or her later growth, health and mental development.

The World Health Organization (WHO) stipulates that breastfeeding is one of the most effective ways to ensure child health and survival.

It added that globally, if every newborn child is breastfed within thirty minutes of birth, with only breast milk without water or any drink for their first six months of life and breastfeeding continued till the child is two years, about 220, 000 child lives would be saved every year.

Recent survey suggests that not more than 40 per cent of women exclusively breastfeed their babies? Why is that and how can the situation be improved? She said: “According to WHO only 36 per cent of babies zero to six months are exclusively breastfed globally and in the recent survey done in Lagos state only 28 per cent of babies are exclusively breastfed.

This is quite low considering the enormous benefits of breast milk. “Most mothers in urban areas are actively engaged in work. When employers have family friendly policies, there is lower health care cost, lower employee absenteeism, lower turnover rate and higher employee productivity and loyalty.”

What is CHAI doing about it? Alonge said: “It is necessary to provide mothers in the urban areas necessary support so that they can breastfeed successfully.

This support could be in form of paid maternity leave, long lunch breaks, reduction of hours of work, part-time work and so on. Employers can also provide crèches or rooms where mothers can express milk at while at work.”

Some nursing mothers in Nigeria are complaining that they do not produce enough breast milk and hence cannot embark on exclusive breastfeeding? Alonge disagrees.

She explained: “It is not true that some mothers do not produce enough milk. The size of the breast has nothing to do with the amount of milk produced by the mother.

Rather mothers must learn the skills and techniques of breastfeeding so that they can produce enough milk. “Firstly, breastfeeding frequently is the number one key to boost milk supply; the more the baby suckles the more the milk flows.

The baby should be put to breast within the first hour of birth and should be fed on demand. “Secondly, she needs to master the technique of positioning and attaching the baby to the breast properly.

The baby’s mouth must be wide open to cover most of the black area of the breast called ‘Areola’; the baby must not latch on to the nipple alone.

Thirdly, the mother should be comfortable while breastfeeding, the whole body of the baby should be supported and the baby carried close to her breast, she must not bend her back while feeding the baby. “Finally, mothers are advised to also take enough fluids such as water, juice, fruits, milk, tea and so on.”

Can every nursing mother breastfeed? The child health advocate said: “Although breast milk is the best food for the baby, there are situations when the mother is advised to stop breastfeeding.

These instances include when a woman is taking certain medications or drugs or when she is diagnosed with a specific illness, certain medications are known to be dangerous to infants and can be passed to the child through breast milk e.g.

Anxiety medications, Birth control medications containing estrogen, cancer chemotherapy agents, mood stabilizers and sleep aid medicines.

Women who actively use drugs or do not control their alcohol intake are also advised not to breastfeed.” What can be done or eaten by mothers to boost breast milk production? Alonge said: “The mother does not have to eat too much to boost milk production, rather she should ensure a well-rounded healthy diet including fruits, vegetables etc. and also take plenty of fluids and have enough rest.

It is also advised that the mother should breastfeed at night because it boosts milk supply.” How can exclusive breastfeeding be enforced in Nigeria? The CAI CEO said evidence has shown that for a woman to breastfeed successfully she needs the support of her employer, husband, government and community.

She said women are likely to continue breastfeeding for a long time when their employer puts supportive family friendly policies in place. “That is why the theme for 2015 breastfeeding week is appropriate ‘Breastfeeding and work: Lets make it work’, she said.

Alonge said breastfeeding mothers need the support of government to make favorable laws to support breastfeeding example paid maternity leave, the role of the family, especially the husband is also very important, he is expected to provide for the needs of the family, so that she can stay home longer and take care of the baby, he is also expected to assist the woman at home so that she can relax and breastfeed the baby properly. “The emotional and encouragement of the father also plays a very important role if the woman is going to breastfeed for a long period,” she said.

Alonge said there is no legislation to enforce exclusive breastfeeding in Nigeria but CHAI is advocating for favorable government policies to support breast-feeding mothers.

She further explained: “For example in Lagos state there is a policy in place for civil servants for the first two children to have six months paid maternity leave and two weeks paid paternity leave for fathers. “We are advocating based on 2015 breastfeeding theme, that other states and the federal government should also adopt the policy.

The private sector is also encouraged to do the same and have spaces for mothers to express milk and also provide crèches. “The global target by WHO is to increase exclusive breastfeeding rate to at least 50 per cent by 2025.

Nigeria is still far from it with the present statistics of about 26 per cent. Countries like Cambodia and Peru have achieved over 60 per cent exclusive breastfeeding rate.

So we urge all stakeholders like employers, family, government and the community to support breastfeeding mothers to achieve their breastfeeding goals.”

Do you recommend breast milk substitutes? Alonge said almost all mothers can breastfeed successfully, nevertheless a number of health conditions of the infant or mother may justify recommending breast milk substitutes example severe illness that prevents mother caring for her baby like sepsis, chemotherapy or sedating drugs.

She said whenever stopping breast milk for substitutes, the benefits of breastfeeding should be weighed against the risks posed by the presence of the specific condition. “Mothers who are Human Immuno-deficiency Virus (HIV) positive are now encouraged to breastfeed if they are taking anti-retroviral drugs,” she said.

Are there recommended alternatives to breast milk? Alonge said there is no recommended alternative to breast milk, which contains all the nutrients and vitamins the baby needs. “Breast milk cannot be duplicated by any artificial milk -Nothing comes close to the original,” she said. Some adults are beginning to go for breast milk.

Why is that? The child health advocate said: “It is true that there is aggressive marketing and sale of breast milk even for adults especially online.

There are claims that human milk is easily digestible and contains positive immune building properties that attract fitness communities and chronic disease sufferers. But this purported benefit for adults cannot be proven clinically.

Failure for some women to sanitize properly when expressing milk, failure to sterilize equipment properly, and improper storage and transportation of milk can expose consumers to bacteria food borne illnesses.

Health practitioners and regulators should issue public guidance against the purchasing of human milk especially online for adults. “No, Breast milk purported benefits to adults are not supported by science; in fact research shows it may be a health hazard.”

Does breastfeeding or not breastfeeding cause cancer? She explained: “Breastfeeding contributes to the health and well being of the baby and mother.

Breastfeeding mothers have quicker recovery after childbirth and have natural birth spacing unlike non- breastfeeding mothers who have slower recovery from childbirth and an early return to menses. “Women who do not breastfeed increase their risk of ovarian cancer by 26 per cent and premenopausal breast cancer by 39 per cent.

Most women feel when they breast feed for a long period their breast is going to sag. The truth is that it is natural for a woman’s breast to sag, as she grows older.

So whether she breastfeeds or not her breast is still going to sag. “So it is advisable for mothers to breast feed their babies exclusively for six months so that the baby and mother can get all the benefits of breastfeeding that is for the present development of the child and also the future.” Are there consequences of not breastfeeding? Alonge said: “Yes, there are several consequences.

In developing countries like Nigeria, an exclusively breastfed baby is 14 times less likely to die in the first six months than a non-breastfed baby.

A non breastfed baby have a 10 times greater risk of death from diarrhea, and 15 times greater risk of death from pneumonia compared to infants who are exclusively breastfed. “The mother who does not breastfeed is going to spend a lot of her family income on milk substitutes; she could have saved the money for other family needs. In developing countries like Nigeria, this is going to increase poverty.”