WBFW: ‘Breastfed babies have higher mental cognitive capability’

Elizabeth Lola Alonge is the founder of Child Health Advocacy Initiative (CHAI), a healthcare and development non-profit focused on promoting the health and wellbeing of Nigerian children. Over the years, she has spearheaded massive awareness campaign on breastfeeding, and as Nigeria joins the rest of the world to mark this year’s World Breastfeeding Week starting today, she tells TOBI AWODIPE how she is working towards moving child nutrition and breastfeeding forward, the importance of breastfeeding for babies now more than ever, as well as the role of society, family, employers and government in supporting and protecting breastfeeding mothers.

How important is breastfeeding in fostering a child’s wellness and wellbeing and even the mother?
Breastfeeding is the foundation to good nutrition and the key to achieving the sustainable development goals by 2030. To achieve optimal growth, development and good health, the World Health Organisation (WHO) recommends breastfeeding in the first hour of life, exclusive breastfeeding for the first six months, and thereafter nutritionally adequate complementary foods, while breastfeeding continues up to two years of age or beyond. Breastfeeding is a child’s first immunisation against death, disease and poverty. Breastfeeding saves lives, reduces the risks of mortality and morbidity. The breastfeeding period is the most critical period of a child’s life in terms of growth and development. Also, breastfed babies have higher scores of mental-cognitive capability than children who were not breastfed. On the other hand, mothers who breastfeed their babies are less likely to suffer from hypertension and have lower risks of breast and ovarian cancer. Breastfeeding saves lives, improves the health and nutrition of women and babies and helps citizens to reach their potential, while contributing to nations’ economic prosperity.

This year’s theme is Protect Breastfeeding: A shared responsibility. Can you explain this?
Many mothers want to breastfeed, but they lack the necessary support from family, employers, government and society. It is well established that maternal experiences, knowledge, attitude and practices heavily influence breastfeeding intention, initiation and duration. Therefore, the success or failure of breastfeeding should not be seen solely as the woman’s responsibility. Her ability to breastfeed is very much shaped by the support and environment in which she lives. There is a broader responsibility of governments and society to support women through policies and programmes.

What would you say is the role of those you mentioned in protecting and supporting breastfeeding?
The society, family, employers and government can support breastfeeding through effective protection, promotion and support strategies. These include enacting policies to support women to continue breastfeeding, when returning to work by provision of breastfeeding breaks, which impact on breastfeeding practices. Also, legislation to enforce the International Code on the Marketing of Breast milk Substitutes (the Code), as well as maternity protection laws, creation of environments that are supportive of breastfeeding, including hospitals, primary health care facilities, work places and public spaces, the development of national breastfeeding policies, and the availability of breastfeeding and Infant and Young Child Feeding (IYCF) programmes that support women to breastfeed. Breastfeeding is a country’s first step towards building the human capital that will drive their economies in the future.

Why is it necessary to enforce the international code of marketing of breast milk substitutes in Nigeria?
The inappropriate or aggressive marketing of breast milk substitutes undermines breastfeeding worldwide, thereby emphasising the need to enforce the international code of marketing of breast milk substitutes. ‘The Code’ provides a set of standards to regulate activities of the breast milk substitute industry. This curbs incidents of breast milk substitute company representatives taking advantage of legislative loopholes to promote their products to pregnant women, new mothers, health workers, health facilities, professional associations and government.

Though not very common, how important is a breastfeeding counsellor in supporting mothers?
The role of counsellors in breastfeeding has often been underplayed. Breastfeeding counselling centres and support groups have been shown to help women cope with breastfeeding difficulties. Sometimes, the mother may need to talk about her breastfeeding problems and may be in need of expert advice. Due to the prevalence of breastfeeding difficulties over the first days after childbirth, training mothers to prevent and treat breastfeeding difficulties and offering practical advice on breastfeeding difficulties are major factors in the continuity of breastfeeding and facilitating breastfeeding empowerment.

Exclusive breastfeeding has always been encouraged, but do you think it is still feasible in today’s fast-paced world?
Yes it is. This is because breastfeeding still remains the best for babies and it nourishes and provides all children with the best start in life. If the mother has to return to work, she can express and store so her baby can be fed with it when she is away. She can also put her baby at a creche near her place of work. All we need is to create an enabling environment that encourages women to practise breastfeeding.

How can husbands show support and protect breastfeeding mothers?
Globally, previous research has shown that family members, such as husbands or grandmothers do not only influence a mother’s decision to initiate and continue breastfeeding, but also play a significant role in the premature cessation of appropriate breastfeeding in the early postnatal period. Breastfeeding interventions, which considered increasing partners/fathers breastfeeding information, resulted in improvements in breastfeeding outcomes. Women need extra support, encouragement and reassurance while breastfeeding. Therefore, families and spouses can provide support by providing adequate nutritious food for the mother, helping make the mother comfortable and loved, or looking after the other children while she is feeding. Massaging and calming a crying baby are other very useful ways of helping out.

How can health facilities galvanise action towards promoting breastfeeding?
In addition to counselling centres and support groups, health workers and professionals are integral to protecting, promoting and supporting breastfeeding, which requires them to have evidence-based knowledge. Health workers, professionals and their professional associations should also be key advocates for breastfeeding and play an important role in influencing political support for breastfeeding. The Baby Friendly Hospital Initiative (BFHI) must be revitalised and the WHO Ten steps to successful breastfeeding fully implemented at health facilities.

What are some readily available resources breastfeeding mothers can employ to receive support?
Breastfeeding support is crucial and readily available resources are workplace breastfeeding and lactation rooms, paid maternity leave, group breastfeeding counselling at health facilities and counselling support from breastfeeding support groups, run by organisations such as CHAI. Breastfeeding mothers can also engage in awareness raising employment protection and non-discrimination.

How are you looking to activate this year’s theme in communities and the country as a whole?
CHAI is involved in advocacy and strategic interventions to effectively support the promotion of breastfeeding, as well as implementing and coordinating programmes that are known to support and enable women to breastfeed. We recently launched a free online breastfeeding support group known as ‘Nutrimums”. Mothers receive daily support through counselling on breastfeeding from professionals.

All over Nigeria, many mothers all have the opportunity to get answers instantly to their breastfeeding challenges.

There is also a helpline for mothers to call on any issue bothering them and also get referred to our partner Primary Health facilities for free support and treatment, if necessary. We also developed an innovation called “Mamajoy Breastfeeding Suite.” This is a mobile room placed in strategic places, so mothers can go there to breastfeed, when they are out of the home. They are located at shopping malls, religious and recreation centres, among others. We’re also setting up breastfeeding support groups manned by trained experts in various LGAs in Lagos to facilitate door-to-door counselling and support in communities.

Also, in order to support less privileged mothers to breastfeed, we donated breastfeeding/nutrition packs to new mothers in public hospitals. The pack contains breastfeeding covers and pillows, lactation cookies, as well as diapers and provisions for the new mother. We are also working closely with the private sector to encourage organisations to set up creches or breastfeeding rooms in work places, as well as working with the government to enact a law protecting and promoting breastfeeding in Nigeria.

Furthermore, we are using notable personalities and the media to raise awareness and amplify breastfeeding messages and a new video with key messages on exclusive breastfeeding by influential personalities was recently launched.

CHAI is also advocating paternity leave for husbands, so they can support mothers to breastfeed successfully. Finally, we recently trained breastfeeding peer mother supporters, who are now champions supporting other mothers online and in various communities. According to WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, “We must urgently scale up support for mothers, so they can give their children the best start in life.”