Thursday, 28 November 2013 10:37

Breast-Feeding Practice

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By Veronica Ezeh (Mrs) MNIFST, Assistant Director-Food, Establishment Inspection Directorate, NAFDAC, Abuja, Bobboi  U. A. (Mrs) MNIFST, Chief Regulatory Officer, Establishment Inspection Directorate, NAFDAC, Abuja and Joyce Odoh  (Mrs,) Senior  Regulatory Officer, Establishment Inspection Directorate, NAFDAC, Abuja.

Breastfeedingis a tradition in every culture in Nigeria regardless of socio-economic status. Until the late 1960’s, breastfeeding took a dangerous downward trend when it started to be discouraged through the aggressive marketing of commercial breast milk substitutes. As a result, traditional infant feeding practices started to shift towards more ‘modern’ feeding practices.

 

Existing records show that in Nigeria, malnutrition is widespread, for example, 43% of all children less than five years of age are stunted, 9% wasted and 25% are underweight (NHDS 2003).

Also 60% of all childhood deaths are reportedly due to underlying malnutrition. The causes of malnutrition in Nigeria are many and complex. The immediate causes of malnutrition in the first two years of life are inappropriate breastfeeding and complementary feeding practices coupled with high rates of infections.

Breastfeeding is natural, and anything natural is best for everyone. Successful breastfeeding requires support either from a person who has experienced it or from a professional. Despite initial difficulties, both the mother and the baby normally succeed in establishing a comfortable and satisfying breastfeeding practice within a few days after birth.

Exclusive breastfeeding reduce the baby’s risk of diseases such as diarrhea and respiratory infections. It also prevents weight loss associated with illness in a baby.

It is desirable that every expecting mother delivers her baby in a hospital or maternity clinic where the doctors, midwives and other healthcare staff are committed to promotion of breastfeeding. At such places she will be educated on how to prepare the breast for breastfeeding during pregnancy and learn the benefits and management of breastfeeding.

All hospitals are supposed to be baby-friendly. The Baby-Friendly Hospital Initiative (BFHI) was launched by WHO and UNICEF in 1991, following the Innocenti Declaration of 1990. The initiative is a global effort to implement practices that protect, promote, and support breastfeeding. And also to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding.

The BFHI assists hospitals in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies or feeding formula safely. Nursing staff at such hospitals help the expecting mother to initiate early and successful breastfeeding.

Successful breastfeeding requires that mothers practice the following guidelines:

  1. Initiate breastfeeding within a half hour after birth. Although there may be no milk secretion at this time, the baby suckling the nipples will stimulate milk secretion in the breast.
  2. Learn from a trained doctor, midwife or nurse the correct technique of breastfeeding.
  3. Do not give any food or drink other than the breast milk, unless there is a medical reason for not breastfeeding the baby.
  4. Keep the baby with you throughout the day and night soon after the delivery.
  5. Feed the baby on demand.
  6. Do not give any artificial teats or pacifiers to breastfeeding babies.

The “Ten Steps to Successful Breastfeeding”, which was established in the WHO/UNICEF Baby-Friendly Hospital Initiative, will support mothers to actualize breastfeeding desire. These steps were to be implemented fully by all the health facilities designated as Baby Friendly Hospitals (BFH). The Ten Steps include:

  • Have a written Breastfeeding policy that is routinely communicated to all health care staff
  • Train all health care staff in skills necessary to implement this policy
  • Inform all pregnant women about the benefits and management of breastfeeding
  • Help mothers initiate breastfeeding within a half hour of birth
  • Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants
  • Give newborn infants no food or drink other than breast milk, unless medically indicated
  • Practice rooming in - allow mothers and infants to remain together - 24 hours a day
  • Encourage breastfeeding on demand
  • Give no artificial teats or pacifiers ( also called dummies or soothers) to breastfeeding infants
  • Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

    ADVANTAGES OF BREASTFEEDING

    BREASTFEEDING HAS ENORMOUS ADVANTAGES BOTH TO THE MOTHER AND HER BABY.

    For the baby:

    • Breast milk contains the required amount of proteins, fats, vitamins, minerals, water and enzymes for the baby. it therefore reduces the risk of various types of nutritional deficiencies.
    • Breast milk contains all essential fatty acids that are needed for the growth of brain, eyes and healthy blood vessels.
    • Breast milk is always at a temperature that is most suited for the baby. It therefore does not require any preparation.
    • The baby can digest and use the nutrients in breast milk more efficiently than those in other types of milk.
    • Breast milk is sterile, which means that it cannot be contaminated with bacteria or other disease causing germs.
    • Breastfeeding prevents development of anaemia in infancy because the iron present in the breast milk is better absorbed than other sources of iron.
    • Malnutrition cannot develop in breastfed babies because breast milk meets the baby’s energy requirements for up to first six months.
    • Colostrum is rich in antibodies and other anti-infection substances that protect the baby from infections. Antibodies are substances that are secreted in the body whenever any disease-causing agent enters the body. It is therefore essential for destroying these agents.
    • It also contains growth factors such as “epidermal maturation factor.” this factor lines the inner lining of the respiratory tract and prevents disease causing germs from entering the respiratory tract.
    • Antibodies present in the colostrum also protect the newborn from allergies, asthma, skin rashes, etc.
    • Colostrum is rich in Vitamin A, which prevents infection, and Vitamin K, which prevent bleeding in the newborn.
    • Breast milk contains a “gut maturation factor”, which lines the inner lining of the digestive tract and prevents diseases causing germs and heavy proteins from being absorbed into the body.
    • It contains a “cerebroside maturation factor”, which makes the breastfed baby more intelligent later in life.
    • Breast milk helps the growth of healthy bacteria in the intestines called lactobacillus bifidus. These bacteria prevent other disease causing bacteria from growing in the digestive tract and therefore prevent diarrhoea.
    • Breast milk contains a substance called lactoferrin, which combines with iron and prevents growth of disease causing germs.

     

    For the mother, breastfeeding:

    • Helps the uterus contract faster and reach its normal size in a short time. This reduces the amount of bleeding after delivery and therefore prevents anaemia.
    • Reduces the risk of pregnancy for up to six months after delivery.
    • Reduces the risk of cancer of the breast and ovaries.
    • Helps reduce excessive weight gained during pregnancy. It therefore reduces the risk of obesity.

    References

    1. Dr Savitri Ramaiah 2006: Infant Nutrition
    2. Federal Ministry of Health, Nutrition Division Abuja 2005:  National Policy on Infant and Young Child Feeding in Nigeria
    3. Jane Moody, Jane Britten & Karen Hogg 1996: Breastfeeding Your Baby 
    4. Ministry of Health Uganda Policy Guidelines on Infant and Young Child Feeding
    5. NHDS 2003.
    6. WHO Nutrition: information and attitudes among health personnel about early infant-feeding practices. WklyEpidemiol Rec 1995; 70: 117-120.
    7. WHO . Protecting, promoting and supporting breastfeeding: the special role of maternity services: a joint   WHO/UNICEF statement. Geneva: WHO, 1989.
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