Breastfeeding:Unending war between breast and bottle

Tayo Oredola, 30, is barely two years old in marriage. She had planned to exclusively breastfeed her child. But when her now 7-month old baby arrived, she took ill and could not.

“After my delivery, I was sick and I was not lactating well. So, I could not do exclusive breastfeeding. My baby was big. She was 4.5 kg when she was born. My breast milk was not enough for her. So, the doctor advised me to use baby food. I was breastfeeding her and giving her baby food at the same time,” revealed the teacher.

Another 30-year old nursing mother, Wuraola Olagunju, who nurses a 4-month old baby did exclusive breastfeeding for just three months before she stopped, because she had to resume work after her three-month maternity leave.

“I only did exclusive breastfeeding for three months and resumed work. I placed my baby in a crèche near my office but my schedule is so tight that I cannot say because I am a nursing mother, I would leave my job to go and breastfeed my baby,” volunteered Olagunju who works in an educational consultancy firm.

With a very tight work schedule, she only breastfeeds her baby when she can.

Exclusive breastfeeding refers to feeding babies with breast milk alone with no other liquids for the first six months after birth.

Breastfeeding provides all the nutrition a baby needs for physical growth especially in the first two years of life, enhances cognitive development, boosts the infant’s immunity against infections especially child-killer ones such as malaria, diarrhea and pneumonia even as it reduces risks of chronic diseases such as obesity, diabetes and cardiovascular, later in life.

A nutritionist, Prof Ngozi Nnam, President of Nutrition Society of Nigeria, said that breast milk is nature’s perfect food for babies.

“The nutrient composition is adequate in quantity and quality to meet the nutritional needs of the infant and sustain the rapid growth and development of the baby. Breast milk contains anti-infective factors, which protect the baby against infection.”

Corroborating Nnam’s beliefs, Dr Chinwe Muomalu, a paediatrician at the Children Outreach Hospital, Festac, Lagos, said that breast milk is easily digestible by infants, provides them antibodies and helps mother and child bond, benefits which are lacking with bottle-feed.

“Breast milk has natural antibodies which the cow milk(baby formula) does not have. The breast milk is such that the baby’s intestine can digest it easily. Breastfeeding increases the bonding between the mother and the child.

You do not buy it, so you won’t say you cannot afford it,” she said.

Even mothers attest to benefits of breastfeeding not just to their babies alone but themselves. It is a form of contraceptive. Studies show that breastfeeding reduces the risk of ovarian and breast cancers.

Inconvenient it was for Abimbola Olusola who works in a financial institution in Lagos to exclusively breastfeed her infant child but she said that, “It was worth the price.” Olusola said of her two children aged four and two: “They are very clever, very intelligent and my tummy is so flat you won’t believe I have had two children.”

Another mother, Nonye Ekwomadu, who exclusively breastfed her first two children aged, 7 and 5, and is doing same for her two-month old baby, said that it helps babies to stay healthy, is easier and cheaper and mothers to firm up their tummy.

“The baby is healthy and you don’t run into health problems like diarrhea for the first 6 months. My first son who is 7 years now, first fell ill when he was 7 months old, by then I had introduced other foods. With breastfeeding, my tummy contracts faster.

“It is easier, not difficult for me because I am self-employed. It is also cheap,” added Ekwomadu, an author.

Although, breastfeeding especially exclusive breastfeeding come highly recommended by health authorities; medics, nutritional experts and the World Health Organisation, less than 20% of Nigerian women currently practise it. According to the World Bank., exclusive breastfeeding rate in Nigeria was 13.10% in 2008, 15%, in 2011 and 17% in 2013.

While some of them do not breastfeed due to inability to lactate well after delivery (as was the case with Oredola), unfavourable workplace policies especially as more women now work outside the home, others shun it over fears of sagging breasts, loss of sexual appeal to their husbands and myths and misconceptions about exclusive breastfeeding and ill-health.

For instance, HIV-positive mothers, tuberculosis and cancer patients are advised by doctors not to breastfeed.

Olagunju and Ekwomadu concurred that some women are worried about losing their frontal arsenals too soon or are too embarrassed to breastfeed in public, some are constrained by tight work schedule and fear of impairing the health of their baby particularly if they fell pregnant while nursing their baby.

Olagunju explained “For some women it is the work schedule. Some don’t want their breast to sag in time. Some get pregnant and believe they need to suspend breastfeeding or they hurt their baby. Some do not want to breastfeed in public.”

“Some women believe breastfeeding sags their breasts. Some worry that when they are breast feeding hey husbands cannot ‘play’ with them. You know, one’s a woman(who is breastfeeding) gets sexually excited, breastmilk starts to drop and some men don’t like it,” disclosed Ekwomadu.

But experts disagree. “Whether they breastfeed or not, the breasts will still sag,” said a gynaecologist, Dr. Joseph Akinde.

The Medical Director of Living-Spring Hospital who conceded that pregnancy alters the size and shape of breasts, making them bigger and fuller in readiness for breastfeeding insisted that, “Sagging is a function of aging.”

The bottle has continued to enjoy the upper hand in the war despite revelations from various studies of its propensity to increase risks of infections such as gastroenteritis, asthma, pneumonia, and diarrhea, especially in developing countries like Nigeria where access to clean and safe water and hygienic environment is highly limited.

There is also the risk of contamination of baby formula with harmful chemicals at the point of manufacture. Studies also show that use of baby formula lowers the cognitive development of a child.

In the beginning, it was not always so.

Breastfeeding was part of infant-nursing across cultures and societies around the world, except where ill-health, death or exigencies made wet-nursing an alternative as was with the Biblical Moses.

However, since the invention of the rubber nipple by Eljah Prat in 1845 and subsequent manufacture of the world first baby formula in commercial quantity in 1867 by Justus Von Liebig, it has been war without end between the breasts and the feeding bottle as many mothers in Europe and America ditched the age-long practice of breastfeeding their newborns for a ‘trendier’ modern and more convenient bottle-feeding.

The fad was transported to Nigeria alongside colonialisation and Westernization but peaked in the 1980s as more women embraced formal education and with it the notion that breastfeeding was for uneducated and less sophisticated women who cared little about flashing flabby breasts in public.

Efforts by the government and development partners to encourage more women to breastfeeding through nutrition-specific interventions such as the national policy on breastfeeding in the 1990s, the 2008 national infant and young child feeding (IYCF) strategy and Maternal Newborn Health Week, have not improved the practice in any significant way as Nigeria remains one of the countries with poorest exclusive breastfeeding rates in Africa, according to the Saving Newborn Lives Program report.

The 2013 National Demographic and Health Survey(NDHS) showed only a slight improvement from 13% in 2008 to 17 % in 2013 of children under 6 months who were exclusively breastfed even as it reported that 47% babies under 6 months were given plain water, 5% other milk, and 23 percent were fed complementary foods in addition to breast milk, contrary to WHO recommendation.

While the battle rages, some mothers are resolute in standing behind the retreating soldiers. Mrs Demilade Oloyede, a mother of three exclusively breastfed her first child,4 years, the second 2 years and is doing so for her third, a 20-day old baby.

Mrs Oloyede who works in a leading Pentecostal church as an administrative officer is privileged to enjoy the baby-friendly environment provided by her employers.

“I resumed after three months maternity leave with my baby and on resumption, you are entitled to closing work by 2pm for another three months.”

Olusola is not as lucky as the duo of Ekwomadu and Oloyede but her aversion for the bottle made the mother of two put up with pumping her breasts for milk as much as four times a day; sometimes, at work, in middle of the night and keep in a refrigerator, just to make sure her babies were exclusively breastfed. “It is not easy but it is a price one has to pay.”

But how many more mothers are ready to pay for healthier children with their mammary assets? It remains to be seen.