Exclusive breastfeeding for the first six months of life has been termed one of the best gifts a mother can give her baby as it plays a key role in shaping the child’s future. But poor compliance to codes for marketing breastmilk substitutes has been fingered as one of the drawbacks to Nigerian mothers providing this special gift to their babies. Martins Ifijeh writes was
Nothing beats the ‘baby blues’ and intense feelings of love parents have for their newborns. In one breathe, they wish the infant remains that little innocent baby whose yawns and cries take their breathe away. In another, they imagine how much of good life their baby deserves so he or she can grow into a meaningful contributor to the society.
They imagine giving their newborns the best vacations in life, taking them to the best schools, and how much of choice toy-cars they can enjoy.
For parents with limited resources, the feelings are also the same. All they think of is giving their newborns the best life they can afford. In their eyes, there’s no better way to love their offspring than to give them the beautiful life they had imagined.
Breast milk as the Best Gift
While these, no doubt, are some of the things little ‘angels’ deserve from their loving parents as they journey through childhood, an Associate Professor, University of Maryland School of Medicine, United States, Maureen Black believes the best gift parents can offer their newborns is to place them on exclusive breastfeeding for the first six months after birth, and then continue breastfeeding along with other foods until the child clocks two years or 1,000 days of life.
No gift surpasses this, since a child who is well breastfed will most likely acquire the capacity needed to journey through childhood and adulthood, as well as has the social, health and mental capacity to make the best out of every other gift the parents are capable of providing.
According to the World Health Organisation (WHO) and the United Nations Children Fund (UNICEF), an exclusively breastfed infant will achieve optimal growth, early childhood development and health; and thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or beyond.
WHO studies show well breastfed babies have optimal intellectual development, improved vision, reduced incidence of Sudden Infant Deaths (SID); prevention against diarrhea, respiratory and urinary tract infections, ear infections, cancers, asthma, among others.
A research by Amy Rose of North Michigan University, USA in 2010, showed that the developmental process associated with memory, mood, mental clarity, increased intelligence quotient, emotional and mental well-being is being altered when a child is deprived of exclusive breastfeeding and fed with something else.
Benefits to Mothers and the Nation
Health experts believe infants are not the only ones benefiting from exclusive breastfeeding. For mothers, it prevents postpartum haemorrhage, new pregnancy from occurring too early, and protection against iron deficiency anaemia, ovarian and breast cancers, as well as osteoporosis.
For the society, it is believed since a well breastfed child will have a high intelligent quotient, he or she will most likely contribute to the society economically, thereby aiding national development.
However, despite these obvious benefits associated with exclusive breastfeeding, only about 43 per cent of newborns globally are initiated on breastfeeding within the first one hour of life, with about 41 per cent of infants under six months exclusively breastfeed, if figures from the 2019 global breastfeeding scorecard are to go by.
More worrisome is that Nigeria is still far below the global index, with only about 28.7 per cent of infants age zero to five months are exclusively breastfed, leaving a whopping 71.3 per cent not to enjoy the benefits of breast milk in their formative stage. This narrative, according to a Health Expert with Alive and Thrive, Dr. Sylvester Igbedioh, was causing Nigeria at least N6.93 billion every year.
Causal Factors for the Poor Indices
While several factors have been tipped to be responsible for the low rate of exclusive breastfeeding in Nigeria, including ignorance, and mothers’ desires to give water to their newborns, poor adherence to the code for marketing breastmilk substitute has been fingered as one of the drawbacks.
WHO says millions of infants have lost their lives because they were not well breastfed, as they were instead given breastmilk substitute, an alternative that has continued to threaten the health and development of the Nigerian child.
Sales of Breastmilk Substitutes on the Rise
Global sales of breast-milk substitutes reached US$40 billion in 2013, with growth rate exceeding 10 per cent annually in many low- and middle-income countries, including Nigeria, according a report published in the SAGE journal and authored by Ellen G. Piwoz.
In 2017, for instance, the market value for breastfeeding substitute in Nigeria was around N114.9 billion, and this has continued to grow every year.
Adoption of the Breast Milk Substitute Code
However, to ensure regulations for the marketing of breastmilk substitutes are adhered to strictly, the World Health Assembly (WHA) in 1981 adopted the International Code of Marketing of Breast Milk Substitutes (BMS). The code was meant to help curtail the adverse effects that aggressive marketing and advertising, free samples and other promotional practices by infant food manufacturers have on breastfeeding rates and duration.
The code is aimed at protecting the most vulnerable. Since its approval, it has been regularly revised by the WHA, taking into cognisance new scientific data on breastfeeding and the BMS industry’s new products and promotional tactics.
While the Nigerian government has domesticated this code several years ago, through a legislation championed by the National Agency for Food and Drugs Administration and Control (NAFDAC), tagged; ‘The Marketing of Infant and Young Children Food and Other Designated Products Regulations 2019’, implementation has continued to be a concern.
The legislation, ideally, seeks to control and regulate the marketing of breastmilk substitutes and complementary foods when marketed or otherwise represented to be suitable as a partial or total replacement for breastmilk.
It states that the advertisement or promotion to the public for breastmilk substitutes and related products were prohibited and manufacturers and distributors were prohibited from providing, directly or indirectly, samples of BMS and related products to pregnant women, mothers or members of their families.
Poor Implementation of the Code
While strict adherence to the code will no doubt improve infant health and their cognitive and mental prowess, investigations show marketers are still having a field day.
But NAFDAC has stated that it is the duty of the manufacturers and distributors of breast milk substitutes and complementary foods, non-governmental organisations, professional groups and consumer organisations to collaborate with the agency in the implementation of these regulations.
Even though this may work in some climes, the Nigerian environment requires the regulatory agency to go all out in implementing the policy rather than waiting for self-regulation.
Provisions of the Code
According to the provisions of the code, marketers are not to advertise BMS and related products such as feeding bottles, teats, pacifiers, among others, to the public. They are not to give free samples of breastmilk substitutes and related products to mothers, healthcare workers or their facilities, including the distribution of free or low-cost supplies.
“There should also be no words or pictures idealising artificial feeding, or pictures of infants on labels of infant milk containers. Information to health workers should be scientific and factual. All information on artificial infant feeding, including that on labels, should explain the benefits of breastfeeding and the costs and hazards associated with artificial feeding.
“Unsuitable products, such as sweetened condensed milk, should not be promoted for babies. Manufacturers and distributors of breastmilk substitutes and related products shall not sponsor meetings of health professionals and scientific meetings,” the code noted.
It is believed that if the code is strictly adhered to, or if regulations are effective, Nigeria’s infant mortality will reduce, and on the long run bring economic prosperity to both the nation and the children when they eventually reach productive age.