Legislators and critical stakeholders nationwide are consciously championing six months of exclusive breastfeeding against the pervasive effects of hunger, childhood malnutrition and micronutrient deficiency among children under-five to enhance proper cognitive and physical development. Rebecca Ejifoma highlights how girls’ education, comprehensive antenatal care, and six months of exclusive breastfeeding strengthen nutrition levels and boost the economy
Although Mahatma Gandhi, in his famous quote, said there’s enough on this planet for everyone’s needs, ironically, health experts and legislators are decrying the rate of hunger, malnutrition and lack of nutrients that frustrate mental and physical growth, especially among children under-five in the country.
Sadly, research has shown that malnutrition and micronutrient deficiency in children eminently affect a child’s mental and cognitive development. These experts have decried that such a state of malnutrition could also stunt their growth, impede their mental ability and expose them to airborne and childhood diseases. This problematic issue, they believe, is propelled by a lack of nutrition and an absence of food fortification.
Therefore, to accelerate the level of nutrition in its citizenry, particularly children under-five as a means of addressing the nutrition and health challenges facing the nation, the Civil Society Legislative Advocacy Centre (CISLAC), National Economic Summit Group (NESG) and E-Health powered a campaign launch and media roundtable themed “Fortifying Nigeria’s Future: A Media Roundtable on Promoting Fortification Compliance and Workforce Nutrition in Nigeria” in Lagos state.
Among their recommendations are the need for girl-child education even before marriage, proper nutrition, comprehensive antenatal care, food rich in fortification, six months of exclusive breastfeeding without water, and enforcing the existing food fortification policy.
Fringe Benefits of Girl-child Education
In his impressive presentation, the Chair of the Senate Committee on Health, Dr Ibrahim Oloriegbe, told the hall that nutrition starts when the child is conceived. “When we talk about the nutrition of a woman, a pregnant woman and a nursing mother, we talk about a woman that will get pregnant. It is only a healthy body that can bear a healthy baby.
“We need our young girls to have good nutrition. One of the reasons we have malnourished children is when the mothers are trying to conceive. The girl must be mature enough physically, mentally and emotionally, which nutrition contributes for her to get pregnant,” he emphasised.
The chairman suggested that for the nation to get nutrition, it is related to girl-child nutrition and early marriage. When we have early marriages, he warned that because the girls have not matured, they give birth to underweight and malnourished babies.
Regrettably, Oloriegbe listed the northwest and northeast parts of Nigeria with many malnourished babies. Adding, the senator lamented that the number of children born underweight in the country is arguably high, particularly in the northeast and northwest.
Thus, he made a case for girl child education. “An educated girl is less likely to marry young and more likely to lead healthy, productive lives. Research has shown. And it also strengthens economies and reduces inequality in every nation and the world at large,” says Oloriegbe.
“Before pregnancy, get our young girls to get good food, discourage early child marriage so women mature before marriage. Their body should be prepared to have babies so that such babies will be well,” he emphasised.
The senator also underscored the significance of integrating nutrition education into the school curriculum to teach nutrition education from childhood through adolescence as a sustainable strategy to promote well-informed citizens on consuming fortified foods.
“There are aspects of health care that relate to nutrition because when a woman is pregnant, the woman attends antenatal. During antenatal, they give supplements which are vitamins and minerals called the folic acid to improve that woman’s blood because the child eats from the mother through the blood,” he added.
He endorsed the role of good health care, primary health care that delivers good antenatal, and promoting at least quality antenatal minimum of four visits during pregnancy as apt. “If children survive this malnutrition, they will not likely develop enough brains to achieve their potential.”
Averting Childhood Malnutrition with Six Months Exclusive Breastfeeding
Breastmilk, according to the United Nations Children’s Funds (UNICEF), is the best food for a newborn. Breast milk is 87 per cent water, seven per cent carbohydrate, four per cent lipids, and the last one per cent is protein.
And the words of Oloriegbe align with UNICEF’s. “Breastfeed the baby immediately after birth for a maximum of one hour. God has put everything for the baby in breast milk. The first milk that comes out of the breast immediately after birth is very rich; it is called cholesterol. It provides food and protection for that baby and a particular element that provides immunity. That is nutrition for the next six months.
“Exclusive breastfeeding rate in Nigeria is still abysmal,” he admitted sadly. “Only 17 out of 100 women have been breastfeeding before. But now, about 45 women out of 100 are doing exclusive breastfeeding.
“Most elite women don’t want to breastfeed; they harm their babies. The first 1000 days are the most critical. After six months, you introduce the infant and young child feeding practices. You must provide appropriate and adequate categories of food.”
He insisted on promoting exclusive breastfeeding – giving breast milk only to a child for the first six months of life. “To do this, particularly for the elite and working women, we have to adopt a policy that allows six months maternity leave so she can concentrate and get fully paid to care for her baby.”
How Breast Milk Protects, Boosts Immunity of Children
Just like UNICEF, nutritionists, legislators and key stakeholders admitted that breast milk contains all nutrition in appropriate proportion. “Breast milk will build up a child’s immunity right from that infancy. The child will be able to withstand the stress of infection. Children exclusively breastfed are less likely to die compared to their not exclusively breastfed counterparts,” the President of the Nutrition Association of Nigeria (NAN), Prof. Wasiu Afolabi, said confidently.
Afolabi echoed UNICEF’s thoughts when he said breast milk is the natural food God designed for a child. “Research shows that it is a complete milk for every child immediately after birth until age two.”
While upholding that exclusive breastfeeding protects against diarrhoea, the NAN president is confident that when a child is breastfed exclusively, it is less likely to fall sick frequently. “And frequently falling sick leads to malnutrition in children. If the child does not fall sick frequently, that will reduce health spending for the family and the burden of healthcare for the country’s government.”
Again, he pointed out, such exclusively breastfed children will be able to do well in life when they grow up to become adults; they’ll be able to contribute meaningfully to the Gross Domestic Product (GDP), the nation’s economy.
According to UNICEF and the World Health Organisation, exclusive breastfeeding is for the first six months of a child’s life – this means you should not give the baby any other food or liquid, not even water.
The Role of Antenatal in Boosting Nutrition Status
Another recipe for accelerating the nutrition status in women and children, according to the legislators, is quality antenatal service, a minimum of four visits during pregnancy.
“Antenatal presents an opportunity where health workers meet with pregnant women. Antenatal is a package of interventions. During antenatal is nutrition education where mothers are educated on taking care of themselves during pregnancies as they prepare them ahead for childbirth and child nutrition,” says Afolabi.
Beyond that, he endorsed antenatal care as an opportunity to nurse the nutrition of the mothers, clarifying that the child’s nutrition starts from conception. He expressed, “Whatever nutritional issues a child suffers during the window period of 1000 days, it is irreversible. Any intervention the government or agency must implement must target that 1000 days window opportunity.”
Folic, Iron Acids Provide at Antenatal against Diarrhoea, Deformity
For Afolabi, a professor of Community Nutrition at the Department of Nutrition and Dietetics at the Federal University of Agriculture, Ogun State, part of the antenatal care package is the supplementation of pregnant women with iron and folic acid. “Iron and folic deficiency anaemia have been recognised as nutritional deficiencies of public health importance.”
During antenatal care, he insisted pregnant women are given iron and folic supplements to reduce and prevent anaemia. “It will increase the nutritional status of the mother as well as the micronutrient supply to the baby in the womb so that it will reduce the likelihood of low birth weight and premature delivery among pregnant women.”
Again, the nutritionist is pleased that folic and iron acids save the lives of mothers during delivery while noting that many of the births associated with delivery are linked to anaemia, inadequate blood and so forth.
He cautioned succinctly, “The folic component is to reduce some contingent abnormality in children, particularly neural tube defects which the child may suffer from inside the womb and delivery. Pregnancy outcome is hanging on the nutrition status of the mother.”
Impacts of Malnutrition from Statistics
In his illustration, the NAN president narrated how in 2016, anaemia prevalence in Nigeria hit 68.3 per cent in children under-five, 48.8 per cent in non-pregnant women aged 15 to 49 years of age, and 57.8 per cent in pregnant women aged 15 to 49 years of age, respectively.
“At least, a third of the anaemia is attributable to iron deficiency; about 42 per cent of children six to 59 months are vitamin A deficient; while an estimated 21 per cent of Nigeria’s population is at the risk of inadequate zinc intake,” says the professor.
Making a case for food fortification, the expert quoted findings from a recent systematic review and meta-analysis that showed that large-scale food fortification reduced anaemia by 34 per cent, reduced goitre by 74 per cent and reduced neural tube defects by 41 per cent.
The NDHS report also showed that 44.1 per cent of children under-5 are stunted in Nigeria — too short for their age — a decrease from 46.0 per cent in 2018.
Also, stunting is a sign of chronic malnutrition that can have long-term consequences for health and development. Afolabi warned. At the same time, nothing less than 20.3 per cent of children under-five are wasted in Nigeria, meaning they are too thin for their height – an increase from 19.9 per cent in 2018. “Wasting is a sign of acute malnutrition and can be a life-threatening condition,” says the NAN president.
Call to the Federal Government
To foster a healthy nutrition level that would salvage the nation’s economy from depression, legislators have recommended that the government develop a policy by providing a meal a day for their workers in the workplace.
It was for the cause of nutrition that the Executive Director of CISLAC, Auwal Ibrahim Musa, chorused the ideas of the previous speakers. “As you know, Nigeria is facing a serious nutrition crisis. Millions of Nigerians are malnourished, and many more are overweight or obese. It has a devastating impact on health, productivity, and economic development. We must raise awareness of the importance of food fortification and workforce nutrition.”
Unanimously, these legislators, nutritionists and critical stakeholders shared the same thoughts on the need to design and implement the right policies on food fortification and total overhauling of the nation’s existing food fortification policy and laws. This way, they are confident of a positive impact on the well-being and productivity of the workforce, thereby rebuilding the future of Nigeria.
CAPTION L-R: Assistant Chief Regulatory Officer (NAFDAC), Ms. Chukwu Sylvia Ifeoma; Executive Director, Civil Society Legislative Advocacy Centre (CISLAC), Auwal Musa Rafsanjani; Chairman, Senate Committee on Health, Senator Ibrahim Oloriegbe; M&E Manager (CISLAC), Mrs. Lovelyn Agbor-Gabriel; and Assistant Director, Standard Organisation of Nigeria (SON), Mr. Moshood Adebayo Shittu during a Media Roundtable on Promoting Food Fortification Compliance and Workforce Nutrition in Nigeria organised by CISLAC in collaboration with NESG and e-Health Africa in Lagos
