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Six Nigerian women aged from 22 to 56 years who had not recently been pregnant were successfully relactated by breast suckling alone. All of them produced enough milk to exclusively breastfeed 'motherless' infants. All except one child have continued to breastfeed up to the time of this report and show adequate growth.

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SummaryOBJECTIVE Neonatal tetanus (NNT) is the leading cause of neonatal deaths in developing countries. The objective of this study was to determine prognostic indicators in NNT. METHODS We reviewed the clinical records of all neonates (n ϭ 174) admitted to Ife State Hospital with the diagnosis of NNT from 1991 through 1995. RESULTS Delivery had occurred at home in 73.3% of cases. Only 37/164 of the mothers had had adequate immunization with tetanus toxoid. The umbilical cord appeared to be the portal of entry in 58.6% of cases. Mean age of infants at presentation was 7.2 days. Mortality was 57.5%; non-survivors succumbed after mean stay in the hospital of 5.0 days. Mortality was significantly associated with an incubation period of 6 days or less (P ϭ 0.0026), infant's weight of less than 2.5 kg (P ϭ 0.0113), lack of antenatal care in a health facility (P ϭ 0.0279), birth at home (P ϭ 0.0455), but not with lack of adequate maternal immunization (P = 0.2081; not significant). Multivariable analysis showed that a short (р 6 d) incubation period was the strongest predictor of mortality (OR ϭ 3.11, P ϭ 0.0030) while low infant weight (Ͻ 2.5 kg) was also a significant predictor (OR ϭ 2.46, P ϭ 0.0408). CONCLUSIONS Hygienic deliveries and adequate cord care are very important for the prevention of neonatal tetanus deaths, and universal prenatal care, including education programmes on appropriate perinatal and cord care, can significantly reduce NNT incidence and mortality in developing countries.

Breastfeeding is an important child survival strategy. This report aims to describe the unique contributions of education, ethnicity, and other variables to breastfeeding outcomes. The study was conducted among two groups of lactating mothers in Ile Ife, southwestern Nigeria, using structured questionnaires focusing on their breastfeeding history and current practice. Breastfeeding initiation was delayed in both groups, and primary education is the most significant predictor of initiation of breastfeeding within 6 hours of delivery (OR = 3.92, p = 0.0117). Breastfeeding duration (SD) was 13.7 (4.3) months for the Yorubas and 17.5 (3.4) for the Hausas. Its only significant predictors are education (p < = 0.0001), with an average decrease in breastfeeding duration of 3.2 and 6.6 months with mother's education to the primary and post-primary levels respectively, compared with mothers with no education. In turn, breastfeeding duration is the most significant predictor of the duration of lactational amenorrhoea (p = 0.0000). Mothers with some formal education are also more likely to start feeding human milk substitutes at 2 weeks (OR = 3.83, p = 0.024). The most important variable determining breastfeeding in this study is education. The educated mother is more likely to be involved in economic activity away from the home. To protect breastfeeding in these communities, there is a need for programmes to support the breastfeeding mother who works.