Exclusive Breastfeeding is Undermined by Use of Other Liquids in Rural Southwestern Nigeria

Abstract

Exclusive breastfeeding (EBF) requires that the child be started on breastmilk on the first day of life and to continue with breastmilk alone for the next 4-6 months. EBF is compromised even when water is given to a child. This study surveyed the breastfeeding practices and opinions of 411 mothers of children aged 4-28 months in the rural community of Igbo-Ora in southwestern Nigeria. While all children were given breastmilk throughout that period, all received plain water during the first week of life. Herbal tea was given to nearly half (47 per cent) during their first week, and by the fourth month 97 per cent had taken herbs. Glucose water was commonly given during the first week (72 per cent). In-depth interviews with health workers confirmed that they gave advice to use glucose water for newborns. Only 45 (11 per cent) of women practised what could be termed predominantly breastfeeding (PBF), i.e. giving only plain water and/or herbal tea in the first 4 months. These were primarily women with some education and in skilled occupations. Mothers believed that breastmilk alone would not satisfy their children and would be physically draining on themselves because the current economic hard times did not allow them to eat as they wished. The results imply a need for health education that starts with the health workers themselves and addresses the cultural context of the mothers' fears about EBF.

Effects of early extra fluid and food intake on breast milk consumption and infant nutritional status at 5 months of age in an urban and a rural area of Burkina Faso

“…In addition, Sachdev et al (1991) and Nwankwo and Brieger (2002) reported that health workers advised mothers to give water or glucose water to new-borns. Such beliefs and advice were contrary to WHO and UNICEF recommendations.…”

Prevalence of iron deficiency anaemia and dietary iron intake among infants aged six to nine months in Keiyo south Sub County, Kenya

“…A few mothers had stopped breastfeeding probably because they had a lactation failure, not enough milk, engorged breasts, sore nipples, sickness and a busy employment schedule which involved traveling [21]. Such possibilities have been proven from studies in Nigeria where complementary foods are introduced due to perceived lactation inefficiency [21,22]. However, mothers in developing countries introduce complementary feeding for many reasons.…”

“…However, mothers in developing countries introduce complementary feeding for many reasons. In Nigeria few infants are exclusively breastfed but instead they are given alternative feeds like water, formula and herbal tea from an early age [21]. In a Malawian study, only 19% of the infants in a cohort of 720 were exclusively breastfed for the first six months in their first year of life [22].…”

“…Exclusive breastfeeding is considered 'risky', hence supplementary water herbal infusions are believed to enhance growth, quench thirst, and serve as food and medicine [23]. In addition, it is a mother's perception that breastfeeding is 'physically draining' especially when lactating mothers find limited access to nutritious and adequate amount of food for themselves [21]. Some of the Indian communities believe infants need additional fluids to maintain body-water balance [24], while in Honduras solid foods are introduced early in order to extend the time between feeds and because mothers believe breast feeding to be time demanding [25].…”

Body composition changes among lactating mothers In Abia State, Nigeria

“…This decline was attributed to several factors. One of this was that mothers had the perception that exclusive breastfeeding was 'physically draining' on them (Nwankwo and Brieger, 2002;Naanyu, 2010). The energy cost of lactation is generally considered to represent a substantial drain on maternal nutritional metabolism (Lunn, 1996).…”