CHAPTER ONE


  • Background to the Study

Breastfeeding is the act of milk transference from mother to baby that is needed for the survival and healthy growth of the baby into an adult (United Nations Children’s Fund (UNICEF), 2009; Heckman, 2011). Breastfeeding provide infant with essential calories and nutrients to nourish the baby (National Institute of Child Health & Human Development, 2009).According to the American Academy of Pediatrics  (AAP) policy Statement on Breastfeeding, women who do not have health problems should exclusively breastfeed their infants for at least the first six months of life (AAP,2012).  The importance of appropriate infant feeding and the vital role played by breastfeeding in child survival, growth and development cannot be over-emphasized (AAP, 2012). The World Health Organization (WHO) has recommended two years breastfeeding; first sixmonths exclusive breastfeeding; more than eight times breastfeeding per day in the first three months of an infant’s life. The AAP suggested that a woman should try to breastfeed her infant for the first twelve months of life.

Despite the documented value of exclusive breastfeeding during the first months of a child’s life and struggles for promoting this practice, rates for exclusive breastfeeding in Nigeria are below those recommended by the World Health Organization (WHO), which advocates exclusive breastfeeding during the first six months of baby’s life. Breastfeeding a baby exclusively for the first six months and then continued breastfeeding in addition to appropriate solid foods until twelve months and beyond has health benefits  for both mother and the child and these include;  reduction of the risk of mothers from developing gestational diabetes, osteoporosis, and breast cancer. It can also assist the women to lose weight after delivery, and also help the uterus of the women to return fast to pre-pregnant state. Advantages to the babies may also include: reduced risk of development of gastro intestinal illness, allergies, asthma, diabetes, obesity, some childhood cancer, respiratory infections and diarrhoea.

Based on the WHO Global data on infant and young Child Feeding in Nigeria, 22.3% of children were exclusively breastfed for less than 4 months, while 17.2% were exclusively breastfed for less than 6 months, in the year 2003. According to the Nigerian Demographic and Health Survey (NDHS), in 2008 17% of children were exclusively breastfed for less than 4 months, while 13% were exclusively breastfed for less than 6 months. The median exclusive breastfeeding period in Southwest Nigeria by months in the year 2003 was 7 months. In the year 2008, it was 6 months. Within the same period, early initiation of breastfeeding among women in the region was 12.7% in 2003, but increased to 35.5% in the year 2008. All these figures are far below the 90% level recommended by the WHO. Child mortality therefore remains high in low and middle-income countries. Nigeria has the highest under-five rural mortality rate of 242.7 per 1,000 among selected sub-Saharan Africa countries. (NDHS, 2008; NPC, 2009; WHO, 2010)

The technique used in breastfeeding, especially mother-infant positioning and attachment or suckling by the infant, has been shown to be important for the effective transfer of milk from the breast to the child as well as for preventing nipple damage. Heckman (2011) evaluated mother-infant pairs in a maternity ward and observed that only 2% of pairs achieved optimal latch performance (chin touches the breast, mouth opens wide, lower lip flared outward ,moderate lip tension, and infant grasps the areola), and only 0.2% achieved optimal mother-infant positioning (mother in a comfortable position, C-hold of the breast [leaving the areola free and making gentle compression of the breast tissue between the thumb and fingers]. infant’s head and body aligned facing the mother and in close contact with the mother’s body, infant’s arm not between the mother and infant, infant’s head and neck supported, infant’s mouth facing the nipple, and infants nose free for breathing).