Nigeria’s Breastfeeding Crisis: How Culture, Work & Weak Policies Are Denying Millions Of Babies Their ‘First Vaccine’
By DIANA CHUKWUKA
A Child-Survival Intervention Being Lost
FOR millions of Nigerian newborns, one of the earliest opportunities to build protection against disease is being lost—not because breastmilk is unavailable, but because the conditions surrounding mothers make exclusive breastfeeding difficult to sustain.
Health experts, UNICEF and the World Health Organisation have raised concerns over Nigeria’s persistently low breastfeeding indicators, with only about three in 10 Nigerian babies reportedly exclusively breastfed during their first six months of life.
Only about one in three newborns is reportedly put to the breast within the first hour after birth.
The implications extend beyond infant feeding.
Health specialists describe colostrum—the nutrient-rich first milk produced after childbirth—as a baby’s first line of immune protection. The wider evidence on breastfeeding also links optimal breastfeeding with lower risks of childhood infections, healthier development and important long-term health benefits.
Yet Nigeria’s breastfeeding challenge is increasingly being framed as a failure of mothers when the factors influencing feeding decisions extend far beyond the mother herself.
The “First Vaccine” That Many Babies Miss
UNICEF’s Chief of Field Office in Lagos, Celine Lafoucriere, said breastmilk provides babies with critical protection against disease and supports healthy brain development.
But she stressed that mothers cannot win the breastfeeding battle alone.
Families, employers, health workers and governments, she argued, must create conditions that allow mothers to breastfeed successfully from the moment a child is born.
Dr. Paul Ikhurionan, a Consultant Developmental Paediatrician and Paediatric Neurologist at the University of Benin Teaching Hospital and the University of Benin, similarly described millions of Nigerian infants as being denied what could be regarded as their first vaccine.
He drew particular attention to the first hour after birth, when colostrum provides newborns with antibodies and other immune factors.
Missing that early opportunity is part of a wider problem: many infants do not receive exclusive breastfeeding for the recommended first six months.
Why Mothers Stop
The reasons are neither simple nor exclusively medical.
Ikhurionan identified poverty, cultural beliefs, aggressive marketing of breastmilk substitutes, inadequate family support and inconsistent counselling as major barriers.
For mothers working in the informal economy, the challenge can be even more severe.
Many return to work shortly after childbirth because they cannot afford to remain at home without income.
Paid maternity leave may be unavailable, while workplaces may have no private breastfeeding areas, childcare facilities or arrangements that allow mothers to express or feed breastmilk during working hours.
In such circumstances, the recommendation to breastfeed exclusively for six months can become difficult to reconcile with the economic realities of daily survival.
When Culture Overrides Medical Advice
Prof Beatrice Oganah-Ikujenyo, Professor of Home Economics (Nutrition) at Lagos State University of Education, identified cultural practices as another powerful influence on infant feeding.
She argued that deeply rooted beliefs that newborns need water or herbal mixtures can undermine exclusive breastfeeding.
The influence is particularly significant in extended-family settings, where older relatives may exercise considerable authority over childcare decisions.
According to Oganah-Ikujenyo, this can become especially pronounced during the traditional postnatal support period known as omugwo, when grandmothers and other relatives assist new mothers.
The problem, therefore, is not simply a lack of information.
A mother may know that exclusive breastfeeding is recommended and still find herself under pressure to introduce water, herbal preparations or other substances.
The Social Status of Formula
Another challenge is changing perceptions of formula feeding.
Oganah-Ikujenyo said formula is sometimes associated with wealth, modernity and social status, while breastfeeding can be unfairly perceived as old-fashioned.
Such perceptions can weaken mothers’ confidence and create pressure to substitute or supplement breastmilk unnecessarily.
The problem is compounded when commercial messaging competes with public-health education.
For health professionals, the challenge is therefore not merely to tell mothers what to do, but to ensure that families understand why exclusive breastfeeding matters and are not undermining the practice at home.
Grandmothers, Fathers & the Wider Family
Prof Wasiu Afolabi of the Nutrition Society of Nigeria emphasised that breastfeeding decisions are rarely made by mothers alone.
Fathers, mothers-in-law, grandparents and other relatives can exert substantial influence over infant feeding.
The persistence of the belief that newborns require water is one example.
If a mother receives one message from a health worker and another from relatives immediately after returning home, the effectiveness of professional counselling may be significantly weakened.
This is why health experts are calling for breastfeeding campaigns that deliberately include fathers, grandmothers, traditional leaders, religious leaders and other influential members of communities.
The Workplace Barrier
For working mothers, particularly those in low-income and informal employment, breastfeeding can become a race against economic necessity.
The recommendation that babies be exclusively breastfed for six months assumes that mothers have sufficient time, support and resources to maintain that practice.
But many women cannot simply stop working for six months.
Even where maternity leave exists, the duration and accessibility of leave vary, while many workers in informal employment have no formal maternity protection.
Experts therefore argue that breastfeeding policy must be connected to labour policy.
Six-month maternity leave, breastfeeding breaks, private spaces for expressing milk and workplace childcare facilities can turn breastfeeding recommendations from theoretical guidance into practical possibilities.
The Health Cost of Failure
The consequences of inadequate breastfeeding are not limited to feeding difficulties.
Ikhurionan warned that babies who are not exclusively breastfed face higher risks of diarrhoea, pneumonia, ear infections, malnutrition and hospitalisation.
Health experts also associate optimal breastfeeding with improved cognitive development and reduced risks of certain chronic conditions later in life.
Prof Afolabi similarly warned that inadequate breastfeeding can contribute to poor growth and weakened immunity while potentially affecting brain development, educational performance and productivity over the longer term.
These outcomes have economic consequences.
A child who becomes repeatedly ill places additional financial pressure on households and healthcare systems.
A population experiencing widespread childhood undernutrition can also carry the consequences into adulthood through poorer educational and economic outcomes.
Nigeria’s Wider Nutrition Problem
The breastfeeding crisis exists within a broader national nutrition challenge.
Nigeria has one of the world’s largest populations of children affected by stunting, with about 32 percent of under-five children reported to be stunted.
Experts argue that improving breastfeeding could form part of a wider strategy to address child malnutrition and prevent avoidable illness during the earliest and most vulnerable stage of life.
The significance is particularly important because breastfeeding is comparatively inexpensive when compared with many other health interventions.
The challenge is not primarily the absence of a naturally available food source.
It is creating the social, economic, institutional and cultural conditions necessary for mothers to use it effectively.
The Baby-Friendly Hospital Initiative
Health experts have called for stronger implementation of the Baby-Friendly Hospital Initiative, which promotes practices designed to support mothers and newborns from the moment of delivery.
The World Health Organisation and UNICEF have urged health facilities to follow evidence-based steps that encourage early initiation of breastfeeding, skin-to-skin contact, proper counselling and continued support.
But policies on paper are not enough.
Hospitals require trained personnel, adequate resources and systems capable of ensuring that breastfeeding support continues after delivery.
A mother who receives appropriate counselling in a hospital but returns to a community where family members discourage exclusive breastfeeding may still struggle to maintain the practice.
The Six-Month Policy Question
Several experts interviewed in the report called for six-month maternity leave as part of a broader strategy to reverse Nigeria’s breastfeeding crisis.
Such a policy would address one of the most obvious contradictions in current breastfeeding advocacy: asking mothers to breastfeed exclusively for six months while many are expected to resume economic activity much earlier.
But maternity leave alone would not solve the problem.
The policy would need to be accompanied by breastfeeding-friendly workplaces, childcare support, effective enforcement and protection for women in vulnerable employment arrangements.
From Maternal Responsibility to National Responsibility
Perhaps the most important shift required is conceptual.
Exclusive breastfeeding is often discussed as something mothers must achieve.
But the evidence presented by health experts points to a more complicated reality.
Mothers make breastfeeding decisions within families, workplaces, hospitals, communities and economies.
If a woman lacks maternity protection, receives contradictory advice from relatives, encounters inadequate counselling at a health facility and returns to a workplace without breastfeeding support, the outcome cannot reasonably be treated as an individual failure.
It is a systems failure.
The Cost of Doing Nothing
The World Health Organisation recommends exclusive breastfeeding for the first six months, followed by continued breastfeeding alongside appropriate complementary foods until two years of age or beyond.
Nigeria has had years of breastfeeding advocacy, the Baby-Friendly Hospital Initiative and repeated public-health campaigns.
Yet the country continues to struggle with low exclusive breastfeeding rates.
The next phase therefore requires more than another awareness campaign.
Government must adequately fund nutrition programmes, strengthen maternity protection and enforce relevant health and workplace standards.
Health facilities must provide consistent counselling.
Employers must create practical conditions for breastfeeding.
Families and community leaders must stop treating evidence-based infant feeding recommendations as incompatible with cultural traditions.
The central message from health experts is straightforward: mothers cannot carry the entire burden alone.
If breastmilk is truly a baby’s first vaccine, ensuring that babies receive it should be treated not merely as a mother’s responsibility but as a national child-survival priority.
