When Mrs. Bukola Ajao, an accounts officer, started bringing her four-month old baby to her work place, it seemed like a convenient compromise, until he developed cold, cough and catarrh barely two weeks after.
“Every night afterwards, he would cry due to the stress of taking him out early every morning,” she recollected. After that episode, she immediately stopped taking him to the office.
Although she had not planned to, Mrs. Ajao’s hectic work schedules had forced her into this arrangement because she wanted to be able to continue the recommended six-month period of exclusive breastfeeding for her baby, as her doctor had advised. So whenever she could not breastfeed her baby she used baby, formula.
“I breastfeed him in the morning before I leave home and at night when I return from work. I also make sure he is exclusively breast fed during the weekends. Although I would have loved to do it all the time, I can’t because I am a working and nursing mother. When you know the kind of situation you are faced with, you have to find another way out,” she explained.
Like Mrs. Ajao, many working and nursing mothers in Nigeria are facing this situation of compromise when it comes to exclusive breastfeeding for their babies because of their busy work schedules and the stress that comes with it.
While the use of baby formula seem like a convenient way out, it is not advisable, said Dr. Sunday Olanrewaju, a gynecologist, who noted that exclusive breast feeding meant breast feeding babies from birth to the first six months of life without adding any supplements or other food. According to the World Health Organisation, exclusive breastfeeding is recommended up to six months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond. “Colostrum, the yellowish, sticky breast milk produced at the end of pregnancy, is the perfect food for the new-born, and feeding should be initiated within the first hour after birth,” it stated.
Dr. Olanrewaju agreed and added that not only is breastfeeding essential for a baby’s growth, it is also very good for the baby’s brain development, especially in the second year. “Breast milk is a natural source of food for the baby and it is important for the baby’s growth and development because it contains cells and antibodies that prevent infections.”
He further explained that breastfeeding is beneficial because it helps the mother and her baby to bond well. “It also helps the mother to lose excess weight gained during pregnancy. It is also good for the economy of the family as it saves them a lot of money used in buying baby formula,” he said, adding that a family could spend up to N100,000 or more buying baby formula in a year. Some mothers spend between N3,000 and N6,000 or more monthly, depending on the brand of baby formula. This amount increases as the baby grows.
This is where the breast pump, a device used to extract milk from the breast of a lactating woman, comes to the rescue. Working and nursing mothers use it to ‘express’ their breast milk into a bottle that can be used for storage and feeding. It should be stored in the refrigerator at a temperature between four and ten degrees Celsius, noted Dr. Olanrewaju. “Because it can be stored for up to six to eight hours at the right temperature, the baby can feed on this until the mother returns from work. Then, she can feed the baby directly from her breasts when she gets back home,” he said.
However, expressing breast milk comes with its own additional cost, like Mrs. Ajao found out when she first tried using the breast pump after she gave birth. “I had to stop because I couldn’t maintain preserving it in the refrigerator due to lack of electricity,” she complained. Expressed breast milk could go stale if it is not properly stored under the right temperature conditions, because just as with any other type of food, this allows the growth of bacteria, Olanrewaju explained.
Despite the country’s electricity problems, using breast pumps has been helpful for some others, especially when they can also afford the extra cost of fuelling their generators to keep the breast milk well refrigerated and fresh.
This was what helped Dayo Adekunle, a nursing mother who just finished her mandatory one-year National Youth Service Corp scheme, to breastfeed her now one-year old baby exclusively for the first six months before she introduced him to formula milk. Beyond using breast pumps, medical experts advise mothers to maintain good hygiene while breastfeeding their babies. These include washing their hands, sterilizing the bottles and pump parts and immediately storing their breast milk to keep it fresh.
Despite the challenges, working and nursing mothers face in keeping up with breastfeeding medical experts have advised that they at least maintain the recommended six months of exclusive breast feeding, because of its many health benefits. “No baby formula milk can compare with breast milk because it contains antibodies to protect the baby from infections. It has been scientifically proven that babies who are not exclusively breast fed have morbidities such as diarrhoea, upper respiratory tract infections, bacterial meningitis and other diseases. They are also prone to having more allergies,” said Dr. Dorka Bekee, a paediatrician.
Although it is not 100 per cent guaranteed, the period of breastfeeding could also serve as a form of family planning, added Dr Olanrewaju. “This is because breastfeeding increases the secretion of the prolactin hormone – which helps the breast to produce milk – and also inhibits ovulation. Some women don’t even see their menses during breast feeding,” he said.
While Dr. Bekee advised that nursing mothers should eat well to be able to produce enough milk for the baby, this may pose another challenge for a working and nursing mother as they may not be able to properly breastfeed their babies after a hectic day’s job, especially if they put in long working hours.
Although stress does not affect the quality of breast milk, it does affect the quantity, Dr. Olanrewaju noted. “In some developed countries, they now encourage mothers to exclusive breast feed by giving them extended holidays. So instead of three months, they are given up to six months. Even in some places, they also give the husband a leave period so that he can help the wife during this time. That’s why we encourage mothers to have proper relaxation and rest and take adequate nutrients for their benefit, as well as that of their babies,” he said, adding that with less stress, a working mother would be able to produce more milk to nourish the baby.
This is why Dr. Bekee suggested that organisations should create crèches for working and nursing mothers to help them meet this demand to feed their babies with breast milk; an arrangement that would certainly suit Mrs. Ajao who had to register her son in a nearby crèche.
“At least, this would give us (nursing mothers) peace and rest of mind, knowing that our babies are very close to where we work. And from time to time, one can then go and breast feed them,” she said. For her, she would prefer if organisations could give nursing mothers at least a four-month maternity leave, instead of the regular three.
For some who have been able to adhere to the six-month exclusive breastfeeding period, the rewards are enormous. “Breast milk is the best food for an infant. Although it could be very stressful sometimes, but you would be glad you did it. Because your baby would hardly fall ill, have a high intelligent quotient, sharp mind, and would be stronger than his peers,” said Mrs. Ese Chiadika, who breast fed her now one year old son exclusively for six months.
Despite the work schedules of nursing mothers, it is important that they find a way to ensure exclusive breastfeeding for their babies, Dr. Bekee advised. As she put it, breast milk is still superior to any formula milk, no matter how much the latter is modified.
Her point was buttressed by the American Academy of Pediatrics, which noted that human milk is uniquely superior for infant feeding and is species-specific; all substitute feeding options differ markedly from it. “Human milk is the preferred feeding for all infants, including premature and sick new-borns,” it stated.
Beyond exclusively breastfeeding, with no supplements, for the first six months of life, the AAP also advised that breastfeeding should continue for 12 months or longer if mutually desired, because, among many other significant factors, human milk contains at least one hundred ingredients not found in any artificial infant milk. In addition, it stated that current research indicated that adults who were breastfed as infants have a decreased risk of developing diabetes, heart disease and obesity, as well as multiple sclerosis and breast cancer.