Exclusive breastfeeding is undermined by use of other liquids in rural southwestern Nigeria

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.