Hurdles On Path To Breast Milk Banking, Packaging
The number of malnourished children in Nigeria is on the high side. Incidentally, a Ministry of Health report, last year, disclosed that Nigeria has been ranked second, after India, in the list of countries with the highest cases of malnourished children in the world. It accounts for 10 per cent of the 160 million stunted children globally. And there are huge consequences for this in the future, not just for the child but also for the society.
Studies have also showed that breast milk is a critical tool in tackling malnutrition in children especially infants. The Center for Disease Control and Prevention, Atlanta, Georgia disclosed that breast milk is widely acknowledged as the most complete form of nutrition for infants, with a range of benefits for infants’ health, growth, immunity and development.
This implies that, if there is increased access to breast milk for infants, it would check the number of malnourished children.
Mrs. Funsho Owasanoye agreed that better access to breast milk would not only reduce, but eradicate malnutrition in children under five because nutrients in breast milk boost the immunity of children.
Relating a personal experience, she said, “My second daughter refused baby milk formula entirely. I even went to buy a bottled food; she would spit it out until she was almost going to two years. I had to run to sleep in another room for her to leave me.
For working mothers in full employment and have babies to nurse, the issue of appropriate breast-feeding poses challenge. Many of the nursing mothers in this category have little time for their babies, let alone breastfeeding these babies appropriately.
For fear of have sagging breast, many young nursing mothers are said to be not willing to breastfeed their babies adequately.
With these challenges among others that are slowing down the rate of breastfeeding with the attendant negative consequences, will breast milk bank or commercialised breast milk be the way out for infants to enjoy the appropriate breast milk required for growth?
The idea of having a breask milk bank is not popular yet in this clime. But how acceptable will it be for nursing mothers to purchase ‘strange’ breast milk from some bank for their children?
For it to make an impact, Owasanoye suggested seeking the people’s acceptance of the idea then the breast milk should be screened before banking.
“People would be scared since they do not know the source of the breast milk, not wanting anything negative to happen to their baby.
To increase the breast milk babies enjoy, she advised having a crèche within the workplace, so that mothers could easily breastfeed their children during breaks.
“It makes mothers even more productive, as they would concentrate better.”
Managing Director, Bask Nutrition & Herbs Limited, Dr. Patience Ikeme Ogbuli, was also of the view that access to more mothers’ breast milk will definitely benefit the infant.
“Subsequently, adequate milk secretion from a well nourished mother will continue to sustain the infant.”
According to Kidshealth.org, breast milk could be stored for up to a year depending on what was used in preserving it. For instance, breast milk could be kept in a freezer for between six and 12 months, while it could kept for between six and eight hours in a room temperature.
Ogbuli noted that commercialisation of breast milk is not an easy venture, otherwise, it would have been in abundance in developed countries.
On the way out of the challenge of adequate breast milk, she said that it is cheaper and safer to focus on providing adequate healthcare and sound nutrition for the mother, pre- and post natal, with subsequent rich infant formulae for babies six months and above than embarking on the commercialisation of breast milk.
In preparing for the commercialisation of breast milk or breast milk bank in Nigeria, she said there should be uninterrupted electricity supply, well-equipped laboratories and adequately trained personnel.
A professor of Paediatrics, College of Medicine, University of Lagos, and Head, Neonatology-Perinatology Unit, Department of Paediatrics, Lagos University Teaching Hospital, Mrs. Veronica Chinyere Ezeaka noted that nutrition remains the bedrock of maternal, newborn and child health, and Nigeria has one of the lowest exclusive breast feeding rates in the world.
“Breastfeeding remains an investment in a healthy future. However, early and exclusive breastfeeding remains a major challenge in Nigeria,” Ezeaka noted.
According to her, while breast milk remains the best food for babies, because it is the best way to provide newborns with all the nutrients they need, commercialisation of breast milk has globally generated medical, social, psychological, legal and ethical issues.
“Whereas the major advantage is the fact that the babies will be receiving albeit, processed breast milk, many disadvantages have been noted with commercial breast milk, which is even an advancement over breast milk banking.
“Currently Nigeria does not have a breast milk bank, let alone talking of issues around commercialisation. In the whole of Africa now, it is only South Africa (Cape Town only) and Cape Verde that have breast milk bank facilities.
Buttressing her argument on the importance of breast milk, she alluded to a joint statement by WHO and UNICEF: “Where it is not possible for the biological mother to breast feed, the first alternative, if available, should be the use of human milk from other sources. Human milk banks should be made available in appropriate situations.”
To Ezeaka, setting up of a breast milk bank would require a very huge programme that is capital intensive, in addition to rigorous screenings, sterilisation and pasteurisation processes that must be carried out.
“Many countries including Nigeria cannot afford to go into it now in view of all the infection transfers and the preservation processes involved. We have to screen for bacteria, viruses including HIV, hepatitis, fungi among others. We currently do not have stable electricity for the processing and storage.
“Furthermore, hygiene will be a very major issue. Currently, infections are one of the commonest causes of morbidity and mortality in our newborns and infants, which will be significantly escalated if breast milk banking is inappropriately instituted.
“Beyond breast milk banking, which is usually instituted in huge hospital facility and have networks to other companies, commercialisation of breast milk is being established in very few of the countries that already have good network of breast milk banks. However, the commercialisation is by pharmaceutical companies and not hospitals.
“Presently, there are only two companies into commercialisation of breast milk in the United States of America; Prolacta and Medolac.”
In her view, breast milk banking or its commercialisation are still for the future in Nigeria, as the country does not have the appropriate prerequisites to go into the project, as it could result in calamities of epidemics and deaths if not well thought out.
“We are yet to have regular uninterrupted potable water in institutions for hand washing and sterilization and processing of the milk banks, uninterrupted electric supply is a must.
“Then, all the attendant high technology equipment needed for DNA analysis, and monitoring, diagnosing, sterilising and pasteurising of the breast milk. Also, strictly ensuring that this process is not in any way interrupted as the breast milk is obtained from the donors, to the processing facilities to the end users is essential.
“However, Nigeria, as an economic giant of Africa, should be working towards instituting a breast milk bank in the country for the teeming population of its preterm babies and vulnerable infants.
She called for increased awareness in the area of early and exclusive breastfeeding because the country’s 17 per cent national figure is dismally below the world average of 35 per cent with countries like Ghana having exclusive breastfeeding rates of about 63 per cent.
“A lot of mass enlightenment programmes should be instituted towards the acceptance, early initiation, and sustenance of exclusive breast feeding in Nigeria, from birth to six months. Until these are attained, newborn and infant morbidity and mortality reduction will not be attainable in Nigeria in the nearest future.”
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