A Systematic Review of Breastfeeding Practices and Their Impact on Infant Immunity Development in Nigeria
Chapter One
OBJECTIVE OF THE STUDY
The objective of this study is to systematically review existing literature on breastfeeding practices in Nigeria and examine their impact on the development of immunity in infants.
Specific Objectives
- To identify and analyze the prevalent breastfeeding practices among Nigerian mothers
- To evaluate the relationship between breastfeeding practices and infant immune development
- To examine socio-cultural, economic, and healthcare-related factors influencing breastfeeding practices across different regions and demographics in Nigeria.
- To assess the effectiveness of national policies, programs, and health system interventions
CHAPTER TWO
REVIEW OF RELATED LITERATURE
Breastfeeding
Breastfeeding is a fundamental and natural method of nourishing infants and young children, providing essential nutrients and immunological protection required for healthy growth and development. The World Health Organization (WHO, 2023) defines breastfeeding as the process of feeding a baby with milk directly from the motherโs breast, ideally initiated within the first hour of life. Breastfeeding plays a dual roleโoffering complete nutritional needs and bolstering the infant’s immune system, particularly during the critical early months of life.
Exclusive breastfeeding (EBF), which involves feeding the infant only breast milk without any supplementary liquids or solids (except for oral rehydration solutions, drops, or syrups of vitamins and medicines), is recommended for the first six months of life. Following this period, appropriate complementary foods should be introduced while continuing breastfeeding up to two years or beyond (UNICEF, 2022).
Breast milk contains a unique blend of nutrients, including proteins, fats, carbohydrates, vitamins, and minerals, tailored to meet an infantโs developmental needs. More importantly, it includes immunological components such as secretory immunoglobulin A (sIgA), lactoferrin, lysozyme, cytokines, and human milk oligosaccharides (HMOs), which play a significant role in enhancing the infant’s immune system (Ballard & Morrow, 2023).
In Nigeria, breastfeeding remains a culturally rooted and widely accepted practice. However, the actual practice varies widely due to factors such as maternal education, socio-economic status, healthcare access, and traditional beliefs. According to the Nigeria Demographic and Health Survey (NDHS, 2018), while breastfeeding is nearly universal, only 29% of infants under six months are exclusively breastfedโwell below the WHO global target of 50%. This low rate of exclusive breastfeeding poses significant challenges to infant health and immunity, especially in regions like Uyo, where traditional prelacteal feeding and early cessation of breastfeeding persist (Udo et al., 2022).
Breastfeeding is not only beneficial for the infant but also for the mother. It aids in uterine contraction post-delivery, reduces postpartum bleeding, and lowers the risk of breast and ovarian cancers (Victora et al., 2016).
CHAPTER THREE
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RESEARCH METHODOLOGY
This chapter presents the methodology adopted for conducting a systematic review on breastfeeding practices and their impact on infant immunity development in Nigeria. The process followed a rigorous and structured approach to identify, select, appraise, and synthesize relevant studies to address the research questions.
Research Design
This study employed a systematic review research design, which is appropriate for synthesizing existing evidence from multiple sources on a specific topic. A systematic review is a methodical and replicable process that ensures comprehensive coverage and minimizes selection and publication bias. It allows the researcher to collate, appraise, and interpret all relevant studies related to breastfeeding practices and their impact on infant immunity in Nigeria.
CHAPTER FOUR
DATA ANALYSIS AND RESULTS
This chapter presents the analysis and synthesis of findings from the selected studies based on the systematic review of breastfeeding practices and their impact on infant immunity development in Nigeria. The data were extracted, organized, and thematically analyzed to answer the following research questions:
What are the common breastfeeding practices (e.g., exclusive breastfeeding, early initiation, duration, and complementary feeding) among mothers in Nigeria?
How do breastfeeding practices influence the development of immunity in infants in Nigeria?
CHAPTER FIVE
DISCUSSION, CONCLUSION, AND RECOMMENDATIONS
ย Discussion of Findings
This study systematically reviewed existing literature on breastfeeding practices and their impact on infant immunity development in Nigeria. The discussion is structured around the two main research questions and supported by findings from the reviewed studies.
Common Breastfeeding Practices in Nigeria
The review revealed a growing awareness of breastfeeding practices in Nigeria, particularly exclusive breastfeeding (EBF) and early initiation. However, awareness does not always translate into practice. Many studies, such as those by Nwachukwu & Ezegwu (2019) and Yusuf et al. (2022), indicated a gap between knowledge and practice. For instance, although over 70% of mothers are aware of EBF, only a smaller proportion maintain EBF for the recommended six months due to socio-economic pressures, maternal employment, or cultural beliefs.
Early initiation of breastfeeding, though encouraged by health institutions, is often delayed in rural settings due to traditional practices and myths around colostrum. This delay prevents the infant from receiving critical antibodies present in the colostrum. The prevalence of pre-lacteal feeding and early introduction of complementary foods before six months was also noted, particularly in communities where there is limited access to professional healthcare advice.
Influence of Breastfeeding Practices on Infant Immunity
The review consistently found that breastfeedingโespecially exclusive breastfeeding plays a critical role in the development of passive and active immunity in infants. As noted by Eze & Uche (2017), exclusive breastfeeding reduces incidences of infections such as diarrhea, pneumonia, and otitis media.
Early initiation of breastfeeding provides infants with colostrum, which is rich in immunoglobulin A (IgA) and other immune-boosting factors. Studies such as Okon & Bello (2021) confirmed that infants who received colostrum were less prone to neonatal sepsis.
Furthermore, breastfeeding enhances the effectiveness of vaccines. For example, Adamu et al. (2020) observed that infants who were exclusively breastfed showed stronger responses to BCG, polio, and hepatitis B vaccines. This immune-boosting effect underscores the biological value of breast milk in priming the immune system.
Additionally, infants with extended breastfeeding durations demonstrated improved nutritional status and immune competence, supporting the World Health Organizationโs (WHO) recommendation for breastfeeding up to two years or beyond.
Conclusion
This systematic review concludes that breastfeeding, particularly exclusive breastfeeding and early initiation, is vital for promoting infant immunity in Nigeria. Despite widespread knowledge of the benefits, there remains a significant gap in practice due to cultural, social, and economic barriers. The reviewed studies highlight that breastfed infants are better protected against infections, respond better to vaccines, and show enhanced overall health outcomes.
Therefore, promoting optimal breastfeeding practices is essential not only for individual child health but also for reducing under-five morbidity and mortality rates in Nigeria.
Recommendations
Based on the findings of this review, the following recommendations are made:
Government and NGOs should intensify awareness campaigns, especially in rural areas, to correct cultural myths around colostrum and promote early initiation and exclusive breastfeeding.
Employers should be encouraged to provide extended maternity leave and breastfeeding breaks to support working mothers.
Continuous training of healthcare providers (especially in primary healthcare centers) on breastfeeding counseling is essential.
REFERENCES
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