Poor complementary feeding practices fuelling under-five malnutrition in Nigeria –Nutritionist

Angela Onwuzoo 

A Professor of Public Health Nutrition at the Obafemi Awolowo University, Ile-Ife, Osun State, Beatrice Ogunba, says poor complementary feeding practices are contributing significantly to the high prevalence of malnutrition in children under five years in Nigeria.

Prof. Ogunba urged mothers not to joke with the nutrition of their babies, especially after six months of exclusive breastfeeding, warning that malnutrition usually sets in during the complementary feeding period for many infants.

Speaking in an interview with PUNCH HealthWise, the nutrition expert said complementary feeding is needed to provide energy and essential nutrients required for the continued growth and development of babies.

The nutrients in recommended complementary foods, she noted, complement those in breast milk, hence the name.

Complementary feeding, Prof. Ogunba says is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk.

According to the World Health Organisation, after six months of age, it becomes increasingly difficult for breastfed infants to meet their nutrient needs from human milk alone, and therefore most infants are developmentally ready for other foods at about six months.

Also, according to UNICEF, optimal feeding practices are fundamental to a child’s survival, growth, and development. The UN agency, however, noted that too few children benefit.

The nutritionist says mothers should avoid giving their babies unhealthy foods, warning that they could expose them to the risk of malnutrition during complementary feeding.

According to her, there is a list of foods that mothers should avoid giving to their babies during complementary feeding which she said have been classified by the WHO and UNICEF as unhealthy for consumption for their age.  

Giving insight into how babies should be fed after six months of exclusive breastfeeding,  Prof. Ogunba said, “Children between ages of six to eight months must have at least the two to three minimum feeding of complementary foods while ages nine to 24 months must have at least four meals with additional healthy snacks.

“Children must eat from groups of food such as grains, roots, tubers and plantains, pulses (beans, peas, lentils), nuts and seeds, dairy products (milk, infant formula, yogurt, cheese, flesh foods (meat, fish, poultry, organ meats, eggs), Vitamin-A rich fruits and vegetables, other fruits and vegetables and breast milk.

“Minimum of two milk feeding for non-breastfed babies(200-500ml per day) was recommended.”

The nutritionist noted that what, when, and how young children are fed during the first two years of life lay the foundation for survival, growth, and development. 

Continuing she said, “Thirty-seven per cent of children in Nigeria are stunted (below -2 SD), and 19 per cent are severely stunted (below -3 SD) (Nigeria Demographic and Health Survey, 2018).

“In Nigeria, 22 pe rcent of children are given complementary foods in addition to breast milk before six months and consequently Nigeria has the highest number of stunted children under the age of five in sub-Saharan Africa and second highest in the world after India (Global Nutrition Report 2018).”

She identified the absence of breastfeeding, early and late introduction of solid, semi-solid and soft food as some of the characteristics of inappropriate complementary feeding.

In a 2020 Article published in the Journal of Dieticians Association of Nigeria, titled, “Malnutrition and feeding practices among under-five children in rural communities of Federal Capital Territory Abuja, Nigeria,” the dieticians said poor dietary practices and malnutrition among under-five children in Nigeria have remained great public health concern.

They acknowledged that there is a high prevalence of malnutrition and poor infant and young child practice in the country.

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