 |
| Exclusive breastfeeding gives babies breast milk alone during their first six months, except for medically indicated medicines or supplements. |
Breastfeeding is one of the most important ways to support a baby’s nutrition, growth and early development. However, for many mothers, it is not always as simple as placing a baby at the breast.
Pain, concerns about milk supply, recovery after a Caesarean delivery, pressure from relatives, returning to work and conflicting advice can make breastfeeding difficult. Some mothers may also feel guilty or inadequate when feeding does not go as expected.
The truth is that breastfeeding is natural, but it is also a skill that mothers and babies often learn together. Timely information, practical assistance and support from families, healthcare workers and employers can make a major difference.
This guide explains what exclusive breastfeeding means, why it is recommended for the first six months, the challenges mothers commonly face and practical steps that can help.
What Is Exclusive Breastfeeding?
Exclusive breastfeeding means giving a baby only breast milk for the first six months of life.
The baby should not receive:
Water
Infant formula
Pap or cereal
Herbal mixtures
Glucose water
Juice
Other foods or drinks
Medicines, oral rehydration solution, vitamins and mineral supplements may be given when medically necessary and recommended by a qualified healthcare professional.
Even in hot weather, a healthy baby who is exclusively breastfed generally does not need additional water. Breast milk already contains the water and nutrients needed during the first six months.
The World Health Organization and UNICEF recommend that breastfeeding begin within the first hour after birth and that babies receive only breast milk for their first six months. At six months, safe and nutritious complementary foods should be introduced while breastfeeding continues up to two years or beyond.
Why Exclusive Breastfeeding Matters in Nigeria
Breastfeeding is widely practised in Nigeria, but exclusive breastfeeding remains less common than recommended.
UNICEF reported from the 2023–2024 Nigeria Demographic and Health Survey that approximately 29 per cent of Nigerian babies under six months were exclusively breastfed.
Several challenges contribute to this low rate, including:
Inadequate maternity leave
Limited breastfeeding support at work
Poor access to skilled breastfeeding counselling
Pressure from relatives to introduce water or pap
Misconceptions about milk supply
Separation of mothers and babies after delivery
Financial and social pressures on working mothers
Improving breastfeeding outcomes requires more than advising mothers to breastfeed. It also requires functional maternal and newborn health services, respectful healthcare, skilled birth attendance and early postnatal support.
These wider health-system issues are closely connected to efforts to reduce maternal mortality in Nigeria.
Some families introduce water because they believe breast milk cannot satisfy a baby’s thirst. Others introduce pap or formula because frequent feeding is interpreted as evidence that the mother’s milk is insufficient.
However, frequent feeding is normal for newborns. It helps stimulate milk production and does not automatically mean that the mother is producing too little milk.
Benefits of Exclusive Breastfeeding for Babies
1. It provides suitable early nutrition
Breast milk contains water, carbohydrates, protein, fat, vitamins and minerals needed for a baby’s growth and development.
Its composition changes as the baby grows. The milk produced immediately after delivery, known as colostrum, is usually thick and yellowish and contains concentrated nutrients and protective components.
Colostrum should not be discarded. It is the baby’s valuable first food.
2. It helps protect against infections
Breast milk contains antibodies and other protective substances that support a baby’s developing immune system.
Breastfeeding is associated with a lower risk of several childhood illnesses, including some respiratory and gastrointestinal infections.
Early breastfeeding also allows the baby to receive colostrum, which provides important protection during the first days of life.
3. It supports healthy growth and development
The first six months are a period of rapid physical and neurological development.
Breast milk provides nutrients required for growth during this period. Exclusive breastfeeding is therefore recommended as an important part of protecting infant health and development.
4. It is generally easy to digest
Breast milk is generally easier for babies to digest than many substitutes.
Breastfed babies may feed frequently because breast milk is digested relatively quickly and because newborn babies have small stomachs.
Frequent feeding should not immediately be interpreted as evidence that the baby is not receiving enough milk.
5. It reduces exposure to unsafe water
Breast milk is available without mixing or preparation.
This can reduce risks associated with:
Contaminated water
Unsterilised feeding bottles
Incorrectly mixed formula
Poor food storage
Unsafe feeding utensils
This benefit is especially important in places where access to clean water, reliable electricity or adequate sanitation may be limited.
6. It supports broader child-survival efforts
Breastfeeding is one part of a wider package of interventions needed to protect babies and young children.
Routine immunisation, growth monitoring, prompt treatment of illness, safe complementary feeding and access to primary healthcare remain essential.
Parents should therefore ensure that breastfeeding is combined with the vaccines and health services described in this guide to immunization coverage in Nigeria.
7. It may reduce certain long-term health risks
Research has associated breastfeeding with a reduced risk of some health conditions during childhood.
However, breastfeeding should not be presented as a guarantee that a child will never become ill. A child’s health is also influenced by genetics, immunisation, nutrition, housing, sanitation, healthcare access and the wider environment.
Benefits of Breastfeeding for Mothers
1. It supports recovery after childbirth
Breastfeeding stimulates the release of oxytocin.
Oxytocin helps the uterus contract after delivery and supports the body’s natural recovery process.
2. It may help reduce bleeding after delivery
The uterine contractions encouraged by early breastfeeding may assist in reducing bleeding during the period immediately after childbirth.
Heavy or persistent bleeding is not normal and requires urgent medical attention.
3. It may reduce the risk of some diseases
Breastfeeding has been associated with a lower maternal risk of breast and ovarian cancers.
The amount of protection varies and may be influenced by the total duration of breastfeeding and other personal health factors.
4. It can reduce household feeding costs
Breast milk does not require routine spending on infant formula, feeding bottles, fuel or repeated preparation.
However, breastfeeding should not be described as completely free.
Mothers still need:
Adequate food
Rest
Healthcare
Time away from work
Family support
Safe working conditions
Breast pumps or storage containers when necessary
5. It can support closeness between mother and baby
Breastfeeding creates repeated opportunities for skin-to-skin contact, eye contact and responsive interaction.
However, bonding is not limited to breastfeeding. Mothers who are unable to breastfeed can also develop strong and loving relationships with their babies through holding, talking, skin-to-skin contact and responsive feeding.
Starting Breastfeeding After Birth
Where the mother and baby are medically stable, skin-to-skin contact should begin as soon as possible after delivery.
The baby can be placed on the mother’s bare chest and given time to show feeding cues.
Early skin-to-skin contact can help:
Keep the baby warm
Calm the baby
Encourage early feeding
Support milk production
Strengthen contact between mother and baby
Early feeding cues include:
Moving the head from side to side
Opening the mouth
Bringing the hands towards the mouth
Making sucking movements
Becoming increasingly alert
Searching for the breast
Crying is usually a late hunger cue. A baby who is already crying intensely may find it more difficult to attach calmly to the breast.
Getting the Position and Latch Right
A good latch allows the baby to remove milk effectively and helps prevent nipple pain and damage.
During feeding:
The baby’s body should face the mother.
The baby’s head and body should be in a straight line.
The baby should be held close to the mother.
The baby’s mouth should open widely before attaching.
The baby’s chin should touch or come close to the breast.
The baby should take a large portion of the darker area around the nipple into the mouth.
Sucking should become slow and rhythmic after the first quick sucks.
The mother may hear or notice the baby swallowing.
Some pulling or tugging may be felt, but breastfeeding should not remain sharply painful throughout a feed.
Persistent pain, cracked nipples, clicking sounds, repeatedly slipping off the breast or very long ineffective feeds may indicate an attachment problem.
A nurse, midwife or trained breastfeeding counsellor should ideally observe a full feed rather than relying only on a verbal description.
Common Breastfeeding Challenges and What Can Help
1. Sore or Cracked Nipples
Some nipple tenderness may occur during the first few days, but severe or persistent pain should not be accepted as normal.
The most common cause is poor positioning or attachment. Other possible causes include:
Tongue-tie
Infection
Skin irritation
Incorrect breast-pump use
Removing the baby from the breast without breaking the suction
Practical steps include:
Ask a trained professional to observe the latch.
Break the suction gently before removing the baby.
Start the next feed on the less painful side where appropriate.
Avoid applying harsh soaps or antiseptics to the nipples.
Avoid vigorous nipple scrubbing.
Check that the breast-pump flange is the correct size.
Seek medical help if the nipples are cracked, bleeding or increasingly painful.
Correcting the cause is more helpful than applying creams while continuing with an ineffective latch.
2. Breast Engorgement
Engorgement occurs when the breasts become unusually full, hard, swollen and painful.
It may happen when milk production increases during the first few days or when milk is not removed frequently enough.
Helpful measures include:
Breastfeed frequently.
Check that the baby is attached properly.
Express a small amount of milk if the breast is too firm for the baby to latch.
Use brief warmth before feeding when it helps milk flow.
Use a cool compress after feeding for comfort.
Wear a supportive but not excessively tight bra.
Avoid repeatedly pumping large quantities unless medically necessary.
Excessive pumping may increase milk production further and make engorgement worse.
Seek medical advice if the breast becomes increasingly red, hot or painful or if fever develops.
3. Blocked Ducts and Mastitis
Mastitis is inflammation of the breast and may sometimes involve an infection.
Possible symptoms include:
Breast pain
Swelling
Redness
Warmth
Fever
Chills
Tiredness
Feeling generally unwell
Continuing to breastfeed or express milk is usually encouraged unless a healthcare professional advises otherwise.
Stopping suddenly may worsen milk accumulation.
Mastitis that is severe, worsening or not improving requires medical assessment. An untreated infection may occasionally progress to a breast abscess.
4. Flat or Inverted Nipples
Many mothers with flat or inverted nipples can breastfeed successfully because a baby attaches to the breast, not only to the nipple.
Skin-to-skin contact, careful positioning and assistance from a trained professional may improve attachment.
Nipple shields should generally be used with professional guidance because incorrect use may affect milk transfer.
5. The Baby Falls Asleep While Feeding
Some newborn babies are naturally sleepy, particularly during the first few days.
Premature babies, babies with jaundice and babies recovering from difficult deliveries may be sleepier than usual.
Helpful strategies include:
Offer feeds when early hunger cues appear.
Keep the baby skin-to-skin.
Gently rub the baby’s back, hands or feet.
Change the baby’s position.
Change the baby’s nappy.
Use gentle breast compression while feeding.
Ensure the baby is not wrapped too warmly during feeds.
Seek professional help if the baby is consistently difficult to wake, feeds weakly or produces too few wet nappies.
6. Cluster Feeding
Cluster feeding means that a baby wants to feed repeatedly over a period, often during the evening or during periods of rapid growth.
This behaviour is usually normal and helps stimulate milk production.
Cluster feeding does not, by itself, prove that breast milk is inadequate.
Is My Baby Getting Enough Breast Milk?
Breast fullness, the amount obtained during pumping and the length of a feed are not reliable measures on their own.
More useful indicators include:
Effective sucking and swallowing
The baby appearing satisfied after at least some feeds
An increasing number of wet nappies during the first days
Regular urine production once milk supply is established
Normal changes in stool colour during the newborn period
Steady growth after the initial normal weight loss
The baby being active and responsive when awake
Newborn babies normally lose some weight during their first few days.
They should still be monitored to ensure that the weight loss is not excessive and that they begin gaining weight appropriately.
Warning signs of inadequate intake may include:
Very few wet nappies
Persistent dark urine
Worsening jaundice
Continued dark stools beyond the expected period
Unusual sleepiness
Weak feeding
Poor weight gain
Dry mouth
Sunken eyes
Reduced activity
A baby with any of these signs should be assessed promptly by a qualified healthcare professional.
Low Milk Supply: Perception Versus True Low Supply
Many mothers worry that they are not producing enough milk.
In some cases, milk supply is genuinely low. In many others, normal newborn behaviour is mistaken for inadequate milk.
Behaviours that do not necessarily mean low milk supply include:
Feeding frequently
Cluster feeding
Breasts feeling softer after the first few weeks
The baby accepting milk from a bottle after breastfeeding
Producing only a small quantity during pumping
The baby wanting comfort at the breast
The baby waking frequently at night
Breast-milk production works largely through supply and demand.
The more effectively and frequently milk is removed, the stronger the signal for the body to continue producing milk.
To support milk production:
Feed responsively during the day and at night.
Improve the baby’s positioning and attachment.
Allow the baby to feed actively from the first breast before offering the second.
Avoid unnecessary long gaps between feeds.
Express milk when separated from the baby.
Eat regular balanced meals.
Drink according to thirst.
Rest whenever practical.
Ask relatives to assist with household responsibilities.
Obtain professional advice before using herbs, mixtures or medicines promoted as milk boosters.
No single food automatically produces abundant breast milk.
Pap, oats, soups and warm drinks may form part of a balanced diet, but effective and frequent milk removal remains one of the main drivers of milk production.
Persistent concerns require assessment of both the mother and baby.
Possible causes of genuinely low milk supply may include:
Ineffective attachment
Tongue-tie
Infrequent feeding
Early unnecessary supplementation
Retained placental tissue
Thyroid problems
Previous breast surgery
Certain medicines
Maternal illness
Hormonal conditions
Poor milk removal
Breastfeeding After a Caesarean Section
A Caesarean delivery does not prevent a mother from breastfeeding.
However, pain, anaesthesia, delayed contact, difficulty moving and separation of the mother and baby can make breastfeeding initiation more difficult.
Where the mother and baby are medically stable:
Request skin-to-skin contact as early as possible.
Ask for help bringing the baby to the breast.
Use positions that reduce pressure on the incision.
Keep the baby in the same room where possible.
Express colostrum if direct feeding is delayed.
Ask healthcare workers to provide appropriate pain relief.
Request support from a nurse, midwife or breastfeeding counsellor.
Positions that may help include:
Side-lying position
Football or underarm hold
Reclined breastfeeding position
A pillow can also help prevent the baby’s weight from pressing directly on the wound.
A mother recovering from surgery may need help lifting the baby, changing nappies and settling into a comfortable feeding position.
Returning to Work While Breastfeeding
Returning to work is one of the biggest barriers to maintaining exclusive breastfeeding.
Planning can begin before maternity leave ends.
Before returning to work
Practise hand expression or pumping.
Build a small supply of stored milk.
Avoid creating an unnecessarily large freezer stock.
Introduce an appropriate cup or feeding method with professional guidance.
Discuss break times with the employer.
Identify a clean and private place for expressing milk.
Arrange access to a refrigerator, cooler or other safe storage method.
Explain the feeding plan to the baby’s caregiver.
Label stored milk clearly.
While at work
Express milk at roughly the times the baby would normally feed.
Use clean equipment and labelled containers.
Keep the milk cool as soon as possible.
Breastfeed before leaving home.
Breastfeed after returning from work.
Continue night feeds according to the baby’s needs.
Avoid repeatedly skipping expression sessions.
Skipping expression sessions may reduce milk supply and lead to breast discomfort or engorgement.
Workplace policies that can help include:
Adequate maternity leave
Reasonable expression breaks
A clean private space that is not a toilet
Safe milk storage
Flexible working arrangements
Protection from discrimination
Supportive supervisors and colleagues
Digital health and telehealth services may also help mothers obtain breastfeeding guidance when face-to-face support is difficult to access.
Such services can connect mothers with trained health professionals, provide appointment reminders or support the early identification of breastfeeding difficulties. However, digital support should not replace physical assessment when a mother or baby shows warning signs.
How to Express Breast Milk
Breast milk may be expressed by hand or with a manual or electric breast pump.
Before expressing:
Wash your hands thoroughly.
Use a clean collection container.
Sit in a comfortable position.
Try to relax.
Gently massage the breast.
Keep the baby nearby when possible.
Look at a photograph or video of the baby if this helps stimulate milk flow.
Hand expression can be particularly useful during the first few days, when colostrum is produced in small quantities.
Mothers using breast pumps should follow the manufacturer’s cleaning instructions.
Pump parts that come into contact with milk should be cleaned appropriately after use.
Safe Storage of Expressed Breast Milk
According to current guidance from the United States Centers for Disease Control and Prevention, freshly expressed breast milk can generally be stored:
At room temperature of 25°C or colder for up to four hours
In a refrigerator for up to four days
In a freezer for about six months for best quality
In a suitable freezer for up to 12 months where necessary
These recommendations assume good hygiene, clean containers and reliable temperature control.
In hot environments or where electricity is unreliable, expressed milk should be placed in a refrigerator, freezer or properly prepared insulated cooler as soon as possible.
Do not rely on the four-hour room-temperature limit when the room is hotter than 25°C.
Breast-milk storage tips
Use breast-milk storage bags or clean food-grade containers with secure lids.
Store milk in small quantities to reduce waste.
Label each container with the date and time.
Use the oldest suitable milk first.
Leave some space at the top because milk expands when frozen.
Do not store milk in the refrigerator door.
Cool newly expressed milk before adding it to milk that is already chilled.
Never heat breast milk in a microwave.
Thaw frozen milk in a refrigerator or place the sealed container in warm water.
Swirl the milk gently to mix separated fat.
Do not shake breast milk aggressively.
Follow safe-handling guidance for milk left over after feeding.
Power cuts can affect milk safety.
Where there is uncertainty about how long stored milk has remained warm, it is safer to seek professional guidance rather than risk giving unsafe milk to a baby.
Common Breastfeeding Myths
Myth 1: Babies need water in hot weather
Healthy babies receiving exclusive breastfeeding generally do not need additional water during their first six months.
Breast milk already contains a high proportion of water.
The baby should be breastfed responsively and assessed if there are concerns about dehydration, illness or inadequate milk intake.
Myth 2: Small breasts cannot produce enough milk
Breast size is not a reliable measure of milk-producing ability.
Milk production depends more on glandular tissue, hormonal processes and effective removal of milk.
Myth 3: Colostrum is dirty or harmful
Colostrum is normal, safe and valuable.
It contains concentrated nutrients and protective components needed during the first days of life.
It should not be discarded.
Myth 4: Frequent feeding means breast milk is insufficient
Newborn babies normally feed frequently.
Cluster feeding can also occur during periods of rapid growth.
Milk sufficiency should be assessed using feeding effectiveness, urine output, stool changes, weight and the baby’s general condition.
Myth 5: A mother must drink large amounts of cow’s milk
A mother does not need to consume cow’s milk to produce breast milk.
She needs a balanced diet, adequate fluids according to thirst, rest and appropriate healthcare.
Myth 6: Breastfeeding should always be painful
Brief sensitivity may occur during the first few days, but persistent or severe pain often indicates a problem.
Possible causes include poor attachment, nipple damage, infection or incorrect breast-pump use.
Myth 7: Breastfeeding must stop whenever the mother takes medicine
Many medicines can be used while breastfeeding, although some require caution or an alternative.
A mother should not stop a prescribed medicine or discontinue breastfeeding without discussing the specific medicine with a doctor, pharmacist or other qualified healthcare professional.
How Partners and Families Can Help
Breastfeeding should not be treated as the mother’s responsibility alone.
Partners and relatives can help by:
Preparing meals
Making drinking water available
Handling household chores
Caring for older children
Protecting the mother’s rest
Avoiding pressure to introduce water or other foods
Accompanying the mother to health appointments
Helping arrange professional support
Supporting expression and storage of milk
Respecting the mother’s informed feeding decisions
Defending the mother from criticism and misinformation
The best support is practical, respectful and free from blame.
Frequently Asked Questions
Can I breastfeed after a Caesarean delivery?
Yes.
Breastfeeding can begin after a Caesarean delivery when the mother and baby are medically stable.
Extra help with positioning, skin-to-skin contact, pain management and expressing milk may be necessary.
Should I give my baby water during hot Nigerian weather?
A healthy baby receiving exclusive breastfeeding generally does not need additional water before six months.
Breastfeed responsively and seek medical advice if the baby shows signs of dehydration or illness.
How often should a newborn breastfeed?
Newborn babies usually feed frequently, including at night.
Rather than following a rigid feeding timetable, parents should watch for early hunger cues and allow responsive feeding.
Does soft breast tissue mean my milk has dried up?
Not necessarily.
Breasts often feel softer after milk production adjusts to the baby’s needs.
Milk production should be assessed using the baby’s feeding pattern, urine output, weight gain and clinical condition rather than breast firmness alone.
Can I breastfeed when I am sick?
Many common illnesses do not require breastfeeding to stop.
The appropriate decision depends on the illness, the mother’s condition, the baby’s condition and any medicines being used.
Obtain advice from a qualified healthcare professional.
Can a mother living with HIV breastfeed?
Infant-feeding recommendations for mothers living with HIV depend on national guidelines, access to antiretroviral treatment, viral-load monitoring and the availability of safe alternatives.
In Nigeria, mothers living with HIV should receive individual counselling through prevention-of-mother-to-child-transmission services and follow the recommendation provided by their HIV and maternal-health teams.
They should not make feeding changes without consulting the healthcare team managing the mother and baby.
When should complementary feeding begin?
Complementary feeding should generally begin at about six months.
The baby should receive safe, nutritious and age-appropriate foods while breastfeeding continues up to two years or beyond.
What should I do if I cannot breastfeed exclusively?
Seek help early to identify any correctable difficulties.
When supplementation is medically necessary or breastfeeding is not possible, a trained healthcare professional can help the family choose the safest appropriate feeding option.
A mother’s worth is not determined by how her baby is fed.
The goal is a nourished baby and a healthy, supported mother.
When to Seek Medical Help
Contact a qualified healthcare professional urgently when:
The baby is difficult to wake.
The baby appears unusually weak.
The baby is feeding poorly.
The baby refuses feeds.
Wet nappies are fewer than expected.
The baby shows signs of dehydration.
Jaundice appears severe or is getting worse.
The baby is not gaining weight appropriately.
The baby has a fever.
The baby has difficulty breathing.
The baby has repeated vomiting or diarrhoea.
The mother has a high fever.
The mother feels seriously unwell.
A breast is increasingly red, swollen, hot or painful.
There is pus or a painful breast lump.
The nipples are badly cracked or bleeding.
Breastfeeding remains severely painful.
The mother experiences severe anxiety, sadness, confusion or difficulty coping after childbirth.
Online information cannot replace the physical examination of a mother or baby when warning signs are present.
The Bottom Line
Exclusive breastfeeding means giving a baby breast milk alone during the first six months, apart from medically indicated medicines or supplements.
It offers important nutritional and health benefits, but successful breastfeeding depends on more than maternal determination.
Mothers need:
Skilled healthcare
Accurate information
Family support
Adequate maternity protection
Supportive workplaces
Access to trained breastfeeding counsellors
Prompt assistance when difficulties develop
Challenges such as painful feeding, engorgement, concerns about milk supply, Caesarean recovery and returning to work can often be managed when appropriate help is available early.
The most useful message for families is simple:
Support the mother, monitor the baby and seek qualified assistance before a manageable feeding difficulty becomes a serious problem.
Medical Disclaimer
This article provides general health education and does not replace diagnosis, treatment or individual advice from a doctor, nurse, midwife, dietitian, pharmacist or trained lactation professional.
Feeding recommendations may need to be adapted for premature babies, babies with medical conditions and mothers receiving treatment for specific illnesses.
Author Bio
Adeyinka Joseph Alonge is a public health professional, researcher and writer with interests spanning health, science, technology, personal development and practical knowledge for everyday life.
No comments:
Post a Comment