One in three Nigerian newborns breastfed within first hour, as poor diets persist among toddlers - NDHS

The 2024 Nigeria Demographic and Health Survey (NDHS) has shown that just 35.5 per cent of children born in the two years preceding the survey were put to the breast within one hour of birth.

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At the same time, only 12.4 per cent of children aged six to 23 months were fed from at least five of the eight recommended minimum dietary diversity. The findings raise serious concerns about the country’s progress on Infant and Young Child Feeding (IYCF) standards and its implications for child survival and development.

The report also reveals that exclusive breastfeeding among children aged 0-5 months, with a sample size of 2,734, stands at 28.8 per cent.

According to the trend figure in the report, exclusive breastfeeding has improved from about two per cent in 1990 to around 29 per cent in 2018 and remains near that level in 2023-24.

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These figures are far below global averages. For example, data from multiple low- and middle-income countries show early initiation rates are around 50% or more and exclusive breastfeeding around 45% in recent years.

Health experts say the findings highlight persistent gaps in maternal and child nutrition practices that threaten the survival and development of young children.

Gaps in complementary feeding and diet diversity

Among children aged six–23 months (sample size: 7,611), the NDHS reports that only 12.4 per cent met the minimum dietary diversity threshold by consuming foods from at least five of eight defined food groups the previous day.

By contrast, 41.2 per cent of toddlers consumed sweet beverages, while 23.7 per cent were fed unhealthy foods high in sugar, salt, or unhealthy fats.

In practical terms, this means that only about one in eight toddlers is receiving diverse complementary foods. Meanwhile, nearly half consume sweet beverages and about one in four are fed unhealthy foods.

According to the World Health Organisation (WHO), poor infant feeding practices are the leading cause of malnutrition in all its forms, including undernutrition (wasting, stunting, and underweight), macronutrient deficiency, and obesity, which coexist within the same population.

Why the benchmarks matter

Global guidelines from WHO and UNICEF indicate that optimal infant and young child feeding includes early initiation of breastfeeding, exclusive breastfeeding for the first six months, followed by introduction of safe and nutrient-adequate complementary foods from six months while continuing breastfeeding up to two years or beyond.

The health agencies placed exclusive breastfeeding rates at around 45-48 per cent in low- and middle-income countries, with early initiation of breastfeeding averaging about 50 per cent.

However, Nigeria’s figures fall far below these benchmarks, leaving children to face higher risks of illness, poor growth, impaired cognitive development, and longer-term health problems.

Zainab Sa’idu, an expert in sexual reproductive and maternal and newborn health, said the figures revealed major weaknesses in Nigeria’s infant feeding practices.

Ms Sa’idu said the numbers highlighted existing gaps in optimal breastfeeding practices in the country.

“Essentially, it means many newborns remain at increased risk of infections and malnutrition, both major drivers of infant mortality,” she said.

She noted that the situation, though concerning, presents opportunities to scale up breastfeeding support in hospitals, communities, workplaces, and homes, where it can be a policy in an environment that can support the mother and newborn.

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She added that the barriers are multifaceted, citing delayed initiation of skin-to-skin contact, limited counselling in health facilities, cultural beliefs discouraging exclusive breastfeeding, and inadequate knowledge on the benefits of exclusive breastfeeding on the part of the mother.

“Professional and working mothers also face a lack of workplace support for nursing or partial implementation of the nationally recommended duration for maternity leave,” she explained.

Toddlers’ diets shrinking with the economy

For Nigerian toddlers, the NDHS data reveal a worrying nutrition gap. Only about one in eight children aged six to 23 months received food from five of the eight defined food groups on the previous day, well below the global goal.

Ms Sa’idu linked the problem to socio-economic hardship, systemic and behavioural factors and rising food costs, which have made nutrient-rich foods unaffordable for many households.

“Food insecurity is a major issue. Families are turning to cheaper processed foods, and the poor implementation of nutrition-centred policies, especially at community and primary health-care levels,” she said.

She explained that improving diet diversity will require making nutritious foods affordable, raising public awareness, and strengthening the implementation of policies that promote healthy eating for toddlers.

Turning data into action

Ms Sa’idu said Nigeria must reposition infant and young child feeding not merely as a health message but as a social norm that is acceptable and supported by everyone in the home, community, and workplace (including men).

She urged stronger enforcement of maternity-leave policies, and the creation of lactation spaces in both formal and informal sectors.

“There is also a need to work with communities and media to promote messaging on the benefits of breastfeeding and diverse complementary feeding using simple language and local context.”

WHO estimates that optimal breastfeeding alone could save more than 800,000 children under age five globally each year.

In Nigeria, where child malnutrition remains a leading cause of under-five mortality, poor infant and young child feeding practices amplify existing vulnerabilities.