Factors Contributing to the Low Utilization of Online Breastfeeding Support Groups in Nigeria: A Commentary

Exclusive breastfeeding ensures that newly born babies grow optimally. The World Health Organization (WHO) recommends that babies should receive it solely for six months.^[1] Thereafter, suitable complementary food should be introduced up to age two and beyond. This provides adequate nourishment for babies, fortifies their immune systems, and reduces their risks of killer diseases. Mothers who adopt the practice have lower risk of type 2 diabetes and breast and ovarian cancers. It is environmentally friendly and a huge investment in global economy. Not less than US $340 billion would be lost annually worldwide should the practice be ignored.^[5]

However, in spite of these benefits, many nursing mothers quit the practice no sooner than they began. One of the reported barriers to exclusive breastfeeding practice in Nigeria is inadequate support for nursing mothers who are barely able to access and utilize any responsive support system in their quest to exclusively breastfeed their babies.^[6] Although several research papers have shown the effectiveness of online breastfeeding groups in providing adequate support for nursing mothers,^[7] its use is still low in Nigeria. Therefore, this article shall discuss the factors contributing to its low usage even with the rising number of smart mobile devices and internet connectivity. Such analysis will be a helpful resource for policy makers in designing appropriate interventions for tackling this problem and eventually be a step towards addressing the low rate of exclusive breastfeeding in Nigeria.

 An online group is a community of people who use internet facilities such as websites, messaging apps, etc. to socialize based on their common interests or goals. Unlike face-to-face groups whose members interact physically, online groups meet virtually and are not limited by the locations of its members. Many formats of online communities are available for creators to select. Their choices are often influenced by the purpose of creating the group and the ease of integration with other platforms. This is very important because whichever device or platform each of its members uses, a smooth access to the community and a round the clock communication with other members should be guaranteed. Even though online groups vary in form and purpose, they all possess peculiar features which are obvious and readily recognizable.

Notable online groups, which have been able to meet the yearnings of its members, place emphasis on user-generated contents. Not only has such a strategy increased relevant and helpful contents for the groups, but it has also promoted engagements or interactions among its members. This goes a long way in strengthening the values and goals of such groups. In addition, successful online groups encourage the use of high quality photos and videos by members to communicate. Such engaging posts provide avenues for members to either ask or answer questions. Ultimately, this increases engagements and discourages contribution from only one individual in the group. Likewise, online groups that meet the expectations of its members enjoy positive reviews and recommendation to others. This is an important way of spreading news and the activities of the group thereby connecting more members.

The use of online groups to provide support for nursing mothers has become a viable option to address some of the problems associated with the adoption of exclusive breastfeeding practice in Nigeria. For instance, because doctors, nurses, and other health care workers have continued to travel out of the country in droves for better opportunities,^[2] the health system has been overwhelmed and struggling to cope with the shortage of health care professionals. Online breastfeeding support groups would be a convenient way of providing the necessary information and guidance and connecting nursing mothers to their peers so as to share experiences and thus receive additional emotional support. And even when some of the health care professionals travel out of the country, they can still offer their professional support online. Nigeria has an internet penetration rate of 51% with about 109 million internet users.^[8] Also, the literacy rate of female youth (15–24 years) is 68.8% while 86 and 34% of Nigerian women own a mobile device and have some internet connection, respectively.^{[9, 10]} Moreover, 78.8% of public university students in the northeastern part of the country use the internet for educational purposes.^[11]

Culture-induced mindset that breast milk is inadequate to meet the nutritional needs of babies is the reason a good number of nursing mothers do not seek breastfeeding support. This explains why in many places colostrum is seen as bad, expressed and thrown away. Such a wrong perception thrives easily considering the fact that low milk supply is also a commonly reported breastfeeding problem. Therefore, no need is seen to seek help that would enable them to adopt exclusive breastfeeding practice.

 Equally, poor housing or lack of safe and convenient spaces for breastfeeding contributes to the disinterest in adoption of exclusive breastfeeding. Nursing mothers living in camps of internally displaced persons will hesitate to seek support for a practice they are unlikely to adopt. The situation in such places and other areas where living conditions are poor creates discomfort for nursing mothers. They are often overcrowded and lack privacy and basic amenities such as potable water essential for personal hygiene and a successful breastfeeding session.^[4]

Lack of knowledge about the existence of online breastfeeding support groups is a crucial factor for its low utilization in the country. In Nigeria, mobile phones have become valuable tools for personal communication or business. It is used to receive news updates, to chat with friends and family members, and to socialize on various platforms. However, many users, especially young women, are not aware of its possible use to access support for mothers who wish to exclusively breastfeed their babies. And the apathy of admins of many female social media groups to repost or encourage discussions and promotional contents on the benefits of online breastfeeding support groups is a serious hindrance to creating awareness and thus reaching out to more women. Social media groups should not be seen as platforms only for exchange of gossip and latest trends, but they are also useful tools for promoting the well-being of everyone including educating and supporting nursing mothers in their quest to exclusively breastfeed their babies. Many more women will be willing to take advantage of these online breastfeeding support groups if only they are aware of the opportunities they provide for accessing tips needed to navigate common breastfeeding problems and to consult health care professionals.

Besides, irregular network signals and the high cost of data discourage many nursing mothers from accessing breastfeeding support online. Those residing in rural areas may not even enjoy the luxury of switching from one service provider to another whenever network signals become unstable nor be able to upload required pictures and videos needed for proper assessment of their conditions and needs. Even though some social media platforms have launched free basic programs that allow free use of their platforms without data, it comes with limitations on pictures and videos.

Moreover, the unreadiness of the government to establish and maintain official online breastfeeding support groups is not encouraging its use. Such official sites, if established, could be sources of verified information which nursing mothers and the general public could use without worrying about its accuracy. They would also serve as standards or yardsticks for individuals or groups wishing to provide similar support services in Nigeria. That way, complaints about the judgmental approach and unprofessional responses to users’ queries will become minimal.

Furthermore, some existing groups lack fresh contents on their pages and have been inactive for several months. Without financial assistance from the government and non-governmental organizations, many online breastfeeding support groups might find it difficult to maintain their pages and also respond promptly to users’ queries.^[3] Payment of stipend to lactational consultants, breastfeeding counselors, and other health care volunteers will compensate them for their time and hard work and will further guarantee their long-term commitment.

Consequently, charitable and religious organizations should be encouraged to partner with the government in order to fully implement its Infant and Young Child Feeding Policy which aims, among other goals, to promote and strengthen community-based breastfeeding support groups. By establishing and maintaining online breastfeeding support groups, these private organizations would make great contributions to increasing its utilization by nursing mothers in Nigeria. Similarly, since it is not uncommon for wives of political office holders to launch pet projects for improving the welfare of women, children, and the less privileged in society, the offices of the first ladies of the three tiers of government in the country should be encouraged to participate in the effort of making breastfeeding support accessible to all nursing mothers in Nigeria. With their involvement, not only will the issue of funding and maintenance of online breastfeeding groups be resolved, but it will also be possible to recruit suitable professionals who would understand the peculiarities of nursing mothers in their domains and who are likely to join such groups for counseling.

Cultural practices, inadequate safe spaces, lack of knowledge about the existence of online breastfeeding support groups, irregular network signals, and the unwillingness of the government to establish official online breastfeeding support groups are factors contributing to its low utilization in the country.

Conflicts of interest

Authors declared no conflict of interest.