We assessed nutritional status among children aged 6 to 47 months by measuring their mid-upper arm circumference (MUAC). We counted children as malnourished if their MUAC measurement was well below the predicted value for their age and sex.

In Bauchi state, 12% of children aged 6-47 months were malnourished. In Cross River state, 5% of children aged 6-47 months were malnourished in 2011.

A field worker measure mid-upper arm circumference, 2011

The study established a significant association between frequent episodes of diarrhoea and malnutrition among small children. We used diarrhoea in the last two weeks as an indicator of frequent episodes of diarrhoea and found that overall children who had diarrhoea in the last two weeks were nearly twice as likely to be malnourished as children who did not have diarrhoea in this period.

Female children across both states were more likely to be malnourished than male children.

The study also found that children whose mothers had at least four antenatal care visits during their last pregnancy and had their last delivery attended by a skilled health worker, were less likely to be malnourished.

Other maternal factors in Cross River state that protected children from malnutrition were mothers’ education and if the mother had fewer than three children.


Exclusive breastfeeding

We also looked at mothers’ practice of giving colostrum and exclusive breastfeeding of children aged 6 to 47 months old. In Bauchi, 76% of all children were given colostrum at birth and only 17% completed six months of exclusive breastfeeding. In Cross River state, 89% of all children were given colostrum while only 25% had exclusive breastfeeding for 6 months.

The study found that children who were given colostrum at birth were less likely to be malnourished compared with those who were not given colostrum. This finding was significant in Bauchi state. In Cross River, children who completed six months of exclusive breastfeeding were less likely to be malnourished.

Focus group discussions about exclusive breast feeding

Many people in focus groups spoke out against the practice of exclusive breastfeeding across the two states. In Bauchi, most groups mentioned the common belief that even young children need water in addition to breast milk. They said that exclusive breastfeeding can kill a child since giving only milk may cause heartburn and intense thirst. Many groups were ignorant about exclusive breastfeeding and said they had never heard of such a practice.

A female focus group in Bauchi discusses exclusive breastfeeding, 2011

In Cross River state, women’s groups expressed similar doubts. Many also said that mothers don’t eat well and are not able to practice exclusive breastfeeding. Groups said weaning is easier if the child is used to taking water and solids from an early age. Men’s groups noted that women are afraid that their breasts will drop and so they don’t practice exclusive breastfeeding. Groups also said that working women find it difficult to practice exclusive breastfeeding.