How Catholic initiatives are partnering to reduce infant malnutrition and mortality in Nigeria

Zara Ishaku, 35, faced significant challenges with breastfeeding after the birth of her second surviving child in September last year. She experienced issues such as low milk supply, engorgement, sore nipples, blocked ducts, and latching difficulties. Tragically, she had previously lost four of her children—each under six months old—to severe acute malnutrition, a deadly condition marked by extremely low weight-for-height and/or swelling from fluid retention, often caused by insufficient energy, protein, and nutrient intake.

The emotional toll on her family was immense. “Losing four of my babies to malnutrition due to my inability to breastfeed was heartbreaking. My husband, who is the sole breadwinner, could barely provide for our basic needs, including food,” she told the Catholic Herald.

Zara’s struggle began in 2013 with her first child, born in Borgozo, a remote village about 90 km from Maiduguri in northeastern Nigeria. At the time, she practiced mixed feeding, giving her babies pap—a fermented blend of maize, millet, water, and guinea corn—without breast milk. When her infants became ill, she turned to herbal remedies, a common practice in rural communities with limited access to healthcare.

Her approach to infant feeding changed when she encountered a team from Catholic Relief Services (CRS) and the Justice Development and Peace Commission (JDPC), who were implementing the Management of At-Risk Mothers and Infants (MAMI) project in northeastern Nigeria.

Malnutrition remains a leading cause of death for children under five in Nigeria. A June 2024 UNICEF report estimated that about 11 million Nigerian children face severe food poverty, with undernutrition contributing to nearly half of all deaths in this age group.

In sub-Saharan Africa, malnutrition is a critical health issue—second only to malaria in causing child mortality. Children in the region are over 14 times more likely to die before age five compared to those in developed countries. In Nigeria alone, UNICEF reports that around 2,400 children die from malnutrition every day—above the global average.

One major reason is that many breastfeeding mothers themselves are undernourished due to poverty, lack of formal education, poor diet, and limited antenatal support. Social factors, including lack of spousal support and traditional beliefs, also play a role.

Further worsening the situation are ongoing conflicts, insecurity, recurrent droughts, and floods. Inflation and fluctuating oil prices have pushed food costs beyond the reach of many families.

According to the UN, the first 1,000 days—from pregnancy to a child’s second birthday—are the most crucial for proper nutrition. David Jankoli, CMAM and MAMI Officer with JDPC in Borno State, explains that inadequate maternal nutrition in this period can lead to poor breastfeeding, malnutrition, and stunted development.

“If a child is malnourished at six months, it means something went wrong during exclusive breastfeeding,” he said. “A well-fed child from birth to six months should not be malnourished.”

The MAMI project, launched in March 2024 in Benisheikh (headquarters of Kaga district in Borno), specifically targeted infants under six months—marking the first CRS-JDPC effort focused on this age group.

Prior to this, CRS worked on the CMAM project in 2017, focusing on children aged six to 59 months in Borno’s Kaga, Magumeri, Gubio, and Jere districts. However, their findings revealed a significant gap in support for children under six months.

“We found over 1,000 cases needing follow-up. Many of the affected infants were just six to seven months old,” Jankoli said. “This pointed to serious gaps in exclusive breastfeeding practices.”

In Benisheikh, only three community volunteers were selected and trained on the MAMI approach. Healthcare workers at local clinics and the general hospital were also trained to facilitate proper medical referrals.

“MAMI isn’t a standalone solution. When needed, it involves referrals to healthcare facilities. That’s why training both community mobilizers and healthcare professionals was essential,” Jankoli added.

Initially targeting 30 families, the program later expanded to support 50 due to greater need.

Data from the initiative reflect the grim reality: 6.5% of Nigerian children under five suffer from wasting—compared to a global average of 4.6%. Stunting affects 31.5% of Nigerian children, much higher than the global rate of 19.9%. Nigeria’s child mortality rate of 11.7% far exceeds the global average of 3.7%.

UNICEF notes an alarming rise in both wasting and stunting among children in northern Nigeria. The 2024 Global Hunger Index ranked Nigeria 110th out of 127 countries, scoring 28.8—a level classified as “serious.”

Wilson Kipkoech, CRS emergency coordinator, says the MAMI project aims to bridge maternal and infant nutrition gaps through education and direct support. “It provides both preventive and curative solutions—rehabilitating mothers so they can produce enough milk and breastfeed exclusively for six months.”

The project also highlighted the vulnerability of displaced families, particularly in Internally Displaced Persons (IDP) camps. Many of these families, including Zara’s, were forced to flee due to insurgency and banditry. Zara now lives in Benisheikh’s magistrate camp with her husband, a small-scale farmer.

The MAMI initiative addresses not only physical but also social barriers to exclusive breastfeeding. It educates mothers and challenges cultural norms that discourage proper infant feeding.

Zara’s perspective has transformed thanks to the MAMI project. “Before, I didn’t know how to handle issues like engorgement and low milk supply. My grandmother even told me not to exclusively breastfeed. But now, my 7-month-old is healthy and rarely gets sick—unlike my other babies who didn’t make it.”

With the success of the pilot, the program is set to expand into Sokoto in northwestern Nigeria, with a target of reaching 200 infants. “Our work in Kaga was encouraging,” Jankoli said. “Initially, we aimed to support 50 children under five, but now we’ve raised our goal to 200.”