Maternal Care and Breastfeeding in Colonial and Postcolonial Ibadan

 

 

Introduction

The British colonial administrators’ economic exploitations and expropriation in Nigeria, as well as other colonies in Africa, were dependent on the healthiness of the indigenous populace, as the indigenous population constituted the manual labour in the colony.[1] The introduction of western maternal and child care methods such as industrial baby food and milk created multiple modes of the indigenous and western maternal care system. Scholars such as Blacklock and Van Tol, argues that the introduction of a new mode of infant nutrition, baby food and milk, as an alternative to breastfeeding in the colonies was targeted at reducing maternal and child mortality in the colonies.[2] Oladejo examined the effects of the western model of child nutrition, baby food and milk, during colonialism as it intersects the existing indigenous maternal care knowledge.

This study explored colonialism’s introduction of multiple modes of maternal care and child nutrition in Ibadan. It attempts to unmask the colonial legacy of maternal care and child nutrition in postcolonial Ibadan by interrogating the following questions; how did the people respond to the existing multiple modes of maternal care and child nutrition?  What were the effects of these dual regimes of care and nutrition on postcolonial Ibadan? Why did mothers choose a particular form of care and nutrition over the other? It argued that the duality in maternal care and child nutrition in postcolonial Ibadan is a continuum of the medical pluralism prevalent in colonial Ibadan. The focus on Ibadan is due to the high rate of maternal and infant mortality experienced in the area of study throughout colonial and postcolonial periods. The study uses archival materials from the National Archives Ibadan, Oral histories of seven young mothers (within age 20 to 35) and four aged mothers (within age 50 to 75), and related secondary sources.

Background to Maternal and Child Health Care in Colonial Nigeria

The colonial government approached public health through the mapping of racial segregation as the practices and places of health interventions were defined by socioeconomic status leading to the unequal health development of the colonies. The concept of biopolitics was integrated into colonialism, this was framed as a politics concerned with the colonizers’ issues of sexual and reproductive conduct concerning health, colonial policies, and power.[3] The healthiness of the populace became consequential for administration and industrial labour in the colonies. Foucault argues that the exercise of power by optimising the capacities of a population through an interest in sexual and reproductive health conducts, fecundity, illness, and longevity foreground the advancement of Western medicine in the colonial empire.[4] However, the colonial influence on public health in the colonies was far worse than mere neglect as it involved the traducement of existing culture, tradition, and indigenous health practices. David Arnold argued that Western medicine and its impact on the indigenous medical system was more complex than the profound suspicion, wild rumours, and resistance it was often greeted with.[5] He argued that the introduction of Western medicine into the colonies led to a shift that assaulted the existing corpus of knowledge of indigenous medical science.[6]

The Western medicine introduced to British colonies such as India and Nigeria were initially focused on the health of the British administrators and segregated the indigenous people. For instance, in Nigeria, the colonial officials approved the housing scheme of separating European quarters a mile away from native dwellings to ensure good health for the Europeans. This housing reform in colonial Nigeria stemmed from the belief that the Europeans suffers from living near-native dwellings, with further emphasis on mostly the poorer type that should be marked.[7]

The colonial institution commenced health programmes for the indigenous populace as a form of humanitarianism and a means of preserving a healthy population due to the high level of maternal and infant mortality in places such as Lagos and Ibadan. Thus, the health intervention programs that were designed formally for the colonial administrators and the metropole rather than in the colony began responding to indigenous health needs and concerns. Particularly, the focus was given to issues of reproductive health that concerns maternal and child health.

In the colonial Annual Report of Nigeria in 1914, the statistics for the death rate of children between 1909 and 1914 was at 47.7% in Lagos. The death rate of children were recorded as follows; in 1909, there were 2,312 births and 1,975 death, 1910, 2,389 births and 1,937 death, 1911, 2, 430 births and 1,873 death, 1912, 2,391 births and 1,829 death, 1913, 2, 437 births and 1,867 death, and in 1914, 2,261 births and 1,735 death.[8] The proportion was recorded in other localities such as Ibadan and Abeokuta. Similarly, the number of deaths among the Europeans, 5 officials and 17 non-officials, from diseases such as malaria, black water, measles, and particularly yellow fever which recorded the highest number of Europeans killed around 4 non-officials and 1 official spurred the immediate health intervention programs in the colonies through the opening of a private hospital in Lagos.[9]

In Ibadan between 1914 and 1925, there had been the introduction of public health measures for both the Europeans and natives, pipe-borne water and ‘salgas’ (Salanga) were introduced, new town planning measures were adopted and due to infectious disease centres in Nigeria, particularly Ibadan, a bush hut could be run-up in a few hours, at a comparatively small cost, and after the patient has been discharged, the hut was burned down.[10] Also, lectures were scheduled to be given by the colonial medical officers to the natives, and essential discussions and topics of hygiene and sanitation were introduced to the school curriculum.[11]

Mary Blacklock, a colonial medical staff in Africa and India between 1935 and 1936, argues that the colonialists developed an interest in women and children welfare due to the high rates of maternal mortality and infant mortality in the colonies.[12] A medical missionary, Walter Miller, in his work ‘Have we Failed in Nigeria’ commented that the greatest need in Nigeria is increased population but the death of infants remained a major problem.[13] This could be used in analysing Deanne van Tol’s position that the focus of the colonial administration on Maternal and Child health was a measure to pacify indigenous populations as the problem of maternal and infant mortality was prominent in places such as Ibadan and Lagos.[14] In Sanya Onabamiro’s ‘Why Our Children Die’, he posed questions about the reasons why infant mortality and maternal mortality was high between the 1920s and 1950s.[15] He stated that the reasons for maternal and infant mortality were associated with the food we eat in Africa, houses we live in, or the way the indigenous people responded to reproductive health, especially, as recorded by Miller ‘the treatment of babies in their first few months.’[16] This point was used in questioning the indigenous peoples’ approach to reproductive health as inadequate and justified the need for a sophisticated intervention of Western medicine.

Another prominent opinion on the motive of the colonial administration in maternal and child welfare in colonies was Judith Lasker’s ‘The Role of Health Services in Colonial Rule…,’ she argues that the decision to focus on Maternal and Child welfare was the need to ensure healthy colonial labour population in the colonies.[17] Hence, this means that a healthy indigenous population is consequential on the rate of colonial production of raw materials and consumption of European imported goods, and an unhealthy population would lead to unstable raw materials production in the colonies and depreciation of demand for finished goods from the metropole.

Maternal and infant morbidity were not just colonial problems, but national problems in Europe as well, along with fertility decline, infant welfare, and this enhanced the provision of sterile breast milk substitutes. These concerns were fuelled by the menace of depopulation in both the imperial metropoles and colonies. Infant welfare became important, not just in the national countries, but the colonies as well. One of the key attempts at maternal and child welfare was the 1924 Declaration of the Rights of Children by the League of Nations in Geneva, while a similar summit targeted at health promotion of the children of non-European Origin ‘Save the Children’ was held in Geneva in 1931.[18] Other efforts towards child health include the 1932 and 1934 Conferences of the health representatives of African territories that met in Cape Town under the auspices of the Health Organization of the League of Nations. There were nineteen countries with their representatives present for the conference such as Angola-Dr. L. Ribeiro, Kenya- Dr A.R. Paterson, Uganda- Dr De Boer, and Nigeria Dr J. M. Mackay among others and the League was represented by Dr Gautier of the Health section, the Paris Office by Dr Stock and the International Health Division of the Rockefeller Foundation by Dr Soper.[19]

Transitioning and Contestation: Child Nutrition in Postcolonial Ibadan

In Europe, the high rate of infant mortality was viewed as the ignorance and negligence of mothers, particularly working-class mothers. The solution to this problem was the provision of a substitute for motherhood as infant milk depots, and well-baby clinics were established.[20] The absence of breastfeeding among women, particularly among mothers working in the industrial and agriculture sector, contributed to infant mortality, the availability of sterile breast milk changed the tide of action, as mothers need not nurse under supervision anymore, and they were able to leave their babies in the care of another, without having to worry about breastfeeding. This was later introduced in the colonies, as there was high infant mortality, particularly in Africa.

African women were recorded to abstain from sexual intercourse for two to three years after childbirth, the woman nurses her child for two years or more, and during the period, she cannot perform such duties of reproduction for her husband. Having sexual relations during this period, African women believed that it would lead to the newborn dying and the mother’s milk drying up, and this gave a justification for the husband taking another wife because of the fertility gap years.[21]  The Europeans perspective on African women’s prolonged lactation and sexual abstinence were that these were irrational and unhealthy to the African colonial population as this only enhanced population growth. Also, it was noted that some African mothers began giving their infant breast milk along with thick, not easily digestible foods at the age of one month by holding the child horizontally and pushing it into the child’s throat, despite cries and breathing difficulties.[22] This method of child care was deemed infanticide by the Europeans, and it was recorded as prominent due to the lack of adequate food alternatives to breast milk, and the generally poor nutritional level of mothers.

The colonialists’ concern for the desired increase in fertility rate in the colonies was the practice of abstention during the nursing period and prolonged breastfeeding which makes the milk of the mother dispensable and suppressed ovulation. The colonialists’ remedy to these problems was to make other food available to children, by distributing milk and milk products so mother’s milk would be dispensable. As noted by Hunt, the lack of mother’s milk substitute causes infantile mortality as it slows the fertility of families, delays weaning, and do not resume conjugal relations, thereby, it is necessary to have animal milk to supplement the deficiency of maternal milk.[23]

The introduction of infant and child food became prominent in Nigeria as the newspapers of the colonial era served as the promotional agencies for this new child nutritional culture. In the 1930s and 1940s, newspapers such as Nigerian Daily Times and West African Pilot advertised baby food and milk on the pages of their newspapers. For instance, baby food and milk such as Ovaltine and Horlicks were more profound and prominent in the indicated newspapers.[24] A cookery book titled Miss Williams Cookery Book was used to teach mothers desired food mix to ensure adequate protein for child consumption in substitute for breast milk or thick traditional food.[25] According to Oladejo, in 1959, a newspaper advertisement of a baby food “Amama” has these wordings:

The child is miserable, lifeless and has little strength because he is fed only cassava, yams and corn. Amama is always added to this child’s food and he is always happy and healthy. Amama adds strength, always add Amama to baby food.[26]

The next section would use a case study of both young mothers and aged mothers in Ibadan, in Southwest Nigeria, to investigate and explore the colonial legacies, dynamics, changes and continuities in child nutrition in postcolonial Nigeria.

Mothers’ Choice of Nutrition: Breast Milk, Bottled Baby Milk, and Infant Food

Breastfeeding is one of the oldest practices in human history. According to Ballard and Marrow, it is the healthiest, simplest and least expensive means of meeting the nutritional needs of newborns and infants. Also, it was noted that breast milk contains all essential nutrients such as carbohydrates, essential fats, proteins, minerals, and contains immunological features required for the optimal growth and development of infants.[27] According to the World Health Organization (WHO), breastfeeding can be calibrated into three categories that include exclusive, predominant, and complementary.[28] Exclusive breastfeeding involves child feeding on mother’s breast milk only and excludes water, breast milk substitute, other liquids, and solid foods. Predominant breastfeeding includes breast milk with other liquids, including water, semi-solid and solid meals. Complementary feeding is the concentration on breast milk from a wet nurse, as well as on solid or semi-solid foods. Exclusive breastfeeding was prominent among mothers in pre-colonial Nigeria, however, colonialism ushered in other modes such as predominant and complementary.

The advent of colonialism in Nigeria and the introduction of breastfeeding substitutes by the colonial government led to the reduction in exclusive breastfeeding in Nigeria. Scholars have given numerous justifications for the low practice in exclusive breastfeeding in postcolonial Nigeria which include mothers with a caesarean section and those with high socioeconomic status as less likely to practice exclusive breastfeeding.[29] In the 1990s, according to Iya Oroki, a beverage seller and mother to five children, she noted that the period marked an abundant availability of breastfeeding substitutes such as bottle feeders and processed baby food but her choice of child nutrition was exclusive breastfeeding. She stated that ‘any child given breast milk would have strong bones.’ Although she uses liquid herbal medicine as a complement for her children between ages 0-3, she claimed this was the best effective way of reducing a child’s vulnerability to diseases or mortality.[30] Other respondents within the same age bracket such as Simiatu Ramoni, Anifa Adegbite, and Saliyu shared a similar perspective.[31] Also, the usage of breast milk and liquid herbal medicine was prominent among mothers in suburban Ibadan in the 1970s, 80s, and 90s. For instance, Saliyu stated that there was a time in the 1980s when she wanted to change her child nutritional style from breast milk feeding to bottle baby-milk feeding and industrial baby food ‘I tried giving my baby, one of the advertised baby food, it did not digest, he vomited it,’ and she concluded that this shows that her children preferred breast milk and liquid medicinal herbs to bottled baby-milk and industrial food.[32]

This shows a trend of predominant nutritional style among aged mothers in Ibadan in the last decades of the 20^th century. They used breast milk and liquid medicinal herbs for their babies. Their perception of bottled milk and food as a substitute for breast milk was that it causes a defect in a child’s growth and facilitated increased infant mortality in the 20^th century. The claim on the defect of industrial food and baby milk was corroborated by Stunnings and Sani’s ‘Powdered Infant Formula in Developing Countries’ that recorded a targeted mass protest in 1971, against some infant industrial food and bottle feeding factories such as the Nestle Baby Foods. The protest was labelled ‘the Nestle boycott.’[33]

On the other hand, most of the interviewed young mothers’ adopted mixed methods of both breast milk and baby-milk feeding. They acknowledged the nutritional implication of baby milk and industrial food but emphasised the need for breastfeeding as it is traditional, cultural and healthy. Suliyat Akinbobola, a food seller with one child, noted that breastfeeding and baby-milk bottle feeding were both important and adopted for her child’s nutrition and care. She breastfed her child and concurrently used baby milk in a bottle-feeding container.[34] Similarly, Amope noted the same approach of using both breastfeeding and bottle feeding, as she stated that her breastfeeding lasts for three months, afterwards, she fed the infant with baby milk and industrial food.[35] Damilola Adetayo and Tosin Adefami shared a similar perspective on using both breast milk and bottled baby milk nutritional approaches for their children between 0 – 3 years. Although they emphasized that breastfeeding should be more than bottle feeding.[36] These young mothers stated that the maternity centre’s recommended the use of baby milk and industrial food. It is pertinent to note that the reproductive health awareness decades of the 1980s and 1990s had increased women’s access to healthcare. Several health policies that promoted maternal and child care were introduced to reduce maternal and infant mortality in Nigeria. For instance, advocacy for mothers to consistently visit maternity centres to ensure active women’s reproductive cycle was launched. Also, policies on mothers’ need to breastfeed their child for six months, and afterwards uses baby milk and industrial food were adopted and shortened period of abstinence was promoted. Emergent mothers in the 2000s were educated with this ideology. It became a transition from breast milk and liquid herbal medicine to breast milk and baby bottled milk. This created a distinction between the aged mothers and young mothers.[37]

However, two out of the interviewed young mothers were recorded to deviate from the trend of breast milk and baby milk and food which was prominent among mothers. Debora Olowookere and Bukola adopt exclusive feeding of breast milk. According to Bukola, ‘breast milk feeding ensures her child’s healthy development that bottle-feeding cannot provide,’ she breastfeeds her children from 0 to the sixth month and later gives them food and water.[38] Likewise, Debora Olowookere noted that her choice for breastfeeding her infants was due to the effect it has on the infant’s growth and physicality.[39] While Olowookere breastfed her children for one year and six months, she expressed her interest to expand the duration.

Having identified the existence of a dual trend, breast milk and baby milk and food feeding or breast milk and liquid herbal medicine feeding, in child nutrition system among the suburban demography in Ibadan, it is evident that the adoption of either of the two identified methods is dependent on the mothers’ perception.  Stemming from the aged mothers’ perspectives, breast milk and liquid herbal medicine aid a child’s physical growth and mental development, this is contradictory to the young mothers’ preference for breast milk and baby milk and food. For instance, Iya Oroki stated that in the 1990s, babies given bottle-feeding milk did not have much strength and were more vulnerable compared to those that were breastfed.[40] In addition, Anifa Adegbite noted that her attempt to use baby milk and food as a supplement for her child’s quality growth was unsuccessful due to the child’s preference for liquid medical herbs.[41]

Factors Affecting Child Nutrition in Ibadan

Most scholarly works on breastfeeding in Nigeria engaged the discourse from an elitist perspective, these works identifies education, socio-economic status, and occupation as the core factors influencing mothers’ choice of child nutrition in postcolonial Ibadan.[42] This work explores these determinant variables from the perspective of low income aged and young mothers living in suburban areas of Ibadan. Mothers’ high or low practices of exclusive breastfeeding have been attributed to households’ socioeconomic status as some mothers’ could not afford breast milk substitutes due to their high price. This created an economic class dichotomy among mothers at the time, particularly, in colonial Nigeria.

By the 1960s and 70s, the consumption of infant foods and baby milk had become prominent owing to the reduction in their cost, the implication was the neglect of breast milk feeding method as most households could afford it. Also, the government hospitals adopted the policy of not discharging mothers from maternity centres until they were monitored to take industrial foods as a supplement to breast milk feeding, they were advised not to feed infants with solid indigenous foods.[43] This has eliminated the economic-based argument that

Cultural beliefs and traditions is another factor influencing mothers’ choice of nutrition. According to Saliyu and Anifa Adegbite, they stated that in their immediate environment, most mothers’ uses breast milk feeding due to the socio-cultural belief that it reduces children’s vulnerability to sickness and ensures optimal development.[44] Simiatu Ramoni commented that the colonialists’ introduction of bottled baby milk and infant food feeding by the colonialists was solely for working women to avoid the stress of breastfeeding their children during working hours.[45] Nancy Hunt corroborated this assertion, as she argues that the introduction of alternatives to breastfeeding allowed more time for European women to continue their careers in industries or administrative roles without a prolonged maternal break due to breastfeeding.[46] However, Simiatu Ramoni noted that the adoption of bottled baby milk and infant food feeding by contemporary young mothers was not only based on occupation but also to avoid stress and stay in physical shape. It was noted that other factors such as sore breasts facilitate the adoption of breast milk feeding substitutes.

West African Mother feeding her babyA health perspective on mothers’ adoption of breastfeeding substitutes was offered by Iya Oroki. She noted that some mothers died from childbirth complications, and such infants did not have access to their mother’s breast, hence, alternative feeding such as bottle-feeding were considered. Also, mothers’ with breast infections needed to use breastfeeding substitutes.[47] For instance, Simiatu Ramoni narrated that in the mid-1980s, one of her children bites her breast to a hurtful extent which motivated her to consider bottled baby milk and infant food at some point.[48]

The contemporaneous young mothers gave different perspectives on the factors influencing child nutrition. The majority of the respondents were ardent users of bottled baby milk and infant food, and they noted that the need to focus on their trade and market was the motivating factor for adopting such a method. For instance, Tosin Adefami noted that;

My children, as I breastfed them, I bottle-fed with baby milk and food as well. I introduced bottle feeding not only because the hospital recommended it, but I might want to go to Agbaje Market, and due to the market’s rowdiness, I cannot take the baby along, so I have to leave him with someone at home and hand over the feeding bottle for my child’s care.[49]

Also, Akinbobola gave another perspective that some mothers gets sick after childbirth and the way to ensure good child nutritional care is to adopt breastfeeding substitutes, bottled baby milk and infant food, as the mother would not have the needed strength to breastfeed the child. She noted that government workers and other career professionals do not have the time to breastfeed their children, hence, they adopt breastfeeding substitutes.[50] According to Damilola Eyitayo, mothers use breastfeeding substitutes due to the injury suffered on their breasts while breastfeeding their children.[51] Amope expatiated that mothers use bottled baby milk and infant food due to the instructions and benefits stated by the maternity centres.[52]

However, this study noted that mothers practising a predominant breastfeeding system in terms of breastfeeding and other liquids such as bottle feeding could be forced to engage in exclusive breastfeeding due to factors such as economic recession and a pandemic. For instance, Oladejo posited that the 1980s economic recession as a result of the government’s introduction of the Structural Adjustment Program (SAP) led to the high cost of industrial infant foods and most mothers had to result to breastfeeding due to the hike in the price of bottle-feeding using industrial foods.[53]

The Covid-19 pandemic has been identified as another significant factor that has affected mothers’ choice of nutrition in Ibadan. According to Amope, a fashion designer, she stated that;

In this Covid-19 period, there is a hike in the price of infant food, so, I do not buy baby milk and infant food such as 1, 2, 3 milk anymore, I cannot afford it. I now use Amala and Ewedu. We used to buy the baby food for 1,500 naira but now it is 2,000 naira.[54]

The change in the price of baby milk and infant food was solely based on the restrictions n economic activities caused by the pandemic, this affected child’s nutrition and consumption pattern in Ibadan. The highlighted example of Amope depicted the change from bottle feeding to full-time infant solid food consumption. According to Nancy Hunt, giving infant’s thick not easily digestible food is dangerous to infants’ health. In addition, Tosin Adefami noted that ‘there was a hike in bottled baby milk and infant food price during the pandemic, and I could not buy the baby food unlike before, and now I have switched to full-time breastfeeding.’ Adefami’s example shows the shift from the predominant breastfeeding method to exclusive breastfeeding.[55]

In conclusion, the alternative breastfeeding introduced, bottled baby milk and infant food, introduced by colonialism as a means to reduce infant mortality and women’s sexual abstention has continued to have legacy effects in postcolonial Ibadan. This study shows the existence of contestation between indigenous and western child nutritional systems. While the indigenous system upheld breastfeeding with liquid medicinal herbs, the western system gives significance to breastfeeding and bottle feeding. It contended that in postcolonial Ibadan, mothers’ attitude to child nutrition varies. Aged mothers were identified to practised breast milk feeding and liquid medicinal herbs as supplements. On the other, young mothers’ have adopted breast milk, bottled baby milk and infant food feeding. In addition to the submission of the previous works that socio-economic status, educational level and household economy were the determinant factors for mothers’ choice of child nutrition in Ibadan, this study has highlighted cultural belief and traditions, maternal health, and pandemics as other significant factors that affect children nutrition in Ibadan. Also, the study contended that prominent usage of breastfeeding substitutes is not limited to the urban areas, but is also used in the suburban in Ibadan.

 

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[1] Rodney, W. (1972). How Europe underdeveloped Africa, London: Bogle -L‟Ouverture Publications, p162; Frantz, F. (1965). A Dying Colonialism. U. S. A: Monthly Review Press

[2]

[3] Burchell, G. (1991). Governmental Rationality. In Graham Burchell et al. (Eds), The Foucault Effect. University of Chicago Press, p4–5; See also, Foucault, M. (1984). The Politics of Health in the Eighteenth Century. In Paul R. (Ed.), The Foucault Reader, Penguin

[4] Foucault, M. (1978). The History of Sexuality, Volume 1. An Introduction. Translated by Robert Hurley. New York: Pantheon Books. p.139

[5] Arnold, D. (2000). The New Cambridge History of India III.5: Science Technology and Medicine in Colonial India. Cambridge, Cambridge University Press, p.83

[6] Arnold, D. (1993). Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-century India. Berkeley Los Angeles, University of California Press; Watts, S. (1999). Epidemics and History: Disease, Power and Imperialism. New Haven and London, Yale University Press, p167–169; See also, Madhuri, S. (2012). Indigenous and Western Medicine in Colonial India. Delhi: Cambridge University Press

[7] NAI., CSO 19/3; File no N.3605/1913, Annual Medical and Sanitary Report for Nigeria, p.85

[8] NAI., Annual Medical and Sanitary Report for Nigeria for the year 1914, p.60-61

[9] NAI., Annual Medical and Sanitary Report for Nigeria for the year 1914, p.59

[10] NAI., Annual Medical and Sanitary Report for Nigeria for the year 1914, p83-84

[11] NAI., Annual Medical and Sanitary Report for Nigeria for the year 1914, p83-84

[12] Blacklock, M. G. (1936). Certain Aspects of the Welfare of Women and Children in the Colonies. Annals of Tropical Medicine & Parasitology, 30:2, p221-264

[13] Miller, W. (1947). Have We Failed in Nigeria. United Society for Christian Literature, p156

[14] Van Tol, D. (2007). Mothers, Babies and the Colonial State: The Introduction of Maternal and Infant Welfare Services in Nigeria, 1925 – 1945. Spontaneous Generations: A Journal for the History and Philosophy of Science, 1(1), p126; Thompson, O. O., Afolabi, S. A., & Nwaorgu, O. G. F. (2019). Sweeter with Age: The Enigmatic Miss Jane McCotter in the Colonial Services of the Egba Native Administration in Abeokuta, Nigeria, 1929-1955. Journal of International Women’s Studies, 20(7), 334-348

[15] Onabamiro, S. D. (1949). Why Our Children Die; the Causes, and Suggestions for Prevention, of Infant Mortality in West Africa. Methuen, London, p18

[16] Miller, W. (1947). Have We Failed in Nigeria. United Society for Christian Literature

[17] Lasker, J.N. (1977). The Role of Health Services in Colonial Rule: The Case of the Ivory Coast. Culture, Medicine and Psychiatry, 1;3, p277-297

[18] Oladejo, M.T. (2019). Child Nutrition and Motherhood in Nigerian History, 1920s-1980s. Nig. J. Child Adol. Health Vol. 2 No.1, p19

[19] NAI., CSO 26/2; File no 13471A Vol.III, Report by the British Representative on the Session of the Committee of the Office – International D. Hygiene Publique etc,

[20] Hunt, N. (1988). “Le Bebe en Brousse”: European Women, African Birth Spacing and Colonial Intervention in Breast Feeding in the Belgian Congo. The International Journal of African Historical Studies, 21(3), 401-432. p.405

[21] Hunt, N. (1988). “Le Bebe en Brousse”: European Women, African Birth Spacing and Colonial Intervention in Breast Feeding in the Belgian Congo, p.405

[22] Ibid, p.409

[23] Ibid, 4.10

[24] See, Aderinto, S. (2012). Of Gender, Race, and Class: The Politics of Prostitution in Lagos, Nigeria, 1923–1954. Frontiers: A Journal of Women Studies, 33(3), p71-92; Oladejo, M.T. (2019). Child Nutrition and Motherhood in Nigerian History, 1920s-1980s. Nig. J. Child Adol. Health Vol. 2 No.1, 19-29

[25] Williams, O. (1957). Miss Williams Cookery Book Lagos: Longman; Ikpe, E. B. ( 1994). Food and Society in Nigeria: A History of Food Customs, Food Economy and Cultural Change 1900-1989 Germany: Steiner.

[26] Nigerian Daily Service. (1959, November 4). In Oladejo, M. T. (2019). Child Nutrition and Motherhood in Nigerian History, 1920s-1980s. Nig. J. Child Adol. Health Vol. 2 No.1, 19-29

[27] Ballard, O., & Morrow, A. L. (2013). Human milk composition: nutrients and bioactive factors. Pediatric clinics of North America, 60(1), 49–74

[28] Binns, C. W., Fraser, M. L., Lee, A. H., & Scott, J. (2009). Defining Exclusive Breastfeeding in Australia. Journal of paediatrics and child health, 45(4), 174–180

[29] Onah, S., Osuorah, D. I., Ebenebe, J., Ezechukwu, C., Ekwochi, U., & Ndukwu, I. (2014). Infant feeding practices and maternal socio-demographic factors that influence the practice of exclusive breastfeeding among mothers in Nnewi South-East Nigeria: a cross-sectional and analytical study. International breastfeeding journal, 9, 6.

[30] Interview held with Iya Oroki, a beverage seller, age 63 with 5 children. Oje, Ibadan, Oyo State, 24^th June, 2021

[31] Interview held with Mrs Simiatu Ramoni, age 65 with 5 children. Ode-Aje, Ibadan, Oyo State, 27^th June 2021; Interview held with Mrs Anifa Adegbite, age 55 with three children. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021; Interview held with Mrs Saliyu, age 75 with 6 children. Ode-Aje, Ibadan, Oyo State, 27^th June, 2021

[32] Interview held with Mrs Saliyu, age 75 with 6 children. Ode-Aje, Ibadan, Oyo State, 27^th June, 2021

[33] Stunings, S. E. Abdullah Sani N. (2008). Introduction. In J. M. Farber & S. J. Forsythe (Eds.), Powdered Infant Formula in Developing and other Countries -Issues and Prospects. Washington: ASM Press.

[34] Interview held with Mrs Suliyat Akinbobola, Food Seller, age 25 with a child. Oje, Ibadan, Oyo State, 24^th June, 2021

[35] Interview held with Mrs Amope, a hairdresser, age 21 with a child. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[36] Interview held with Mrs Tosin Adefami, a trader, age 31 with 2 children. Oje, Ibadan, Oyo State, 24^th June 2021; Interview held with Mrs Damilola Adetayo, age 24 with a child. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[37] Fotso, J.C., Ajayi J.O., Idoko E.E., Speizer I., Fasiku D.A. & et.al. 2011. Family Planning and Reproductive Health in Urban Nigeria: Levels, Trends and Differentials. Chapel Hill, NC: Measurement, Learning & Evaluation (MLE) Project (UNC, USA) and National Population Commission (NPC) (Nigeria).

[38] Interview held with Mrs Bukola, age 26 with 2 children. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[39] Interview held with Mrs Debora Olowookere, a fashion designer, age 22 with 2 children. Ode-Aje, Ibadan, Oyo State, 27^th June, 2021

[40] Interview held with Iya Oroki, a beverage seller, age 63 with 5 children. Oje, Ibadan, Oyo State, 24^th June, 2021

[41] Interview held with Mrs Saliyu, age 75 with 6 children. Ode-Aje, Ibadan, Oyo State, 27^th June 2021; Interview held with Mrs Simiatu Ramoni, age 65 with 5 children. Ode-Aje, Ibadan, Oyo State, 27^th June 2021; Interview held with Mrs Anifa Adegbite, age 55 with three children. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[42] Adewuyi, E. O. & Adefemi, K. (2016). Breastfeeding in Nigeria: a Systemic Review. International Journal of Community Medicine and Public Health, 3 (2): 385-396; Kuti, O., Adeyemi, A. B., & Owolabi, A. T. (2007). Breast-Feeding Pattern and Onset of Menstruation Among Yoruba Mothers of South-west Nigeria. European Journal of Contraceptive Reproduction & Health Care, 12(4):335-9; Olayemi, O., Aimakhu, C. O., & Bello, F. A. (2007). The Influence of Social Support on the Duration of Breast-Feeding Among Antenatal Patients in Ibadan. Journal of Obstetrics and Gynaecology, 27(8):802-5; Torimiro, S. E., Onayade, A. A., Olumese, I., & Makanjuola, R. O. (2004). Health Benefits of Selected Global Breastfeeding Recommendations Among Children 0-6 Months in Nigeria. Nutr Health, 18(1):49-59

[43] Oladejo, M. T. (2019). Child Nutrition and Motherhood in Nigerian History, 1920s-1980s, p.23

[44] Interview held with Mrs Saliyu, age 75 with 6 children. Ode-Aje, Ibadan, Oyo State, 27^th June 2021; Interview held with Mrs Anifa Adegbite, age 55 with three children. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[45] Interview held with Mrs Simiatu Ramoni, age 65 with 5 children. Ode-Aje, Ibadan, Oyo State, 27^th June, 2021

[46] Hunt, N. (1988). “Le Bebe en Brousse”: European Women, African Birth Spacing and Colonial Intervention in Breast Feeding in the Belgian Congo, p.406

[47] Interview held with Iya Oroki, a beverage seller, age 63 with 5 children. Oje, Ibadan, Oyo State, 24^th June, 2021

[48] Interview held with Mrs Simiatu Ramoni, age 65 with 5 children. Ode-Aje, Ibadan, Oyo State, 27^th June, 2021

[49] Interview held with Mrs Amope, a hairdresser, age 21 with a child. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[50] Interview held with Mrs Suliyat Akinbobola, Food Seller, age 25 with a child. Oje, Ibadan, Oyo State, 24^th June, 2021

[51] Interview held with Mrs Damilola Adetayo, age 24 with a child. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[52] Interview held with Mrs Amope, a hairdresser, age 21 with a child. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[53] Oladejo, M. T. (2019). Child Nutrition and Motherhood in Nigerian History, 1920s-1980s, p.24

[54] Interview held with Mrs Amope, a hairdresser, age 21 with a child. Atender, Irefin, Ibadan, Oyo State, 9^th July 2021

[55] Interview held with Mrs Tosin Adefami, a trader, age 31 with 2 children. Oje, Ibadan, Oyo State, 24^th June, 2021