Wednesday, 11 September 2019

EXCLUSIVE BREASTFEEDING AND THE RIGHT OF THE CHILD TO NURTURANCE: APPRECIATING MEDICAL JURISPRUDENCE

EXCLUSIVE BREASTFEEDING AND THE RIGHT OF THE CHILD TO NURTURANCE: APPRECIATING MEDICAL JURISPRUDENCE
By:

Charles Ojochegbe ALI*
Mathew Ojoago AROME *


Abstract

Thousands of children under the age of five die every day in developing  countries,  largely from preventable causes often form lack of little or no financial worth of health care, a regular supply of nutritious food or clean water and sanitation. This paper examined the sensitive issue of breastfeeding from both infant’s and mother’s points of view. This research considered the right of the child to nutrition and life and the place of breast milk and concludes by considering the relationship between mothers to breastfeeding and the infant’s right to being breastfed. This research further examined that the right of the mother to breastfeed has often being exercised to the disadvantage of the child who is mentally immature and ought to be protected by law. This paper recommends that except in cases where medical precautions are given by health practitioners to a mother to withhold breast milk from a child, strict implementation of breastfeeding polices should be ensured by law. Finally, it was recommended that, government should provide the right knowledge and supportive environment to enable mothers practice exclusive breastfeeding in nurturing the child, despite several Anti-breastfeeding campaigns in the 21st Century which undermines human right goals and jurisprudence.

KEYWORDS: Breastfeeding, Human-right, Health, Nutrition, Infants, Child-right.

1.0 INTRODUCTION

Among the rights of the child, the right to life is the basis of other rights. The declaration of the rights of the child recognizes that - “…the child by reason of his physical and mental immaturity, needs special safeguards and cares; including appropriate legal protection, before as well as after birth”  and “every child has the inherent right to life”.

Human life medically begins at conception, and the proper custody thereof is the immediate duty of the mother with the supportive role of other health practitioners. The right of the child to nutrition at conception and upon birth cannot be over-emphasized; as same has been given several international statutory recognitions.  The major source of food for an infant is liquid; hence the idea of exclusive breastfeeding of infant as a human right is not in doubt,  considering the health implication of same on the life and growth of the child.

It is trite, that breastfeeding given its benefit to mother and infant, is considered to be the best form of nutrition for infants, though maternal and infants diseases may hinder breastfeeding in some instances.  Under these circumstances, the health professional should be skilled, have technical knowledge and adopt a favorable attitude so as to properly access the viability of breastfeeding.

Survey shows that, it is not that women don’t understand the value of breastfeeding, however mother’s across many countries of the world in the 21st century are concerned about themselves not having enough milk or time; exhaustion and rejection from their babies; feeling awkward to breastfeed in public (especially at work) and that their spouses are often not supportive,  thereby denying infants of natural breast milk, hence putting the child’s health and life at risk. Research further reveals that non-exclusive breastfeeding of the child has lead to about 70% of death rate of Children between 0-5years in the world.  Hence, this article focuses on the effectiveness of Article 6,  in protecting the child’s right to life and addressing the issue of ‘death by omission to breastfeed’ the child.

1.1 CONCEPTUAL CLEARIFICATION

Child

The word “child” has been defined differently in both local and international instruments dealing with the right and welfare of the child depending on the purpose for which it is made. The Black’s law Dictionary  defined a child as a person under the age of majority. The Children and Young Person’s Act,  defines a child as a “person under the age of fourteen years…”

The United Nations Convention on the Right of the Child  defines a child as every human being below age of eighteen years”. The Child Right Act,  defines a child as a person under the age of 18 years and majority means the age at which a person attains the age of eighteen.

The researchers are of the view, that the perception of age as a definition of a child in Nigeria and other international statutes depends on who is defining and varies according to cultural background. For all intent and purposes, a child as envisaged in this article is simply referred to a person who is below the age of years.

Infant
The word “infant” has often been used in various statutes inter-changeably with the word “minor” or “child”. However, for the purpose of this research, attempt is made to bring out the precise meaning of the word ‘infant’ especially within the context of medical practice.

The word “infant”, is derived from the latin word ‘infans’ meaning “unable to speak” or “speechless”, is the more formal or specialized synonym for ‘baby’.  A new born infant or neonate in medical context is a child under 28days of age.

Exclusive Breastfeeding

Exclusive breastfeeding is the process of feeding a newborn baby exclusively with breast-milk and no other supplement. The duration of exclusive as given by the World Health Organization (WHO) is 6 months after birth. The WHO, recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health.  Exclusive breastfeeding infants also reduce child mortality among Children between the ages of 0-5 years; as it helps lower risk of gastrointestinal infections, weight loss, inter lia.

Child Right

Children’s rights are human rights. They protect the child as a human being, and specifically adapted to the child because they take into account his fragility, specificities and age-appropriate needs.  Also, the idea of right can be described as an entitlement to something, whether of concepts like justice and due process, or ownership of property or some interest in property, real or personal. Hence, child right can be simply put as the legal entitlements of the child as a human being.

2.1 THE CHILD AND NUTRITION RIGHTS

The human rights of infants with regard to their nutrition are primarily located with the broader context of nutrition rights in modern international human rights law and principles. The foundation thereof lies in the Universal Declaration of Human Rights,  which declared that ‘everyone has the right to a standard of living adequate for the health and well-being of himself and his family including food…’
This right was also reaffirmed is two (2) major binding international agreements.

Article 11 of the International Covenant on Economic, Social and Cultural Rights,  states that-
The states parties to the present covenant recognize the right of everyone to an adequate standard of living for himself and his family including food, clothing, and housing…’ and  also recognizes the fundamental right of everyone to be free from hunger.

In the Convention on the Right of the Child 1990, two major articles address the issue of nutrition, to wit: Article 24, which states that - “State parties recognize the right of the child to the enjoyment of the highest attainable standard of health… ”  and shall take appropriate measures ‘to combat disease and malnutrition…through the provision of adequate nutritious foods, clean drinking water and health care’  this article further states that State parties shall take appropriate measures to ‘to ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and disadvantages of breastfeeding…’.

By Article 27,  parties ‘shall in case of need provide material assistance and support programmes, particularly with regard to nutrition, clothing and hosing’.

In Nigeria, the Child’s Right Act, Section 13, provides for a child’s right to heath and health services. The section provides thus; “every child is entitled to enjoy the best attainable state of physical, mental and spiritual health”  and every government, parent, guardian, institution, services agency, organization or body responsible for the care of a child shall (a) endeavor to reduce infant and child mortality (c) ensure the provision of adequate nutrition and safe drinking water. (e) Combat diseases and malnutrition within the framework of primary health care for children”

Thus a cumulative reading and interpretation of the aforestated provisions agrees that the human right to food and nutrition is well established both in international and domestic laws. Also, several non-binding international declarations and resolutions also help to shape the emerging international consensus on the meaning of the human right to food and nutrition.

The world summit for children held in 1990, called for ‘Empowerment of all women to breastfeed their children exclusively with complementary food, well into the second year’.  The World Declaration and Plan of Action for Nutrition 1992, pledged ‘to reduce substantially…social and other impediments to optimal breastfeeding’. The plan of Action asserted that, ‘Breastfeeding is the most secure means of assuring the food security of infants and should be promoted and protected through appropriate policies and programmes.’  It further stated that ‘Government, in cooperation with all concerned parties, should…prevent food-borne and water-borne disease and other infections in infants and young children by encouraging and enabling women breastfeed exclusively during the first four to six months of their children’s lives’

For the nutrition right of an infant to be protected on one hand, is basically dependent on the parents, most especially mother’s, this is because of the child’s immediate and direct dependence on them. The nutrition status of infants is also not determined by the quality of the food, health service care they receive directly but also the mother herself.  Hence, we submit that, Mothers, and Fathers as well should be entitled to good health services not only because of their own rights alone but also because of their obligations to provide for their children.

Accordingly, it is important to further note that, the Mother’s breast-milk protects the baby against illness by either providing direct protection against specific diseases or by stimulating and strengthening the development of the infant’s immature immune system. This protection results in better health, even years after breastfeeding has ended.  This optimal practice contributes to the highest standard of health for infant and young children and this forms an integral part of the Article 24 of the Convention on the Rights of the Child to the highest attainable standard of health.

2.2 ANTI-BREASTFEEDING CAMPAIGNS AND CHILD’S RIGHT TO
      HEALTH AND LIFE

Survey has it that, several feminist oriented groups and women around the world have launched various anti-breasting campaigns, thereby promoting their core value which is essentially the ‘Bottle Formular’ feeding patterns exclusively for the child.  These groups of activists disapprove of the declaration by international medical establishment(s) that only breast is best, and the position that anything short of exclusive long-term nursing with breast milk is an extreme danger to their children’s survival and heath.

Analytic reviews have repeatedly revealed the enormous impacts of breastfeeding on global health, nutrition, development and survival with nearly nine million child deaths each year primarily in low income countries, with half in Sub-Saharan Africa.  This infant death toll is largely attributable to infectious diseases, including diarrhea, pneumonia, measles, malaria, all of which can be reduced by optimal breastfeeding.  These analyses conclude that exclusive breastfeeding for the first six months of life, with continued breastfeeding for at least one year, is the single intervention that would save the largest number of children’s lives globally, preventing fifteen percent of child deaths and overcoming health set backs from preterm and how birth weight deliveries.

Consequently, the World Health Organization (WHO) and other international bodies strongly recommends exclusive breast feeding as discussed essentially in this work. Hence, the position of Anti-Breastfeeding activist basically grounded on the claim of woman’s fundamental rights to choice and fight against oppression is a treat to the child’s life, as the option of the use of breast milk substitutes are not without their hazards.

Also, some writers express the view that state should not interfere in parent-child relationship when it comes to child’s feeding except only in extra-ordinary situations when there is extremely compelling evidence that the parents are acting contrary to the best interest of the child. We are opposed to this position, by asking two questions; how do we justify or measure extra-ordinary situations? And at what point will it be ascertained that the parents conduct in not in the best interest of the child? Is it when the child is permanently deformed mentally or physically? In reply to this view, we submit that, since the state vide the instrumentality of the law is saddled with the duty to protect the life of all citizen(infants inclusive), the role of  the use of legal instruments in regulating parent-child relationship should not  be set aside, especially considering the mental capacity and immaturity of the child (infancy), and the medical benefit of natural breast milk (and the practice of exclusive breastfeeding ) on the child’s development, health and life.

CONCLUSION

The issues examined in this article raise two fundamental concerns to wit: that the right of the child to nurturance, especially for infants who by the reason of their mental immaturity are basically at the disposition of their parents to be well fed is exhaustive and less implemented especially at the national governmental level; striking a balance between women’s interest in breastfeeding and the infants right to being breastfed on the one hand ; and secondly, that the study observed that, in most cases where world international organizations, NGO’s, make efforts to introduce international and statutory legal norms on the need to protect the infant’s rights to nutrition, health, and life via the adoption of exclusive breastfeeding policies, is given little or no attention, especially that they are not of binding effect.
RECOMMENDATION
This article by way of recommendation prays for a holistic reform of National laws to adopt breastfeeding rights as prescribed in several global breastfeeding policies through international laws to enable infants, and those not exempted by medical prescription, access to natural breast milk as of right.
Furthermore, the National government is encouraged to strengthen the enforcement provision of domestic Child rights laws, to include exclusive breastfeeding right given its health benefit, and to ensure right based accountability rather than the mere use of government’s social campaigns on breastfeeding, issuing codes of corporate conduct which are non-binding recommendations.
We also recommend that international organizations should through their negotiated documents, committees, elaborate the right to breastfeeding, with the goal of assisting states in setting proprieties for the progressive realization of breastfeeding policy.
And lastly, that government provides the enabling environment and education for women, especially of working class citizens to practice exclusive breastfeeding in the infant’s interest, especially in safe guarding the life of the child.

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