The Harrowing Tradition of Breast Ironing in Nigeria: One Woman's Struggle and Hope for Change

In Summary

• Breast ironing, a harmful cultural practice intended to delay puberty and protect girls from male attention, remains prevalent in parts of Nigeria and Cameroon.
• Elizabeth John, a Cameroonian refugee, underwent breast ironing at age 10, leading to long-term physical and emotional trauma.
• The practice causes severe pain, uneven breast development, and complications with breastfeeding, as evidenced by John's personal struggles.
• Activists and organizations are working to raise awareness and end breast ironing, but cultural beliefs and secrecy hinder progress.

Abuja, Nigeria – When children turn 10, their first double-digit milestone is usually a time of excitement. But for Elizabeth John, it was a day filled with dread. A day after her 10th birthday, three older women held her legs down as her mother pressed a burning hot pestle against her developing breasts, ignoring her screams of pain.

Nearly two decades later, the 27-year-old Cameroonian refugee, who grew up in Nigeria’s Cross River State, vividly remembers that day. John still grapples with the physical and emotional scars left by the practice of breast ironing.

Breast ironing, or "breast flattening," is a cultural practice where young girls’ breasts are ironed or pounded down with heated objects to delay their development or disguise the onset of puberty. According to the Africa Health Organization (AHO), communities believe it makes girls less attractive to men, thus protecting them from harassment, rape, abduction, and early forced marriage, while also keeping them in school.

However, health bodies and rights groups label it as a form of physical mutilation that harms a child’s social and psychological wellbeing and contributes to the high school dropout rate among affected girls. The United Nations (UN) reports that breast ironing affects some 3.8 million women in Africa and is one of the five most under-reported crimes related to gender-based violence.

In countries like Cameroon and certain parts of Nigeria, an estimated 25 to 50 percent of girls are subjected to the practice, according to data from the Annals of Medical Research and Practice. In John’s home community in Cross River State, the procedure is culturally imposed on most girls and typically performed by their mothers or other maternal figures.

For years, John suffered from pain, uneven breast development, and weak and saggy muscles. The pain was so intense at age 19 that she had trouble sleeping. Despite visiting doctors, her family did not believe breast ironing was the cause, adhering to their cultural beliefs.

"Before I married, I would buy painkillers for the breast pain, but it worsened after marriage [and pregnancy] when I was trying to breastfeed my child," she told Al Jazeera.

In 2021, as she was about to give birth, a doctor explained that breast ironing had damaged her glandular tissue, making breastfeeding difficult. The suggested medical procedure to help her cost $5,700, which she and her husband, who works in furniture, could not afford.

After giving birth, she struggled to breastfeed correctly. The doctor recommended formula, but the couple could not afford it. Tragically, they lost their baby when he was four months old.

Dr. Ushakuma Michael Amineka, a gynecologist at the Benue State Teaching Hospital, explained that breast ironing can leave long-term effects. "The immediate consequences can include pain because the breast is very soft tissue. If compressed, it can cause pain and even distort the normal anatomy of the breast tissue. Long-term consequences could include difficulties with lactation, as it can destroy breast tissue and lead to infections, causing long-term pain and reduced breast milk production."

According to 2021 research published by the United States’ National Institutes of Health (NIH), the harmful practice is typically carried out by close female relatives, sometimes with the help of traditional midwives, and is maintained in secret by female members of the family and community, typically hidden from men.

Traditional and household tools are usually used, including grinding stones, cast iron, coconut shells, calabashes, hammers, sticks, or spatulas. Additionally, it can involve tightly wrapping the breasts with a belt or cloth.

The lack of good data and empirical studies on breast ironing has limited a broader understanding of the practice and its prevalence.

"This cultural practice is horrible and inhuman," David Godswill, a Nigerian human rights activist, told Al Jazeera. He emphasized that the procedure is cruel, causing women and girls physical pain and shame about their bodies.

For John, the health effects of breast ironing have caused years of personal pain and struggle. Now living in Gbagyi, an Indigenous community in Nigeria’s capital Abuja, every day is a reminder of her childhood trauma.

Breast ironing is a longstanding tradition in Gbagyi. Many young girls in the community have had their breasts ironed, John told Al Jazeera. When she tried to warn mothers about the health risks based on her own experience, they did not believe her and thought she wanted to encourage intimacy between men and younger girls.

Conversations Al Jazeera had with seven local women in Gbagyi revealed that nearly all had experienced breast ironing and had pushed their daughters to undergo the procedure to protect them from male attention and sexual abuse. Many said their mothers and grandmothers also underwent this practice.

One woman, Roseline Desmond, said that when a group came three years ago to raise awareness about the health implications of breast ironing, some women promised to stop while others remained unconvinced. Some midwives even perform breast ironing as a source of income, similar to female genital mutilation.

John is determined to stop the practice in her own family. "My daughters will never experience the pain I endure from breast ironing," she said.

Breast ironing, like other harmful traditional practices, is considered a violation of human, child, and gender rights. In Nigeria, practices such as female genital mutilation, breast ironing, and forced marriages are criminal offenses under the Violence Against Persons and Prohibition (VAPP) Act.

Olanike Timipa-Uge, the executive director of Teenage Network, a feminist-led nonprofit, explained that one of their key focuses is breast ironing in Nigeria’s capital, Abuja. A baseline assessment revealed that one in three adolescent girls in various communities within the Federal Capital Territory (FCT) had experienced breast ironing.

Timipa-Uge emphasized the importance of educating parents about the severe health consequences of breast ironing through community outreach and advocacy programs. Despite their efforts, the reporting rate remains significantly low due to a lack of awareness.

In Gbagyi, John faces pressure from her husband’s family to have another baby after they lost their first child. But only she and her husband know the real reason behind their ordeal. "I have been silently battling pain in my breasts. The doctor told us we need over N15 million ($5,400) for treatment before the pain stops and my breasts can be fit for breastfeeding," she said.

Since her husband lost his job last year, it has been difficult for them to afford food, let alone an expensive medical procedure. "I don’t know when the pain will stop. It keeps hurting my breasts," John said. "And since we don’t have money for treatment, only God knows."