Child malnutrition is a huge problem in Africa.
Fatima Idi straps her two-year-old to her back and begins a long trek every week that takes her to a place where Nigeria's tragic struggle with child malnutrition is on full display.
"I breastfed my child for 18 months before I weaned him, but he kept growing thinner and sicker," Idi said at a feeding centre amidst the weak cries of frail children. She walks about 15 kilometres (about 10 miles) to get here.
Nigeria has one of the world's highest number of malnourished children, and the problem is particularly concentrated in the country's north, a hot, dry region not far from the desert.
But besides the climate, aid workers say a range of cultural factors also play a role, including a belief that water should be given to newborns and herbal concoctions ward off ailments and evil spirits.
New mothers also tend to return to work soon after giving birth in rural Nigeria, leaving little time for proper breastfeeding, and the water provided to the children can sometimes be unsanitary, they say.
"Most mothers will tell you they breastfeed their babies, but after a few inquiries you realise that they don't do it the proper way," said Oluniyi Oyedokun, a nutrition specialist with UN children's fund UNICEF.
"They don't practice exclusive breastfeeding for the first six months of birth."
Nigeria has seven million malnourished children under five. That makes it third, after India and China, on the global list of 20 countries that account for 80 percent of the world?s undernourished children, according to UNICEF.
The centre for malnourished children under five in remote Jigawar Nafada village is one of 15 primary health care clinics run by UNICEF focused on the problem in northeastern Gombe state.
Gombe and five other states in northeastern Nigeria have the most cases of child malnutrition in the country. Idi is among more than 160 mothers who attend the Jigawar Nafada clinic to seek nutrition therapy for their children.
In some parts of Nigeria's northeast, malnutrition for children under five is believed to be as high as 42 percent, according to a UNICEF report.
"Child malnutrition is a huge problem in northern Nigeria," Susan Ojomo, a UNICEF official for 10 northern Nigerian states, told AFP.
"By the time you are having two-digit prevalence rate, malnutrition becomes a serious health problem that should be urgently tackled."
Treatments involve feeding children nut pastes, while also giving them anti-malarial drugs, de-worming tablets, vitamin A supplements, measles vaccine and amoxicillin antibiotic.
The problem in the north is mainly due to a lack of consistent breast feeding, said Tunde Oguntona, a nutrition professor who led a UNICEF-funded malnutrition study in four northern states with the highest rates.
"Infants are usually given holy water at birth to ward off evil spirits and introduced to herbal concoctions as a cure for ailments such as fever and jaundice," Oguntona said.
He added that "in some cases the infants are denied breast milk for three days with the belief that the colostrum from the breast is harmful."
Colostrum is the thick yellowish milk from a new mother?s breasts just after childbirth that nutritionists say is good for infants as it is rich in protein, calcium, sodium and vitamin A.
According to Oguntona, introducing an infant to breast milk within an hour after birth reduces the child's chances of death by 22 percent. He said 70 percent of mothers in the four northern states with the highest rates do not do that.
Mothers in northern Nigeria also have little time for breastfeeding because they complement family income by working on farms or in the civil service.
"Time is very crucial in taking care of infants, and mothers? occupations can have definite bearing on the degree of adequate care given to infants," Oguntona said.
Health workers say education is needed to help mothers understand how to keep their newborns healthy. UNICEF workers advise mothers who attend the clinics, but experts say the government should do more to reach out to pregnant women.