Breastfeeding: Understanding the past, planning for the future

Exclusive breastfeeding for the first six months of life yields health benefits, provides critical nutrients, protection from deadly diseases and fosters growth and development. Unfortunately, mothers are avoiding this crucial duty, exposing infants to early death, writes Peter Orengo

This month, the world comes together to mark World Breastfeeding Week (WBW) amid startling reports that more than 11,000 children under the age five in Kenya die annually due to poor breastfeeding practices.

The global event is marked every August to advocate for the right of infants and young children to proper nutrition through optimal breastfeeding. The objective is to promote, protect and support breastfeeding as the optimal way of feeding infants in the first six months of life.

Although Kenya is a predominantly a breastfeeding nation, only 32 per cent of Kenyan children are exclusively breastfed for the first six months of life as indicated in the 2008-09, Kenya Demographic and Health Survey (KDHS).

The report also reveals how children fed with their mother’s milk in the first six months are performing better in school than those who were given milk formula.

“Adequate provision of nutrients, beginning in the early stages of life is considered crucial to ensure good physical and mental development,” read the report in part.

This is done through exclusive breastfeeding, which is considered as the single most effective intervention to reduce under-five mortality by one fifth.

As part of national child survival strategies in Kenya, exclusive breastfeeding is one of the High Impact Interventions (HII) that has been prioritised as a critical intervention in child survival.

“This calls for concerted efforts in advocacy, especially by key policy-makers, stakeholder’s, health workers, private sector and the general community in order to support mothers to successfully breastfeed their children,” said Dr Annah Wamae, senior assistant director of Medical Services, during the launch Infant Feeding and HIV Guidelines, at a hotel in Nairobi.

The study also revealed that Kenya loses more than Sh76 billion every year treating three major, but preventable diseases caused by improper breastfeeding. The three include Otitis Media, lower respiratory tract infections, and gastrointestinal illnesses.

New developments

It is recommended that babies should be breastfed for the first six months before weaning, but the survey showed most Kenyan mothers prefer ‘mixed-feeding’ rather than exclusive breastfeeding.

The report adds: “One in three children in Kenya are malnourished mitigating in a child’s right to optional survival and development and failing to eradicate extreme poverty and hunger, reduce child mortality and improve maternal health.”

A similar study by Oxford University and the Institute for Social and Economic Research, Essex University, found that as little as four weeks of breastfeeding for a newborn baby has a significant effect on brain development, which persists until the child is at least 14 years old.

The research is published in a working paper The Effect of Breastfeeding on Children’s Cognitive Development, which has yet to be peer reviewed. The researchers matched each breastfed baby with one or more babies who were not breastfed, but who were similar in all other respects. Test scores in reading, writing and mathematics for the children at ages five, seven, eleven and 14 revealed a statistically significant difference between those who had been breastfed as compared to those who had not.

According to Gladys Halima, a nutritionist specialising in health promotion, the benefits of breastfeeding are numerous because breast milk is readily available and affordable to all whether rich or poor.

“Colostrum is the initial fluid from the mother’s breast immediately after delivery and is the instant immunisation baby gets immediately it is born,” Halima says.

She adds that in the first six months of life, breast milk offers optimal nutrition for the infant because it is safe even in case of any illness. It is a process that enhances bonding between mother and child. Breastfed babies also have notable milestones compared to babies who have been fed on alternative feeds.

Latest scientific research corroborates exclusive breastfeeding as a practice with the potential to avert at least 13 per cent of all under-five deaths in developing countries, or more than a million lives a year.

“Studies by World Health Organisation (WHO) and United Nations Children’s Fund (Unicef) have found that education and support for mothers significantly extends the number of months that mothers breastfeed, and is especially helpful in promoting exclusive breastfeeding,” said Halima.

Education on breastfeeding

She says breast-milk alone is the best food and drink for a baby for the first six months, since babies who are breastfed look healthier and grow better than those who are not.

According to Unicef, mothers need to get all the information and encouragement that they need regarding breastfeeding from a health worker at the nearest clinic, or from other experienced mothers in their community who have exclusively breastfed successfully.

With regards to HIV, it is important for all women to be counseled and tested for HIV during pregnancy so that they can be given information on how to best prevent infecting the baby if they are HIV positive.  This can be when pregnant women go to clinic for antenatal care, as soon as they know of their pregnancy.

This year’s celebration will mark the 20th year of world breastfeeding week celebration and all countries will be celebrating their achievements in the ten years of implementing the WHO and Unicef’s Global Strategy for infant and young child feeding.

The theme for this year will be: Understanding the Past- Planning the Future” Celebrating ten years of WHO/UNICEF’s Global Strategy for Infant and Young Child feeding.

GLANCE

Fact File

Importance of breast milk alone for first six months

•     The baby grows and develops very well.

•     The baby is protected against sickness because breast milk has antibodies for immunity.

•     Breast milk has all the nutrients that a baby needs.

•     Breast milk is easy for the baby to digest.

•     Breast milk is always available for the baby. It does not need time to be cooked or prepared.

•     Breast milk is always warm enough for the baby to drink.

What should not be fed to a baby in the first six months

•     Water

•     Infant formula

•     Animal milk – examples: from cow, goat, camel

•     Milk products – examples: ghee, cream or butter

•     Any food – examples: mashed potatoes, green bananas, pawpaw

•     Any fruit juices – examples: orange, passion

•     Any liquids – examples, juice, tea, sugar water, gripe water, rice water or porridge

Dangers of giving a baby other foods or liquids in the first six months of life

•     The baby may have difficulties in digesting other foods and liquids.

•     The baby is exposed to diarrhoea and vomiting if preparation of the foods and liquids is not done using clean utensils and water.

•     The foods or liquids may be cold, exposing the child to coughs, colds and pneumonia.

•     The foods or liquids do not have natural antibodies, so child is exposed to other health problems such as ear and chest infections.

•     A baby who takes other foods or liquids in the first six months is likely to suckle less on the breast. This reduces breast-milk production.

What mothers fear about providing breast milk alone in the first six months

•     That breast-milk will not be enough to satisfy the baby.

•     That when the mother goes back to her routine work, she will not have time to breastfeed exclusively.

•     That it is not possible for the child to grow well with breast-milk alone.

•     That when the mother is HIV positive, the virus will pass to the baby.