Exclusive breastfeeding in first six months is good for children

Globally, malnutrition remains a key health issue whose severity threatens to derail progress towards the 2025 nutrition targets as envisioned by the World Health Assembly.

With less than three years to go, the world remains off track to achieve the targets, which aim to among others, achieve a 40 per cent reduction in the number of children under-five who are stunted, and increase the rate of exclusive breastfeeding in the first six months by up to 50 per cent.

Despite breastfeeding being customary in Africa, where more than 95 per cent of infants are breastfed, exclusive breastfeeding for the first six months of life stands at only 33 per cent. Yet the benefits are clear. Exclusive breastfeeding provides great nutritional value to infants, protecting them against childhood diseases and in the long-term, from chronic diseases such as obesity, hypertension, cardiovascular disease, and some types of cancers. Conversely, poor breastfeeding practices expose millions of infants to the risk of malnutrition and diarrheal diseases, leading causes of mortality in children under five. They also deny lactating mothers health benefits such as reduced risk of breast and ovarian cancers, type 2 diabetes and post-partum depression.

Integrating exclusive breastfeeding into existing health programmes can help improve outcomes along the life-course, reduce strain on health systems and decrease health care costs. Sustained breastfeeding can also drive progress towards other global nutritional targets, making it a sustainable tool to improve health and contribute to economic growth. According to research, low-and middle-income countries lose more than $70 billion annually due to low breastfeeding rates, which reduce cognitive abilities in children.

Despite clear evidence of the benefits of breastfeeding, millions of women around the world do not receive the support they need to exclusively breastfeed their children for the first six months of life. Barriers to breastfeeding include individual, structural and environmental factors such as short maternity leave, heavy workloads, inflexible working hours and lack of lactation facilities in the workplace, which increase the odds of mothers not breastfeeding by nearly 400 per cent.

Other barriers include aggressive promotion of breast-milk substitutes, lack of knowledge on the benefits of exclusive breastfeeding and inadequate healthcare support in addition to discomfort due to poor breastfeeding techniques, misconceptions on changes in physical appearance, social disapproval of breastfeeding in public and cultural practices that influence early introduction of other foods and fluids.

The Covid-19 pandemic has also created further challenges. In Uganda and Zambia, mitigation efforts have led to breastfeeding promotion and nutrition counselling either being paused or reduced, compromising the heath of mothers and infants.

As we celebrate World Breastfeeding Week this week, under the theme 'Protect Breastfeeding: A Shared Responsibility’, we must reflect on the actions we need to take to address these barriers. Beyond the rhetoric, we must take shared responsibility and put in place policies and incentives to support lactating mothers.

Interventions which seek to protect, promote and support breastfeeding have proved to be effective. Additionally, the value of hospital-initiated policies focused on exclusive breastfeeding education cannot be overlooked.

Other interventions include knowledge and skills training of health providers to improve education and practices, which should be complemented by legislation to enforce health insurance reforms that cover costs of lactation support and regulate the breast milk substitutes industry.

Exclusive breastfeeding coverage of 90 per cent could reduce child death rates in low-income countries by 11.6 per cent.

Dr Kuria is the regional programme manager for RMNCAH and Nutrition at Amref Health Africa