By Maryanne Waweru-Wanyama, Kenyan motherhood blogger and maternal/child health journalist based in Nairobi.
As Kenya joins the rest of the world in marking the World Breastfeeding Week, health experts in the country are calling on more stringent efforts to be put in place that will encourage more women to exclusively breastfeed their babies. Though the country has noted an increase in the exclusive breastfeeding rates over the last decade, the numbers are still not enough.
Data from the Kenya Demographic Health Survey (KDHS) show that in 2003, the exclusive breastfeeding rates stood at 13 per cent, and which rose to 32 per cent in 2008. Despite this remarkable improvement, Kenya’s Health Cabinet Secretary Mr. James Macharia says that the figures are still not at a desirable level, adding that many Kenyan children still miss out on the important nutritional benefits of breastmilk.
“Out of approximately 1.5 million children born each year in Kenya, only 500,000 of them are exclusively breastfed. This means that over 1 million babies are exposed to the unnecessary risk of malnutrition and increased illness which impact negatively on the country’s road to achieving MDG 4 –that of reducing child mortality,” he says.
A new mother at Pumwani Maternity Hospital on August 1 2014, the day of the launch of the World Brestfeeding Week celebrations in Nairobi at the maternity hospital.
The reasons for the low uptake of exclusive breastfeeding among Kenyan mothers are many. A study conducted by the African Population and Health Research Center (APHRC) in two urban slums in Nairobi revealed that only about 2 per cent of children were breastfeed exclusively for the first six months. The study also found out that about 15 per cent of children stop breastfeeding altogether by the end of the first year. Some of the reasons for this low uptake include: poverty, food insecurity, ignorance about best breastfeeding practices, lack of social support, as well as myths and misconceptions about breastfeeding.
Another reason for the low uptake of exclusive breastfeeding is misinformation about breastfeeding when the mother is HIV positive. A significant number of HIV+ Kenyan women think they will transmit HIV to their newborns if they breastfeed them, and so do not offer them breastmilk at all, instead offering them cow’s milk. Notably, and in relation to this, is the fact that the number of Kenyan women who seek antenatal care services (a minimum of four visits during their pregnancy) is only at 47 per cent. Similarly, the number of women who seek postnatal care is 42 per cent. These figures only mean that a large number of women miss out on ideal opportunities for them to receive information about best practices in maternal and newborn health, including information about the extraordinary benefits of breastfeeding.
Working women face barriers too as there are some Kenyan employers who do not adhere to the Kenya Employment Act which offers women a maternity leave of fourteen weeks. Many working women have been called to return work before the end of their maternity leave. Sadly, and despite being aware of the law and its provisions regarding this, many career women agree to return to work before completion of their maternity leave for fear of losing their jobs. Consequently, many middle and upper class working women introduce formula milk to their babies from as early as two months, while the low income women who cannot afford formula milk introduce cow’s milk or porridge to their baby’s diet.
Ignorance also exists among many rural women, who believe that breastmilk alone is not sufficient enough for a baby’s optimal growth and therefore introduce porridge (blended with fish, millet and sorghum) from as early as two months in order to ‘supplement’ the baby’s diet. For many rural communities, a ‘fat’ baby is considered healthy, and many mothers, for fear of reprimand by relatives and health workers about having a ‘think unhealthy baby’ introduce solids to babies (mixed with margarine) at a tender age. Many women in rural communities are yet to be reached with information on the fact that breastmilk alone contains all the nourishment a baby needs for the first six months of life.
Some of the steps the government has made to try and increase the uptake of breastfeeding among Kenyan mothers is the enactment of the Breastmilk and Substitutes (Regulation and Control) Act (2012) which regulates the marketing and distribution of breastmilk substitutes and provides for safe and adequate nutrition for infants through promotion of breastfeeding.
The government has also adopted the Option B+ program, where mothers and their newborns receive ARVs, and which helps keep the baby HIV negative while still enjoying all the benefits of breastmilk.
Terry Wefwafwa, head of nutrition and dietetics at the Ministry of Health. She is hopeful that increased awareness campaigns on breasfeeding will translate into more women taking up the practice.
There have also been awareness campaigns through the media –both mainstream and community radio promoting exclusive breastfeeding. Such campaigns work towards increasing the level of information to not only the women, but also men and other members of the household on the critical role they can play with regard to supporting best breastfeeding practices. It is these awareness campaigns that are giving Kenya’s head of nutrition and dietetics, Mrs. Terry Wefwafwa confidence that the next survey will reveal a significant increase in the number of women exclusively breastfeeding.
“Since the last survey was done in 2008, intense sensitization among communities about the benefits of breasmilk have been done, and I am confident that the uptake on exclusive breastfeeding has increased. This will be evident in the next survey report,” she says.
Maryanne Waweru-Wanyama is a motherhood blogger from Nairobi, Kenya. She tells her motherhood stories on her blog mummytales.com where she also incorporates the experiences of other Kenyan mothers. On her blog, Maryanne provides education on pregnancy, birth, delivery and infant and child care and nutrition. Maryanne is a journalist with over fourteen years experience and who has written, and still writes for various publications in Kenya including: the Daily Nation newspaper, the Star newspaper, the Standard newspaper, Parents Magazine, Healthy Woman Magazine, Healthy Child Magazine and many other publications. Her area of specialty is human interest features, maternal and child health articles. Maryanne is married with two sons.