Mother’s milk has an enormous impact on child survival. While in Kenya it has improved over the past decade, the number of children who die before five years remains significant. The rate has decreased from 115 per 1000 live births in 2003 to 52 in 2014.
Neighbors Rwanda (2008), Tanzania (2012) and Uganda (2011) have recorded 50, 66 and 65 deaths per 1,000 live births for children below five years, respectively.
The main causes of childhood deaths are infections, preterm births and lack of sufficient oxygen, or asphyxia.
Breastfeeding infants on breast milk alone until they are six months old has been shown to reduce child mortality. When mothers can’t provide their own milk, the next best alternative is donor milk from other women. Access to “human milk banks” gives vulnerable infants, without access to their mother’s own milk, a healthy start to life.
The milk bank concept was initiated in Vienna in 1909 and was preceded by a century old practice of wet nursing – a mother breastfeeding another mother’s child.
Since then, over 500 human milk banks have been established in more than 37 countries globally in developed and developing countries. The pioneer countries include Brazil, South Africa, India, Canada, Japan and France.
I am always happy when World Breastfeeding Week rolls around each year. It gives me a chance to hear about the latest programs that are working around the world to increase breastfeeding rates. This year I learned about how World Vision is promoting breastfeeding in the Philippines through its 7-11 Core Intervention Framework which includes 7 interventions for women and 11 for children 0 – 24 months of age.
The way in which we discuss breastfeeding is different depending on the country and the context. While in the United States we talk a lot about infant feeding choices, in other countries, especially those that have thousands upon thousands of yearly infant deaths caused by diarrheal diseases, infections, and sub-optimal feeding, the context changes. In these cases, it is nearly always critical that mothers breastfeed their children up to two years of age.
In the Philippines, parents spend $240 million on breast milk substitutes and multinational formula feeding companies spend $100 million on marketing in the Philippines alone. Those numbers account for the fact that only 34% of infants under the age of six months are exclusively breastfed. While providing the best start in life for infants, many mothers are convinced that formula is better and easier for their lifestyles. But, often times women in low-and-middle-income countries like the Philippines do not always have access to clean water for formula. Dirty water can cause deadly diarrheal diseases that kill infants.
There’s a growing global recognition of proper infant nutrition in the child’s first 1000 days of life. This can be monitored through encouraging proper nutrition during pregnancy and the first two years of life for optimal growth, health and survival.
Poor breastfeeding and complementary feeding practices are some of the common causes of malnutrition in the first two years of life. Breastfeeding confers both short-term and long-term benefits to the child like reducing the risk of infections and diseases like asthma, obesity, and type 2 diabetes. Mothers who breastfeed also lower their risk of developing breast and ovarian cancer, weak bones, obesity and heart diseases.
For countries to reap the benefits of breastfeeding they need to achieve a baby friendly status. Kenya began promoting the baby friendly hospital initiative approach in 2002. It ensures that health facilities where mothers give birth encourage immediate initiation of breastfeeding and exclusive breastfeeding for the first six months. Unfortunately, this programme was only accessible to women who delivered in the health facilities, leaving out those who give birth at home.
We conducted a two year study involving 800 pregnant women and their respective children in a rural area in Kenya. The study involved testing feasibility and potential effectiveness of the baby friendly community initiative (BFCI), whereby women in the intervention arm were given home-based counselling on optimal breastfeeding alongside health facility based counselling. These mother-child pairs were followed until the child was at least six months.
Breastfeeding has both short-term and long-term nutritional benefits for children. Nutrition is central to sustainable development. Good nutrition in the first 1000 days of a child’s life is critical for child growth, well being and survival, and future productivity.
The World Health Organisation recommends exclusive breastfeeding for children until they are six months old and continued breastfeeding with appropriate complementary feedings until children are two, for optimal growth and development.
What Kenya did right
Kenya has seen a remarkable growth in exclusive breastfeeding for children under six months old. In 2003 only 13% of mothers were breastfeeding exclusively. This year, according to the National Demographic and Health Survey, 61% of mothers of children aged less than six months were breastfeeding exclusively.