Exclusive breastfeeding: A chance for survival [Archives:2005/904/Health]

December 19 2005

The lives of almost six million infants could be saved every year if for the first six months of life they were exclusively breastfed immediately within half an hour of birth. That means nothing but breast milk)no solids, no other liquids, not even water, as recommended by UNICEF and WHO. The lives of almost six million infants could be saved every year if for the first six months of life they were exclusively breastfed immediately within half an hour of birth. That means nothing but breast milk)no solids, no other liquids, not even water, as recommended by UNICEF and. In the first two months of life, an infant who is not exclusively breastfed is up to 25 times more likely to die from diarrhoea and four times more likely to die from pneumonia than a non-breastfed baby. Exclusive breastfeeding (EBF) also minimizes an infant's exposure to potentially unsafe food or water. Breastfeeding is the initial source of vital micronutrients, as will as providing overall sound nutrition and good health. The immune factors, growth factors, and other protective factors in mother's milk cannot be found anywhere else in nature.

Recent research is indicating that early infant feeding, especially exclusive and continued breastfeeding, is associated with less obesity and reduction in other heart risk factors throughout childhood and into adulthood. Incidence of diaper rash, stomachache and constipation are far fewer among breastfed infants. Currently, an estimated 63% of children less than six months in the developing world are not adequately breastfed. Lack of breastfeeding exposes infants to an increased risk of death and disease in childhood, and increases the risk of chronic diseases such as diabetes and childhood cancer. The results can be devastating. Infants who are not breastfed early and exclusively are left with limited defenses against killer diseases like pneumonia and diarrhoea and lack essential nutrients to develop body and mind. In a developing country, a child that is not breastfed is about three times more likely to die in early infancy than a breastfed child, and EBF reduces the risk still further. In the majority of cases, the lethal hand of malnutrition and poor breastfeeding practices is far more subtle: they cripple children's growth, render them susceptible to disease, dull their intellects, diminish their motivation, and sap their productivity. Recent research has proven that a woman who breastfeeds is less likely to get breast and ovarian cancer including many other forms of cancer. Unfortunately despite these benefits, most mothers are not following the recommendations. The causes are largely due to social attitudes, lack of support within the community, especially by husbands and grandparents, women working long days, inadequate education and mothers not being aware of the vital importance of this issue. The need to protect the rights of women and girls is critical. Wherever women are discriminated against, there is greater malnutrition. Children born to mothers with no education are twice as likely to die in infancy as those born to mothers with even four years of schooling.

Breastfeeding is critical to efforts to combat hunger and promote child survival as well as progress towards the Millennium Development Goal: to reduce child mortality by 2015. “Exclusive breastfeeding is one of the most powerful tools we have to combat child hunger and death,” said UNICEF Executive Director Ann M. Veneman.

Currently, about 39% of infants worldwide are exclusively breastfed during the first six months of life. Data from 69 developing countries, including new estimates from 40 countries show that half of them have EBF rates below 25%, with 14 countries at 10% or less. In only 15 countries are 50% or more of the infants exclusively breastfed. The Middle East and North Africa region has yet to engage in more resolute action to ensure that infants are breastfed between 0-6 months of age, although notable achievements by countries like Syria and Egypt have reached more than 50% of EBF at their national levels.

In Yemen EBF rate reached 24.5 (1997). Such figure is considered low. High illiteracy rates, social attitudes and lack of family support are considered the most common constraints. More efforts should be done to scale up action in this issue by investing new updated approaches recommended by UNICEF and WHO. Empowerment of women by increasing female primary school enrollment is required, as will as disseminating awareness among Yemeni population will help attaining the objective to adopt this strategy.

Comparably EBF rates increased by 10% over the past decade in the region and improvements were also noted in complementary feeding and in continued breastfeeding for the second year of life. However, the lack of continued support and irregular monitoring of the process have led to a recent decline in breastfeeding and in the number of hospitals promoting the practice.

It's not always easy for a mother to breastfeed. The pressure of family responsibilities, restrictions in the workplace, and social expectations can, and often do, interfere with a mother's preference to exclusively breastfeed her children. Women must be supported by husbands, communities, healthcare systems, and grandparents when considering what is best – and they must be supported to succeed once a choice is made.

Promoting policies and systems that improve health skills and support communities in educating mothers about the benefits of breastfeeding and creating an environment that will enable mothers to make the best possible choices in feeding their infants and young children should be the top priority of concerned national programmes in countries with low EBF rates. Protecting the rights of women and girls, delivering proper nutrition messages and educating the general public, particularly child care providers on the absolute benefits of breastfeeding are key interventions. UNICEF works with partners, governments and communities to protect and promote breastfeeding by supporting national infant-feeding legislation, improving ante- and post-natal care and boosting resources for new mothers at the community-level. Protecting breastfeeding during emergencies is also a major UNICEF priority, when poor feeding practices can allow diseases to claim lives with frightening speed.

Calling on governments to promote and protect early and EBF, UNICEF and WHO have jointly launched the Global Strategy for Infant and Young Child Feeding. The strategy calls for a dramatic increase in the number of infants who are exclusively breastfed. The strategy is an invaluable roadmap for governments to create supportive environments where women can make informed choices about feeding their children. The strategy also highlights the issue of optimal feeding of the millions of children who are born to HIV-infected women each year. While about 10-20 percent are born already infected, there is an additional risk of HIV transmission through breastfeeding – estimated to be between 5 percent and 20 percent. This risk needs to be balanced against the increased risk of morbidity and mortality when infants are not breastfed. All HIV-infected mothers should receive information about the risks and benefits of various options and guidance in choosing the most suitable option. In addition to stressing the link between the health and nutritional status of mothers and children, the strategy addresses the challenges of feeding in exceptionally difficult circumstances, such as natural or man-made emergencies.