What if governments had a proven, cost-effective way to save babies’ lives, reduce rates of malnutrition and support children’s health?
Unicef executive director Anthony Lake believes breastfeeding is the solution. "It is one of the best investments nations can make in the lives and futures of their youngest members and in the long-term strength of their societies,” he said.
According to WHO, breastfeeding is a baby’s first vaccine and the best source of nutrition. It can improve brain development and mothers are encouraged to exclusively breastfeed their babies for the first six months of their infants’ lives.
But breastfeeding is not just a one-woman job. Women require support from family, healthcare providers, employers and policymakers to make the six months target attainable.
World Breastfeeding Week 2017
‘Sustaining Breastfeeding Together’ – that has been this year’s theme for the World Breastfeeding Week which runs from August 1 to August 7 every year.
As mothers and stakeholders came together to discuss the progress in attaining the WHO recommended six months of exclusive breastfeeding, Kenya was not left behind.
In June, before adjourning, MPs passed the Breastfeeding Mothers Bill, 2017 that seeks to compel employers to set aside rooms where lactating mothers can express milk for infants while at work freely.
If assented to, every organisation with more than 30 employees will be required to not only have a breastfeeding room, but a changing facility for babies. The Bill proposes that employers give mothers with infants regular breaks lasting not more than 40 minutes every four hours.
In addition to the Breastfeeding Mothers Bill, another development is the formation of the Kenya Association for Breastfeeding, which seeks to increase awareness, promote the activity and support mothers.
Kenya Association of Breastfeeding
KAB was launched on July 29. It was founded by a group of certified breastfeeding counsellors and lactation educators. The association’s motto is ‘Breastfeeding takes a village’.
The Star spoke to KAB co-founder Josephine Karoki and Career Mothers for Exclusive Breastfeeding director Martha Kimkung on the developments towards achieving the six months breastfeeding target.
New mothers’ struggles
Many mothers lack sufficient emotional, mental and physical support during the first six months postpartum, but the issues are magnified for working mothers because there is almost no support available in most workplaces.
Kimkung says a breastfeeding mother who also works needs a supportive employer who is also invested in her goal to exclusively breastfeed her baby for the first six months.
This can only be achieved if mothers are given the time and facilities to express milk, store it and get it to her child in good time.
Kimkung says, “It would be better if a mother can physically breastfeed her baby by either bringing the child to work, working part time or working from home after the three months maternity leave has expired.”
Organisations with best practices
Few organisations in Kenya support breastfeeding mothers. According to the Kenya Private Sector Alliance, some of the companies with best practices include Safaricom, Kenya Women Microfinance Bank, NestlÃ© and Mabati Rolling Mills. Other organisations include the International Medical Corps, the Kenya Red Cross, World Vision, ICRAF and the World Bank.
Some of the best practices include allowing women to combine the 90 days statutory maternity leave with their annual leave, the option of flexible working arrangements - reporting to work later and leaving early, the provision to work half day after maternity leave, designated breastfeeding rooms with pumping and milk storage facilities and the setting up of children’s crÃ¨ches.
Karoki says, “It is difficult for working mothers to strike a balance between being available to their children and excelling in their careers, and more often than not, one aspect will suffer. Some women choose less demanding careers after having children while others choose to create a strong support system of caregivers at home that allows them to focus on their careers.”
Concerning the Breastfeeding Mothers Bill, Karoki is cautious about celebrating it being passed. She says, “Breastfeeding bills are usually passed in Parliament, but are never assented to by the President. These bills continuously coming back into Parliament shows there is a need to improve the health of infants in Kenya. Breastfeeding is the optimal way of feeding an infant for the first six months of life. We need to ensure we bring up a healthy next generation.”
Karoki continues, “Women were given the exclusive and unique position to be mothers and nurses of the next generation of workers – male and female – by God and nature. They, therefore, should not be discriminated against because of the motherhood factor or just because men do not have the awesome privilege of bearing and nursing children. The uniqueness of motherhood should be acknowledged and not frowned upon. Motherhood should not be looked at as a disadvantage, but rather should be celebrated and protected.”
Kimkung says it is unfair to make women choose between motherhood and their careers.
Myriad of challenges
Time and space to breastfeed in the workplace is not the only challenge nursing mothers face that make them abandon breastfeeding early. Cracked nipples, pain and discomfort as the baby learns to latch on and engorgement are some of the other issues that have made some mothers abandon breastfeeding early.
Samantha Wayua, a mother of one, says, “Every time my son tried to grab my nipple, I felt so much pain I wanted to cry and push him away. So many times I wanted to give up on the breastfeeding, but it got better with time. I know many friends who didn’t have the patience to stick it out.”
Karoki says there is a lack of cohesion between stakeholders and influencers.
“The information given to an expectant mother regarding breastfeeding will most likely come from her peers or the internet and this information may not be correct or supported by facts. Therefore, even before the mother has begun her breastfeeding journey, she has already formed biases, and makes decisions based on this,” she says.
Not many healthcare professionals have specific training in lactation and how to support breastfeeding mothers, so if a mother experiences difficulties during the first few days postpartum, she may not get adequate support from doctors.
“This is the information and support gap that breastfeeding counsellors and lactation educators are trained to fill by offering prenatal breastfeeding and postpartum support,” Karoki says. Karoki is a certified lactation educator.
Kenya not doing badly
Despite the challenges, Kenya has seen a remarkable growth in exclusive breastfeeding for children under six months old. In 2003, only 13 per cent of mothers were breastfeeding exclusively. In 2014, the figure shot up to 61 per cent, according to the Kenya Demographic Health Survey.
There is a push by WHO to encourage governments to ensure more mothers exclusively breastfeed for six months.
How to make the breastfeeding experience better
1. Ask for help right away
Reading about breast-feeding is one thing. Doing it on your own is something else. The first time you breast-feed your baby — preferably within the first hour after delivery — ask for help.
2. Let your baby set the pace
For the first few weeks, most newborns breastfeed every two to three hours round-the-clock. Watch for early signs of hunger, such as stirring, restlessness, sucking motions and lip movements.
Let your baby nurse from the first breast thoroughly, until your breast feels soft — typically about 15 to 20 minutes. Keep in mind, however, that there is no set time. Then try burping the baby. After that, offer the second breast. If your baby's still hungry, he or she will latch on. If not, simply start the next breast-feeding session with the second breast. If your baby consistently nurses on only one breast at a feeding during the first few weeks, pump the other breast to relieve pressure and protect your milk supply.
3. Gauge your success
When your baby is latched on successfully, you'll feel a gentle pulling sensation on your breast — rather than a pinching or biting sensation on your nipple. Your breasts might feel firm or full before the feeding, and softer or emptier afterward.
4. Take care of your nipples
After each feeding, it's fine to let the milk dry naturally on your nipple. The milk can soothe your nipples. If you're in a hurry, gently pat your nipple dry. If your breasts leak between feedings, use bra pads — and change them often.
When you bathe, minimize the amount of soap, shampoo and other cleansers that might contact your nipples. If your nipples are dry or cracked, use purified lanolin after each feeding. This can soothe cracked nipples, as well as help your nipples retain moisture.
5. Make healthy lifestyle choices
Your lifestyle choices are just as important when you're breastfeeding as they were when you were pregnant. For example:
Eat a healthy diet
Drink plenty of fluids
Rest as much as possibl
Be cautious with medication
6. Give it time
If breastfeeding is tougher than you expected, try not to get discouraged. Feeding a newborn every few hours can be tiring, and it's fine to have a slow start. Just remember that the more often you breast-feed your baby, the more milk your breasts will produce — and the more natural breast-feeding is likely to feel.
Adapted from mayoclinic.org