Early to Breast, Early to Thrive: Let’s Make It Work for Women in Developing Countries

Early to Breast, Early to Thrive: Let’s Make It Work for Women in Developing Countries

 {Photo credit: Matthieu Koy Matili/MSH}Elene O. and her baby, Omedji village, Benadibele health zone.Photo credit: Matthieu Koy Matili/MSH

Breastfeeding is a human right, and critical for the health of both newborn and mother. Newborns benefit from early skin-to-skin contact and the antibodies in the mother’s first milk, plus factors that protect against later obesity and chronic diseases such as diabetes and asthma. Mothers benefit because early breastfeeding assists in uterine shrinkage and helps prevent postpartum bleeding. In addition, frequent, exclusive, breastfeeding reduces the likelihood of an immediate new pregnancy.

Optimal breastfeeding is most advantageous when started within an hour of birth and continued exclusively for six months; research shows that it could save 800,00 children’s lives. Yet, globally, only 38 percent of infants are breastfed exclusively.

World Breastfeeding Week 2015 (August 1-7) focuses on supporting women breastfeeding at the workplace (“Let’s make it work”).

For many women, especially in the developing world, barriers to breastfeeding start in the home or even the health facility -- before returning to work in her household, community, or workplace.

Stronger health systems can shift these cultural norms to encourage, women, families, and communities to exclusively breastfeed starting just after birth.

Take Democratic Republic of the Congo (DRC). A baseline study of 80 health zones in 4 provinces in 2010 found that only 52 percent of children (under 23 months) had breastfed within an hour of birth. This finding prompted the USAID-funded Integrated Health Project (IHP), led by Management Sciences for Health (MSH) with partners, to design an Infant and Young Child Feeding (IYCF) strategy to train health zone managers, health care providers, and community health workers to promote optimal feeding.

Three years later, 96 percent of newborns in the area were breastfeeding within the first hour.

How is IHP sparking such a significant shift?

MSH and partners are empowering local leaders to build stronger health systems at the community, household, and facility levels.  

[IYCF support group in village Tshamundenda, Kanzenze health zone, DRC.] {Photo credit: Matthieu Koy Matili/MSH}IYCF support group in village Tshamundenda, Kanzenze health zone, DRC.Photo credit: Matthieu Koy Matili/MSH

Community support groups, home visits

At the community level, community health workers organize IYCF support groups composed of pregnant and nursing women, their spouses, influential female leaders, women who are no longer lactating, grandparents, and other interested residents. The groups meet to encourage nursing within the first hour and exclusively for six months, demonstrate nursing and preparation of weaning food, share experiences, and organize events in the community.

Community health workers also make home visits to encourage women to continue nursing their newborn exclusively for six months, counsel them, assist them as they may need, and refer them to a health center if necessary. Today, over 1,000 trained community health workers lead 1,080 support groups in 261 health areas in 45 health zones.

Training and supervision in health facilities

In public, private, and faith-based health facilities, IHP-trained nurses and birth attendants counsel women throughout pregnancy, encourage immediate breastfeeding, assist with newborn positioning and latching, and help new mothers overcome any obstacles. IHP also provides supportive supervision to community health workers and facility-based providers.

The early and exclusive breastfeeding strategy has strengthened links between the community, the community health worker, the health facility, and the health provider as they work together toward a common goal. 

Stronger health systems rooted in the community

Other countries also are using community-based interventions to strengthen health systems to support optimal feeding and improve newborn and maternal health. In Madagascar, more than 4,480 community health volunteers lead health education sessions with large groups in the community, at home visits to pregnant women, and during growth monitoring sessions. In villages, women’s groups discuss various healthy behaviors, including breastfeeding, and conduct health promotion sessions to encourage optimal newborn feeding among other women in the community. In Uganda, MSH and partners used an improvement collaborative approach and peer-to-peer learning in 46 health facilities in 10 districts to accelerate the immediacy of breastfeeding to within 30 minutes of birth. In Honduras, MSH and partners are working to increase efficiency in the country’s community-level nutrition and growth monitoring and promotion strategy, which includes exclusive breastfeeding.

As we celebrate World Breastfeeding Week, we strongly encourage women worldwide to immediately and exclusively nurse their newborns. Supporting locally led, locally run health systems that encourage optimal feeding is just one way we are acting on the call to end preventable child and maternal deaths. Health systems must support and encourage breastfeeding starting close to home: with families, in communities, and in health facilities.

Let’s make it work for women in developing countries.

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Comments

Raphael Udonna
The importance of a breastfeeding policy cannot be overstated. If only the government can impose such a policy through the right ministries, it'll go a long way to promote neonatal and maternal health, and reduce mortality rate.
Deb van Dyke
Global Health Media Project has produced a series of videos designed to help breastfeeding mothers. Breastfeeding is a skill that is learned most effectively by "seeing and doing". The power of visuals is vitally important for mothers learning how to breastfeed. Our new videos—narrated in English, French, Spanish, and (soon) Swahili—will help mothers by providing practical information on “how to” skills and problem management. The videos are intended primarily for mothers in the developing world, but may be helpful for breastfeeding mothers worldwide. They can be viewed on-line as well as downloaded free-of-charge in several sizes through this link: http://globalhealthmedia.org/videos/breastfeeding/ Thanks and kind regards, Deb

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