Forget the ‘Mommy Wars’ – Breastfeeding Inequality is the Real Issue

Too many heated words and firey tweets are being spent on the breastfeeding ‘mommy war’. It needs to stop.

Whether or not a well-educated and well-off mother chooses to breastfeed is not the big issue. The real problem – one impacting tens of thousands of lives – is breastfeeding inequality. Too many mothers are NOT getting equal opportunity to breastfeed.

Did you know that in the US, breastfeeding rates vary wildly from state to state? In Louisiana, 57% of infants are ever breastfed. In California, it’s 93%. That’s a huge difference.

It’s no surprise that Louisiana is one of the poorest states while California is one of the wealthiest. In fact, socioeconomic forces drastically affect breastfeeding rates. This visual guide by WeTheParents brings the shocking reality of breastfeeding inequality into focus.

Women born into socioeconomic hardship tend to have lower family income, lower level of education, and lower breastfeeding rates.

It’s not fair for the baby or the mother.

Some of the reasons for reduced breastfeeding are:

  • Less access to paid maternity leave
  • Lower paid jobs that are less likely to allow for pumping breaks
  • Inadequate maternity and lactation support in hospital
  • Less effective family and community support
  • A culture that doesn’t treat breastfeeding as a desirable status symbol (in contrast to the ‘crunchy mommies’).

The problem is intensified because babies born into conditions of hardship are less likely to receive adequate healthcare, parental involvement, and nutritious supplementary food once weaning begins.

This means that the babies who would benefit most from breastmilk are the ones least likely to get it.

Mothers Unite

This week is World Breastfeeding Week organized by World Alliance for Breastfeeding Action (WABA). It is the perfect opportunity to begin reframing the debate.

The mommy wars are a distraction. Let’s not waste valuable energy debating whether or not a well-off, middle-class mother is right to breastfeed her child. Yes, breast is best, but it’s likely her child will get a good start in life either way.

Mothers, let’s all come together and fight for breastfeeding equality. Surely we can all agree, that if a woman wants to breastfeed, she should be given the best possible chance to do so. The fact that less well-off mothers often don’t have the same knowledge or opportunities to breastfeed their babies is simply not right.

Instead of dividing along tribal lines, let’s unite and push for all mothers to have the same access to breastfeeding information, support, and workplace lactation programmes. It’s this that will really drive up breastfeeding rates and improve health outcomes for mothers and babies.

And so, the next time you find yourself caught up in breastfeeding guerrilla warfare taking place within the comments section of some blog, remember the real issue: breastfeeding inequality.

Neve is a mother of two, writer and breastfeeding advocate. You can find her trying to simplify parenting and empower new moms to meet their breastfeeding goals over at her blog WeTheParents.

 

The Amazing Reason Mothers in India are Giving their Babies Wearable Medical Records

This blog post was originally posted on Upworthy.com as part of a project with Girls’ Globe, Upworthy and Johnson & Johnson.

When Ruchit Nagar’s parents moved to Houston, Texas, in the late 1980s, they had no idea their son would grow up to save children’s lives in their home country of India.

Then again, it wasn’t exactly a total surprise, though, as their son had been interested in global health from a young age. Nagar had loved biology in high school, so he volunteered in American hospitals to learn more about the healthcare system. Later, he went on global health mission trips to Honduras and Ecuador, where he spent time working in a research laboratory at a government-run hospital.

But it was while he was in college, studying at the Yale Center for Engineering Innovation and Design, that he learned a startling truth. 1.5 million children die from vaccine-preventable diseases every year and an estimated 9.5 million infants worldwide still don’t have routine immunization services. Despite how critical these vaccines are, this “vaccination gap” still exists.

Nagar quickly realized that it wasn’t just an issue of access, either. Poor record keeping was making the problem much worse.

An agricultural community in Udaipur, India. Photo credit: Wikimedia Commons/TeshTesh

Maintaining immunization data in developing countries is a difficult task. Healthcare workers usually collect and store the information manually in paper log books, which means searching through all that data by hand. Couple that with how often families lose their medical documents and you can see what obstacles providers are up against.

That’s why, after Nagar’s professors asked the question: “What can you do to address the world’s vaccination gap?”, he and a group of other students came up with a business plan that could help address the vaccination gap, while helping healthcare workers too.

This led them to launch a nonprofit called Khushi Baby to help monitor the health care of mothers and children in India.

Khushi Baby (which translates to “Happy Baby” in Hindi) created a culturally-symbolic necklace that also happens to contain their full medical history.It’s a digital, battery-free, waterproof data storage device. In other words, it allows people to literally wear their medical records.

In order to access those medical files, healthcare workers in rural villages just need to scan the necklace with the help of the smartphone Khushi Baby app.

Photo credit: Khushi Baby

So, in a way, this invention is like a child’s medical passport, as well as a visual reminder for mothers to get their babies vaccinated on time.

The team hopes that when mothers and their babies wear their Khushi Baby pendant in the village, it might also start a conversation among mothers who may not be attending health camps regularly. And since Khushi Baby services include voice call reminders in the local dialect, the team is also hopeful that more mothers will plan checkups and vaccinations ahead of time.

Hopefully, this easy-to-use technology will help bridge the healthcare gap that exists between developing nations and the rest of the world.

“I have a reason to get out of bed every morning because I truly believe that what we are doing has the potential to make a difference to improve maternal and child healthcare for those who may otherwise be forgotten,” says Ruchit.

Digitizing vaccination data makes treating patients much easier, and, since the technology is relatively low-cost, it’s accessible even in low-income areas.

But Khushi Baby is about more than access to vaccines. It’s also about giving health workers the data they need to improve their treatment programs.

The technology empowers healthcare providers by allowing them to make better decisions faster. The app’s checkup summary page helps them consolidate patient info from busy health camps, which then helps them make appropriate recommendations and offer the right kind of care.

The Khushi Baby team at work developing technology. Photo credit: Khushi Baby

“Many of our early interactions with mothers and frontline nurses in rural Udaipur [India] showed us that there was an opportunity to do things better,” says Nagar.

Monitoring data is crucial in helping countries prioritize and tailor vaccination strategies for each region. The app also comes in handy for medically-focused nonprofits because it helps them monitor the impact of their work, ensuring the success of their immunization programs.

Of course, for the Khushi Baby app to work, people have to actually use it. That’s why Nagar chose to make it a necklace.

He tapped into a cultural norm in India to get locals interested in wearing his smart device. The black thread around the necklace is traditionally worn across India to ward off buri nazar, or evil eye. It’s said to bring good health and fortune.

“By observing that children were wearing jewelry in rural Udaipur, we realized that we could slot our technology into something that was already culturally-symbolic and accepted by the communities. In doing so, it made our wearable less likely to be lost or forgotten,” he explains.

A woman in India wearing the Khushi Baby necklace. Photo credit: Khushi Baby.

So far, the Khushi Baby app is operating in over 350 villages and tracking the health of over 15,000 mothers and their babies.

And they’re not stopping there.

Khushi Baby aims to scale its impact to over 1000+ villages with a team of over 250 health workers. They hope to track the health of over 80,000 beneficiaries in the future.

Photo credit: Khushi Baby

“Closing the vaccination gap will require national and multinational resources and efforts,” says Nagar. “Our goal is to track the health of the entire district of Udaipur by 2020 and lay down the blueprint for other districts across India (and elsewhere) to replicate and scale-up.”

It’s no surprise Khushi Baby was named as one of the finalists of the GenH Challenge, which acknowledges and awards innovative solutions to worldwide health issues.

Khushi baby is on the verge of transforming lives for the better in areas that desperately need the help.

It all started with a simple but powerful idea — that everyone, no matter where they are in the world, deserves the chance to thrive. Thanks to innovators like Nagar, that possibility is closer than ever.

And with technology like this leading the way, we might someday live in a world where no mother or child is left behind.

Preeti Shakya co-authored this post with Maisha Z. Johnson.

Obstetric Fistula in Zimbabwe

“It’s been three years now, I can’t wear underwear, urine is always leaking. I have developed sores on my genitals that aren’t healing because of the moisture. I dread going out in public. The last time I went to a gathering, people distanced themselves from me because of the bad smell, it repelled them. I’m confined to this house so I can bathe each time I soil myself. My entire family believes I was cursed, they say no one has ever had a disease like mine before.”

Nyaradzai, a nineteen-year-old living in my community in Mashonaland, West Province, Zimbabwe, is one of the many women suffering from fistula. Like many others, Nyaradzai has been unaware that hers is a condition that needs medical attention. She tells me her story…

“Three years ago, I dropped out of school. I was pregnant. My parents chased me from my home, so I went to stay at my boyfriend’s house. He was still in high school too, but his parents accepted me. I stayed there for six months. However, the baby died while I was in labour. It took me 6 hours to get to the nearest clinic – I was walking because my in-laws couldn’t afford to hire an ambulance to take me there. When I arrived, the nurses ignored me. In fact, they scolded me for getting pregnant at such a tender age. I was 16 at the time. While I was in labor, I passed out. I can’t recall what happened, but when I gained consciousness, I was in so much pain,” said Nyaradzai.

“When my in-laws heard that I had delivered a stillborn baby, they called me a witch and returned me to my parents’ house. My problems started a few days after labor. At first, I thought maybe I was delaying going to the toilet, but I was also wetting the bed at night. Now when I go to sleep I take a cloth and place it between my legs and put a plastic sheet underneath me so I won’t wet the bed. I can’t wear underwear because of the sores on my genitals,” she told me.

Nyaradzai’s story could be the story of many women living with fistula in Zimbabwe and other developing countries. Fistula is a silent condition, and as a result many women are suffering in silence. Huge numbers of people are not aware of what it is, what it means for women, and that women feel ashamed talking about it.

A fistula is a passage or hole that has formed between the two organs in one’s body. Obstetric fistula is the primary type of fistula that affects women in developing countries due to poor obstetric care, and can be caused by a prolonged and obstructed labour without treatment. Statistics show that at least 2 million women in developing countries are living with fistula.

Obstetric fistula is an abnormal opening that develops between the birth canal and the urinary tract. Young girls whose birth canals are still narrow can often experience fistula as the head of the baby presses hard on the mother’s bladder causing a tear which, if not surgically repaired, will cause a continuous leakage of urine.

Today marks International Day to End Obstetric Fistula. It is important that we talk about fistula, teach communities about it and encourage women to help one another through education and empowerment and delaying marriage and child bearing.

Read more posts about Obstetric Fistula on girlsglobe.org here

Health Heroes on the Front Lines

The ability to see a doctor, nurse, or other trained health provider when we need to is hugely important. We may not think about it much when we are healthy, but sometimes, a visit with a health provider could mean the difference between life or death.

Unfortunately, millions of people in rural areas and low-income communities live far away from their nearest hospital, clinic, or health center, and don’t have adequate transportation or resources to reach them during an emergency. In fact, about half of the world’s population cannot access health care when they need it.

Consider those living in areas affected by natural disasters, emergencies, or armed conflict. Frontline health workers typically live in or near the communities they serve. If a community is affected by drought, the health workers are affected too. If ongoing conflict causes people to flee their homes and communities, doctors and nurses will likely flee with their families as well (if they can). Those left behind may have no one to provide them medical care or to help them stay healthy.

CARE trains, works with and relies on frontline health workers (FHWs) to deliver health services every day in a variety of low-resource settings. These include doctors, nurses and other health workers with varying degrees of formal and informal training. We know that their jobs are difficult, even in the best circumstances. Now imagine what life is like as a FHW in an area affected by crisis or armed conflict.

Let us introduce you to some of the people doing this work:

Mary is a midwife working in the Imvepi refugee settlement in Uganda. She has a three-year-old son.

Photo credit: Jennifer Bose/CARE

Uganda has become one of the largest refugee hosting countries in the world. At the height of the crisis, more than 3,000-7,000 people from South Sudan would arrive every day in the search of refuge. Of the 1.2 million refugees in Uganda, 900,000 are South Sudanese and 86% are women and children in real danger of sexual and physical violence, with many reporting incidents of violence on their journey. Imvepi refugee settlement hosts more than 110,000 refugees.

CARE has established five centers in Imvepi where refugee women and girls can seek assistance and sexual violence survivors can be provided with psychosocial support and health services. Mary works in one of these centers.

She has a busy schedule. At the women’s center, she identifies pregnant refugees who need maternal health services, screens for possible complications, and advises them on antenatal care. She refers any serious medical cases to nearby health clinics and balances a large case load. “Usually in a day I see around 80-100 people, many of them are pregnant mothers,” she explained. “I make sure to highlight the importance of hospital deliveries, as most of them have never seen a doctor before. But it is challenging.”

Because of the scale of Imvepi (about 150 square kilometers), Mary also makes home visits. She provides education on different topics – from family planning to gender-based violence to malnutrition and HIV.

“[Intimate partner violence] is a reoccurring problem in many families. I mostly hear of cases where food shortages lead to physical violence. Many families decide to sell the food rations they receive, ending up with little to no food left for themselves and extreme tensions at home.” Mary said. “I screen such women to see if they are in need of immediate help or referrals.”

Khawla is also a midwife, providing family planning services in Aleppo, Syria. She lives with her husband and children.

Photo Credit: CARE/SRD

Conflict has been ongoing in Syria for over seven years, and civilians are bearing the brunt of the suffering, destruction, and disregard for human life. An estimated 13.5 million people require humanitarian assistance, including 4.9 million trapped in besieged and hard-to-reach areas, where they are exposed to grave protection threats.

Working through partners, CARE supports 10 primary healthcare centers and 10 mobile clinics in northern Syria to provide vulnerable Syrian households with access to sexual and reproductive health and primary health education and services.

Khawla’s home and the health center often do not have electricity. She spends most of her time talking to women about their reproductive health and contraception. While most of Khawla’s work happens during daylight hours at the health center, sometimes she gets emergency calls from women late at night. “This is what scares me – having to go out during evening or night hours due to the security and conflict conditions in Syria,” Khalwa explains. The nearest hospital is 15 kilometers away.

Mary, Khawla, and other frontline health workers make personal sacrifices every day to deliver life-saving health care and emergency assistance to those in need under difficult circumstances. They experience and witness incredible suffering and choose to run towards the need when many would run away.

At CARE, we want to say thank you to all health heroes, wherever you are. We appreciate you, and your commitment to helping others.

Meet more of CARE’s frontline health heroes in our World Humanitarian Day publication: A Day in the Life of Seven Aid Workers.