Breastfeeding for Survival, Health & Wellbeing

The right to the highest attainable standard of health, as well as the right to adequate food and nutrition are fundamental rights of every human being. Breastfeeding provides babies with the best start in life and is a key contributor for survival, health and wellbeing of infants and mothers. 

The Lancet Breastfeeding Series published in 2016 provides the most recent and detailed analysis of available research on breastfeeding. The Series confirmed that breastfeeding has numerous benefits – including decreasing the risk of infections and increasing the intelligence of children, and preventing cancers in mothers. There is also unequivocal evidence of breastfeeding’s protection from hypertension, type 2 diabetes, high cholesterol levels, and obesity in the long term.

Support for breastfeeding mothers is essential. In the light of the overwhelming evidence on the positive impact of breastfeeding on survival, health and well-being, coordinated global action is urgently needed.

WHO, UNICEF and 20 other prominent international agencies and non-governmental organisations have recently formed the global Breastfeeding Advocacy Initiative (BAI), to unify the voices of breastfeeding advocates and galvanise political, financial and social support for breastfeeding policies and programmes. The BAI aims to increase awareness of breastfeeding as a foundation of child and maternal survival, health and wellbeing – and to advocate to governments to invest in breastfeeding.

The Global Breastfeeding Advocacy Initiative (BAI) is consistent with the Every Woman Every Child (EWEC) Global Strategy for Women’s, Children’s and Adolescents’ Health. According to EWEC:

“Breastfeeding is a fundamental driver in achieving the SDGs as it plays a significant role in improving maternal and child health, survival and wellbeing. One year into the implementation of the SDGs, we must work together to level the playing field.” 

In the Global Strategy, breastfeeding is acknowledged as an essential driver in achieving the Sustainable Development Goals (SDGs). EWEC highlights breastfeeding as fundamental in improving not only nutrition, but also education, maternal and child health, survival and wellbeing. Together with the movement’s core partners, EWEC supports governments with strategic interventions in order to improve breastfeeding rates, to eventually reach or exceed the WHO global target of increased rates of exclusive breastfeeding in the first 6 months up to at least 50%.

We have all of the facts in black and white about the benefits of breastfeeding, and we have devoted advocates who fight for women’s and children’s right to the highest attainable standard of health. Grassroots participation and its potential to create massive impact from simple ideas seems to be at an all-time high – a trend that will hopefully continue as the need for even more multi-level and cross-sectoral partnerships increases.

In order to achieve the SDGs by 2030, partnerships are not merely helpful to improve the health and wellbeing of the present and future generations—they are essential.

World Breastfeeding Week takes place from 1 – 7 August 2017. Celebrating collaboration and sustainability, it will focus on the need to work together to sustain breastfeeding. World Alliance for Breastfeeding Action (WABA) has created an online platform with downloadable resources available in a range of languages to support individuals and organizations in their own campaigning and advocacy. 

 

Breastfeeding for Nutrition, Food Security & Poverty Reduction

Some time has passed since the adoption of the UN Sustainable Development Goals (SDGs) – an inclusive agenda to create positive, sustainable change. To say the least, we’ve got work to do! Breastfeeding is a vital part of sustainable development.

In 2016, the United Nations placed nutrition at the heart of sustainable development by declaring 2016-2025 as the UN Decade for Action on Nutrition. Breastfeeding is a non-negotiable component of this globally intensified action to end malnutrition. An infant, at the very start of life, is assured optimal nutrition and protection if breastfed. Breastfeeding also ensures food security, especially in times of humanitarian crises. Breastfeeding contributes to poverty reduction by being a low cost way of feeding babies and not burdening household budgets compared to artificial feeding.

Increased rates of exclusive and continued breastfeeding can only be achieved by cooperating and collaborating across all sectors and across generations. Fortunately, the importance of working in partnership is now recognised and translated into various global initiatives. A key recommendation in the Every Woman Every Child Global Strategy for Women’s, Children’s and Adolescents’ Health is access to good nutrition:

“By working in partnership, we can ensure women, children and adolescents, everywhere, can access adequate, diverse and nutritious food throughout the life course, which will help them survive, get an education, become resilient and thrive. In turn, so will their communities and countries, empowering them to break poverty cycles and contribute to inclusive, sustainable, healthier, more prosperous societies.” – Every Woman Every Child

Success in breastfeeding is not the sole responsibility of a woman  the protection, promotion and support of breastfeeding is a collective societal responsibility which states have an obligation to ensure. Together, we can achieve success and ensure adequate nutrition, food security and poverty reduction in the generations ahead.

“If we want to change the world for girls and women—and we sure do—we need to work together. Collaborate, not duplicate. Integrate, not separate. We all have a part to play in achieving a healthy, happy world, where hunger and malnutrition are things of the past.” – Women Deliver

Women Deliver apply a gender lens to the SDGs in their new campaign Deliver for Good, which promotes 12 critical investments in girls and women that will foster progress for all.

“No matter where you start, investments in girls and women bring about high social and economic returns. For example, bringing water and sanitation to communities keeps girls in school which then leads to increased use of contraception, less child marriage, less gender-based violence, increased economic stability, and better health outcomes for generations of families.” – Women Deliver

The Deliver for Good campaign – developed and driven by a diverse set of founding partners – focuses on partnership and inclusion identifying siloed sectors, data, and funding as pervasive challenges in achieving global development. It proposes that cross-collaboration is fundamental in achieving the SDGs. Breastfeeding is included in the Deliver for Good campaign targets as a way to ensure maternal and child survival, health and nutrition.

To ensure that breastfeeding is a central part of the Sustainable Development Goals, it is time to raise our voices and advocate at national levels. We need to ensure that our governments create an optimal environment for women and children to thrive – and do so in partnership with civil-society movements, NGOs, and partners at multiple levels. One way for us to influence decision-makers is to remind them of the Return of Investment of breastfeeding – saving lives as well as saving resources.

In our advocacy, as well as in creating lasting policies, we need to make sure that no one is left behind and put our focus on young people and vulnerable groups – such as adolescents, single mothers, and migrants. In order to truly address the challenges of breastfeeding, we must use a gender lens, understanding that breastfeeding protection, promotion and support requires increased investments in gender equality and human rights.

Breastfeeding is not a woman’s issue. All of us, in all segments of society – from business owners to family members and government leaders to citizens – need to be involved in safeguarding women’s and children’s right to breastfeeding.

World Breastfeeding Week takes place from 1 – 7 August 2017. Celebrating collaboration and sustainability, it will focus on the need to work together to sustain breastfeeding. World Alliance for Breastfeeding Action (WABA) has created an online platform with downloadable resources available in a range of languages to support individuals and organizations in their own campaigning and advocacy. 

6 Things I’ve Learned About Breastfeeding

I would still consider myself a breastfeeding novice. My daughter was born 8 months ago and we have been on an incredible journey as she has grown from a newborn into a little girl who is exploring the world on her hands and knees – largely thanks to breastmilk.

When I was pregnant, breastfeeding felt incredibly far away, I had a hard time imagining that my body (and even moreso, my breasts) would be able to produce those incredibly important nutrients that would be so essential for my baby to grow. From the very first moment she was laid on my belly, she smacked her lips as she reached for my breast and latched on carefully. The first night she fed throughout the night and in the coming months I learned so many new lessons about this universal act of nursing a baby.

1. Baby knows best

Nobody knows how my baby feels better than she does herself. At the hospital the midwives encouraged me to watch for my baby’s signs for wanting to feed. I also found this incredible video interview with Priscilla Dunstan about the universal language of newborns, which helped me listen to and understand my baby. As she grew, I started to feel like I was beginning to master the act of breastfeeding and began to learn that a new phase in her development also meant new routines and new ways. Listening and learning needs to be a constant for me to support my little one in the best possible way.

IMG_99902. Every mother and every baby is different

Don’t compare yourself with others. There is nobody who knows you or your baby better than you – and your baby is unique! Everyone does things differently, and that is OK. As a new mother there are times I feel vulnerable and when comparisons are easy to make, especially when I find myself doing things in a way that I hadn’t planned to before my daughter was born. It is impossible to know who your baby will be, what needs she will have and how you will react to those needs, so it is imperative to have an open mind and be flexible if you need to do things differently.

3. It can be a physical and emotional rollercoaster

Being a breastfeeding mother for the first time is full of firsts. Like waking up for the first time soaked in milk with bulging breasts that hurt like they are going to explode. Or like the time I let my hungry, crying two-weeks-old baby take a few sips to calm her down and as I pulled her away just to try to get the remote control before sitting down to feed, milk sprayed a meter away, onto the TV screen and all over my baby’s face. I was so startled and in a wet panic, grabbed the control and let my baby latch on.

Not only has my body surprised me, it has drained me from all energy. When my daughter was about 3 months she had an incredible growth spurt and one evening as I was feeding, for what felt like hours, I sat shaking, dehydrated and crying without any energy left over for myself. And now, at 8 months, with a whole new world to explore as she has learned to crawl, pull herself up and communicate in new ways, I find myself being needed more than ever, with a waking baby in the night who wants to nurse. In these times I try to remind myself that this is what my daughter needs now, and these phases will come and go.

4. Support is necessary – ask for help

I would say that we are lucky. We haven’t encountered many problems when breastfeeding, but it certainly hasn’t been easy. For me, breastfeeding has been the most draining and exhausting exercise I have ever done. I have never felt as insecure at times, as when I have been nursing my baby to sleep, wondering if I am doing this all wrong. In those moments a support system is necessary.

My husband has been an incredible help, always preparing with a glass of water and emotional support when I feed and taking our daughter in the morning when I’ve had an intense night of nursing. I am also lucky to have a midwife and breastfeeding expert as a sister-in-law who has answered several questions. If you don’t have a close support system in place already, don’t hesitate to reach out to a midwife or an existing group of mothers in your area (maybe you can find one through social media). In my city, Malmö, Sweden, there is also a breastfeeding centre at the hospital with midwives ready to support you with whatever issue you may have when nursing your child. In some places there are even breastmilk donation centers for women with low or no supply in breastmilk.

What support can you find in your area? Let us know using #GGBreastfeeding on Twitter and Instagram. 

5. Breastfeeding is more than feeding

For a little one breastfeeding is more than just giving your baby enough
energy to grow and develop, it is also an IMG_0744incredibly important source of love, comfort, safety, warmth and soothing hormones. I have found that breastfeeding is a cure all – for hunger, anxiety, stomach aches and more. There is nothing more beautiful than looking down at my baby, knowing that I can give her so much more than just the food that she needs, by holding her in my arms and letting her nurse at my breast.

6. Listen to your maternal instincts

IMG_0742Probably the most important thing that I have learnt is to listen to my gut feeling – my maternal instinct. Sometimes that instinct is different than the advice that I have been given from well-meaning friends and family, and when I have listened to that instinct, it has just felt right. Being calm and confident in myself has been the best tool for successful breastfeeding. Don’t let blog posts, popular advice and even health professionals get you down – listen to yourself and your baby. You know best what feels right.

Breastfeeding has been a big part of becoming a mother and it continues to be a learning experience. However, one thing is certain, I am my daughter’s mother and in that I am confident.

The Best and Worst of Breastfeeding

Nursing my now 10-month old son is one of the most beautiful, but also one of the hardest and most challenging things I’ve ever done.

first latchI always knew I wanted to nurse my baby. Before giving birth to him in last September, I had prepared for breastfeeding the best I could. I had talked to my mom friends about it, I had read about possible challenges, I had gone to a childbirth education class with my husband and hired a doula who was also able to support me with breastfeeding. I had my troops gathered and ready, and once my son was born, it quickly became clear he was a pro at nursing. Mere seconds after he was born, he eagerly latched on – and hasn’t let go of my breast since. We had our challenges in the beginning, there were a few days when nursing definitely wasn’t the most comfortable thing in the world – but fairly quickly we got the hang of it, and we got off to a good start. We have now enjoyed a very successful 10+ months of breastfeeding with very little, if any, real issues.

And yet – breastfeeding is still one of the most difficult, challenging, emotional and draining things I have ever experienced in my life. Breastfeeding may be a very natural thing, but that definitely does not mean it’s easy.

I’ve had many moments of anxiety about nursing. Instead of nursing feeling like a privilege and pleasure, it has sometimes felt like a chore, something I had to do but didn’t really want to. While I love to see my son grow from breast milk and feel proud about my body’s ability to nourish him, there are days when I also feel anxious over how dependent he is of my breasts. In the beginning, his tiny belly could only hold very little at a time, and he needed to feed often – which meant I would sometimes jump out of the shower in the middle of shampooing my hair because I heard his hungry wails through the running water. I couldn’t imagine leaving the apartment without him, and most of the time I ate my meals over him, with my baby lying on the nursing pillow and eating at the same time. By the end of the day, he would be covered in crumbs of whatever I had been eating throughout the day.  I would sit on the couch until there was an imprint of my butt permanently pressed to the cushion, watch my son’s cheeks move in and out as he nursed – and inside, I would feel horrible over the negative feelings I was experiencing. I felt smothered by how attached to my breasts he was – and then I felt guilty about feeling that way, and would try to push those feelings aside and ignore them. The longer I ignored them, the harder it got – and eventually I would find myself nursing him while crying at the same time, without really knowing why I was crying.

I’d barely been a mom for five minutes, and already I was overwhelmed, feeling crushed under the weight of someone depending on me so completely and utterly as this little baby boy did. What was wrong with me?

Nothing. Nothing was wrong with me, and I’ve come to realize that the feelings I was experiencing – and still experience every now and then – are perfectly normal. Even when mothers are able to breastfeed their babies, there are still moments when it’s very hard. It’s emotional, draining, tiring, frustrating– and this is why it is so incredibly important that we ensure that all pregnant women, everywhere in the world, have access to proper support for breastfeeding before and after labor, and that there are policies and structures in place to allow mothers to continue nursing after returning to work, which is also the focus of this year’s World Breastfeeding Week. Not all women will want to nurse, and whether to nurse or not should always be a mother’s personal decision – but no one’s breastfeeding journey should be cut short or doomed from the start because of a lack of proper support, information and help. Our societies don’t make breastfeeding easy. Nursing women are shamed, shunned, marginalized, pushed to toilets and alleyways to nurse out of sight, because we see breasts as a form of entertainment and an advertising tool rather than recognize and celebrate them for their ability to feed our children. It’s time to stop making breastfeeding even harder for women because of lack of proper support systems, policies, structures and lack of supportive environment – and time to start giving breastfeeding women everywhere in the world the recognition and support they deserve.

IMG_7889Before having my baby, I wrote an article titled “It Takes a Village to Breastfeed a Child”, but I didn’t truly understand how crucial breastfeeding support really is until I had my son. I’ve talked with women from around the world, and know our challenges and troubles are universal – I’ve met mothers who are going through the same feelings I’ve gone through, and I’ve even ended up breastfeeding another mother’s child when she wasn’t able to do so herself in that particular moment. So here is my message to you on the occasion of this year’s World Breastfeeding Week: Whatever you are feeling, whatever you’re going through, you are not alone. Ask for help, offer help, be a part of that global village – and whether you’ve nursed for a day, a week, a month, a year, or multiple years, be proud of yourself and be gentle to yourself. Breastfeeding is everything but easy, but we can make it so much better for ourselves by supporting each other, being kind to each other and encouraging each other.

And as for those moments when I feel like breastfeeding is too hard – luckily they are outnumbered by the good moments, when I look down on my child and see not only his hunger, but his pain, worries and fears melt away as he finds comfort and safety from nursing, from pressing up against me, from smelling my skin and my milk. Days like today when I look at him and I know: it is worth all the pain and trouble and it really does matter – every single drop of it.

Chewed Rice, not Exclusive Breastfeeding in Laos

In villages in southern Laos, breastfeeding mothers are as ubiquitous as thatched roofs and playing children. In my time among villagers, I have never seen a breastfeeding mother cover up or go inside to continue feeding. Breastfeeding stigma seems non-existent. On front stoops and in gathering places, babies get their fill, comfortably ensconced in slings or resting on laps.

This freedom to feed however, isn’t reflected in Lao’s exclusive breastfeeding rates: just 39% of babies benefit from early initiation of breastfeeding and only 40% are exclusively breastfed until 6 months.

With child mortality rates in Laos among the highest in the region – nearly 79 deaths per 1,000 children under 5 – the government has taken measures at improving child survival.  One such initiative is a joint Lao government-UNICEF program to promote exclusive breastfeeding.

In a 2012 presentation on the progress of this joint program, Dr.Khamseng Philavong from the Lao Ministry of Health tied breastfeeding to improving child survival:

“Evidence indicates breastfeeding as the most important preventive intervention with potentially the single largest impact on reducing child mortality.”

Given that breastfeeding is common practice and the government is promoting it why isn’t exclusive breastfeeding the norm in Laos?

One reason, according to the nurses we work with, is that there is a long tradition of feeding pre-chewed rice to babies as early as the first week of life.

Breastfeeding Mom, Tahoy District, Salavan, Laos
Breastfeeding Mom, Tahoy District, Salavan, Laos. Photo Credit: CleanBirth

A study by Kaufmann et al found that pre-chewed rice was given to 20-48% of Lao infants in the first week of life.  There is a belief that breast milk is not enough – that supplementation is needed.  While rice has long been the traditional addition to a baby’s diet, the marketing of breast milk substitutes is proving effective in urban areas.

The consequences of supplementation seem to be significant. According to another study, the practice of supplementing rice is tied to Laos’ high rate of stunting (low height for age as a result of chronic malnutrition) which stands at 44 %.  In Salavan Province where I work, stunting affects 54 % of children under 5, one of the highest rates in the country.

So what can be done to promote exclusive breastfeeding?  

My organization, CleanBirth.org which works to promote safe birth, trains Lao government nurses to promote the WHO’s breastfeeding strategy among their families. This includes:

  • Early initiation of breastfeeding within I hour of birth
  • Exclusive breastfeeding for first six months
  • Continued breastfeeding for two years or more
  • Safe, appropriate and adequate complementary foods beginning at six months.

The local nurses understand the efficacy of exclusive breastfeeding. They have told us that they believe that with education, families will eventually move away from supplementation.

This type of education is essential because when parents understand how to properly feed their children, children survive and thrive.

Featured Image: Lao government poster promoting breastfeeding at local clinic. Photo Credit: CleanBirth

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It Takes a Village to Breastfeed a Child

Originally published on Huffington Post.

1-7 August marks World Breastfeeding Week, this year celebrated under the slogan of “Breastfeeding: A Winning Goal – For Life!” Those of us who are pregnant or have children have most likely heard the phrase “breast is best”, and many of us have come across information about the undeniable benefits of breast milk to a newborn’s health and development. According to the World Health Organization, if all children were breastfed within an hour of birth and given only breast milk for the first 6 months with continued breastfeeding up to the age of two, up to 800 000 child lives would be saved annually. Breast milk delivers infants with all the nutrients they need for healthy development, and it contains antibodies that protect babies from illnesses such as diarrhoea and pneumonia. In addition, breastfeeding is free – at least if you don’t count the opportunity-cost of time spent nursing.

Breast milk is without a doubt the mother of all superfoods, but despite all the evidence, according to the 2014 Breastfeeding Card, only 49% of infants born in 2011 in the United States were breastfed at 6 months and 27% at 12 months. In developing countries, less than 40% of children aged 0-6 months are exclusively breastfed and in my native country, Finland, shockingly only around 1% of mothers meet the recommendation of exclusively breastfeeding their baby for the first 6 months.

The reasons behind low breastfeeding rates are many. Especially in developing countries, mothers often lack access to information about the importance and benefits of breastfeeding and many misconceptions exist around infant feeding, (i.e. babies need water in addition to breast milk during first months of life). Poor women, both in developing and developed countries, rarely have the option of staying home after giving birth. Mothers often return to work soon after delivery, and babies are left in the care of relatives and family members, making breastfeeding simply not possible. Breast may be best – but it isn’t always a realistic and viable option for mothers, no matter how much they would like to nurse their babies and even when they are aware of the benefits of nursing.

For some mothers, breastfeeding just doesn’t come easily – and can be a painful, scary journey, ending in the feeling of failure and guilt. I am currently expecting my first baby, and have no firsthand experience of breastfeeding – but I’m already worried. What if the baby doesn’t latch, or there’s not enough milk and he isn’t gaining enough weight? What if it hurts too much? What if I fail with breastfeeding – the most natural thing in the world – and fail my baby? I know I am not alone with my worry – millions of mothers around the world want to breastfeed, but just can’t make it work. Stigma, shame and fear are also associated with breastfeeding, and while we happily erect billboards of half-naked women to sell everything from cars to alcohol, a woman exposing her breast to feed her child is still considered controversial and in some places unacceptable. Women’s bodies, when exposed for the purpose of celebrating birth or nursing, are censored – while over-sexualized images of half-naked women are considered normal and acceptable.

If we really want to enable women to succeed with breastfeeding, it is time to recognize that this cannot be a journey the mother has to embark on alone.

We have to create a supporting, enabling and judgment-free environment to give mothers the best possible starting point to successfully breastfeed their babies. This includes access to reliable information about the importance and benefits of breastfeeding, lactation support immediately after birth and throughout the first months of an infant’s life, and workplace policies and legislation that enable women to stay home for long enough to properly establish breastfeeding, and then continue it after they return to work. In developing countries, providing access to quality and affordable health care services throughout pregnancy and during the postpartum period is essential for ensuring that women are informed about the benefits of breastfeeding and have access to support after giving birth.

We also have to stop shaming and blaming mothers –pressuring mothers to nurse through guilt is never the right approach. This shouldn’t be a war between breast feeders and formula feeders, and the important thing to keep in mind is that nearly all mothers strive towards one shared goal: a healthy, happy child. That is a goal we can all agree upon, and do our best to strive towards. We should aim to ensure that no mother has to give up breastfeeding because they didn’t get enough support or information to make it work – and that all mothers feel they can talk about their challenges, fears and experiences without being shamed or shunned. There’s also no such thing as being pro-breastfeeding, but against women’s right to breastfeed in public. If you want to support nursing mothers, then you have to also support and promote their right to feed their children in public and not expect them to nurse in bathrooms or alleyways. How would you feel about having to sit on a toilet seat while eating your lunch?

The stigma and hypocrisy around this issue must end — and the responsibility of enabling mothers to succeed with nursing is not just on the shoulders of mothers. It’s time to recognize that when it comes to breastfeeding, it takes a village to make it work — and we, whether mothers, fathers, partners, co-workers, employers, law- and policymakers, friends or bystanders, are all a part of that village.