In the field
Education begins on the maternity ward
by Debbie Stowe
New topics polarise opinion as much as childrearing. What’s the best age to have a baby? Caesarean or natural birth? Fixed mealtimes or feeding on demand? But where most are in agreement is the old adage that “breast is best”. Breastfeeding confers numerous health benefits on both mother and baby as well as facilitating parent-child bonding, of which more later. In these times, recession or not, it’s always free and delivered with love.
However, despite the pro-breastfeeding consensus, many new mothers would be hard pressed to explain what’s so good about it. Addressing this lack of knowledge is one of the many tasks that UNICEF has set out to achieve through its Baby Friendly Hospital Initiative. The advances are manifest. In participating maternity wards, babies now lie alongside their mothers in specially adapted cots attached to the side of the mother’s bed, provided by UNICEF with support from private sector sponsors. Known as “rooming in”, it’s a far cry from the old practice of tightly swaddling newborns and whisking them off to another room, away from the mother, thereby preventing crucial early bonding. This old orthodoxy – a misguided attempt to ensure straight limbs – is still the norm in certain areas, something else UNICEF is working to change.
At Pantelimon Hospital, in district 2 of Bucharest, the new mothers mostly look relaxed and content, their babies at their side, despite their recent efforts and pain. Eighteen-year-old Claudia, whose first child, Ion Jean Alexandru, is just two days old, endorsed the new set-up: “It would be bad if he was in another room.” Most of her information on childrearing has come from magazines and her mum, as well as her own experience of taking care of her two younger brothers, with whom she still lives, while her own mother worked. Ion was not planned but Claudia wanted him as soon as she found out she was pregnant, and his father’s family got over their initial reluctance and have already been to see their new grandson.
Claudia has started breastfeeding, persevering although she found it painful at first. She is adamant that she will continue, even though she does it because it feels natural, not because she is aware of any of the benefits it brings to her or her child. This is where the ward team comes in, encouraging Claudia and her fellow new mothers to try and persist with breastfeeding and enlightening them as to its countless advantages. The teenager, who left school in the eighth grade, is open and willing to learn. And training is provided in the hospital, with staff helping the women to prepare for the huge challenge that has just begun.
In the next room is Mioara, a Roma woman of 28 who has just given birth to her second child, Marius Ionuţ. He was born at great risk to his mother, who suffers from serious heart and neurological complications brought on by the repeated beatings she suffered at the hands of her elder daughter’s father (who left her because of the health problems he had caused). With 11 other sons to take care of, her own mother won’t be able to provide much help, but she will be supported by Marius’s father and her daughter.
Mioara exemplifies the well-meaning ignorance of many of the women who pass through the ward, who range in age from 13 to nearly 50, about half of whom come from the villages near Bucharest. “Nobody told me what to do with my daughter,” she says. Hearing it was good to massage a baby in oil, Mioara dropped her baby in the bath – “Who could tell me to put the oil on after the bath, not before!” She is a keen exponent of breastfeeding, having nursed her daughter until she was three. “There’s nothing healthier than mother’s milk,” she says, although, like Claudia, she cannot name any of the actual advantages.
The list of advantages is a long one. Babies who are nursed enjoy higher survival chances in their early months of life, due to breast milk’s protection against potentially lethal infection, including diarrhoea and breathing problems. A breastfed child has a reduced risk of suffering from cancer, obesity, diabetes, asthma and ear, stomach and chest infections. Behaviour, speech and social skills also get a boost. And nursing avoids the associated risks of bottle-feeding, such as from faulty sterilisation. Health benefits also accrue for the mother, notably reduced incidence of breast, uterine and ovarian cancer, hip fractures, osteoporosis, heart disease, heart attack, stroke, high blood pressure, high cholesterol, diabetes and depression. The skin-to-skin contact inherent in nursing could, if adopted universally, prevent hypothermia, saving about 200,000 lives annually. And the bonding the practice cements also reduces the risk of child abandonment.
The Baby Friendly Hospital Initiative aims to impart this information to new parents. By training doctors and nurses to educate women in the benefits of breastfeeding and child nutrition, dedicating a special room to nurse-led training in how to take care of a newborn and supplying leaflets and DVDs for use at home, UNICEF hopes to equip women like Claudia and Mioara to be the good mothers that they are determined to be.
UNICEF Romania/ Teenage mother Claudia nurses two-day-old Ion. The benefits of breastfeeding are among the topics covered by staff as part of the UNICEF Baby Friendly Hospital Initiative.