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World Breastfeeding Week: interview with Felicite Tchibindat, UNICEF Regional Advisor for nutrition

© UNICEF/NYHQ2007-0413/Pirozzi
An indigenous Aka woman breastfeeds her infant in her hut in a settlement in Mbaiki, in the south-western Lobaye Province. Three-quarters of villages in northern parts of the Central African Republic have been abandoned as people flee internal conflict.
 

From August 1 to 7, individuals, organizations and governments around the world celebrate World Breastfeeding Week, an event sponsored by the World Alliance for Breastfeeding Action (WABA) and supported by UNICEF.

This year’s theme is "Breastfeeding as a vital emergency response".

UNICEF Regional Advisor for nutrition in West and Central Africa, Felicité Tchibindat, tells us about the benefits of breastfeeding and why it is a vital emergency response.

Q: Can you tell us why breastfeeding is vital in emergency response?
A: Even in non-emergency settings, breastfeeding is the best source of nutrition for newborns and young children. It is estimated that exclusive breastfeeding alone has the potential to avert 13 per cent of all under-five deaths in the region. And the region holds the worst child mortality indicators in the world, with one in five children dying before their fifth birthday – or 3 millions each year.

So, if exclusive breastfeeding can be so life saving in non-emergency settings, imagine how vital it is in emergencies.  Emergencies are often characterized by turmoil, insecurity, poor sanitation and a short supply of clean water, medical care, food and shelter that put children and their caregivers in danger.  Emergencies often lead to rise in diseases and deaths due to diarrhea, respiratory illnesses and malnutrition. 

Whether the emergency is great or small, short or long, the main anxiety for parents is their children’s health and survival. In emergency and relief situations breastfeeding is of critical importance: it saves babies lives. Artificial feeding in these situations is difficult and increases the risk of malnutrition, disease and infant death. The basic resources needed for artificial feeding such as clean water and fuel are scarce in emergencies. Transport and adequate storage conditions of breastmilk substitutes (BMS) cause additional problems

When a mother breastfeeds, she gives her child a clean, safe, sustainable food and water supply and actively protects him or her from infections. Breastfeeding is a life saving intervention and protection for the youngest, especially in emergencies.

Exclusive breastfeeding is among be the most important child survival intervention in the region.

Q: Is breastfeeding widely practiced in the countries of the region?
A: Breastfeeding is a tradition in every culture in the region, but only 20 per cent of babies under six months are exclusively breastfed, with rates as low as 2 per cent in Chad, 4 per cent in Côte d’Ivoire. The rates of exclusive breastfeeding in the region remain among the lowest in the world.

However, a lot of progress has been made during the last few years. Countries such as Mauritania and Niger have been able to increase the rate of exclusive breastfeeding; demonstrated that even in very difficult circumstances, it is possible with a coherent intervention achieve remarkable results. It is important that countries that are lagging behind accelerate the rate of progress if West and Central Africa region is to meet the MDGs 1, 4 and 5 (poverty and hunger, child mortality, maternal health).

Q: What is undermining the practice of breastfeeding?
A: The practice of breatfeeding is undermined by three major factors:. The lack of access of mothers and caregivers to health information, the lack of support for breastfeeding mothers and the promotion of infant formula. These three factors are underlyed by deeply entranched beliefs and misconceptions about breastfeeding such as the need to give water to a young baby to quench his thirst.

Let me take this occasion to reiterate that breastmilk contains all the nutrients and water that a child needs during the first six months of his or her life. That is why UNICEF recommends that women breastfeed exclusively for six months and continue breastfeeding with age-appropriate complementary feeds up to two years.

Q: What can be done to support breastfeeding in emergencies?
A: In emergency and relief situations breastfeeding is of critical importance: it saves babies lives. Artificial feeding in these situations is difficult and increases the risk of malnutrition, disease and infant death.

The basic resources needed for artificial feeding such as clean water and fuel are scarce in emergencies. Transport and adequate storage conditions of breastmilk substitutes (BMS) cause additional problems. Furthermore, BMS donated as humanitarian aid often end up in the local market and can have a negative influence on feeding practices in the host community.

Three coherent interventions have been developed in emergency situation to promote, protect and support breastfeeding:
• Mother and Baby Tents are special shelters in refugee camps where mothers with children under two years of age can find a safe and secure place to rest, eat and receive support.  
• Breastfeeding corners: a supportive environment for breastfeeding mothers with low birth weight babies
• Baby-friendly emergency shelters allow interaction with mothers and counselors.

These settings will ensure that all mothers and caregivers have access to key information. It also means that mothers should be encouraged to breastfeed and that breastfeeding mothers should be supported and protected. Protection also means preventing unsolicited donations; untargeted distribution and unmonitored of infant formula.

In emergency settings,support and protect breastfeeding by ensuring that women have access to food, water and shelter, and if necessary some privacy to breastfeed.

Basic, yet life-saving information must be disseminated and myths dispeled such as such as stress dries up breastmilk or malnourished mothers are no able to breastfeed or babies with diarrhea need water or it is not possible to re-start breastfeeding after mothers have switched to infant formula. All women and caregivers should know that a mother can increase its milk supply, relactate after having stopped, and that wet nursing may be an option as a temporary measure or if a baby is orphaned.

To be ready in case of an emergency, breastfeeding must be widely understood, supported and protected, even in normal settings.

The potential of breastfeeding for saving children’s lives is such that all actors, at all levels should work to promote and protect it, from the government officials, to the health agents, to the traditional matron and leaders.

 

 
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