Awareness of the importance of breastfeeding is not sufficient - support is also needed

Breastfeeding is crucial for the survival, nutrition and development of infants and young children and the health of mothers. Breast milk protects newborns from infections, helps develop immunity, is beneficial for digestion and optimal growth, and breastfeeding has been found to improve the closeness of mother and baby, while direct physical contact with the mother contributes to a sense of security and later psychosocial development of a child. On the other hand, breastfeeding mothers are less likely to develop breast cancer and bring back their physical health and body shape easier. After giving birth, it is recommended to exclusively breastfeed a baby during the first six months and then continue with adding solid food, until 24 months or longer, if it suits both mother and baby.

Why is it necessary to protect breastfeeding and from whom?

Primarily from the aggressive marketing of the Breastmilk Substitution Industry, which many countries seek to regulate by adopting the International Code of Marketing of Breastmilk Substitutes and by applying the national laws. Unfortunately, even though child mortality due to hunger or inadequate nutrition increases globally, due to restrictive measures and the consequences of the COVID-19 pandemic, manifesting through the economic weakening of families, the situation has worsened.

Who then has the responsibility to protect the breastfeeding?

Everyone, from decision-makers, through healthcare institutions, healthcare professionals, employers, the media, the experts, to family members, colleagues, and friends. Everyone in their field of work can support the breastfeeding process, by providing support, advice, commitment, promotion, care, by enabling flexible working hours or just by encouraging breastfeeding.

Who holds the most power to preserve and save breastfeeding?

Those two people one can see on UNICEF’s logo, behind which the world stands.

The mom and her baby.

Lamija is the Education officer at UNICEF Bosnia and Herzegovina. Four months ago, she became the mother of a beautiful baby girl named Dunja, but due to a combination of circumstances, she was also one of those brave women who experienced the pregnancy, the childbirth and the first days of motherhood during the severe wave of the COVID-19 pandemic.

“Although I did not experience many physically uncomfortable symptoms, my pregnancy was very challenging. I had a fear of infection, and the time in isolation narrowed my circle of support. I couldn’t see my loved ones and I was worried about older family members. A year before, I’ve lost my baby, who did not survive childbirth, so my pregnancy was filled with a mix of emotions: happiness, sadness, and anxiety. Sometimes, the pregnancy seemed infinitely long to me, but some days were better than others and I found moments of enjoyment. I needed a lot of support and understanding, primarily from my partner but also from the doctor who was managing my pregnancy.”, says Lamija.

Baby Dunja was born by caesarean section under general anesthesia, so the mother and baby met only the day after - after returning from the intensive care unit.

“Meeting a baby is definitely the most beautiful moment of my life, and soon after our first glances, I tried to breastfeed. I must admit I wasn’t ready enough to breastfeed. Although I read about the importance of breastfeeding during pregnancy, I somehow underestimated its complexity. I soon realized that breastfeeding is a kind of skill and that there are many details I need to pay attention to. Upon discharge from the hospital, I sought the help of a nurse specializing in breastfeeding who helped me a lot. I was also helped by certain online breastfeeding support groups that provided the answers to many of my questions. ”, Lamija recalls.

Fear is our greatest enemy. A small suspicion is enough to shake the self-confidence of a breastfeeding mother. Lamija also experienced this, after a pediatrician once noticed that the baby's weight gain had slowed down. This is the moment that many mothers have encountered. Either we will succumb to fear, the pressure of the environment, or marketing whose influence we are often not even aware of and reach for an easier solution, or we will find our own power to protect breastfeeding. Lamija and Dunja have managed it:

“I decided to follow the advice of specialized nurses and my own instinct. I breastfed on demand, did compressions, and additionally stimulated milk production with a pump. Soon, milk production increased according to needs, and the baby is now gaining weight properly. I also realized that breastfeeding is a wonderful opportunity to connect with Dunja and that I enjoy breastfeeding. My colleagues know that I love numbers, so I had calculated that in the first three months I breastfed for an average of six hours a day! I realized that it is not enough for mothers to be aware of the importance of breastfeeding, but they need a lot of support. My partner and our moms were there for me so I could focus on breastfeeding. ”

For decades, UNICEF in Bosnia and Herzegovina is supporting the initiative of the Baby-Friendly Hospitals, whose basic claim is to support mothers to establish breastfeeding immediately after the birth. Lamija had a lot of support from doctors and primarily nurses - from the first steps after the operation to the discharge from the hospital. She also received helpful advice from the medical staff regarding the care of herself and the baby, and the home visits by the nurse after discharge from hospital were of great significance. Yet she feels the breastfeeding support in hospitals themselves could be improved and given even more attention and time.

Although pregnant and lactating women are sometimes vaccine hesitant, Lamija took the first available opportunity to be vaccinated against COVID-19.

"After researching the available resources of the WHO and UNICEF regarding the vaccination of breastfeeding mothers and after consulting with my gynecologist, I decided to get vaccinated to protect my baby, family and myself. I received the vaccine, with minor side effects of fever, one day after vaccination. I continued to breastfeed and did not notice any changes with a baby. My partner has also been vaccinated, as have most of our friends and family, either through a regular vaccination program here or in Serbia, so we can finally enjoy being with our baby and the people we love. ”

In Bosnia and Herzegovina, the last Multiple Indicator Survey was conducted back in 2012 and showed the devastating fact that at that time only 16% of mothers exclusively breastfed their babies. We do not have any recent data, but hoping that in addition to UNICEF supported interventions, Lamija's and Dunja's story will contribute to increasing these numbers in our country.