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Promoting exclusive breastfeeding to save babies’ lives

© UNICEF Kenya/2015/Ayisi
Margaret Mumo, with her 2-year-old son, Julian on her lap, with a group of mothers at Kavuta health centre in eastern Kenya. Julian has been successfully treated for severe acute malnutrition.

By Ruth Ansah Ayisi

KITUI, Kenya, 20 March 2015: Painful memories are evoked as Margaret Mumo listens to a group of mothers who are chatting and laughing together at a gathering at Kavuta health centre in the semi-arid county of Kitui, some 200 kilometres north of Nairobi, the country’s capital.

The mothers, with babies on their laps, are talking about their experiences of exclusive breastfeeding, which Margaret, 22, later explains she had also wanted to do, but her mother-in-law insisted she introduce food at four months for both of her children.

As well as stopping breastfeeding earlier than is recommended, Margaret was unaware of the importance of diversified and age-appropriate infant feeding practices. Instead she fed her babies only starch, and water collected from a river two kilometres away.

Her first born, Faith, did not thrive and at 9 months suffered a severe bout of diarrhoea and vomiting. Margaret rushed Faith to the health facility, where she was treated with oral rehydration salts, but at night Faith worsened. Margaret then hired a car to take Faith to the nearest hospital, 38 kilometres away.

“She died on the way,” says Margaret softly, looking down.

Building resilience in Kenya

Underlying malnutrition contributes to 45 per cent of all child deaths in Kenya and recent official data estimates that 2.8 million or one third of Kenyan children under the age of 5 are stunted.  

In a renewed drive to tackle malnutrition, the Government of Kenya, the European Union and UNICEF launched a four-year maternal and child nutrition programme on 18 February 2015, part of a larger resilience building programme covering the Horn of Africa. The programme aims to reduce the impact of recurrent food shortages in Kenya’s semi-arid and arid lands, like Kitui, and to strengthen health systems.

“The EU is committed to this programme as development is one of our central goals,” says EU Chargé d'Affaires, Mrs. Marjaana Sall. “As well as having a detrimental impact on the economy, malnutrition hinders efforts to reduce poverty.”

The programme aims to empower mothers like Margaret.  She has brought her other child, 2-year-old Julian, to Kavuta health centre. The visit is to monitor his progress after being treated at home for severe acute malnutrition with Plumpy’Nut, a peanut paste fortified by micronutrients which is supplied by UNICEF to community health centres.

© UNICEF Kenya/2015/Ayisi
Margaret Mumo, holding her 2-year-old son, Julian, who has been successfully treated for severe acute malnutrition in Kitui County, eastern Kenya.

The joys of exclusive breastfeeding

Curious, Margaret had entered the room where the mothers are chatting and sits down with Julian on her lap. Public health nurse Ruth Kilonzo, who facilitates the discussion, asks the 15 mothers about their experiences. As they talk, they laugh, clap and listen to each other attentively. They discuss how exclusive breastfeeding strengthens their baby’s immune system, and how it helps with bonding and cognitive development.

“I found that I am more friendly with my last born as I breastfed for six months,” says Miriam Musembi, a mother of four.

A mother of five, Patricia Joseph, joins in, “When you breastfeed for six months, they are brighter.”

Yet they also acknowledge the challenges.

“When you exclusively breastfeed, you can’t leave the baby,” says Katata Kalii. 

“What about expressing your milk?” asks the public health nurse.

“If I express, my mother-in law doesn’t like it, as she says it is like it is not my milk, so you might as well give cow’s milk” she says to the amusement of the others.  

The women are all members of a breastfeeding mother-to-mother support group, which meets regularly at Kavuta health centre, one of the few health facilities in the country that has been declared ‘baby friendly’. The only man present in the meeting is Kusiwii Musyoka, a community health worker and chair of the village health committee, who encouraged the mothers to set up the group.

“Before I received the training about exclusive breastfeeding, I didn’t know it was important,” concedes Musyoka, a father of four. “After my training on how to make a community baby friendly, I felt I had a calling to share this information so that we have a healthier generation of children in our community.”

He explains how he treks up to 10 kilometres, often under the scorching sun, making home visits, checking on cases of malnutrition and advising mothers on infant feeding. His work is voluntary.

Supporting each other

There are now 60 mothers in the support group, which is open to anyone who has a baby under 2 years of age, the window of opportunity before the consequences of chronic malnutrition, such as cognitive and physical impairment, are irreversible. Besides supporting each other with breastfeeding, mothers who have successfully breastfed and weaned their children mentor other mothers, giving demonstrations on how to prepare nutritious foods on vaccination days at the health centre and counselling pregnant women and mothers having difficulty breastfeeding.

Colletta Malonza, one of only two nurses at the health centre, says that the mothers’ support group helps her work.

“About 30 of the mothers are very active which is particularly important now as the rains are poor again, their crops have failed and mothers tend to resort to just giving their children starch. Cases of malnutrition are beginning to increase.”  She adds that both Margaret, who was malnourished herself, and her son Julian, have dramatically improved.

Margaret seems excited that she had the chance to listen to the mothers’ discussion.

“I would like to join this group,” she comments.

When asked about her hopes for the future, Margaret says, rubbing her face fondly on Julian’s, “I would like Julian to grow up healthy and to be a teacher. And I would like to have two more children. This time I will breastfeed them for six months,” she says.



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