Healthcare workers expand their skillsets to help mothers give their babies the best start in life

UNICEF-supported training in Essential Newborn Care is helping to reverse the decline in exclusive breastfeeding rates in Timor-Leste

UNICEF Timor-Leste
UNICEF Timor-Leste/2019/Galvin
21 November 2019

The Comoro Community Health Center is a small, unassuming building tucked away off a dusty side street in suburban Dili, the capital city of Timor-Leste. In a country where the exclusive breastfeeding rate has been on a steep and worrying decline over the past six years, the knowledge and assistance being provided by the center’s midwives is critical. And parents are listening.

Lucia Linda Tchong Stanis, 25, gave birth to her first baby, Kezra, two days ago. As she beams with pride and cradles her bundled up baby in her arms, she shares what her breastfeeding journey has been like over the past 48 hours.

“I tried to breastfeed him on the first night, but I hardly had any milk. There was a problem with my nipples, which affected how the milk flowed and caused me pain,” she says. “My baby was hungry and crying. I was so worried and was tempted to give him formula or water.”

But Lucia decided against supplementing her breastmilk based on advice from her midwife, Fernanda Ana Alves, who recently undertook UNICEF-supported training in Essential Newborn Care, or ENC. Over the week-long training in early August, she and 19 others learnt about optimal breastfeeding practices, such as initiating breastfeeding within an hour of birth, exclusively breastfeeding up to six months of age and the benefits of breastfeeding up to two years of age. So, when baby Kezra arrived, and his mother was experiencing trouble breastfeeding, Fernanda had the right information on hand to help them both navigate the situation.

UNICEF Timor-Leste/2019/Galvin
Fernanda Ana Alves has been a midwife for almost two years and recently undertook UNICEF-supported training in Essential Newborn Care.

“I advised Lucia that exclusive breastfeeding is recommended up to six months of age,” says Fernanda. “I let her know that formula cannot offer her baby what breastmilk can, because breastmilk provides complete nutrition and contains vitamins, proteins and antibodies that help to protect a baby against sickness and disease. It also helps the mother to recover from child birth and can protect her from developing breast cancer later in life.

“I’m really grateful that I got to take part in the ENC training,” Fernanda adds. “It provided me with additional knowledge and upgraded the skills I have so I can help mothers with newborn babies. I’m proud and happy when I can help mothers to successfully breastfeed their babies.” 

In addition to sharing what she learnt during her ENC training, Fernanda also showed Lucia how to massage her breasts to stimulate milk flow and demonstrated some of the best ways to hold her baby while breastfeeding. Lucia says she continued to practice these things after returning home with her baby.

“Before I gave birth, I thought formula was the best for the baby, because most mothers give their babies formula when they find breastfeeding difficult,” says Lucia. “But now I know that I am able to breastfeed, and the benefits it brings to my baby. I feel really good when my baby has a full tummy and is sleeping soundly. I feel a real closeness to him being able to breastfeed. Being a mother has changed how I feel completely.”

UNICEF Timor-Leste/2019/Galvin
New mothers Eulalia, left, and Lucia both experienced difficulty breastfeeding after giving birth, but say their midwives helped them with information and techniques that meant they can now breastfeed their babies successfully.

Eulalia Maria de Araujo, 23, gave birth to her first child, Deo Gracia Maria, three days ago and says she too experienced difficulty breastfeeding at first.

“I had very little milk and my baby was crying a lot,” says Eulalia, who tried to prevent her baby from becoming dehydrated by giving her a couple of teaspoons of water per day along with her breastmilk. “This wasn’t the advice of my midwife,” she says, “but I was just so worried. After speaking with the midwife and seeing that my milk supply was increasing, I felt more assured.”

Gilda da Costa Fernandes, 32, who was Eulalia’s midwife at the Comoro Community Health Centre, also took part in the UNICEF-supported ENC training, which was led by two doctors and two facilitators from the National Health Institute. Both she and Fernanda say that what they learnt has enabled them to help the five to 10 mothers who give birth at this health center every single day.

UNICEF Timor-Leste/2019/Galvin
The Comoro Community Health Centre, where new mothers Lucia and Eulalia gave birth and received help to breastfeed from UNICEF-trained midwives.

According to data from the National Health Institute, 242 health workers have completed training across ENC, newborn care at home, and managing newborn problems since 2018. 

UNICEF’s work on nutrition in Timor-Leste is supported by the Shenzhen World Health Foundation and the European Union.