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Breast-feeding: a Woman’s Happiness, a and Society’s Maturity Test

Darya Plotnytska encourages future mothers to be positive about breast-feeding – and everything will be just fine

 “A breast-feeding woman, for me, has always been a model of womanhood and beauty since I was a child. And when I gave birth to my little daughter, I was confident that I would breast-feed!” - Darya Plotnytska, a young mother from Kyiv.

Darya’s daughter Diana is 23 months old now. Diana was breast-fed until she was 18 months old, and until the age of six months she was exclusively breast-fed – which meant no water, juices or formulas. Her mother’s breast milk was the perfect product to slake the baby’s thirst. “I did the best I could to breast-feed. I attached my baby to my breast as often as possible; I had proper nutrition; I spend a lot of time with her and slept beside her. So the breast milk supply was growing, and we never had any particular problems with that,” continues Darya.

The choice of this young mother is fully in line with recommendations of the World Health Organization, United Nations Children’s Fund (UNICEF) and the Ministry of Health of Ukraine. According to these organizations, babies should receive breast milk exclusively until the age of 6 months, and after the introduction of solid foods, mothers can continue breast-feeding their babies up to the age of two years.

One challenge for women who want to breast-feed is that health care professionals in Ukraine do not actively promote it. For example, Darya didn’t find any support among doctors of Ukraine’s capital. “They never told me anything about breast-feeding at the maternity hospital. After delivery they placed a baby on my breast only upon my request. Nobody ever explained to me how to attach a child to the breast. When I did not have enough milk, they suggested supplementing breast-feeding with formula. At that moment I trusted my intuition, so I refused. Later on, having read a lot of information about breast-feeding, I understood that I was right.” The young mother is outraged.

“When a child fails to gain weight, paediatricians always recommend adding formula. They do not delve deeply into the problem and do not try to explore reasons for the lack of breast milk. Sometimes they even make money out of promoting infant formulas.”

Doctors’ general lack of support towards breast-feeding is one reason why conscious mothers such as Darya are few in numbers. According to the 2007 Ukraine Demographic and Health Survey, conducted with the participation of the State Statistics Committee, only 18 per cent of Ukrainian babies under the age of six months received exclusive breast-feeding. “I have heard a lot of stories of ‘experienced mothers’, who say it is not worth it to continue breast-feeding after four to six months, because they say ‘nothing useful remains’ in the breast milk,” says Darya.

Experts disagree, citing the many benefits of breast milk. “Mother’s milk is the ideal nutrition for a baby,” explains Valentyna Misnyk, leading research officer of the Department of Nutrition of Young Children at the Institute of Paediatrics, Obstetrics and Gynaecology of the Academy of Medical Sciences of Ukraine (IPOG AMSU).  “It is perfectly balanced in proteins, fats, carbohydrates, vitamins and minerals; it also contains various protective factors and biologically active substances. It is the best source of energy. In addition, the process of breast-feeding itself has positive impact on child’s health and psychological and emotional development.”

However, healthcare professionals’ approach towards breast-feeding counselling and aggressive promotion of breast milk substitutes makes things worse. “Thanks to joint efforts of the MOH of Ukraine and UNICEF, currently only several maternity hospitals continue to offer samples or DIRECT advertisements of milk formulas,” says Olena Sherstyuk, UNICEF Child Health and Development Officer. “However, we have to deal with more ‘sophisticated’ marketing methods used by producers of breast milk substitutes, including funding of health care conferences and training, ‘scientific’ research; and collection of personal information about mothers to conduct further targeted advertising. Virtually everywhere we observe, they put formula samples into so-called “mother’s gifts”, and the worst thing is when these are presented on behalf of local authorities, which should prioritize and protect breast-feeding,” she concludes.

Although fewer substitutes are being handed out, pens, calendars, posters and gowns with brand names of various breast milk substitutes can be found in almost every health-care facility. How can we talk about the protection and support of breast-feeding, if a young mother is attended by a doctor wearing a gown with the name of breast milk substitute? Moreover, such substitutes as herbal teas are presented as ‘corrective’ nutrition for babies that are supposed to stimulate digestion or remove colic pains. These recommendations are contrary to research on what is best for babies. Such teas only displace breast-feeding, because the mother will produce exactly the same amount of milk as sucked out by a child, experts say.

Mother’s breast milk, for Diana, is a source of happiness, calmness and health

“When some amount of milk is substituted with tea or water, a child sucks out less milk, so the mother’s brain receives a ‘smaller order’ for milk,” says Ms. Sherstyuk. “It is natural that a woman reacts by thinking, ‘I don’t have enough milk, so I have to supplement it’. However, no one warns mothers about risks of artificial feeding, even though everyone knows about last year’s tragedy in China and formula-related scandals in Italy. There even exists a separate WHO Resolution, that requires informing mothers on the risks of artificial feeding,” adds Ms. Sherstyuk. The goal of International Code of Marketing of Breast-Milk Substitutes is to block off aggressive advertisements.

However, for many years Ukraine has been reluctant to ratify this document. Considering the lack of relevant national legislation, this issue is guided by international norms. However, this International Code is currently perceived in Ukraine only as a recommendation, and not a requirement. About one year ago, upon the request of the MOH of Ukraine and with the support of UNICEF, a group of leading national experts developed a draft Order regulating the observance of the International Code in health-care facilities, but this document is yet to be signed.

In the meantime, women have to rely on themselves. “When I was breast-feeding, I had no problems at all,” says Darya. “When a baby wanted to eat, I gave her the breast anywhere – in the park, in a café, on the plane.” This young woman would like our society to become more serious and responsible regarding breast-feeding. “This breast-feeding period was the happiest time of my life,” remembers Darya. “A child is your second self. She is inseparable from a mother; she breathes her mother in. Mother’s breast milk is a source of baby’s happiness, calmness, love and health. Love your children and give them all the best – they deserve it! Listen to yourself, listen to your instincts and breast-feed your babies, as it is nature’s plan!”

Breast-feeding saves millions of children’s lives annually. United Nations Children’s Fund (UNICEF) supports exclusive breast-feeding until six months of age, and continued breast-feeding for at least two years, along with the timely introduction of adequate age-relevant complementary foods. In addition to awareness-raising activities in this area, UNICEF Country Office in Ukraine supports the introduction of the International Code of Marketing of Breast-Milk Substitutes and implementation of Expanded Baby-Friendly Hospital Initiative (BFHI). Currently 220 Ukrainian health care facilities received this title. During 2005-2007 the rate of exclusive breast-feeding in Ukraine has increased from six per cent to 18 per cent. The rate of exclusive breast-feeding in children’s clinics with BFHI status reaches 50 per cent.



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