As the world marks the World Breastfeeding Week, under the theme ‘Support breastfeeding for a healthier planet’, the World Health Organisation and Unicef have called on governments to protect and promote women’s access to skilled breastfeeding counselling as part of breastfeeding support.
While this rallying call is a welcome move across many communities, it comes at a time when the world is grappling with the coronavirus pandemic that has led to a significant level of apathy towards hospital visits as many people keep off the facilities for fear of exposure to the coronavirus.
With Kenya reporting a rise in Covid-19 positive cases daily, many people are increasingly staying away from health facilities, apart from the ‘serious’ cases. This means that many breastfeeding mothers are likely to seek breastfeeding advice from other ‘lay’ Exclusive Breastfeeding (EBF) opinion leaders such as mothers-in-law, peer mothers and husbands.
However, unfortunately, most of the lay opinion leaders in EBF do not advocate for the WHO-recommended practices, choosing instead to champion cultural practices that lead to unnecessary EBF cessation. In fact, some of these community ‘experts’ have been found to advocate the introduction of post-lacteal feeds as early as two weeks after birth based on the myth that breast milk alone is not enough for a baby.
This, among many other myths, leads to cultural practices such as the introduction of porridge, water, juices or even solid food before six months.
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The recent exponential rise in Covid-19 cases means that, inevitably, many more breastfeeding mothers are likely to turn to ‘experienced’ community members to seek EBF information in the absence of professionals such as nurses and lactation consultants.
While the Baby-Friendly Community Initiative (BFCI) has led to many achievements in ensuring EBF-supportive environments, a lot more needs to be done at the community and household levels. For example, many communities still do not have enough trained Volunteer Community Health Workers to counter the influence of lay EBF opinion leaders.
This leaves EBF and general maternal and infant health care information at the mercy of the often ill-informed community members especially during this global pandemic. Similarly, since the country reported the first case of Covid-19, the Health ministry has encouraged people to avoid crowds and stay at home as much as possible to curb the spread of the virus.
This in turn is likely to affect many BFCI interventions such as targeted home visits and frequent ‘baby-friendly’ meetings, further compounding the challenges facing breastfeeding mothers.
Before the introduction of the BFCI, many EBF campaigns approached men as obstacles to overcome rather than resources to work with in ensuring an EBF-conducive environment. A shift in EBF campaign design and implementation, however, ensures that EBF messages are designed to target both the primary (pregnant and lactating mothers) as well as secondary audiences such as spouses/partners and mothers-in-law.
Studies have shown that when a father supports the exclusive breastfeeding of their baby, a mother is more likely to not only initiate but also sustain EBF for the WHO-recommended duration of six months. This can be attributed to the authority held by men at the household level in many communities.
A husband’s role as the leader of the household bestows upon him the credibility required to communicate EBF information, more so when he communicates WHO-recommended EBF information.
As Covid-19 increasingly overwhelms healthcare systems across the world, therefore, there is need to involve men, and especially husbands and fathers in general, as EBF advocates to ensure that babies growing up during this pandemic continue to get the life-saving milk for the recommended duration. Such messages should focus on raising awareness on the roles that spouses/partners can play to support exclusive breastfeeding at the household level.
Breastfeeding is both a mental and physical activity. While it is biologically a woman’s role to provide breast milk, men can play a critical role in providing the moral and physical support required to achieve optimal breastfeeding for at least six months after birth.
Apart from providing a peaceful, stress-free environment to enable optimum breast milk production, a father can also feed the baby with breast milk from a bottle to enable the mother get the much-needed physical rest. Fathers can also get actively involved in preparing balanced diet meals to ensure that a breastfeeding mother gets all the nutrients she requires for the breastfeeding duration.
The likely impact of Covid-19 on a breastfeeding mother’s mental and physical health cannot be overemphasised. As the world marks the breastfeeding week this year, it is important for EBF advocates to scale up their efforts to reach out to spouses/partners with messages on their role as partners in EBF in order to ensure that mothers have all the support they require to initiate and sustain breastfeeding for the WHO-recommended six months.
Dr Kiambati is a Communications lecturer and trainer at Kenyatta University