Exclusive breastfeeding, ideally starting within the first hour after birth, is recommended by the WHO for the first 6 months of life. Breast milk contains all the nutrients and antibodies that a baby needs for body and brain growth. Additional recommendations highlight that from 6 months onwards, babies should receive complementary foods along with continued breastfeeding for up to 2 years or older.
Breastfeeding gives babies the best possible start in life. Breastmilk works like a baby’s first vaccine, protecting infants from potentially deadly diseases and giving them all the nourishment they need to survive and thrive.
Dr Tedros Adhanom Ghebreyesus, Director-General of WHO.
According to 2015-16 Tanzania Demographic and Health Survey (DHS) 59% of infants under 6 months are exclusively breastfed in Tanzania, still some way to go to the Government’s target of 90% by 2020. Exclusive breastfeeding however declines rapidly with age; only 27% of infants age 4-5 months are exclusively breastfed and only 43% of babies continue to be breastfed, in addition to complimentary feeding, for up to the recommended 2 years.
Reasons for not breastfeeding or initiating breastfeeding within 1 hour of birth
There are many reasons, why mothers in Tanzania do not breastfeed, but a key factor is when mothers deliver without the support of a skilled birth attendant, therefore are not supported to breastfeed during the important first hour following birth. Our DHS reports that only
About six in ten children born in health facilities were breastfed within 1 hour of birth compared to only four in ten children delivered elsewhere.
Save the Children’s 2013 report ‘Superfood for babies’ highlighted data from forty countries and found that women who had a skilled birth attendant at birth were twice as likely as women without such help to initiate breastfeeding within the first hour, stating: "Women who were given post-natal care by someone who was unskilled and had not had sufficient training were 25% less likely to be exclusively breastfeeding than women who had no post-natal care at all. This suggests that those unskilled practitioners, such as traditional birth attendants, were giving poor advice and potentially reinforcing harmful local attitudes and taboos."
Socioeconomic inequities and level of education also contributes to the gap when it comes to exclusive breastfeeding. When collating their report Save the Children analysed data from 44 countries with among the highest global rates of maternal and child mortality (monitored in Countdown to 2015 Final Report). The research found that there were significant disparities in rates of breastfeeding depending on the wealth of the household, with poorer households being less likely to initiate breastfeeding early than those in higher income groups.
In addition the report highlights "The disparity in breastfeeding is particularly pronounced among uneducated mothers, who are 19% less likely to initiate breastfeeding early and 13% less likely to exclusively breastfeed than mothers who had completed primary education."
I discussed this with Lulu Nyenzi, a Tanzanian mother of twin girls, who said "Economics is another reason for mothers to not exclusively breastfeed their children. Wealthy families tend to do well in breastfeeding compared to poor families. Mothers from poor families often need to spend time doing strenuous labour to earn an income".
Myths and misperceptions also remain within some Tanzanian communities, including not having enough breast milk, or the breast milk is not sufficient to satisfy the nutritional needs of the baby.
Benefits of Breastfeeding
There is ample evidence that breastfeeding is among the most effective interventions in reducing infant morbidity, disability and mortality. According to The Lancet
The scaling up of breastfeeding to a near universal level could prevent 823 000 annual deaths in children younger than 5 years.
The early initiation of breastfeeding is important for a number of reasons. Early suckling benefits mothers because it stimulates breast milk production, provides the baby with colostrum which contains a strong immune booster and releases a hormone that helps the uterus to contract and reduce postpartum blood loss.
I wish all parents, families and communities in Tanzania were sensitised on the importance of breastfeeding, within one hour after birth, exclusive breastfeeding for six months, and continued breastfeeding for two years and beyond.
We therefore during #WBW2017 call on advocates and activists, decision-makers and celebrants to forge new and purposeful partnerships to advocate for breastfeeding. Together, let’s attract political support, media attention, participation of young people and widen our pool of celebrants and supporters. Support women to breastfeed anytime anywhere.