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Breastfeeding is the cheapest and most effective life-saver in history

2013-08-01

 
NEW YORK/ HONG KONG, 1 August 2013 –During World Breastfeeding Week starting today, UNICEF is focusing on eastfeeding as the most effective and inexpensive way of saving a child’s life. But with less than half of all children under six months benefitting from exclusive eastfeeding, strong leadership in promoting the practice is essential.

“There is no other single health intervention that has such a high impact for babies and mothers as eastfeeding and which costs so little for governments,” said UNICEF Deputy Executive Director Geeta Rao Gupta. “Breastfeeding is a baby’s ‘first immunization’ and the most effective and inexpensive life-saver ever.”

Children who are exclusively eastfed are 14 times more likely to survive the first six months of lifethan non-eastfed children. Starting eastfeeding in the first day after birth can reduce the risk of new-born death by up to 45 per cent.

Breastfeeding also supports a child’s ability to learn and helps prevent obesity and chronic diseases later in life. Recent studies in the United States and United Kingdom point to large health care savings resulting from eastfeeding, given that eastfed children fall illmuch less often than non-eastfed children.

Niger, November 2012. Haouaou Abdou, 52, mother of 6 children is smiling at her youngest son Issiakou, 8 months, in the village of Mazadou Abdou.   By Jessica Mony  In 2011, droughts across the Sahel plunged millions of families into a food crisis. A year after UNICEF and partners’ emergency response began, we ask ourselves how can we stop this vulnerability and persistent cycle of suffering? A poor, rural Nigerien village 600 people may hold the answer. Here, despite every family’s struggle during the drought, no child suffered malnutrition in 2012.  Just three years ago it was rare for a week to go by without a child dying from combinations of malnutrition, diarrhoea and malaria in Mazadou Abdou village. During the frequent droughts, at times this would rise to two or three. No family was spared the pain of loss and mourning. Haouoau and Loli Abdou are just one set of parents that faced this tragedy. Loli holds up three fingers and lists that in 2000, 2002 and then again in 2004 they lost three children to malaria. Looking solemnly at their healthy 8 month baby boy Issiakou, it is clear the scars will likely never heal for this family. Sadly, their situation is not unique in this or any other village across the Sahel.  Fortunately, in 2008 a simple UNICEF programme of family practices helped change all of this. The practices are simple and include exclusive eastfeeding for the first six months of life; complementary feeding for children after six months; proper hand-washing techniques; treatment of diarrhoea; knowledge of how to seek medical care; immunisation; using mosquito nets to prevent malaria; promotion of delayed pregnancies and girls education. The results of adhering to these practices for the children of Mazadou Abdou have been significant. Moutari Louali, a community volunteer who is helping to implement the programme explains the impact. “Before the programme started, around four to five children would die every month from malaria, diarrhoea and other diseases. Now, during the whole of this year only three children died, and this was because of miscarriages.” From the chief through to parents and children themselves, the whole village is determined that no child should die from preventable diseases. Haouaou is clearly proud of the result “In this village we didn’t have any malnutrition because we take care of our children. I am very happy about how healthy our children are.”   At the heart of the programme are volunteers like Moutari who, along with two other volunteers selected by the community, ensure that every family implements the practices and monitors progress. Every week the group visit up to five families to run information sessions. Today, Moutari is visiting Hoauoau’s household. Starting with an update on the health of their children, Moutari then calls a mother and her child forward to demonstrate a particular practice. Today it’s the use of mosquito nets and hand washing. Everyone here comes to listen and learn. Haouaou points at two of her daughters who were born before and after the programme started and she learnt about the benefits of exclusive eastfeeding. “Look you can see this one is much stronger.” Whilst drought, hunger and vulnerability are an ongoing reality for these families, their efforts to implement the programme are the key to ensuring their children not only survive, but are resilient through times of drought and extreme hardship.   Issa Iahim the 63 year old chief of Mazadou Abdou describes the precarious situation many families across the Sahel live in. “In this village our life is based around farming. The difficulty of this life is that if the rainy season doesn’t give a good harvest, life becomes extremely difficult for us.” For now the health of their children is safe, but the challenges ahead for the village are immense. A community run cereal bank will help tide them over for a while, but after this the only other option for many families is for husbands and fathers to head to Nigeria to search for work. Haouaou has thirty bowls of millet to feed her family until the harvest a year away. It will only last a month. She holds out the bowl and laughs nervously. “What can we do?”    Whilst Mazadou Abdou’s families continue to walk a tightrope of vulnerability, their newfound knowledge will keep their children alive and healthy. It is not the whole solution, but it provides the hope of a future for their most precious resource, their children. The Chief is thankful for how far they have come. “We are very proud and happy for what we have done here. We thank God, we thank the people who taught us these practices”, but he is also conscious of the toll of chronic hunger on the future of this community; “If a man is hungry he cannot hear, he cannot learn anything.”  The impact of the emergency response across the Sahel can be seen in the short term in the lives saved and the malnutrition prevented. For vulnerable families like Haouaou’s though, building resilience and food security will be key to long term change. This village has demonstrated the success of community driven initiatives to improve children’s health, but more support is needed to ensure communities across the Sahel are able to withstand crises. Haouaou tries not to think about what might happen a year from now; “Nobody can forsee the future. Even if we wait and hope for the best, anything can happen at any moment.”  UK Natcom - for local copies of the files: Y:Key-initiativesIFSahel-Stories-2012Niger
Niger, November 2012. Haouaou Abdou, 52, mother of 6 children is carries her youngest son, is Issiakou, 8 months, in the village of Mazadou Abdou.   By Jessica Mony  In 2011, droughts across the Sahel plunged millions of families into a food crisis. A year after UNICEF and partners’ emergency response began, we ask ourselves how can we stop this vulnerability and persistent cycle of suffering? A poor, rural Nigerien village 600 people may hold the answer. Here, despite every family’s struggle during the drought, no child suffered malnutrition in 2012.  Just three years ago it was rare for a week to go by without a child dying from combinations of malnutrition, diarrhoea and malaria in Mazadou Abdou village. During the frequent droughts, at times this would rise to two or three. No family was spared the pain of loss and mourning. Haouoau and Loli Abdou are just one set of parents that faced this tragedy. Loli holds up three fingers and lists that in 2000, 2002 and then again in 2004 they lost three children to malaria. Looking solemnly at their healthy 8 month baby boy Issiakou, it is clear the scars will likely never heal for this family. Sadly, their situation is not unique in this or any other village across the Sahel.  Fortunately, in 2008 a simple UNICEF programme of family practices helped change all of this. The practices are simple and include exclusive eastfeeding for the first six months of life; complementary feeding for children after six months; proper hand-washing techniques; treatment of diarrhoea; knowledge of how to seek medical care; immunisation; using mosquito nets to prevent malaria; promotion of delayed pregnancies and girls education. The results of adhering to these practices for the children of Mazadou Abdou have been significant. Moutari Louali, a community volunteer who is helping to implement the programme explains the impact. “Before the programme started, around four to five children would die every month from malaria, diarrhoea and other diseases. Now, during the whole of this year only three children died, and this was because of miscarriages.” From the chief through to parents and children themselves, the whole village is determined that no child should die from preventable diseases. Haouaou is clearly proud of the result “In this village we didn’t have any malnutrition because we take care of our children. I am very happy about how healthy our children are.”   At the heart of the programme are volunteers like Moutari who, along with two other volunteers selected by the community, ensure that every family implements the practices and monitors progress. Every week the group visit up to five families to run information sessions. Today, Moutari is visiting Hoauoau’s household. Starting with an update on the health of their children, Moutari then calls a mother and her child forward to demonstrate a particular practice. Today it’s the use of mosquito nets and hand washing. Everyone here comes to listen and learn. Haouaou points at two of her daughters who were born before and after the programme started and she learnt about the benefits of exclusive eastfeeding. “Look you can see this one is much stronger.” Whilst drought, hunger and vulnerability are an ongoing reality for these families, their efforts to implement the programme are the key to ensuring their children not only survive, but are resilient through times of drought and extreme hardship.   Issa Iahim the 63 year old chief of Mazadou Abdou describes the precarious situation many families across the Sahel live in. “In this village our life is based around farming. The difficulty of this life is that if the rainy season doesn’t give a good harvest, life becomes extremely difficult for us.” For now the health of their children is safe, but the challenges ahead for the village are immense. A community run cereal bank will help tide them over for a while, but after this the only other option for many families is for husbands and fathers to head to Nigeria to search for work. Haouaou has thirty bowls of millet to feed her family until the harvest a year away. It will only last a month. She holds out the bowl and laughs nervously. “What can we do?”    Whilst Mazadou Abdou’s families continue to walk a tightrope of vulnerability, their newfound knowledge will keep their children alive and healthy. It is not the whole solution, but it provides the hope of a future for their most precious resource, their children. The Chief is thankful for how far they have come. “We are very proud and happy for what we have done here. We thank God, we thank the people who taught us these practices”, but he is also conscious of the toll of chronic hunger on the future of this community; “If a man is hungry he cannot hear, he cannot learn anything.”  The impact of the emergency response across the Sahel can be seen in the short term in the lives saved and the malnutrition prevented. For vulnerable families like Haouaou’s though, building resilience and food security will be key to long term change. This village has demonstrated the success of community driven initiatives to improve children’s health, but more support is needed to ensure communities across the Sahel are able to withstand crises. Haouaou tries not to think about what might happen a year from now; “Nobody can forsee the future. Even if we wait and hope for the best, anything can happen at any moment.”  UK Natcom - for local copies of the files: Y:Key-initiativesIFSahel-Stories-2012Niger
Apart from the benefits to the baby, mothers who eastfeed exclusively are less likely to become pregnant in the first six months following delivery, recover faster from giving birth, and return to their pre-pregnancy weight sooner. Evidence shows that they experience less post-partum depression and also have a lower risk of ovarian and east cancers later in life.

Despite these well documented benefits of eastfeeding worldwide, only 39 per cent of children aged less than six months were exclusively eastfed in 2012. This global figure has improved very little for the past several decades, due in part to large countries where the eastfeeding rate is low, and to the general lack of a supportive environment for eastfeeding mothers.

However, countries with supportive policies and comprehensive programmes that reach all communities have been able to increase their eastfeeding rates significantly.

China, which recently attracted media attention because its strong consumer demand for baby formula caused shortages in other countries, has an exclusive eastfeeding rate of only 28 per cent.

In a bid to boost such low rates in the world’s most populous country, UNICEF and the National Centre for Women’s and Children’s Health in May launched a “10m2of Love” campaign to locate, register, certify and publicize eastfeeding rooms in order to raise awareness and support for eastfeeding.

The campaign has established a web portal (unicef.cn/10m2) where any organization can register eastfeeding rooms for staff, patrons or customers that adhere to simple international standards. A mobile phone application to map the locations of all 10m2of Love facilities is under development

On 13 March, Aissatou Soumaiga eastfeeds 8-month-old Amadou Harouna in the hospital in the conflict-affected city of Gao, capital of the north-eastern Gao Region. Amadou is being treated for severe malnutrition and resulting kwashiorkor, which is characterized by oedema and a loss of appetite.  In mid-March 2013 in Mali, renewed insecurity in central and northern parts of the country continues to exacerbate existing humanitarian needs. An estimated 270,765 people are displaced, while 176,777 continue to seek refuge in neighbouring countries. Additionally, Mali remains one of eight countries in the Sahel region – also including Burkina Faso, Chad, Mauritania, Niger and the northern parts of Cameroon, Nigeria and Senegal – facing a severe food and nutrition crisis. The emergency is the result of repeated drought-related food shortages, from which people have had insufficient time to recover before being again affected. Conditions have improved since the height of the crisis in early 2012. Still, an estimated 10.3 million people throughout the Sahel remain food insecure. In Mali, the pairing of food shortages with conflict has left children increasingly vulnerable: 210,000 children under age 5 are at risk of severe acute malnutrition, and 450,000 are at risk of moderate acute malnutrition. Limited access to basic services, including water, sanitation and hygiene, is another key concern. Additionally, some 200,000 children from conflict-affected areas are at risk of injury or death due to explosive remnants of war. Despite the reopening of some schools, access to education remains severely constricted. To respond to these and other needs throughout the year, UNICEF, together with multiple humanitarian partners, including other United Nations agencies as well as NGOs, have called for over US$370 million in the 2013 Consolidated Appeal for Mali. (UNICEF’s portion of the Appeal is approximately US$84.7 million.) Only 15 per cent of the Appeal has been funded to date.

Social worker Oumarou Zeïnabou conducts an awareness session for women, many holding their infants on their laps, at the Zinder Maternity Centre for Integrated Health, in Zinder, capital of Zinder Region. Ms. Zeïnabou is holding an educational flipchart bearing illustrations of two women, one feeding and one eastfeeding her infant, as well as a variety of nutritious foods. The chart says, in French, “Your sick child should eat and eastfeed more than is typical in order to heal and avoid malnutrition.”  In May 2013, Niger continues to host an estimated 50,000 Malian refugees – further constraining the country’s already limited resources. Both Niger and Mali are among nine countries in the Sahel region – also including Burkina Faso, Chad, the Gambia, Mauritania, Senegal, and the northern parts of Cameroon and Nigeria – facing a severe food and nutrition crisis. The emergency is the result of repeated drought-related food shortages. Though conditions have improved since the height of the crisis in early 2012, an estimated 3.1 million people in the Niger are affected by food insecurity, including over 376,700 children under age 5 suffering from severe acute malnutrition. In April, ongoing wet feeding activities benefitted 5,769 children aged 6 to 59 months in four refugee camps. UNICEF is also supporting programmes in education and child protection, including the provision of child-friendly spaces, in the camps. Initiatives to provide safe water and sanitation facilities to refugees are extending to some host communities, and responses to a recently declared cholera epidemic are also ongoing. To continue emergency responses throughout 2013, UNICEF requires nearly US$33.8 million, of which half remained unfunded by 22 May.

Cambodia has had notable success in raising exclusive eastfeeding rates from 11.7 per cent of infants less than six months in 2000 to a very high 74 per cent in 2010. Togo and Zambia also increased the rates from 10 and 20 per cent respectively in the late 1990s to over 60 per cent by 2000.

At the other end of the scale, Tunisia’s exclusive eastfeeding rate fell dramatically from 46.5 per cent in 2000 to only 6.2 per cent by the end of the decade.

The exclusive eastfeeding rate in Indonesia is declining; Nigeria has made no improvement over many years; and some of the lowest rates in the world are in Somalia, Chad and South Africa.

Such examples reflect insufficient global leadership on eastfeeding, as it continues to be undervalued relative to its importance in the life of child. There needs to be higher prioritization and commitment, targeted policies and greater consensus to engage the world in promoting this life-saving and vital practice.

Although eastfeeding is natural and may seem instinctive, it is essential to create an enabling environment for it to become the norm. Mothers benefit from the help of skilled health providers and community workers to support them to eastfeed, as well as culturally-sensitive communication, and protective laws and policies, particularly around the marketing of eastmilk substitutes and maternity leave.

UNICEF campaigns for exclusive eastfeeding for the first six months and continued eastfeeding for two years or beyond, using creative tactics to draw attention to the issue. It recently rolled out a campaign in Uruguay and Argentina, “Giving the east is giving the best of you,” starring Uruguayan actress Natalia Oreiro, aiming to boost eastfeeding among working mothers.

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