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Malnutrition in Ghana
Malnutrition in Ghana has cost its economy $2.6 billion annually or 6.4 percent of gross domestic product (GDP) due to increased health care costs, additional burdens on the educational system and lower productivity by its workforce, according to a new United Nations report.

In the Northern Region, malnutrition is much more prevalent with 20 percent of children under five being underweight. As a result, there is a high stunting rate of 32.4 percent. The region is also plagued by high rate of micronutrient deficiencies such as anemia and vitamin A deficiency.

The USAID Resiliency in Northern Ghana (RING), a collaborative project dedicated to sustainably reducing poverty and improving livelihoods and nutritional status of vulnerable populations, called for exclusive breastfeeding to combat malnutrition in Ghana.

“Mothers should stick to [exclusive] breastfeeding for the first six months after which they can introduce the sour foods to children,” nutrition officer of the USAID-RING Project, Kristen Kappos underscored.

Kappos also implored health workers, volunteers and farmers to continue raising people’s awareness on breastfeeding within their operational zones.

As far back as 1991, Ghana adopted the Baby-Friendly Hospital Initiative (BFHI) to promote and support the practice of exclusive breastfeeding. However, exclusive breastfeeding rate has remained unchanged for two decades at 64.7 percent, far lower than the World Health Organization would prefer.

According to a recent study, knowledge gaps in key nutritional areas, especially infant and young child feeding, are the main reason leading to a low rate of exclusive breastfeeding in Ghana.

About 26 percent of the mothers studied were unable to define exclusive breastfeeding and 22 percent of them said breastmilk only was not sufficient to meet the nutritional needs of the child. They believed that the child may not be satisfied and could die if fed with only breastmilk for six months. Nearly 90 percent of the mothers did not know that breast milk could be expressed, stored safely and given to the child when the mothers were absent.

In addition, cultural factors also create challenges for mothers to breastfeed. The majority of the mothers showed a lack of confidence in expressing and storing breastmilk, a taboo in the local context.

Interventions must be designed to increase women’s confidence and dispel their misconceptions regarding breast milk, USAID-RING Project urged. Meanwhile, Hajia Ayishetu Bukari, Central Gonja district director of Ghana Health Service, also emphasized the need for employers to create and maintain conducive workplaces for exclusive breastfeeding practices.

Yvie Yao

Breastfeeding Advocacy Initiative
Only 38 percent of infants are exclusively breastfed for their first six months of life. Improper and insufficient breastfeeding contributes to nearly 800,000 preventable child fatalities every year. A breastfeeding advocacy initiative would not only challenge the social pariah of the practice but also contribute to the improvement of mother and children health worldwide.

Breast milk contains all of the nutrients that babies need in their first six months and has the ability to strengthen a child’s immune system to protect against illness. Breast milk has also increased children’s physical and cognitive development.

The benefits of breastfeeding extend beyond a baby’s health. Mothers who breastfeed reduce their risk of suffering from postpartum hemorrhage, which is a leading cause of death among new mothers. Mothers also find themselves at reduced risk for diabetes and breast cancer.

Why Breastfeeding is No Longer the Norm

So why then are such a small percentage of babies exclusively breastfed? One reason for low breastfeeding rates is the issue’s generally low prioritization by political leaders and policy makers.

Women also feel that breastfeeding is looked down upon in the workplace and the public sphere. For instance, if women cannot find a comfortable place to breastfeed at work, then their child is less likely to receive his or her’s natural source of nutrients. Additionally, there are many companies that sell formula and aggressively market the concoction as being a better alternative to breastfeeding.

To improve breastfeeding statistics, there is a global breastfeeding advocacy initiative underway with support from organizations such as UNICEF and the World Health Organization. Initiatives focus on educating mothers and communities about the benefits of breastfeeding, and supporting policies and programs that spread this message.

In the west African nation of Guinea-Bissau, one in ten children will die before they reach five years of age. Organizations such as UNICEF and the non-governmental organization CARITAS work tirelessly to improve this statistic, and a fruit of their labor has been the nutrition bungalows that now exist in Guinea-Bissau.

Nutrition Bungalows

At these bungalows, mothers of children under five years old are invited to gather monthly for information sessions. The sessions are often interactive and they focus on promoting health for mothers and children. Mothers can also have their children measured and weighed to ensure that they are meeting developmental milestones.

These nutrition bungalows and all other projects incorporating a global breastfeeding advocacy initiative aim to spread awareness and increase support for exclusive breastfeeding in both the political and social spheres. In doing so, lives of mothers and children can be saved and their quality of life improved.

Nathaniel Siegel

Photo: Pixabay

World Breastfeeding WeekBreastmilk is a baby’s best protection against illness and disease, but data has shown that the number of newborns breastfed within the first hour of life has not improved over the past 15 years. World Breastfeeding Week is celebrated annually from August 1–7 in over 170 countries, and global organizations are sharing how early breastfeeding can make the difference between life and death.

1. Delayed breastfeeding, even only 24 hours after birth, increases the child’s risk of dying within the first 28 days of life by 80 percent, according to the World Health Organization (WHO).

Several factors contribute to this issue — from inadequate healthcare during delivery to babies being fed less nutritious alternatives, such as formula, cow’s milk or sugar water. These alternatives all decrease a newborn’s chance of survival. As such, government policymakers and organizations are targeting this issue by raising awareness and encouraging others to protect and promote exclusive breastfeeding.

2. Research has found a clear connection between breastfeeding and higher IQ scores and educational achievement.

Giving children the proper nutrition at the start of life supports optimal development and leads to higher earnings later in life–specifically, 12 percent higher per hour in high-income countries, and 16 percent in low to middle-income countries.

3. The Global Breastfeeding Advocacy Initiative led by UNICEF and WHO is working with international partners to help build a healthy society.

Lawmakers can show their support by ensuring a minimum of four months paid maternity leave, requiring employers to provide protection for mothers to pump milk at work and preventing discrimination against women and mothers in the workplace.

4. Approximately 200 million children alive today will fail to reach their full physical, mental and social potential. 

Why? Negative factors inhibiting early childhood development–not being breastfed is among those factors. For this reason, WHO is working with countries to increase the rate of exclusive breastfeeding for the first six months up to, at least, 50 percent by 2025, in order to turn things around and save millions of lives.

5. Breastfeeding produces long-term health benefits for both the mother and the child.

The act of breastfeeding produces oxytocin, protects against diarrhea and common illnesses like pneumonia, and reduces the risk of obesity in childhood and adolescence. It is crucial that people are knowledgeable on the subject of breastfeeding and the effects it has on a child’s life.

Though some of the statistics given might seem shocking, World Breastfeeding Week takes the initial steps necessary to create change by raising awareness of the problem and producing individuals that can implement solutions.

Mikaela Frigillana

Photo: Flickr

Breastfeeding
The importance of breastfeeding is not limited to health benefits. Higher rates of breastfeeding reap economic benefits too, which in turn can alleviate the strain of poverty in developing nations.

According to a series of studies published in The Lancet, a British medical journal, if a greater number of women breastfed from birth through at least six months of their baby’s life, it could save nearly 820,000 lives and billions of dollars.

The United States Department of Agriculture (USDA) estimates that if 50 to 75 percent of mothers breastfed through six months, the U.S. alone would save $3.6 billion each year.

The actual savings could be even higher, as these figures come from the cost savings of only three illnesses that are most common among children who are not breastfed. Breastfeeding reduces the risk factor of many other diseases and health complications as well.

In poorer countries, breastfeeding substantially reduces the number of childhood deaths from preventable diseases such as pneumonia and diarrhea.

These diseases are most commonly found in children in poor and underdeveloped countries, which typically already suffer huge economic losses from health problems.

Not only can breastfeeding greatly reduce the risk of these health problems, it can also save millions that would be spent treating these diseases after the fact.

The continued evidence of the importance of breastfeeding is greatly heartening. The difficulty is in getting this critical information to the women who need it most.

As a Huffington Post article explains, the real and current battle involves increasing awareness and education specifically to poorer mothers about the importance of breastfeeding.

Investments in healthcare programs in developing countries should continue focusing on health education, with a strong priority on basic elements of women’s health.

By increasing awareness of women’s health, including the importance of breastfeeding, countries can save many precious lives and valuable resources.

Emily Milakovic

Photo: Flickr

Destigmatization of Breastfeeding in Urban India
World Breastfeeding Week is celebrated internationally every year from August 1-7th. Each year, there are various events and activities intended to educate about the benefits and encourage the practice. The theme this year was ‘Women and work – Let’s make it work.’ This year, added emphasis was placed on advocating for widespread maternity leave and other accommodations for working mothers.

Many organizations such as UNICEF, World Health Organization (WHO), and the Breastfeeding Promotion Network of India (BPNI) have worked both independently and jointly with the Indian government to provide information and spread awareness throughout the country. The breastfeeding rates are higher in the rural Northern states than the urban South.

UNICEF Nutrition Specialist, Gayatri Singh states, “The government of India has laws, policies and programmes to protect, promote, and support breastfeeding. UNICEF supports national and state governments in the development and implementation of infant and young child feeding policies and plans for promoting optimal breastfeeding.”

Singh goes on to say, “Communication and advocacy activities on breastfeeding are also a key component of UNICEF’s support. We also support governments to design of strategies for social and behavior change communication and in the implementation of the strategies through multiple communication channels.”

In an effort to promote breastfeeding, the Indian government enacted the Infant Milk Substitute (IMS) Amendment Act in 2003 which prohibits any form of advertising claiming newborn formula as an equivalent option.

“In India, between 2006 and 2013, there has been an improvement in the breastfeeding rates. The latest data shows that 44.6 per cent children are put to breastfeeding within one hour of birth and 64.9 per cent children under six months of age are exclusively breastfed,” states Singh. He goes on to add that while knowledge of health benefits appear to be even higher, there are societal factors hindering the practice.

Dalvinder Kaur, a public relations specialist, states, “A lot of people, while thinking of breasts, automatically think of sex, as if that’s their primary reason for existence. I feel that it is pretty much the heart of the matter. Women’s breasts are often defined as sex objects–and nothing more. And since sex is basically a taboo in the public realm, breastfeeding ends up being perceived as some sort of indecent, out-of-bounds behavior.”

Dhanya Ranjit, a software engineer and mother speaks on the stigma attached to breastfeeding, “Women find it difficult to breastfeed and more so, to nurse in public because of the lack of support from any quarter. They also don’t see it happening around them. While I was very hesitant to breastfeed my older child in front of others but the encouragement and exposure to information through the Facebook support groups made me realize that it is as natural as an adult eating food in public.”

As is the case with many social movements, the internet can be utilized very effectively to raise awareness and garner support. “Big Latch On” is an international gathering that occurs in many cities during World Breastfeeding Week and event calls for mothers to join together publicly and breastfeed together. Through a social media campaign, a “Big Latch On” event was held this past August 1st in Hyderabad, Telangana, India. The organization started in New Zealand, but has spread to many countries around the world.

Recent attempts at normalization in mainstream media have begun to manifest themselves as well. Indian cinema has begun to prominently display breastfeeding such as in the recent blockbuster movie Baahubali. The highly anticipated film cost $40 million and is the most expensive movie in Indian history. Whether purposeful or not, the display of breastfeeding in such a popular film shows marked progress towards shifting attitudes of the viewers.

Frasier Petersen

Sources: India Times, Jantaka Reporter, IBN Live
Photo: Flickr

breastfeeding
It has been proven that the first 6 months of a child’s life are amongst the most crucial for establishing their longstanding health immunities and development of antibodies. However, in the rural areas of northern India, UNICEF estimates that only 46 percent of infants are exclusively breastfed during this time. Furthermore, it is believed that approximately 2 million Indian children die each year before the age of 5.

A 2009 study was conducted at the Pravara Rural Hospital in Loni, Uttar Pradesh. Three hundred mothers of children between ages 0 and 5 were surveyed regarding socio-demographics, religious affiliations and breastfeeding practices. In like manner, the children themselves were clinically examined to determine the severity, if any, of their malnutrition.

These data sets were examined, compared and analyzed to determine any patterns or similarities. Male and female children surveyed were split approximately 60 percent to 40 percent, respectively, but there were no indications implying the biological sex was a factor in nourishment.

The data did not reveal a correlation regarding religion, which would imply that the various faith teachings did not object to breastfeeding. It was found that socio-economic and educational status were the primary indicators of malnourishment. Ninety-seven percent of the mothers surveyed were under the age of 30. Additionally, of the 300 mothers, 147 had completed high school or less and had malnourished children.

While the sample size is very small, it is certainly representative of rural breastfeeding habits and conditions during the first few months. Children of young, uneducated mothers in rural areas appear to be at most risk. Initially, this would indicate a lack of understanding regarding the benefits of breastfeeding. Although there appeared to be a common understanding of necessary benefits, the prevalence of this knowledge does not correlate to perfect practice in reality.

Responses revealed an absence of any scheduled patterns for breastfeeding other than as a means to stop the child’s crying. The lack of an organized routine and the late start for breastfeeding practices are central contributors to malnutrition in rural India.

In rural communities, there is also a belief that colostrum, the nutrient milk produced directly after delivery, is unhealthy for children. In many communities, goat’s milk is traditionally provided as a substitute. For these reasons, 80 percent of the mothers surveyed began periodically breastfeeding their children between 4 and 8 months old.

In an effort to encourage earlier, more consistent breastfeeding habits, UNICEF has partnered with local organizations in the northern states to provide home visits to encourage earlier breastfeeding and to dispel any false notions. Durowpadi Bedia, a health worker in the Northern state of Assam says, “Whenever we go on home visits, we talk to all members of the family – the parents, the grandparents, adolescent girls…They have faith in what I am saying.”

“When they come and talk in our own language, I understand better. I feel comfortable with them,” said Monika Bedi, a young mother. Home visits are scheduled with expectant mothers 3 to 4 times per month in the third trimester of their pregnancy. Jeroo Master, UNICEF’s Chief of Field Officer in Assam states, “Now mothers understand how vital breast milk is to the health of their babies…having health and nutrition workers actively promoting breastfeeding at the village level will ensure each child has the best start possible in life.”

Dr. Victor Aguayo, UNICEF India’s Chief of Child Nutrition and Development states, “Unquestionable global evidence demonstrates that breastfeeding counseling and support is the most important child-survival intervention.”

Frasier Petersen

Sources: Research Gate, UNICEF, NIC
Photo: Baby Center

public_breastfeeding_areas_in_india
Health experts and activists are calling for the government in the Indian state of Assam to create public breastfeeding areas in India.

Assam, a state in northeast India, has a bad record when it comes to maternal and infant mortality rates.

With Aug. 1-7 being World Breastfeeding Week, the spotlight has shifted to Assam, where there are no public facilities available for women to breastfeed. As a result, mothers who are lactating often have a difficult time comfortably attending to their infants.

The difficulty is greater for mothers in rural areas, where malnutrition rates in infants are higher. Additionally, mothers who are working do not have the ability to meet their babies’ needs in a timely matter.

To avoid malnutrition, the need for public breastfeeding areas in India, specifically Assam, is high. Creating designated areas, such as in buses and railway stations, would help avoid malnutrition.

Those engaged in World Breastfeeding Week are also asking for uniformity when it comes to maternity leave. Organizations such as the Association of Promotion of Child Nutrition (APCN) and Breastfeeding Promotion Network of India (BPNI) are calling on the state government to implement consistent leave in both the public and private sectors for working mothers.

Currently, women working in the public sector are granted a leave of six months, but most are unaware they can take a leave to care for their babies, as the parameter is not implemented uniformly in the sector.

While women are granted a leave of between three and four and a half months in the private sector, most workplaces in the public and private sectors lack the proper facilities to allow women to breastfeed, leading to problems for mothers.

Matt Wotus

Sources: Encyclopedia Britannica, The Times of India, World Breastfeeding Week
Photo: Healthy Newborn Network

In Brazil, Breastfeeding Positively Correlates with Education Level
What do breastfeeding, IQ range, education, and income all have to do with each other?

In Pelotas, Brazil, a recent study reveals the long-term benefits of breastfeeding. While the short term health and nutrition benefits have been widely acknowledged, this study has discovered new and exciting benefits to breastfeeding.

Here are the two key findings:

1. Duration and predominance of breastfeeding are positively associated with IQ, educational attainment, and income.

2. There is a dose-response association with breastfeeding duration for IQ and educational attainment.

The study was implemented with a population-based birth cohort from 1982. Information about breastfeeding patterns was recorded in early childhood. 30 years later, information related to IQ, levels of education, and income was collected.

Participants who were breastfed for at least 12 months had higher IQ scores, more years of education, and even higher monthly incomes compared to those participants who were breastfed for less than one month.

These results could have important implications for developing countries and the reduction of poverty. It is critical that mothers are supported in breastfeeding. It is recognized that there is not a direct causal link. However, the long-term results from this study could imply that children who are breastfed are more likely to achieve the education that will help them provide for their families. This offers them the opportunity to draw their communities out of poverty.

While breastfeeding is not the only factor related to potential education attainment and income, this study demonstrates that it is an important one. Further evaluation is needed to understand how programs can disseminate information about the long-term benefits of breastfeeding and support parents in this decision.

Iliana Lang

Sources: The Lancet

malnutrition in sierra leone
Sierra Leone has both one of the highest malnutrition rates and one of the highest child mortality rates.  More than a third of children are chronically malnourished; in 2010, 22 percent were underweight, 44 percent were stunted, or had a low height for their age and eight percent were wasted, or had a low weight for their height.

The child mortality rate is 267 deaths per 1,000 children. Almost half of these premature deaths are caused by malnutrition.

The major influence in the high malnutrition rate is the lack of breastfeeding. Only eight percent of infants are breastfed. The rest are given insufficient substitutes, sometimes water.

Because of the conflict in Sierra Leone’s recent past, malnutrition has only recently come into focus as a concern. Even now, malnutrition is one of the most neglected areas of concern for the country. Despite Sierra Leone’s economic growth, the number of underweight children has increased 24 percent.

With such a high rate of malnutrition, many organizations are working to lessen the number of those malnourished.

One focus has been to vary diets, many of which consist mostly of rice. Farmer Field Schools were developed to increase agricultural productivity, but they have now been adapted to teach farmers how to raise more nutritious crops.

These Field Schools also connect farmers to markets where they can sell their crops.

Mother-to-mother support groups have also been set up.  These target the community level by educating women to teach others.  They also report instances of malnourishment that they see.

A total of 1,228 Peripheral Health Units are running in Sierra Leone, too.  They serve around 5,000 people each by providing medical care and nutrition services.

The WFP, UNICEF and WHO have also started their own supplementary feeding programs and centers.

There are 63 WFP-organized supplementary feeding centers in western Sierra Leone, which have reached almost 50,000 children.  They are funded by the government of Japan.

Children who are under 70 percent of a normal body weight are admitted.

The centers give children sugar, oil and a modified cereal that is enriched with micronutrients.  The UNICEF centers provide high-protein biscuits, therapeutic milk and a complex of vitamins and minerals.

Parents also receive health and nutrition education from the centers.  Many parents believe that milk and eggs are bad for children, and this education corrects these notions.  They also teach parents how to provide supplemental feedings.

After they provide rations and education, the centers continue to monitor the progress of the children.  They check to make sure children do not develop pneumonia or diarrhea, and they check to ensure that the child’s health improves.

Sierra Leone faces many struggles as they attempt to combat malnutrition.  The constraints for aid range from low funds, to a lack of data for what is needed, to low governmental support.

Staff are often underqualified, and there is frequent turnover.  The low numbers of personnel lead to less knowledge being passed to the people who need it, as information is diluted passing from person to person.

Mothers have low incentives to help their children because they are often blamed for their children’s poor health.  They see it as shameful to admit their children are malnourished, so they do not seek help.

Many nutrition efforts have seen an added strain from the recent Ebola outbreak, as well.  Sierra Leone has been upgraded to a Level Three food emergency, the highest threat level.

Despite these setbacks, Sierra Leone is working hard to increase the health of its population.  The country is making progress, but there is still work to be done to decrease malnutrition in the country.

– Monica Roth

Sources: WFP, UNICEF, Reuters, New Internationalist
Photo: Sorenbosteendahl

breastfeeding
On August 1, 2014, the United Nations kicked off World Breastfeeding Week in the hopes of launching a worldwide initiative to educate and encourage more mothers to breastfeed. World Breastfeeding Week is celebrated in 170 countries around the world from August 1 to August 7.

This year’s particular celebration is focused on promoting the link between breastfeeding and the Millennium Development Goals, especially MDG 4: decreasing child mortality.

Among the United Nations officials launching the start of this week was Executive Director of the U.N. Children’s Fund, Anthony Lake. In a statement marking the importance of World Breastfeeding Week, Lake stressed, “Immediate breastfeeding within the first hour of birth could prevent one in five unnecessary deaths…that’s more than 500,000 children every year, more than 1,500 children every day.”

Breastfeeding not only supplies good nutrition for infants, but also reduces the risk of malnourishment and the risk of obesity later in life. “By supporting nutrition and strengthening the bond between mother and child,” said Lake, “breastfeeding also supports healthy brain development.” Breastfeeding also helps prevent growth stunting, a tragedy that affects millions of children every year both physically and cognitively.

Although breastfeeding is the most cost-effective and healthy way to support young babies, fewer than half of the world’s newborns are breastfed regularly.

In order to change this, UNICEF is working with governments and local communities to end false marketing and the use of breast milk substitutes, in order to make it easier for women to breastfeed their infants.

Dr. Noel Zagre, the UNICEF Regional Nutrition Advisor for Equatorial and Southern Africa, explained that too often people talk about breastfeeding in general terms. However, the important thing is to teach mothers how to breastfeed effectively, meaning putting the child on breast milk no more than an hour after birth and continuing to exclusively breastfeed for the first six months of life.

Although the number of children under the age of five that die each year has declined in recent decades, there are still nearly seven million that die every year. Forty percent of these children are newborns.

Dr. Zagre noted evidence that “many countries are not yet doing very well even though we know that we have also observed a lot of progress in other countries…some countries are still having very low exclusive breastfeeding rates like five percent while others are…reaching 89 to 95 percent.”

The United Nations is determined to institute plans to promote breastfeeding and educate communities and governments around the world about infant health and the importance of breastfeeding effectively. Although progress has been slow, Dr. Zagre noted the importance of bridging the gap between these startling statistics.

– Cambria Arvizo

Sources: UN 1, UN 2, All Africa
Photo: Tribune