Cover Image
close this book Community Nutrition Action for Child Survival
close this folder Part I - Community nutrition problems and interventions
close this folder Unit 3: PROMOTING BREASTFEEDING
View the document Session 1: The importance of breastfeeding
View the document Session 2: Helping mothers breastfeed
View the document Session 3: Breastfeeding information for Kenyans

Unit 3: PROMOTING BREASTFEEDING

SESSION 1: The Importance of Breastfeeding

SESSION 2: Helping Mothers Breastfeed

SESSION 3: Case Study: Breastfeeding Information for Kenyans

Session 1: The importance of breastfeeding

Purpose:

In this session, trainees list the advantages of Breastfeeding and the dangers of bottle-feeding and breast milk substitutes. Rules for successful Breastfeeding are presented and discussed.

Time: 1 hour

Materials:

- Handout - "Breastfeeding Self-Test" plus answer sheet

- Handout - "Rules for Successful Breastfeeding"

- Flipchart and marking pens

Steps:

1. Distribute the "Breastfeeding Self-Test" and ask trainees to complete it individually. When they finish, tell them that you will discuss the test at the end of the session.

2. Ask trainees to brainstorm the advantages of Breastfeeding for mothers and infants. List their responses on the flipchart. Then, ask trainees to brainstorm the dangers of bottle-feeding and early introduction of foods other than breast milk. List these on the flipchart. Add any advantages or dangers that you feel trainees have missed.

Summarize: "Breastfeeding has many advantages for mothers and infants. Breastfed infants are generally healthier than infants fed with bottles and breast milk substitutes. This is especially true in low income families because breast milk is a clean, nutritious and low cost food for infants. Breast milk also contains anti-infective agents that help breastfed infants fight against infection. Infants who are not breastfed and those who are given foods other than breast milk during the first months of their lives are very often malnourished and at "high risk" of sickness and death."

3. Distribute the Handout - "Rules for Successful Breast-feeding." Discuss each of the rules and the reasons why each one encourages successful breastfeeding.

4. Discuss the importance of giving colostrum. In many countries, women believe that colostrum should not be given to newborn infants. This is not true! The composition of colostrum is different from the milk produced by the mother 3-5 days after birth. Colostrum contains large amounts of protein substances (including secretory immunoglobulin) which helps prevent infection in the newborn. It is a good idea to put the infant to the mother's breast immediately after delivery since frequent sucking is necessary to establish lactation.

5. Summarize this session by asking the trainees to repeat the self-test taken at the beginning of the session. After they finish, review the correct answers to each of the questions and compare scores before and after the session. Leave some time for additional questions and answers.

ANSWERS TO BREASTFEEDING SELF-TEST

1.

T

7.

T

2.

F

8.

T

3.

F

9.

T

4.

F

10.

T

5.

F

11.

F

6.

F

   

 

BREASTFEEDING SELF-TEST

Answer the following questions TRUE or FALSE.

 

T

F

1. Breast milk contains all the nutrients an infant needs until he/she is four months to six months of age.

   

2. Women with small breasts will have difficulty breastfeeding.

   

3. Colostrum has no nutritional value. It should be discarded.

   

4. Breastfeeding should be on a schedule.

   

5. After birth, it is best to wait 24 hours before putting an infant to the breast.

   

6. Malnourished women cannot breastfeed their infants successfully.

   

7. Most women can breastfeed successfully.

   

8. Pregnancy should be avoided while the youngest child is still breastfeeding.

   

9. Frequent breastfeeding will increase milk production.

   

10. Women who are breastfeeding should eat extra food and drink plenty of liquid every day.

   

11. It is advisable to give an extra bottle of milk or formula if an infant appears to be hungry after breastfeeding,

   

HANDOUT

GUIDELINES FOR SUCCESSFUL BREASTFEEDING

1. Breastfeed as soon after birth as possible.

The infant's suckling at the breast stimulates milk production. It also insures that the infant receives colostrum, the first yellowish liquid produced by the breast. Colostrum contains concentrated anti-infective agents that help protect the infant against sickness.

2. Breastfeed frequently (on demand).

The production of milk is stipulated by the baby's suckling so the baby should be fed on demand rather than according to a schedule. The more an infant breastfeeds, the more milk the breast will produce.

3. If possible, eat extra food every day.

During breastfeeding, the caloric needs of the mother are increased. It is estimated that an additional 500 calories per day are needed by the mother. If these calories are not available, the mother's fat supply will be used for milk production. Most women, even in countries where chronic malnutrition is prevalent, are able to breastfeed their infants exclusively for 4-6 months. Research has found that breastmilk from undernourished mothers contains amounts of protein and lactose similar to those of well-nourished mothers. Emphasis should be placed on improving maternal diet before supplementing the diet of the breastfeeding infant.

4. Relax.

Breastmilk is released by the ejection or let-down reflex. It can be temporarily inhibited by tension or anxiety.

5. Do not give other foods and liquids until the infant is at least four months old.

Do not give other foods and liquids until the infant is at least 4-6 months of age. Breastmilk alone is generally sufficient until this age. Supplemental foods reduce the amount of time the infant sucks on the breast and therefore reduces the amount of milk the mother produces.

6. Avoid bottle feeding!

When the infant is 4-6 months of age, foods in addition to breastmilk can gradually be added to the infant diet. A cup and spoon should he used.

Session 2: Helping mothers breastfeed

Purpose:

In this session, trainees analyze some common reasons given for termination of breastfeeding and use of breast milk substitutes. They also discuss activities to promote successful breastfeeding in the community.

Time: 1 hour

Materials:

- Handout - "Helping Mothers Breastfeed"

- Trainer's Reference - Breastfeeding Case Examples

- Flipchart and marking pens

Steps:

1. Read Breastfeeding Case Example #1 to the group. Ask the following questions:

- Why was the woman in this example weaning her daughter? (new pregnancy)

- Is this a common problem in your area?

- Is it necessary to terminate breastfeeding once you become pregnant?

2. Summarize the discussion. Although there are many taboos and cultural beliefs against breastfeeding when a mother becomes pregnant again, breastfeeding is not an uncommon practice during pregnancy in many developing countries. Beliefs in changes in breast milk volume or composition associated with a new pregnancy have not been confirmed by factual observations, nor have any ill effects been detected for either mother or infant. The main concern in such situations is that the mother's additional nutritional requirements are met. They will not be significant during the first trimester of pregnancy, a time when most lactating women would not even be aware of a new pregnancy.

3. Ask one of the trainees to read Case Example #2 to the group. In this example, the infant is not growing properly even though the mother is breastfeeding. Ask trainees to list the reasons why this infant might not be growing.

Responses should include:

- Giving other food decreases the suckling time at the breast, decreasing milk production

- Other foods may be contaminated and cause infections

4. Ask trainees what advice they might give the mother in Case Example #2. This can be done in a role play with discussion about the advice given.

5. The case examples describe several common reasons that women give for terminating and/or supplementing breastfeeding. Ask trainees: "What are some of the reasons given by women in your region who stop breastfeeding?" List these on the flipchart.

6. Discuss each of the reasons listed. You may wish to proceed with the following steps:

- Distribute the Handout - "Helping Mothers Breastfeed". This handout lists common problems that can cause a woman to stop breastfeeding. Review each of the problems and the suggested solutions, referring back to the list generated by the trainees.

- Identify the reasons on the list that are related to false beliefs or misconceptions. Give the facts. Discuss ways to change beliefs and dispel rumors through education and example.

- Review the rules for successful breastfeeding. (Session 1)

- Summarize: Most women can breastfeed successfully if they have access to information and support from their family and community. Only in rare cases will breastfeeding not be possible.

7. Divide into small work groups. Ask each group to brainstorm a list of activities that community groups and community program managers could organize to promote successful breastfeeding. Allow 10-15 minutes, then ask each group to present its list of ideas. These might include:

- Provide information and support for pregnant and breastfeeding women

- Education of community leaders especially women to promote breastfeeding

- Training of health workers and traditional healers, especially TBAs

- Acting to stop the misleading promotion and sale of infant formulas and feeding bottles

- Support for legislation for policies that support breastfeeding, such as maternity leave, creches, nursing breaks, etc..

8. Summarize the session by emphasizing the important role that community members, especially women, can play in providing information and support to breastfeeding mothers.

HANDOUT

HELPING MOTHERS BREASTFEED

POSSIBLE REASONS FOR TERMINATION OF BREASTFEEDING

SUGGESTED SOLUTIONS

Medical Practices that Promote Bottle Feeding: Hospital procedure may require separation of mother and infant at birth.
Sugar water or formula maybe given during this period thus interfering with the beginning of breastfeeding and milk production in the breasts. Health workers may also be poorly informed, recommending that a woman stop breastfeeding unnecessarily

Promote rooming-in at hospitals. Eliminate bottle feeding of fluids to the infants.
Talk to hospital officials about changing outdated practices that undermine breastfeeding
Train health workers to provide correct information to breast-feeding women.

Social Forces:
The use of infant formulas and feeding bottles by upper class women, promotion by formula companies, and Western attitudes toward breasts and sexuality have resulted in an increase in bottle feeding among poor women.

Educate community leaders, women and men.
Provide support and encouragement for breastfeeding women.

Insufficient Milk:

Encourage the mother to breastfeed the baby more often. If possible the mother should eat more food every day and drink lots of liquids.

Pregnancy:
When a woman finds she is again pregnant, she may stop breast- feeding .

Do not stop breastfeeding abruptly. A health woman can continue breastfeeding while pregnant gradually weaning her child. Encourage her to eat additional body-building, energy protective foods.

Temporary Separation of Mother and Infant: If the infant is breast- feeding less often, less milk will be produced.

Breastfeed frequently when reunited.
Express milk manually during the separation.

Working Outside the home:
Undernourished women produce less breast milk.

Encourage women to breastfeed at night and frequently when with their infants.
Educate employers. Promote the passage and enforcement of labor regulations that encourage breastfeeding such maternity leave, legislation, creches, and nursing education.

Maternal Illness:

Breastfeeding is contraindicated only in cases of severe maternal illnesses, for example in the case of heart failure, or severe kidney, liver or lung disease. Most common illnesses in mothers are not in themselves reasons not to breastfeed.

Low-Birth Weight Infant:
A large proportion of low-birth weight infants (below 2500 g) are born at term and behave as fully matured infants.

They can and should be breastfed.
If the infant is pre term and unable to suck properly, the mother can express her milk and feed her child manually. The food of choice for preterm infants is breastmilk.

TRAINER'S REFERENCE

BREASTFEEDING CASE EXAMPLES

To the Trainer: Develop your own examples to illustrate the most frequent causes of early termination of breastfeeding and inadequate milk production. Examples can also be developed as role plays or dramas.

1. An example from Kenya

A healthy 12 month old girl came to the monthly village weighing activity with her mother. The nutrition worker congratulated her on how well her daughter was growing and encourages her to continue what she is doing. The mother is concerned because she has found out that she is pregnant and must stop breastfeeding. In Kenya, it is common for women to stop breastfeeding as soon as they find out they are pregnant again.

2. An example from Nepal

A three-month-old baby boy was brought to the village clinic with diarrhea and vomiting. The baby was pale and thin. When asked if she was breastfeeding, the mother said she was breastfeeding but that she did not have enough milk. To supplement her own milk she started giving buffalo milk in a bottle and porridge made from ground maize when the baby was about two months old. She said the baby had been sick with diarrhea three times in the last month and that he was getting thinner and thinner despite her efforts to feed him. The mother also looked pale and thin.

Session 3: Breastfeeding information for Kenyans

Purpose:

In this session, trainees discuss the experience of a unique Kenyan organization, Breastfeeding Information Group (BIG), started in 1978 by Breastfeeding mothers to promote Breastfeeding in their country. Educational materials produced by BIG for use with health workers, mothers and fathers are provided for review and comment.

Time: 1 hour

Materials:

- One copy of the case study "Breastfeeding Information for Kenyans" for each trainee

- Multiple copies of educational materials developed by BIG and other organizations to promote successful Breastfeeding

- Flipchart and marking pens

Steps:

1. Distribute the case study "Breastfeeding

Information for Kenyans" to each trainee. Ask them to read the case study individually.

2. Divide trainees into small work groups of 5-7 persons each. (It is best to form homogeneous groups of people from, the same regions, organizations, countries, etc. Groups will be discussing whether a project like the one in the case study could be organized in their own areas.) Ask each work group to discuss and answer the questions at the end of the case study.

3. Conduct a discussion based on the groups' answers to the case study questions.

4. Display or distribute copies of educational materials developed by the Kenyan Breastfeeding Information Group and other organizations. Encourage trainees to examine and/or copy materials that could be adapted for use in their areas.

5. Summary: Ask trainees to summarize the most important information presented in this session and/or unit. (You may also want them to state their impressions of the content and the methodologies used.)

CASE STUDY

MOTHERS AND CHILDREN

Volume 3, Number I

January 1983

ISSN 0272-69 17

Breastfeeding Information for Kenyans by the Breastfeeding Information Group, Nairobi.

A widely circulated myth in Kenya holds that ''African women all breastfeed." While it is true that almost all Kenyan mothers start breastfeeding (97% in 1977) old traditions of exclusive breastfeeding for the first months give way to social pressures and the ready availability of commercial products, Early supplementation has become the custom among many families.

A mother attending a clinic with her three-month old may say, ' Oh, yes, I am breastfeeding," while a bottle of formula mixed hours before peeps from her basket. There is no intention to deceive. only the fact that for many mothers today, "breastfeeding" automatically is taken to mean breast-plus-bottle. The bottle may be filled with water a fruit-flavored drink or vitamin preparation, a glucose drink, or some kind of milk feed.

Few parents understand how this recent custom interferes with lactation. Often the health workers themselves do not realize this. In many cases the top-up bottle of glucose water for formula is started soon after delivery. In a nationwide study, researchers from the Breastfeeding Information Group and Ministry of Health found that 97% of the maternity unit nurses and midwives surveyed felt that babies should have pre-lacteal supplements of glucose water or formula, and 95% actually give them. (Veldhuis, Nyamwaya, et al, 1982). This routine once established is continued at home.

"Unfortunately I was never advised about breastfeeding before my baby was born. However, after I hod the baby these was advice from of sides to breastfeed. I hove tried my best in this effort but the baby is not satisfied. She is 15 days old and keeps crying when she is hungry until I feed her the formula milk. Please advise. "Mrs. P.K. (Kisumu)

With this pattern widespread, it is not surprising that mothers who are sincerely trying to do their best for their babies experience two very common problems: "I don't have enough milk to satisfy my baby," and "the baby refuses my breast and prefers bottles.''

The Breastfeeding Information Group (BIG) was started quite informally by a group of seven women to provide help with these kinds of breastfeeding problems. At first we discussed what we knew about breastfeeding. problems we had observed end experienced, and what activities might be useful in Kenya. By late 1978, we had decided to register officially as a voluntary society with a constitution and officers, and to offer advice directly to mothers and also through posters and leaflets on breastfeeding topics.

Parents have responded enthusiastically to talks we have given at clinics, meetings of women's troupe, and also to our printed materials. Our attempts to hold special breastfeeding mothers discussion meetings outside the clink atmosphere have not, on the other hand, drawn more than a handful of participants. In Kenya, breastfeeding help on a mother-to-mother basis seems best given through existing social communities.

We use every medium we can to reach people. The letters quoted in this article were selected from 42 responses to a 'Letter to the editor' which appeared in the Kenya Daily Notion in September 1982. Such publicity reaches a far wide; pubic than the clinics do and draws a varied response.

We answer all inquiries individually. We have responded to frequent questions by developing leaflets. For example, Kenyan men have frequently asked what they can do so we wrote a leaflet called, "Please help your wife to breastfeed." This leaflet is now being translated into Swahili. It joins a number of other leaflets for parents, and a booklet for health worker. Funds for publishing and for the free distribution of our materials were provided by UNICEF and OXFAM.

Answering letters, working on publications and giving talks are frequently done by volunteer temporarily resident in Kenya who can donate substantial time to the breastfeeding Information Group. Increasingly, Kenyans are taking active roles, even though most of them have full time jobs and families to look after. Among our approximately 40 active members in Nairobi, many donate between five and fifteen hours per week to our work. Although we always use breastfeeding mothers to work directly with other mothers, we also value active members who are men, single women, and mothers who could not breastfeed due to lack of information. Throughout the country. we have between 200-250 paying members, including many health workers and teachers. For their yearly membership fee, (about U.S. $1.50) they receive our bi-monthly newsletter. The majority of our officers and members are Africans, but Kenya's Asians and whites also participate.

Through reading and discussion classes, we provide training to our volunteers, end we also maintain a library they can use. Thanks to a grant from OXFAM we can now pay two Kenyan counselor to work with Swahili-speaking mother. Our policy has always been to give help where we are asked, and this means that we work with every sector of Kenyan society from the busy attorney in her Peugeot, to the illiterate mother struggling to support her children alone; from the well-to-do homes of business people to the disadvantaged urban squatters. In the next few years, we expect to strengthen and expand our outreach into the rural areas through existing women's groups, and the rural health service networks.

On a typical day, one of our members might give a talk to patients waiting for treatment at the Mathare Valley Baptist Clinic, in one of Nairobi's poorest areas, and then go on to nearby Pumwani Maternity Hospital where about 100 women crowd the antenatal clinic. In this city-run hospital, the management of breastfeeding is good, but nurses are usually too rushed to discuss mother' questions in detail. So the counselor explains the superiority of breastfeeding, how to have plenty of milk, when to add other foods, and the like. She hands out simple leaflets in Swahili for women whose reading skills may be newly acquired.

Today at the Kawangware-Kabiro Clinic, there is a weaning food demonstration using common local foods to make a nutritious low cost porridge. The clinic is located in a peri-urban, low-income area and is headed by one of our members. The mothers at the clinic have been actively discouraged from the use of supplementary bottles. If a mother comes to the clinic with a feeding bottle, she usually agrees with the nursing sister to exchange it for a cup, and instructions on how to feed with cup and spoon.

In another part of the city, in a private hospital with poor breastfeeding practices (timetable feeds, no rooming in, top-up bottles, and a formula gift pack for every new mother), an expatriate counselor sits with a group of 15 to 20 mothers who have recently delivered. She emphasizes how the home pattern of breastfeeding should differ from the hospital routine. Developing a good milk supply, promoting the let-down reflex, and preventing breast refusal dominate the discussion, and the points made are reinforced with this very literate group by a set of homemade teaching posters. In this hospital, with its well-educated private patients, most will be returning to jobs soon.

"I am expecting my first baby this year and I am a working mother. I will be allowed two months maternity leave. What advice would you give to a working mother who would love to breastfeed but is unable to do so since she is away most of the day?" Mrs. A.D. (Nakuru)

"I am a young mother of one child aged four months. I really find it difficult to cope up with breastfeeding since I work in an office far away from home. I would be very grateful if you could send me your leaflets on increasing one's breast milk, and managing a job and breastfeeding." Mrs. G.I. (Nairobi)

For most urban women in Kenya, workplace child care is not available and returning home during the workday to breastfeed is not possible. We encourage working women to continue breastfeeding at whatever level they can manage, leaving some suitable alternative feed to be given by teaspoon or cup. We also stress the value of extra breastfeeding over weekends and holidays, and the importance of close contact and demand feeds during evenings and nights.

In addition to advising mothers, we also distribute materials throughout the country. Our literature reaches a much wider audience, and we consider it essential to our efforts. Our literature reaches all sorts of people - nurses and mothers of course, but also school girls, church groups - anyone who asks may have it. In the future we plan to do more training of health workers. Our study with the Ministry of Health indicated many areas where nurses do not know enough about breastfeeding management. For example, if a one or two months old child shows insufficient weight gain, more than 3/4 of our wealth workers would at present recommend use of formula, rather than first trying to increase the child's intake of breast milk. In cooperation with the Ministry of Health, we are starting to provide speakers for in-service training workshops, and occasionally organizing our own.

Of course public policies also affect breastfeeding. We are working with health professional organizations and women's organizations to try to establish in Kenya a national Code of Marketing based upon the WHO/UNICEF international model. This effort takes a tremendous commitment of time, but in the long run will be a powerful protection for ** mothers, and babies. Our International Cooperation Committee is coordinating similar breastfeeding support efforts in other African countries, through the IBFAN (International Baby Food Action Network) - Africa Network.

How do we get it all done? We often wonder. We have been fortunate in having many excellent officers, elected annually. Several are nurses, midwives, doctors and nutritionists. We take care to avoid a situation where the Breastfeeding Information Group might come to be seen as a personal power base for individuals, and we emphasize cooperative effort. Through our numerous committees (including publications, counseling, research, newsletter, fund raising) we give a responsible job to any member who wishes one. Each of us get a great deal out of working together, on this matter so close to our hearts which also builds the nation. Throughout all our work runs a common aim: to give parents the information and encouragement they so urgently ask for.

For copies of Breastfeeding Information Group (B.I.G.) publications including an article on starting a group, write the Clearing house on Infant Feeding and Maternal Nutrition, 1015 15th Street N.W., Washington, D.C. 20005, U.S.A. The Clearinghouse would also be interested in information about other groups involved in similar kinds of breastfeeding support activities.

The Breastfeeding Information Group cannot engage in extensive overseas correspondence, but welcomes letters from people in Africa who would like to be on the IBFAN - Africa mailing list. Breastfeeding Information Group materials are not copyrighted and may be reprinted or adapted to conditions elsewhere. If the text is modifies however, please contact the Breastfeeding Information Group , P.O. Box 59436, Nairobi, Kenya.

Note to readers:

In November 1982, an international meeting of community-based breastfeeding support groups was held in Jamaica. Representatives from organizations in more than 20 countries attended (including the Breastfeeding Information Group ). For more information about the conference recommendations, write: Ron Israel, INCS, Education Development Center, 55 Chapel Street, Newton, Massachusetts 02160, U.S.A.


Kenyan mother and baby


Weaning food demonstration


B.I.G. poster


Mother and baby, Kawangware, Kenya

DISCUSSION QUESTIONS

Case Study-: Breastfeeding Information For Kenyans

1. What is the goal of the Breastfeeding Information Group?

2. What activities does the group carry out to reach that goal?

3. Who started the Breastfeeding Information Group? Who carries out the work of the group now?

4. How does the group raise funds for its activities?

5. What aspects of the Breastfeeding Information Groups' program would be beneficial and feasible in your area?

How to have plenty of milk

Breastfeed often:

- Start breastfeeding as soon as possible after birth. Most babies can suck well right after being born. The baby needs your colostrum in order to be healthy.

- Breastfeed the baby whenever he is hungry. This may be ten or more times each day. The more the baby sucks, the more milk supply you will produce,

- Night feedings help to develop a good milk supply. Keep the baby close to you at night.

- Give both breasts at each feeding. Let the baby suck as long as he wants.

- Do not give glucose water or other milk from a bottle between breast feeds. 11 you think that you do not have enough milk. give extra breast feeds to increase your milk production. Do not give other foods instead of the breast.

- Do not stop breastfeeding. Breastfeeding is still good even when your child is two years old, or older. Most babies will give up breastfeeding (wean) slowly, some time between the ages of one and three years. This is natural weaning. You do not need to hurry it.

- When the child is four to six months old, breast milk alone is no longer enough. Start giving other foods in addition to (not instead of) breast milk.


Stand-on breastfeeding


Lying down breastfeeding

Take care of yourself

- Be sure you drink plenty of liquids every day.

- Eat energy, protective, and body-building (protein) foods. All help you make milk.

energy foods: porridge, ugali, sweet potatoes, arrowroot, bread, rice

protein foods: beans, peas, cow or goal milk, eggs, meal, fish

protective foods: fruits and vegetables such as papaya, mango, carrots, spinach

- Rest whenever you can. Sometimes breastfeed lying down.

- Use family planning to space your children. If possible, use any method except pills. The pills can reduce your milk supply.


Fruits and vegetables for mother alimentation

Do not worry

- Do not worry about days when the baby cries more than usual. Comfort him by letting him suck.

- Do not worry about small or soft breast,. After the first days or weeks. your breasts will probably not leak milk. They may not be hard or large. But you still have plenty of milk. It does not simply go away. It will flow when your baby sucks.

If you have any more questions about breastfeeding, please write to:

Breast feeding Information Group PO BOX 59436, NAIROBI

WHY BREASTFEED ?

BECAUSE BREASTMILK IS BETTER THAN ANY OTHER MILK FOR YOUR BABY

- Breast milk Is the best food for your baby. He does not need any other food for the first four months of his life.

- Breast milk is always clean, always ready, and always warm enough. Night feedings are easy.

- A baby digests breast milk easily. This means he has fewer stomach problems.

- Babies who get only breast milk do not get constipation.

- Breastfed babies get more protection against diarrhoea, colds, flu and skin problems. For two to three days after you give birth, a special milk (colostrum) comes from your breasts. This colostrum gives your baby special protection.

- Sucking at the breast helps your baby's tooth and jaw development

- Breastfeeding saves you money because you do not need to buy costly artificial milk foods.

- Breastfeeding develops close and loving feelings between baby and mother.


Photocredit UNICEF

Breast feeding Information Group PO Box 59436, NAIROBI

Please help your wife to breastfeed


Mother, father and the baby

DO YOU KNOW THAT YOUR WIFE NEEDS MORE TO EAT during pregnancy and during breastfeeding (for at least two years)?

- Be sure you bring home protein foods e.g. beans, ndengu, groundnuts, meat, fish, eggs, milk. Be sure your wife eats plenty of these.

- Also she needs some extra protective foods (fresh fruits and vegetables) and energy foods. Encourage her to have bread. bananas. cassava. potatoes or groundnuts with her morning tea.

DO YOU KNOW SHE ALSO MUST HAVE PLENTY TO DRINK?

- Make sure she has something to drink each time the baby suckles: tea, uji, water, squash, or any other drink.

Enough food for the mother means enough breast milk for the baby. And buying some extra food for the mother is cheaper than buying tinned milk for baby!


Food for mothers

Do YOU KNOW THAT YOUR WIFE NEEDS YOUR APPROVAL FOR BREASTFEEDING? If she thinks that you don't care, she may give up.

Tell her, and tell your relatives and friends, that you are proud your baby is being breast fed. Remind them why breast milk is the best baby milk:

- It is free from germs and it protects baby against illnesses. Baby will be healthiest on breast milk. (Not so much diarrhoea or colds).

- It has the comet temperature and is always ready.

- It is easily digested by the baby. (Not so many stomach problems and allergies)

- It is inexpensive. ( No extra expenses for bottles, tinned milk, fuel, etc.)

- Baby is happier close to mother, nights are quieter, and parents sleep better

DO YOU KNOW THAT YOUR WIFE NEEDS REST? An exhausted woman has trouble producing enough milk.

- See what you can do to lessen your wife's burdens so that she may sometimes rest.

DO YOU KNOW THAT GOOD ADVICE CAN SOLVE BREASTFEEDING PROBLEMS? For. example. the milk supply can be increased at any time if you only know what to do. If your wife's milk 'is "going away," encourage her to put the baby to the breast as often as the baby demands. More sucking makes more milk. For the safety of your baby, don't allow the use of feeding bottles unless the clinic or doctor has prescribed them for a special reason.


Feeding bottles

DO YOU KNOW THAT WHEN YOUR WIFE IS RELAXED AND HAPPY, MILK FLOWS WELL?

- Keep your wife as happy as you can. Avoid quarrels.

- Listen it she talks about her worries and try to help her solve any problems.

- Be sure you are at home enough to give her real help with the other children.


Help with the other children

DO YOU KNOW THAT GRADUAL WEANING IS IMPORTANT TO YOUR CHILD’S HEALTH?

- Encourage your wife to continue breastfeeding until the baby is two years old. (It she goes out to a job, she can still breastfeed when she is at home.)

- Other foods should be added to the baby's diet starting when he is about four months old.

- Agree with your wife on a family planning method so that another pregnancy will not come sooner than you want Baby should be eating many other foods and drinking from a cup before the next pregnancy is begun

With your help and encouragement your wife can breastfeed happily.

For more information or advice, please write to us. Breastfeeding Information Group, P. O. Box 59436. Nairobi

REFERENCES

"Breastfeeding Information for Kenyans." Mothers and Children, Vol. 3, No. 1, January 1983.

Cameron M. and Hofvander, Y. Manual on Feeding Infants and Young Children. Oxford University Press, 1983.

Ebrahim, G.J. Breastfeeding the Biological Option. MacMillan Press Ltd., Hong Kong, 1978.

Helsing, E. and Savage King F. Breast-feeding in Practice - A Manual for Health Workers. Oxford University Press, New York, 1982.

World Health Organization. Women and Breastfeeding 1982.

World Health Organization. Report of a Joint WHO/UNICEF Consultation Concerning "Infants WHO Have to be Fed on Breast-milk Substitutes." 1986.

World Health Organization. Factors Influencing Breastfeeding in Relation to Infant and Maternal Health. 1986.