Maimbolwa Mulikelela
2 August 2007
BREASTFEEDING is one of the significant ways that can contribute to the survival of a child. Every year the world commemorates world breastfeeding week with different themes and as such, this year's week focuses on initiating breastfeedingin the first hour of birth.
The theme for 2007is, Breastfeeding: The first hour- save one million babies. This basically means that support to breastfeed in first hour of birth can save one million lives globally. This is because it contributes to reducing high neonatal mortality associated with infection and hypothermia.
In first hour after birth, breastfeeding is established better compared to the hours that follow later.
The benefits of breastfeeding the child in the first hour could help reduce in the levels of infection because breast milk has anti-infective properties.
Breastfeeding in the first hour can also prevent and reduce malnutrition when the baby is exclusively breastfeed for the first six months without the baby being given any fluids including water unless medically indicated.
Breast milk continuesto significantly contribute to meeting the nutritional requirements of a child even in the second year of lifein addition to safe and adequate complementary foods.
And one important element would also to involve male participation in ensuring that the new born were breastfeed in the first hour.
The issue of breastfeeding should not only be perceived as a women affair but should be a collective effort that needs to be supported by the nation in ensuring that baby friendly centers were initiated country wide.
For health facilities in Zambia to support mothers to initiate breastfeeding within an hour there is need for the Baby friendly Hospital Initiative (BFHI) to be revived. This will encourage mothers to breastfeed their babies in the first hour.
Health Minister, Brian Chituwo said the Government is committed in ensuring that Baby Friendly Hospital Initiative were revitalised .This would ensure that other legislation that protect, promote and support breastfeeding was enforced.
This includes the Food and Drugs, Marketing of Breast milk Substitutes, 2006 regulations. This legislation is intended to regulate the way breast milk substitutes are marketed.
Dr Chituwo said the objective of the theme was to reflect and encourage establishing breastfeeding within the first hour of birth as a key indicator of health progress in the country.
Dr Chituwo said breastfeeding is very beneficial both to the mother and the baby as the first milk known as colostrum provides the baby with nourishment that is considered to be the first immunisation due to a number of antibodies found in the milk.
He said immediate initiation of breastfeeding after birth makes use of the baby suckling reflex which is strongest in the 1st hour to establish.
A recent study that was conducted in rural Ghana showed that initiation of breastfeeding within the first hour reduced infant's risk of death.
In this study, there was a marked increase in risk with increasing delay in initiation of breastfeeding. Increase in risk giving pre-lacteal feeds, that is, anything other than mother's milk before beginning to breastfeed also increased the risk of neonatal mortality.
For babies who survived day one, it was clearly shown that 41 per cent of all babies who die during 2 to 28 days of life can be saved by this simple intervention of starting to breastfeed soon after birth, that is, within the first hour.
This means thatif all women began breastfeeding within the 1st hour, it would save one million of the 4 million newborn deathsglobally.
Dr Chituwo, however said the Government is committed in increasing initiation of breastfeeding within the first hour of birth from 51 per cent to 59 per cent by 2010.
He said there was also need to increase exclusive breastfeeding rate for the first six months which is currently at 41 per cent to 60 per cent by year 2010.
Dr Chituwo said his ministry was working in focusing efforts to ensure that increase and quality cares for mothers and babies.
However, HIV-infected mothers could also safely breastfeed their babies for the first six months of life if replacement feeding was not affordable, feasible, acceptable, safe and sustainable (AFASS) in the individual mother's situation.
Dr Chituwo explained that in case of HIV-infected mothers it is very important to discuss feeding of their baby with a health worker.
He has therefore implored the health workers in the country to help HIV mothers make informed choice based on the AFASS criteria.
CARE Zambia through Moyo WA Bana Project, said breastfeeding is very vital especially in promoting child survival through early initiation.
CARE Zambia Moyo WA Bana CBI Project assistant manager veronica, Muntanga said the main aim of the project is to improve key family and community practices that are likely to have the great impact on child survival, growth and development.
Mrs Muntanga said the project is supporting child health activities at both clinic and community to contribute to the national vision of taking health services as close to the family as possible through encouraging mother to breastfeed in the first hour of birth.
Breastfeeding can contribute to reducing the risk of developing ovarian and pre-menopausal breast cancer she said it is important to breastfeed in the first hour for the benefit of the child and a mother
Breastfeeding also delays postpartum ovulation and therefore a means of family planning (especially if a mother breast feed not less than 8 times a day, the baby is less than, 6 months and the mother has not yet had menses return) .
"There are psychological benefits as well. A woman who breastfeeds her baby is able to take advantage of the natural dynamics of nurturing and bonding". She said
Mrs Muntanga said the baby's suckling helps healing after a successful delivery, the new mother feels the continued contractions of her uterus (womb) as it begins to return to normal size.
She said the shrinking process is critical in reducing blood loss after separation of the placenta (the after birth). The baby that is put to the breast during the first hour helps to limit the mother's blood loss. This is an important factor as a way of preventing anemia.
Immediately after delivery, a hormone known as oxytocin is released and this is important in increasing uterine contractions and lessens maternal (mother's) blood loss.
Evidence exists that the hormones produced during breastfeeding (oxytocin and prolactin) contribute to feelings of relaxation and attachment to a mother. The hormone prolactin is responsible for milk production and helps to suppress ovulation. Oxytocin is responsible for milk let down (flow) and also helps to contract the uterus.
Meanwhile, a breastfeeding advocate who is also a registered nurse and midwive, Tina Nyirenda, said breastfeeding is very vital to the survival of the infant especially in the first hour of birth.
Mrs Nyirenda said there is need for a mother to be supported during breastfeeding especially in the first hour as it provides the foundation forsuccessful breastfeeding.
The first hour is the most important moment that would capture the strong suckling reflex.
Mrs Nyirenda said the first milk known as colostrum has a purgative effect which helps the baby to have clear meconium and thereby preventing jaundice.
When the baby misses the first hour breastfeeding becomes very difficult and the baby becomes yellowish because it would have taken long to expel the first stool
Some of the benefits of initiating breastfeeding in the first hour include skin to skin contact between the mother and the baby. This immediate contact contributes to the reduction in maternal bleeding, stabilises the baby temperature, respiratory rate and blood sugar levels, Mrs Nyirenda said.
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