Malawi has some of the highest rates of child malnutrition in the world, and 46% of children under the age of five have stunted growth. Children as old as twelve can appear as young as seven or eight because they have not been able to develop properly. However, these often permanent impairments could be avoided if nutrition interventions were adopted in the first 1,000 days of life.
Breastfeeding is one such intervention that can help to prevent children from becoming malnourished. While many mothers - around 95% - breastfeed immediately after delivery, few continue to breastfeed exclusively for the next 6 months.
Despite it being a free and natural way to protect a newborn baby from opportunistic infections, too little attention is being paid to help mums breastfeed in Malawi. It was not until I became a mother myself that I was truly able to appreciate the struggles mothers face to breastfeed their children.
Breastfeeding is meant to be one of the most natural gifts a mother can give her child. But I struggled with it when my son was born three years ago. I found it very painful at first, my nipples were sore, and my son was struggling to get enough milk.
I am pleased to say that as time went on it did get easier and my son got the milk that he needed. But I can't help but think how much easier it would have been had I been given proper guidance and support in those very early stages.
It's not enough to simply tell mothers to breastfeed if they are not provided with an enabling environment to do so.
While I was relatively aware of the nutritious benefits of breastfeeding, and how important it was for the health and development of my son, I know many mothers are not. When there is not enough support and education for mothers who are struggling with breastfeeding, it is understandable why some mothers switch to baby formula.
Legal protections
When my son was just two months old, I was forced to return to work. My maternity leave was up - which is only 12 weeks in Malawi - and my husband and I had been arguing over financial matters. We felt the only option was for me to return to work. Since I could no longer breastfeed on demand, I began the process of weaning my son off breast milk and started to introduce him to baby formula.
As a mother, I can tell you that this is not the choice I would have liked to have made at this point. I wanted to continue to breastfeed for at least the first six months - the World Health Organisation recommends that babies are breastfed exclusively for the first six months.
I knew infant formula was inferior to what I could provide for my son freely and naturally, as it does not contain the antibodies that strengthen babies' immune systems that are found in breast milk. I always tried to make sure that the infant formula was properly prepared, as I was aware of the risks arising from the use of unsafe water and unsterilised equipment. But the risk was always in the back of my mind.
The transition was from breast milk to baby formula was not an easy one. I remember the stomach aches and diarrhoea he frequently experienced. I was so concerned that he would become malnourished. I contemplated returning to breastfeeding, but that wasn't an option. Feeding had become infrequent due to my return to work, as a result of which my milk production had diminished.
Legislation needs to be stronger to help women breastfeed. Mothers should benefit from protections and be entitled to longer maternity leave. If mothers do make the decision to return to work, employers need to realise the importance of providing day-care at the office so mothers can go and breastfeed.
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If mothers were given more support, many more children would be protected from diseases like pneumonia and diarrhoea, which further exacerbates malnutrition.
A recent report revealed that infants who are not breastfed are 15 times more likely to die from pneumonia and 11 times more like to die of diarrhoea than those who are exclusively breastfed. By supporting mothers to exclusively breastfeed their babies for six months, we could avoid 804,000 child deaths worldwide.
Breastfeeding is one of the most natural gifts a mother can give to her child, and we need to do more to support mothers wherever they are raising their children to be able to give their children this vital start in life.
