Closing the Gap, Breastfeeding Support for All  

Every year from August 1^st to August 7^th, people around the world celebrate World Breastfeeding Week (WBW). World Breastfeeding Week aims to highlight the huge benefits that breastfeeding can bring to both the health and welfare of babies, as well as a wider push for maternal health, focusing on good nutrition, poverty reduction and food security. The event is organized every year by the World Alliance for Breastfeeding Action (WABA), a global network that aims to protect, promote and support breastfeeding around the world. Along the way, it works with the World Health Organization and United Nations Children’s Fund (UNICEF) to get its aid to the right people in the right communities. 

Breastfeeding is essential for a child’s survival, health, growth, and development, offering unparalleled benefits to infants and mothers. The World Health Organization (WHO) recommends immediate initiation of Breastfeeding within the first hour of birth and exclusive breastfeeding for the first six months of life. Sustained breastfeeding for 2 years or beyond alongside appropriate, adequate, and safe complementary feeding from 6 months, optimal maternal nutrition, and social and community support are encouraged.  

Extensive research highlights the numerous benefits of breastfeeding. The Lancet Child Survival Series 2003/2013 has documented Breastfeeding & Complementary feeding to have the single largest impact on child mortality of all preventive interventions. Exclusive breastfeeding for 6 months with continued breastfeeding for 12 months prevents 13% of child deaths. Complementary feeding contributes to 6% of prevented mortalities. Breastfeeding also supports children’s cognitive development and decreases the risk of obesity. Mothers benefit from breastfeeding too, with reduced risks of ovarian and breast cancers. The Kenya Demographic and Health Survey 2022 shows that Early Initiation of Breastfeeding has stagnated compared to 2014 and remains at 61% while Exclusive breastfeeding reduced to 60% from 61% in 2014. Kenya is among the 120 countries globally that celebrate World Breastfeeding Week (WBW) every year. 

The theme for WBW 2024, “Closing the Gap: Breastfeeding Support for All,” focuses on increasing support for breastfeeding among vulnerable groups and highlights breastfeeding as an equalizer in society. It emphasizes the need for continuous capacity development and coordination among various sectors to support breastfeeding, especially during emergencies. 

Emergencies significantly impact the normal functioning of our societies, including disruption of maternal, infant, and young child nutrition (MIYCN) practices. In Kenya, the Kenya Red Cross Society (KRCS) plays a vital role in supporting breastfeeding for vulnerable groups during emergencies, prioritizing Maternal, Infant, and young child Nutrition (MIYCN) even in crises. Some of the impacts of emergencies on breastfeeding are:  

Separation of Babies from Mothers: Emergencies can separate infants from their mothers based on the impacts, leading to the cessation of breastfeeding. 

Stress and Trauma: Maternal stress and trauma can affect milk production and breastfeeding practices. 

Lack of Privacy and Safe Spaces: Overcrowded shelters or camps often lack private and safe spaces for breastfeeding. 

Food Insecurity: Disruption of local markets and food supply chains can lead to food shortages, impacting the nutritional status of mothers and children. 

Inappropriate Donations: The influx of breast milk substitutes (BMS) and infant formula can undermine breastfeeding practices, especially when distributed without proper controls. 

Disruption of Health Services: Damage to health infrastructure and the displacement of healthcare workers can limit access to antenatal and postnatal care, including breastfeeding support. 

Increase in Disease: Overcrowded and unsanitary conditions can lead to higher rates of infectious diseases, affecting the health of mothers and infants. Lack of safe water for food preparation impacts food safety and hygiene practices. 

The organization working in collaboration with other stakeholders continues to be at the forefront of enhancing efforts to protect, promote, and support breastfeeding at all levels, including in emergencies. Key actions taken to promote, protect, and support breastfeeding during emergencies include:  

Identification and registration of the key vulnerable groups: pregnant and lactating women, children under five years, elderly, persons with disabilities as well as persons living with chronic conditions. This targeted registration allows KRCS to prioritize and provide the necessary support to ensure breastfeeding is promoted, protected, and supported even in crisis.  

Care for pregnant and lactating women:  KRCS ensures that the nutritional needs of pregnant and lactating women are provided for, by targeting households appropriately for nutrition support. Good maternal nutrition is important for a successful pregnancy, Child delivery, and lactation as well as good health of the mother.  

Establishment of supportive places for target group and higher risk groups:  

Through the trained KRCS response teams, safe spaces for breastfeeding and feeding support are set up in displaced populations where mothers can breastfeed comfortably and privately, ensuring they feel safe and supported. The organization encourages the early initiation of breastfeeding within the first hour of birth, which is critical for establishing breastfeeding and providing newborns with colostrum, the nutrient-rich first milk. Additionally, communities and mothers are engaged to promote and support exclusive breastfeeding for the first six months of life by educating mothers on its importance and offering the necessary support and resources. For children aged 6-23 months, KRCS ensures access to safe and appropriate complementary foods alongside continued breastfeeding periods appropriate to the needs and context. 

Furthermore, KRCS collaborates with other sectors, such as shelter, water, food, and security, to provide comprehensive support to target groups. This holistic approach ensures that the needs of breastfeeding mothers and their children are fully met. By providing clear and appropriate communication about MIYCN, KRCS that affected populations, first responders, and the media receive accurate information, promoting safe and effective feeding practices during emergencies. 

To effectively support Maternal, Infant, and Young Child Nutrition in Emergencies (MIYCN-e), a comprehensive approach involving several key steps is essential. This begins with the development of supportive breastfeeding policies that prioritize maternal and child health, along with robust coordination among different sectors to ensure cohesive support. The Ministry of Health has the overall responsibility for the guidance and support to Protect, Promote, and Support maternal, infant, and young child nutrition.  It has established sectoral and multi-sectoral coordination mechanisms with partners, which help to promote overall nutrition response. The development of an action plan for the emergency operation that identifies agency responsibilities and mechanisms for accountability is key. 

Kenya has developed the National Maternal, Infant and Young Child Nutrition policy as well as the National Operational Guidance for Maternal Infant and Young Child Nutrition in Emergencies, which guide the implementation of all MIYCN interventions across the routine programming and the disaster continuum. For effective MIYCN E response, there needs to be a pool of well-trained health care and humanitarian teams for deployment in an emergency with an updated database for quick reference. Regular refresher training and on-the-job mentorship are recommended for first responders. Regular assessment and monitoring of breastfeeding practices help identify areas for improvement and ensure the effectiveness of programs. Integrated, multi-sectoral interventions bring together efforts from various fields, enhancing the support network for breastfeeding mothers. Minimizing the risks associated with artificial feeding is also critical, promoting breastfeeding as the safest and most beneficial option. Finally, public awareness campaigns and community support systems play a vital role in promoting, protecting, and supporting breastfeeding, ensuring that all mothers have the resources and encouragement they need to successfully breastfeed their children.  

Through these efforts, the Kenya Red Cross Society helps to protect, promote, and support breastfeeding, ensuring that vulnerable groups have access to the care and resources they need during emergencies. 

Grace Waigumo

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