In Africa, millions of pregnant women and children under five die because of poor maternal and pre-natal care. But health care specialists say those numbers can be dramatically reduced by following a few easy and inexpensive methods to ensure the good health of mothers and their newborns. From Washington, reporter William Eagle tells us about one – breastfeeding.
Forget expensive medicines and complicated instructions. Some solutions for saving the lives of mothers and infants have been around for centuries and continue to work today.
One of the simplest is feeding newborns exclusively with the mother’s milk for several months. The method is not universally followed. In some cultures, taboos discourage dependence on breastfeeding; in others, the use of enriched powdered or dry milk has been encouraged. But experts warn that adding other liquids can introduce germs into the baby’s system that may lead to diarrhea and other illnesses.
Mary Beth Power is a reproductive health advisor for Save the Children in Westport, Connecticut.
"When you look at children exclusively breast-fed in many countries, it is low – like one percent in Niger," she said.
"In many hot and dry places," she continued,"people assume the baby needs water, because they can’t see how much milk the baby is taking in. People [also] introduce other foods that are considered necessary, like…special teas or honey water to sweeten a child’s disposition. All those things introduce potential for infection, whereas breast milk is not only the best food for babies, but has anti-infective property. If you expressed breast milk into a cup it would kill germs in the cup – it’s like [the commercial disinfectant] Lysol in the milk – it can reduce the infection or any infective properties inside baby’s gut."
Especially nutritious is colostrum, the first of the breast milk, which is rich in carbohydrates, proteins and anti-bodies. Doctors say it also promotes an infant’s first stool, which includes dead bloods cells and other waste and helps prevent jaundice.
She said, "The other taboo against breast milk is that…colostrum does not look like milk. It is usually yellowish in color. Many people think there is something wrong with that – that it is something to be expelled. So people will express the milk and not feed the baby for a few days until the mother’s milk came in, or feed the baby something else and throw out the colostrum and provide breast milk later, but that colostrum has those anti-infective properties. It is like the baby’s first vaccination, so the immune properties inside the mother are transferred to baby through breast milk. That’s another reason why these breastfeeding practices are sub-optimal in many countries."
Prolonged breastfeeding is also a natural way to promote birth-spacing, another way of ensuring the health of mother and her newborn. Health experts say an optimal period between births is between three and five years.
Power says a woman who breastfeeds exclusively is not likely to ovulate for six months. She says in some countries health experts recommend LAM (Lactational Amenorrhea Method), whereby a woman breastfeeds for six months and also adds another method of family planning.
LAM has been used successfully in Egypt, where Save the Children health experts say even local religious authorities have accepted the idea.
According to the group's country director in Cairo, Patrick Crump, "In Islam as in Christianity, there are the same sorts of debates [over controlling births]. Originally, the position of Islam was that birth control was not something that you find in the Koran – it was a foreign concept. But over time, public health officials [and] religious authorities have found citations in the Koran that promote birth-spacing."
"There is a sura [chapter] of the Koran," he continued,"that says if a mother is still breastfeeding and gives birth, she is penalizing or killing both children. So, Muslim authorities have started promoting the concept of birth spacing…. You should wait 24 months; the normal breastfeeding period is 18-24 months. Mothers are encouraged to not have another child until breastfeeding the previous child."
Religious authorities have not come out in support of any particular family planning method to help space births. But experts say women receive counseling after delivery and many use a wide range of available birth control methods, including condoms, intrauterine devices (IUDs) and depovera, the shot that includes the hormone progestin to suppress ovulation.
Save the Children says the Egyptian government has made impressive gains in improving maternal and child health over the past 15 years. Maternal morality has been cut by 52 percent. Meanwhile, infant deaths in the first year of life have been reduced by over 63 percent and mortality in the first month of life by a third. Health experts also credit Egypt not only for ensuring improved care in cities, but also in rural and other needy areas of the country.