By Kemo Cham
There are several misconceptions about breastfeeding in Sierra Leone. The myths in particular have stifled efforts to promote breastfeeding and largely contributed to the alarmingly high levels of malnutrition among children under five years of age.
Women complaining about abnormalities in their breasts, shy away from feeding their babies with what experts say is the best natural source of nutrients for any new born baby. A number of other entrenched fallacies border on sex life, eating habits and superstitious beliefs surrounding this wonderful nutrient, have denied hundreds of babies breastmilk.
By breastfeeding, mothers pass proteins, vitamins, minerals to the baby and inadvertently build their immune system. Various scientific bodies, like the American Academy of Paediatricians, strongly recommend exclusive breastfeeding for the first six months of a child life. This is partly informed by the results of several studies indicating that babies exclusively breastfed for this period, are less likely to develop chronic and acute diseases including ear infections, diarrheal diseases, asthma, obesity and respiratory illnesses. And these diseases are among the most common infant ailments and “killers” in Sierra Leone.
A World Health Organization (WHO) research study has shown that children between the ages of 6 months and 2 years, whose main source of nutrients come from breast milk, and whose diet is supplemented by healthy foods after 6 months, often score highly in intelligence tests, and are probably less likely to suffer from obesity and diabetes later on in life.
Mothers also stand to benefit from breastfeeding: notably with a decreased risk for breast and ovarian cancers, according to various authorities.
Yet, Sierra Leone has one of the lowest rates of breastfeeding in the world, a situation largely attributed to ignorance and poverty.
This has led to high rates of malnutrition among children, according to health officials and breastfeeding campaigners.
Only 32 percent of the country`s children under age 6 months are exclusively breastfed, according to the Sierra Leone Demographic and Health Survey (DHS) of 2013.
Feeding Day
Many women complain about injuries to their nipple on the breasts. A number of others cite hereditary traits of so-called ‘bad breast milk’ as a strong reason to deny their children breast milk.
There are even more absurd excuses, all suggesting the need for a robust awareness programme to stem the tide against breastfeeding, and witnessing a trend now seeing parents importing tinned baby formula. These hardly contain the required nutrients for the baby`s growth and development.
- “As far as I am concerned, we have no bad breast milk here,” argues Catherine Kallon, Capacity Building Nurse with the NGO Action Contre La Faim (ACF), attached to the Signal Hill Peripheral Health Unit in the west end of Freetown.
At this small health center, nurses have just concluded the day`s distribution of a special, medicated diet food for malnourished children on the Outpatient Therapeutic Programme (OTP). Isata John, the nurse in charge, says although the OTP had caused a major change in life style in the communities they serve, they continue to record high cases of malnourished children. And worryingly, she notes, some of these babies should have been on breast milk exclusively, since the day of their birth.
Exclusive breastfeeding is also a key for the reduction of infant and child mortality, which is at an alarming rate in Sierra Leone.
As of 2011, it is 185/1000.
Experts in breast milk say it is a perfect starting point to prevent malnutrition and the Ministry of Health and Sanitation has adopted this in its National Nutrition Policy. The distribution of plumpy nuts is a part of that.
Ms. Kallon, a staff member of the Ministry, is saddled with the task, to providing training for the OTP staff at the Signal Hill PHU.
Besides fear of pain and injuries, there are many myths in the area of sex life and breastfeeding in Sierra Leone. Many women feel it is bad to breastfeed while simultaneously having regular and normal sex with their spouse. This has been one of the contributing factors for the weaning of babies early, she commented.
This is linked to a belief that having sex while breastfeeding causes the contamination of breastmilk and therefore many women believe it is responsible for their babies falling ill.
Other women worry that their men would not sleep with them, for fear of impregnating them so soon after their last lactating child.
With all this, ladies have just two options. Wean the baby or abstain from sex, says Musu Kargbo, a community organiser in the Signal Hill community.
Musu, probably in her early forties, has had six children. The elderly woman these days spends some of her time, sharing her experience as a ‘Lead Mother’ in a Mother-to-Mother group supported by Action Contre La Faim, which help in community mobilisation and awareness raising on the importance of breastfeeding. She says women who complain of breast pain are just afraid and lazy.
Supplementing food with breast milk is another cause of headache for nutritionists. And many women who practice this believe breastmilk is not enough for the baby. This is why many babies have been introduced to solid food at such tender age.
According to the Sierra Leone Demographic and Health Survey the proportion of babies under 6 months breastfeed exclusively is highest for those within the age 0-1 month - 42 percent. “It declines sharply as children grow older, so that only 1 percent of children age18-23 months are exclusively breastfed,” it notes.
Breastfeeding mothers have also had to deal with dilemmas around having to skip certain foodstuffs to avoid complications on the babies. Some stop taking medicines so they can breastfeed, or stop breastfeeding because they're taking medicines, fearing the effect on the young one.
Government and its many partners have been promoting behaviour change in mothers. That`s what Kargbo`s “mother-to-mothers” group does.
“If other animals breastfeed their young ones without giving them grass, and they grow to be strong, why not us?” the mother of six says.
And like many other areas in the world, full time engagement as a professional mother may prevent many babies from getting breastfed in Sierra Leone. Working mothers hardly have time to breastfeed their kids and they are affected by many social constraints.
But there is a way out for this category of the people. Ms Kallon suggests advance preparation of the breast milk. But this too, she warns, has some issues. The milk becomes unviable once it`s stored beyond 24 hours.
“Advance preparation of breast milk is actually not limited to working mums. Even elderly woman selling in the market or working at the farm, who do not wish to take their child along, can do so,” she says.
Many women who complain of pain and or injuries to their breast may have caused this themselves by their position while feeding the infant child so the advice is: “If you position your child well there will be absolutely no problem,” she says.
This article was researched and written as part of a Kombra Media Network Sierra Leone initiative.
(C) Politico 26/08/15
