Exclusive breastfeeding targets remain elusive

Many organisations lack breastfeeding rooms where mothers can express milk and storage facilities. FILE PHOTO | NMG 

Breast milk is the best food for a newborn baby. No commercial-made baby formula, or any other food, or drink can match breast milk.

The World Health Organization (WHO) recommends that babies should be breastfed exclusively for the first six months and thereafter continue breastfeeding supplementing with complementary feeds until the baby is two years and beyond for optimal growth and development.

The theme for this year’s World Breastfeeding Week ‘Empower Parents, Enabling Breastfeeding’ calls for empowerment of parents to achieve exclusive breastfeeding right from conception. However, the prevalence of exclusive breastfeeding in Africa including Kenya is less than the recommended standard. Major obstacles cited to hinder exclusive breastfeeding include medical challenges, short maternity leave, a lack of institutional policies to support breastfeeding staff, inadequate food, ignorance and the absence of physical as well as emotional support.


Medical challenges have contributed to the failure to achieve exclusive breastfeeding, especially for mothers living with HIV/Aids or women on medical treatment that is contraindicated for breastfeeding like cancer.


Mothers living with HIV should breastfeed for at least 12 months or up to 24 months or longer— similar to the general population — while adhering to antiretroviral (ARV) therapy in line with the WHO guidelines on the use of antiretroviral drugs.

In settings where health services support lifelong ARV therapy, including counselling and support breastfeeding among women living with HIV, the duration of breastfeeding should not be restricted. Breastfeeding is safe for cancer mothers unless during chemotherapy or hormonal therapy.

Nursing mothers undergoing or scheduled to start chemotherapy should stop breastfeeding until after treatment, which is usually between three to four months.

Radiation treatment can reduce breast milk production. For such mothers, formula milk is recommended as an alternative to avoid transmitting harmful medication from the mother to child.


Interventions should be delivered in a combination of settings by involving health systems, family and community environment concurrently to promote exclusive breastfeeding.

Breast milk formation starts as early as 28 weeks of pregnancy. To ensure steady and continued formation of breast milk, antenatal clinics should initiate and give parents relevant information throughout the pregnancy, delivery and postnatal for them to support each other physically and emotionally to ensure a constant supply of breastmilk.


Pregnancy and breastfeeding place extra demands on the mother’s body. To meet these demands, they need to think about what is best to eat and drink.

Good nutrition in pregnancy helps the mothers to stay healthy and energetic as well as to prepare them to take care of the new baby.

Through breast milk, the baby eats what the mother eats. It is, therefore, the best way to give a baby a healthy diet is for the mother to eat well.

Mothers should eat a balanced diet rich in folic acid, vitamin D, iron and calcium.

Such can include liver, kidneys, green vegetables, plenty of fruits and fluids. Breastfeeding mothers should avoid alcohol, smoking, caffeine and self-medication as these can cause harm to the unborn baby or through breast milk.


The standard three-month maternity leave is not enough to promote exclusive breastfeeding. In some instances, mothers are made to work from home while still on maternity leave, or even resume work before the three months lapse with threats of work termination.

There is also the challenge of workplace support after maternity leave.

Many organisations lack breastfeeding rooms where mothers can express milk and storage facilities.

Organisations should consider introducing day-care centres at the workplace for mothers to promote exclusive breastfeeding.

In rural areas, working mothers experience more challenges than their urban counterparts.

They lack breastfeeding accessories like breast pumps for expressing breast milk, storage facilities and travelling for long distances in search of water away from their babies.

In such cases, babies are introduced to cow milk and complementary feeds early before the recommended period of six months for exclusive breastfeeding.

Empowering parents to achieve exclusive breastfeeding is crucial to curb infant malnutrition, obesity, vulnerability to allergies and diseases as well as achieve both optimal growth and higher baby IQ.

Reporting by Sikolia Wanyonyi, Rose Kamenwa and Mary Mathenge. - Dr Wanyonyi is an obstetrician gynaecologist, Dr Kamenwa is a paediatrician and Ms Mathenge, is the Lactation Manager at Aga Khan University Hospital, Nairobi.