Plan’s position on breast feeding
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The survival, growth and development of children is not only a fundamental right, it is crucial to sustainable socio-economic development. Around 60% of all deaths in children under five are caused by malnutrition and over 60% of these occur in the first year of life as a result of inappropriate feeding practices.
Breast-feeding is an essential contributor to a child’s nutrition and survival during the early years of life. Plan works with mothers, families, communities and other significant stakeholders to develop and strengthen culturally-appropriate approaches that foster, protect and support exclusive breast-feeding for about the first six months of a child’s life.
In areas of high HIV prevalence, Plan works with local institutions to introduce, support and strengthen practices and structures to make breast-feeding safer by reducing HIV transmission through breast milk. |
Plan aims to ensure a good quality of life for children in its partner communities. For many children, however, this is threatened by malnutrition. Inappropriate feeding practices, particularly in the first year of life, have a significant impact on malnutrition-related deaths.
Breast-feeding is vital to infant and child health for several reasons: breast milk is the perfect source of nutrition and energy for the first six months of life; it provides protection from infectious diseases; and it improves cognitive development. Breast-feeding mothers develop a strong bond with their child and are less likely to have further babies in quick succession.
Beginning breast-feeding immediately after delivery contributes to maternal health by stimulating contraction of the uterus after birth and thus helping to control post-partum bleeding. Most significantly, infants who are breast-fed are six times less likely to die during the first two months of life than those who are not.
Breast-feeding alone meets the nutrition and energy needs of the vast majority of babies in the first six months of life and there is no advantage to introducing complementary feeding before this age . Most mothers can breast-feed if given proper information, support and counselling.
Optimal breast-feeding includes:
• beginning breast-feeding within one hour of birth
• breast-feeding exclusively for at least four months and preferably for six months
• introducing complementary locally-available, culturally-appropriate healthy foods at four to six months with continued breast-feeding up to at least two years |
Despite the known and proven benefits, the prevalence of exclusive breast-feeding in many parts of the world is disconcertingly low. In sub-Saharan Africa, for example, only 33% of children under the age of three months are exclusively breast-fed. There are numerous reasons for this, including peer pressure, medical advice and economic considerations.
At the same time, the HIV pandemic poses specific challenges to the promotion of breast-feeding. There are proven risks of HIV transmission from mother to child: an estimated 200,000 to 300,000 infants are infected with HIV each year through breast-milk. Yet, the vast majority of infants breast-fed by HIV-positive mothers do not become infected and these risks should be balanced against the fact that an estimated 1.5 million non-HIV related child deaths worldwide could be prevented each year through breast-feeding.
For relatively affluent HIV-infected mothers living in highly developed urban areas with good access to support services, abstaining from breast-feeding may be a safe option. However, in practically all the communities where Plan works, the benefits of exclusive breast-feeding outweigh any potential risk of HIV infection, even among children born to HIV-infected women. Equally, those born infected with HIV are likely to do much better on breast milk than on substitute feeding. Furthermore, the risk of HIV transmission during breast-feeding can be reduced significantly if breast-feeding is exclusive (that is, if no other nourishments or fluids are given to the baby) and if attention is paid to good suckling position and to care of the breast and nipple. Women resuming sexual activity after giving birth are at risk of HIV infection and it has been shown that the transmission rate of HIV through breast-milk is particularly high when the mother is newly infected.
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HIV/AIDS and breastfeeding
In communities with high HIV prevalence, Plan promotes and supports safer breastfeeding and environments that enable mothers to make informed decisions on what is best for them and their babies while at the same time supporting the choices they have made.
Safer breastfeeding includes:
- exclusive breast-feeding for at least four to six months followed by rapid weaning. If possible, (particularly in women who are not HIV positive and those who do not know their status) exclusive breast-feeding should be continued for up to six months. This must be weighed against the risk that mothers often start mixed feeding (breast plus supplementary food) as the baby grows older
- counselling and support of mothers to ensure that the baby is always fed in a position that allows good suckling and minimises the chance of injury to the nipple
- good medical and hygienic care of the mother and child to prevent and treat breast and mouth lesions and infections
- safer sex during the lactation period
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Plan helps mothers both to overcome barriers to breast-feeding practices and to introduce safe, healthy and locally-available complementary foods during the weaning period. We also train our own, local partner and Ministry of Health staff on how best to encourage and support community approaches to Optimal breast-feeding.
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In Nepal:
we have helped mothers learn about the nutritional and protective importance of starting breast-feeding immediately after delivery so that the baby takes the colostrums (a fluid rich in antibodies and minerals, that precedes the production of true milk). As a result, the number of mothers starting breast-feeding early has risen from five to 33 per cent.
In Senegal:
Plan recognised that grandmothers are the primary decision-makers in infant feeding practices in the household. Groups of grandmothers are now involved in the promotion of exclusive breast-feeding and Plan partner communities have seen a rapid increase in the adoption of best breast-feeding practices among nursing mothers. |
In all breast-feeding promotion activities, Plan aims to help communities, families and mothers to optimise the growth and development of children, which will contribute to a better, healthier and happier society.
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