The County Government of Nakuru has embraced a baby-friendly community initiative to promote, protect and support breastfeeding.
Under the Baby Friendly Hospital Initiative (BFHI) for healthcare workers 2024 guide from the Ministry of Health, health care workers will visit villages and teach lactating mothers on best breastfeeding practices including breastfeeding positions and hygiene to prevent transmission of infections to newborns.
Through the BFHI which has been endorsed by the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF), 26 healthcare workers have been trained with support from the USAID Tujenge Jamii.
USAID Tujenge Jamii (UTJ) is a five-year (March 2021-2026) project made possible by the support through the United States Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
The project is being implemented through Deloitte and Touche LLP and Goldstar Kenya (GSK) to strengthen health and human capacities in Nakuru, Baringo, Laikipia and Samburu counties. It focuses on delivery of HIV, Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH), Water Sanitation and Hygiene (WASH) and nutrition services.
The health care workers who include nutritionists, paediatricians, nurses, and clinical officers have also been trained as Trainers of Trainers (TOTs) on the best breastfeeding practices.
According to County Nutrition Coordinator Ms Wangui Kihara the initiative is important in promoting child survival within the first 28 days of life, a period when infants are most vulnerable.
According to a World Health Organization study (WHO) released in 2022, nearly half (47 percent) of all deaths in children under 5 years of age occurred in the newborn period (the first 28 days of life). WHO emphasizes that proper breastfeeding practices during this time significantly boost immunity and reduce the risk of infections and mortality.
Ms Kihara indicated that further training that is aimed at equipping healthcare workers with the necessary skills and competencies to help mothers initiate and sustain breastfeeding, which is vital for both maternal and child health will be rolled out to healthcare workers in Molo, Bahati, and Naivasha Sub-County Hospitals.
“The aim is to ensure all maternity facilities in the county adopt the new guideline and enhance the adoption of the Ten Steps to Successful Breastfeeding, a global standard for improving breastfeeding support in hospitals,” stated the coordinator.
She added “This initiative is part of Nakuru County’s broader efforts to enhance maternal and child health services. The county hopes to create a supportive environment for mothers, helping to reduce child malnutrition and improve overall health outcomes for both mothers and infant with continued capacity building for healthcare workers,”
Ms Kihara said breastfeeding stands as a cornerstone in nurturing healthy infants and ensuring their survival.
“Breastfeeding can only be improved if mothers, especially young mothers, know best practices,” she stated
The coordinator noted that breastfeeding also gives a child a solid nutrition and health foundation for optimal growth and development, enabling them to attain their full potential, both physically and cognitively.
According to global guidelines on infant and young child feeding practices by the World Health Organization (WHO) and UNICEF, optimal breastfeeding practices include early initiation within the first hour of life, exclusive breastfeeding for the first six months, and continued breastfeeding alongside complementary feeding for two years or beyond.
Recent data from the Kenya Demographic and Health Survey (KDHS, 2022) underscores the importance of breastfeeding, revealing a slight decline in rates of early initiation and exclusive breastfeeding, highlighting the need for concerted efforts to reinforce support for breastfeeding mothers nationwide.
The KDHS survey notes that breast feeding enhances the mother’s health and enhances the bonding with the newborn. It is also associated with reduced risks of breast and ovarian cancers as well as delayed subsequent pregnancies.
Apart from the baby-friendly initiative, the Ministry of Health’s Department of Public Health created an enabling environment for breastfeeding through legislative and policy frameworks.
The Employment Act of 2007 guarantees maternity and paternity leave, while the Health Act of 2017 mandates employers to provide lactation spaces for breastfeeding mothers.
Further, the Breastmilk Substitutes Act of 2012 and the subsequent Breast Milk Substitute Regulations of 2021 ensure appropriate marketing and distribution of breast milk substitutes, promoting breastfeeding as the optimal feeding choice.
The Breast-feeding Mothers Bill before the National Assembly seeks to obligate employers to establish lactation rooms that are private, free of intrusion, have adequate sanitary standards, are secure and equipped with milk storage facilities, appropriate furniture and are adequately staffed.
It requires employers to provide reasonable breastfeeding breaks and consider the same as official working hours so that working mothers are not penalized for absconding work.
Ms Kihara noted that the proposed legislation provides for a break capped at 40 minutes in every four hours worked, which means two of them in a day except ‘where circumstances require a baby to be fed for a long period’ as this is certified by a registered medical practitioner.
The Bill also allows mothers to apply for flexible working arrangements.
The coordinator indicated that breast milk is safe, clean, wholesome and laden with antibodies that provide protection against common infanthood illnesses by virtue of which it reduces infant mortality.
A study titled “A critical look at exclusive breastfeeding in Africa: Through the lens of diffusion of innovation theory” by Olabisi Oyelana, Joyce Kamanzi and Solina Richter published in a 2021 edition of the International Journal of Africa Nursing Sciences, notes that Africans have a strong belief in the psychological, physical and magical importance of breast milk.
By Anne Mwale and Felistars Kahungu
