Lack of breastfeeding in Yemen puts babies at risk

The health of Yemeni children is still threatened by the huge number of mothers who do not practice natural exclusive breastfeeding, said a new study.  The study, conducted by researchers in the Faculty of Medicine and Health Sciences in Sana’a University, was conducted to assess the knowledge of the causes and factors for the lack of exclusive breastfeeding during the first six months of the baby’s life in Sana’a during 2005.  Exclusive breastfeeding is defined as an infant’s consumption of human milk with no other supplementation of any type—meaning no water, juice, nonhuman milk, or foods.

This does not include vitamins, minerals, and medications. A questionnaire was prepared and distributed to 324 mothers who visited measles centers in Sana’a during the months of September and October in 2005.  The study, supervised by Dr. Najiba Abdul-Ghani, found that only 27 percent of mothers know the true meaning of exclusive breastfeeding, and just 17 percent of them know the true period of exclusive breastfeeding. About 30 percent of those sampled did not know anything about exclusive breastfeeding.  The rate of mothers who practice exclusive breastfeeding for a complete six months did not exceed 8 percent, and about 92 percent of them did not practice exclusive breastfeeding for a complete six-month period, for various reasons.  A large number of mothers, 60 percent, believe that breast milk alone is not sufficient for the baby. 

Others, 22 percent, believe that letting the baby drink water early will help the baby eat.  The promotion of supplementary food and the traditions followed by a lot of Yemeni mothers are some other reasons that mothers stop exclusive breastfeeding during the first six months of their babies’ lives.  Most of mothers, 73 percent, who participated in the study were in the 20 to 34-year-old age group. About 89 percent of the mothers were housewives, while just 37 percent of them were working. The study found that mothers who have basic education were in the majority, 37 percent, while another 31 percent of them was illiterate. The mothers’ education level was found to be a factor in whether they practiced natural exclusive breastfeeding.

Illiteracy or low education was a reason mothers did not practice exclusive breastfeeding.  The study also found that low living standards make a lot of mothers stop practicing breastfeeding in the early months of their babies’ age. Work outside of the home also stops a woman from breastfeeding her baby, the study found.      Mother’s milk has just the right amount of fat, sugar, water, and protein that is needed for a baby’s growth and development. Most babies find it easier to digest breast milk than they do formula. Breast milk has antibodies in it, to help protect infants from bacteria and viruses.

Recent studies show that babies who are not exclusively breastfed for six months are more likely to develop a wide range of infectious diseases, including ear infections, diarrhea, respiratory illnesses, and that they have more hospitalizations. Some studies suggest that infants who are not breastfed have higher rates of sudden infant death syndrome in the first year of life, and higher rates of type 1 and type 2 diabetes, as well as higher rates of lymphoma, leukemia, Hodgkin’s disease, obesity, high cholesterol, and asthma. Babies who are not breastfed are sick more often and have more doctors’ visits. Also, when mothers breastfeed, there are no bottles and nipples to sterilize. Unlike human milk straight from the breast, infant formula has a chance of being contaminated. 

Breastfeeding saves time and money. Mothers do not have to purchase, measure, and mix formula, and there are no bottles to warm in the middle of the night. Breastfeeding also helps a mother bond with her baby. Physical contact is important to newborns and can help them feel more secure, warm, and comforted. Nursing uses up extra calories, making it easier to lose the pounds gained from pregnancy. It also helps the uterus to get back to its original size more quickly and lessens any bleeding a woman may have after giving birth. Breastfeeding also may lower the risk of breast and ovarian cancers. The U.S. Surgeon General recommends that babies be fed with breast milk only, no formula, for the first six months of life.

It is better to breastfeed for six months and best to breastfeed for 12 months, or for as long as mother and her baby wish. Solid foods can be introduced when the baby is six months old, while mothers continue to breastfeed. The situation in Yemen is dire. The Yemeni Family Health Survey conducted in 2003 showed that infant mortality rate remained unchanged, while the under-five mortality rate continued to decline slowly compared to the 1997 Demographic Health Survey.  Worldwide, malnutrition has been responsible, directly or indirectly, for 60 percent of the 10.9 million deaths annually among children under five. Well over two-thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first year of life. Malnourished children who survive are more frequently sick, and suffer the life-long consequences of impaired development. 

Yemen has one of the highest rates of malnutrition, said Dr. Kamal Ben Abdullah Chief of the Young Child Survival and Development Section, UNICEF. Fifty-three percent of Yemeni children under the age of five are too short related to their age, and 45 percent are underweight, according to the Yemen WHO’s Family Health Survey 2003, Final Report.  Three percent of people in rural areas suffer from serious emaciation, while that figure is slightly lower, at 2.3 percent, in urban areas.  Almost 30 percent of people suffer from acute diarrhea and 24 percent suffer from acute respiratory infections, the report said. The average period that women in Yemen breastfeed their babies under the age of three is 21.7 months. 

Only 40 percent of Yemeni women feed their babies by natural breastfeeding in the first hours after birth. That figure drops to only 11.5 percent of babies under six months who are exclusively breastfed. Forty-eight percent feed their babies for less than three years by bottle-feeding. The study was conducted by al-Zubair Jel’aos, Amani al-Sawloi, Khalid Issa, Zainab al-Khair, Sorour Rahim, Fatah al-M’ammari, Mohammed Mathkour, Nassima Molouk, and Hind al-Hasamah.

The study recommended developing a policy for exclusive breastfeeding. The policy should be written and reported in a routine way to all employees in the health field. It also recommended that health workers ensure that all pregnant women and nursing mothers are given a detailed explanation on the benefits of breastfeeding. They should also encourage mothers exercising exclusive breastfeeding during the first six months of the baby’s age and to continue to breastfeed their babies until they become two years old, even after they start feeding them complementary foods.    

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