Urgent need to increase breastfeeding in the Middle East

At least YR 1.1 billion is annually spent on breast-milk substitutes when the prevalence of exclusive breastfeeding (0-6 months) in Yemen fell from 18 percent in 1997 to 12 percent in 2003, according to a presentation showed at a press conference held at the UNICEF office in Sana’a, to mark World Breastfeeding Week, taking place 1-7 August.

Despite exclusive breastfeeding being the most complete form of nutrition for infants, figures are not growing in the Middle-East and North Africa, said UNICEF in a press release. There has been progress over the past 15 years, but only 38 percent of infants under 6 months of age in the developing world are exclusively breastfed. 

Exclusive breastfeeding has a wide array of long-term benefits for a child’s health, growth, immunity and cognitive development. Yet, insufficient knowledge of the benefits of exclusive breastfeeding from 0-6 months remains a widespread cause for stagnation in the region, where the practice reaches only 28 percent of newborns. 

In the last 20 years, about 30 million children died worldwide because of the lack of breastfeeding, including 1.3 million infants in the past year alone. 

“In Yemen, exclusive breastfeeding as a practice can save at least 13 percent of all under-five [year-old] deaths (84,000) or around 40,000 a year. It is estimated that about 7,000 Yemeni children died each month (250 per day), as a result of different diseases,” said Naseem Ur-Rehman, Chief Communications and Advocacy at UNICEF-Sana’a. 

Exclusive breastfeeding for the first six months of life reduces infant mortality linked to common childhood illnesses and malnutrition. Breastfeeding can also reduce the number of deaths caused by acute respiratory infection and diarrhea--two major child killers--as well as other infectious diseases. It also contributes to the health of mothers, and creates a bond between the mother and child.

This year, under the theme “Mother Support: Going for the Gold” (partly in the spirit of the Olympic Games that will take place this month), World Breastfeeding Week organizers are calling for greater support to mothers in achieving “the gold standard” of infant feeding: breastfeeding exclusively for six months and providing appropriate complementary foods with continued breastfeeding for up to two years or beyond.

“Exclusive breastfeeding contributes to the achievement of the Millennium Development Goals 1 and 4, in particular, and governments, health-care providers, communities and families all have an important role to play in such necessary success,” said Sigrid Kaag, UNICEF Regional Director for the Middle East and North Africa regions. 

According to the 2003 Family Health Survey of Yemen, the rate of newborn mortality amounts to about 37 percent for every 1,000 live births. About 75 percent of nursing babies die for every 1,000, and about 102 children less than five years old die for every 1,000. Moreover, about 32 percent of nursing babies and 46 percent of under-five-year-old children suffer from a low weight.  

“This is the time to go back to the core values, to support and encourage mothers to breastfeed their babies. It will help stop the increasing, horrible rates of death and malnutrition we record among children in Yemen every year,” said Ur-Rehman. “UNICEF, along with the World Alliance for Breastfeeding Action (WABA) and the World Health Organization (WHO), recommend the provision of increased professional and informal support for breastfeeding mothers,” he stressed.

Considered a basic child survival intervention, exclusive breastfeeding also holds the key to reducing underweight and stunting of children under the age of five years, which remains prevalent around high priority countries such as Yemen, Sudan and Djibouti. Stunting, an absolute indicator of chronic malnutrition, affects more than half of all under five-year-old children in Yemen, where exclusive breastfeeding is also one of the region’s lowest rates, at 12 percent.

Mixed breast and bottle-feeding as early as the first month of the baby’s life, combined with the premature introduction of complementary food are common in all countries in the region. In developing countries, artificially-fed infants are about 4 times more likely to die than breastfed infants, according to UNICEF. 

The enhanced availability and promotion of artificial breast-milk substitutes in the market further confounds the objective of widespread promotion of exclusive breastfeeding in almost every country in the region. 

The lack of familial and broad social support causes many mothers to stop breastfeeding their babies. In addition, misleading cultural beliefs and practices lead many mothers to limit breastfeeding duration and/or include early introduction of complementary foods. 

In drought-prone countries like Djibouti, Yemen and Sudan, the nutritional status of newborns and mothers is seriously jeopardized by growing food insecurity and limited access to basic services and humanitarian aid. These countries in particular would benefit from a comprehensive approach to improving infant and young child feeding, as well as maternal nutrition. 

World Breastfeeding Week was first celebrated in 1992 and is now observed in over 120 countries by UNICEF and its partners. The aim is to promote exclusive breastfeeding for the first six months of life. Continued breastfeeding after six months, for up to two years of age or beyond, combined with safe and appropriate complementary feeding, is the optimal approach to child feeding.

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