Earlier this month,  World Breastfeeding Week was celebrated from 1^st to 7^th August 2023 with the theme “closing the Gap, Support for all.”

Breastfeeding is essential for both infant health and survival. Breastmilk provides ideal nutrition, is clean and safe, and contains antibodies that protect against many common childhood diseases. Additionally, breastfed children tend to score higher on intelligence tests and have a lower risk of obesity and diabetes later in life. Inadequate breastfeeding contributes to 16% of childhood deaths annually. Mothers who breastfeed their babies also benefit from reduced risks of type 2 diabetes, and breast and ovarian cancers.

How about the economic/societal benefits? Breastfeeding contributes to economic productivity, as parents (especially mothers, obviously) can spend uninterrupted  time at work instead of having to take days offs attending to sick children. Economic costs of not breastfeeding also come from direct health care costs to treat maternal and child morbidity, lost economic productivity due to premature mortality, and costs associated with the decreases in cognitive development of the child.

Against that backdrop, the World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months, with continued breastfeeding and appropriate complementary foods up to 2 years or beyond. Exclusive breastfeeding (EBF) means that apart from breastmilk  (including milk expressed or from a wet nurse),  no other food or drink is given to the infant (not even water) for the first 6 months of life. The only exceptions: rehydration solution (ORS), drops and syrups (vitamins, minerals and medicines). Breastfeeding should start within the first hour of birth and occur on demand (as often as the child wants – day and night). Globally, exclusive breastfeeding rates have risen to 48% as of 2023, nearing the WHO target of 50% by 2025.

In Kenya, exclusive breastfeeding rates increased from 32% in 2008 to 60% in 2022, surpassing the global average. This progress is supported by national breastfeeding guidelines and legal frameworks such as the Health Act of 2017, which advances breastfeeding rights for Kenyan mothers in the workplace, including guidelines for employer support towards female workers on combining work with breastfeeding.

Efforts to promote EBF include the Baby Friendly Hospital Initiative (BFHI) at the hospital level and the Baby Friendly Community Initiative (BFCI) at the community level. These programs have enhanced EBF rates by integrating hospital and community-level interventions focused on improving breastfeeding knowledge, attitude and practices.

Nevertheless, also in Kenya, breastfeeding challenges persist for both working and stay-at-home mothers, such as early cessation of EBF coinciding with return-to-work timing, lack of on-site childcare, and inadequate support for milk expression. Many workplaces lack lactation spaces, and mothers often struggle with hand expression and pumping.

To further improve EBF rates, more interventions should be considered at hospital, community, and workplace levels:

• Hospital Level: Implement trained breastfeeding peer supporters (BFPS) to assist with attachment and positioning and support understaffed health workers. Guideline implementation should allow monitoring and evaluation through good record keeping.
• Workplace Level: Expand schedule flexibility, provide on-site daycare and lactation rooms, enhance milk expression education, and increase maternity leave.
• Community Level: Implement BFCI programs with trained community health volunteers (CHVs) and strengthen mother support groups. Also address the socioeconomic and cultural practices.

In sum,  achieving and exceeding global EBF targets requires a continuous, holistic approach that supports mothers, families, and employers leveraging on the existing healthcare infrastructures. The dual benefits (health ànd economic/societal ones) arising from exclusive breastfeeding make these efforts invaluable.