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“If every child was breastfed within an hour of birth, given only breast milk for their first six months of life, and continued breastfeeding up to the age of two years, about 800 000 child lives would be saved globally every year,” says the World Health Organization (WHO, 2013 reports).

In line with the recently commemorated international Breastfeeding Week, the 2014 theme, “Breastfeeding a winning goal for life”, presents an opportunity for Zimbabwe to reflect on the importance of breastfeeding on child health and survival.

Exclusive breastfeeding, which entails giving every child breast milk only for the first 6 months of life, is being recommended as an effective and inexpensive feeding practice that enhances child survival and nutrition. Breastfeeding is so much more than food alone.

Studies have proved that breastfed infants are much less likely to die from diarrhoea, acute respiratory infections and other diseases (UNICEF, 2010/WHO, 2010). Breast milk provides all of the fluids and nutrients that a young baby requires and strengthens the child’s immune system.

Although 97 percent of children in Zimbabwe are reported to be breastfed, only 1 in 3 (31 percent) under-six months children are being exclusively breastfed. (Zimbabwe Demographic and Health Survey 2010-2011).

More than 60 percent of women in Zimbabwe are therefore practising early mixed feeding-giving children breast milk and any other food and liquids. This is a great cause of concern as research conducted by UNICEF (2013) indicates that mixed feeding poses higher risks to an infant’s health because it can increase the chance of their getting diarrhoea and other infectious diseases.

Breastfeeding in the context of HIV
The Ministry of Health and Child Care (MoHCC) recommends exclusive breastfeeding to all children, regardless of the mother’s HIV status. Exclusive breastfeeding helps safeguard the child’s health by reducing malnutrition, stunting and underweight.

While breastfeeding is one of the modes of HIV transmission from an HIV positive mother to the child, provision of lifelong ART to all HIV positive women during pregnancy and breastfeeding-also known as Option B+, has made breastfeeding safer.

By significantly lowering the viral load in a pregnant or lactating mother, the new HIV prevention and treatment approach reduces chances of passing on the virus to the child.

Women who attend Antenatal and Postnatal Care visits at clinics and hospitals are continuously empowered with information to appreciate the importance and benefits of breastfeeding and how mixed feeding before 6 months increases the risk of mother to child transmission of HIV.

Enestina Mugadza (33) from Chitungwiza is proud to have exclusively breastfed her child.  “Breast-milk is the best food that I have given to my child, at no cost,” says Mugadza. She added that following advice from nurses on ART adherence has enabled her to stay healthy and maintain a low viral load. “This gives me confidence to breastfeed my baby, since I know that my milk is safe.”

Mugadza’s baby is now 9 months. At six weeks, the baby tested HIV negative. She is set to continue giving her breast-milk and other recommended foods until the baby turns 2 years.

Need for family and community support towards exclusive breastfeeding
Although breastfeeding is a very personal act between a mother and her child, family members and communities can play a role in promoting it. While a woman may understand the importance of giving breast milk, the decision to practise exclusive breastfeeding does not lie on her alone.

She sometimes faces family and social pressure not to adhere to the recommended infant feeding practices.
Cultural practices such as “bota redzinza” (traditional porridge) or other traditional medicines given to a new born baby also affect adoption of exclusive breastfeeding. Without adequate counselling and support, a mother may feel the urge to discontinue giving the baby breast milk. Yet it is the best food that she can give at this age.

Memory Churu from Chitungwiza says she has managed to overcome the pressure from family and friends to practice early mixed feeding by being assertive and putting her child’s health first. “I tell people that mwana wangu ingoda, haadye porridge (my baby is a precious gift, she won’t eat porridge until she turns 6 months),” says Churu.

Upholding this decision, Patricia Mbetu, Chief of Party for the Families and Communities for the Elimination of Pediatric HIV (FACE Pediatric HIV Consortium) commended breastfeeding women for supporting healthier children and stronger families.

“Giving children the best start in life begins with breastfeeding and this is also the natural way of bonding with a child,” she says.
The FACE Pediatric HIV Consortium, led by the Organisation for Public Health Interventions and Development (OPHID), is supporting the MoHCC to implement the national Prevention of Mother to Child Transmission program. Positive outcomes are being witnessed through provision of ART during pregnancy and breastfeeding to reduce mother to child transmission of HIV.

“Through this program, we have celebrated birthdays of HIV negative children born by HIV positive mothers,” says Mbetu. “We are hopeful that by 2015, children everywhere in Zimbabwe will be born free of HIV and their mothers and families live healthy fulfilling lives.”

The writer is Policy, Advocacy and Communications Manager at OPHID