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DISPELLING
MYTHS ABOUT
BREASTFEEDING IN EMERGENCIES
Myths
about breastfeeding can undermine both a mother's confidence
and the support she receives. The four most common
myths are:
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"STRESS MAKES MILK
DRY UP"
While extreme stress or fear
may cause milk to momentarily stop flowing, this
response, like many other physiological responses
to anxiety is usually temporary.There is growing
evidence that breastfeeding produces hormones
that reduce tension, calm the mother and the baby
and create a loving bond.
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"MALNOURISHED MOTHERS
CANNOT BREASTFEED"
Food should go to the lactating
mothers so that they can feed their babies and
maintain the strength to care for older children
in the family as well. In the case of severe malnutrition,
the use of a breastfeeding supplementer can ensure
increased breastmilk production.
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"BABIES WITH DIARRHOEA
NEED WATER OR TEA"
As breastmilk is 90% water,
exclusively breastfeeding babies with diarrhoea
do not usually need additional liquids such as
glucose water or tea. What is more, water is often
contaminated in emergency situations. In the case
of severe diarrhoea however, oral rehydration
therapy (administered by cup) may be required.
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"ONCE BREASTFEEDING
HAS STOPPED, IT CANNOT BE RESUMED"
With an adequate relactation
technique and support, it is possible to help
mothers and their babies to restart breastfeeding
after they have switched to infant formula. This
is sometimes vital in an emergency.
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From: BFHI News, UNICEF, September
/October 1999, J. Newman, Dispelling myths about breastfeeding
in crisis - http://www.unicef.org/bfhi/sepoct99.pdf
For more info: see references below.
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Breastfeeding
women need ASSISTANCE
General promotion is not enough
Women in
displacement and emergency situations are at
increased risk of facing breastfeeding difficulties.
They need help, not just motivational messages.
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HIV/AIDS
and breastfeeding
The controversy regarding
feeding options for infants born to mothers
diagnosed as HIV positive highlights numerous
limitations and gaps in our current knowledge
about HIV transmission through breastfeeding.
Women have the right to be clearly informed
about all appropriate feeding options, in order
to be able to make an informed choice, and be
supported in carrying it out.
Recent reports (Coutsoudis
et al, 1999; The Lancet 354: 471-474; AIDS 2001,
15:379-87) suggest that, in the first months
of life, infants who were exclusively breastfed,
showed similar HIV transmission rates to those
infants who received only formula feeds, and
lower transmission rates than infants who were
mixed fed. Currently, most pregnant women do
not know their HIV status and of those who do
only a minority receive adequate counselling
on infant feeding options.
In most emergency situations,
voluntary counselling and testing is not available.
Exclusive breastfeeding should therefore be
protected, promoted and supported as a general
rule. It is simply not realistic to consider
testing especially in the initial phase of an
emergency, when water and sanitation, food,
shelter, immunisation and basic health care
are top priorities.
For those mothers who have
been tested and are found positive, counselling
about the advantages and disadvantages of the
various feeding options should be provided,
carefully taking into account the situation
at hand.
"However, even where
testing is possible and the mother has the option
to artificially feed, exclusive breastfeeding
is likely to remain the safest choice, as the
risk of mortality from artificial feeding will
in most emergency situations, far exceed the
risk of mortality from HIV transmission. The
risks of spill-over to the general population
and problems of ensuring sustainable supplies
of breastmilk substitutes (BMS) in the long
term must always be borne in mind."
Source: Declaration
of the participants of the inter-agency Africa
Regional Meeting of Infants and Young Children
in Emergency Situations in Dar-es-Salaam 1999,
organised by IBFAN Africa.
For
more information :
Updated info : http://www.welcome.to/breastfeeding
UNAIDS: http://www.unaids.org
(search for MTCT)
HIV and Infant Feeding
Counselling: a training course. WHO/UNICEF/UNAIDS
(2000)
HIV and Infant Feeding
guidelines, UNICEF/UNAIDS/WHO, 1998
WHO (2000) Effect of
breastfeeding on infant and child mortality
due to infectious diseases in less developed
countries: a pooled analysis. The Lancet,
vol 355. February 5th, 2000.
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Bear in mind that …
in
a population with a relatively high
HIV prevalence of 20%, it is estimated
that 15% of infants of HIV positive
mothers will be at risk of contracting
HIV through breastfeeding. Thus, out
of a population of a 100 mothers and
infants, only 2 or 3 infants will be
at risk of contracting HIV through breastfeeding.
97 will not.
On
the other hand, the relative risk of
death from diarrhoea for non-breastfed
infants in resource poor areas, is known
to be significantly higher than for
exclusively breastfed infants. A recent
analysos by WHO (2000) shows that infants
who are not breastfed have a 6-fold
greater risk of dying from infectious
diseases in the first 2 months of life
than those who are breastfed.
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