For implementing an emergency infant and young child feeding project, it is possible to find a mother for a non-breastfed child in order to breastfeed that child. However, the social aspects must be respected because it is not allowed in the communities of north central Burkina that any woman breastfeeds that child. A guide for the choice of the new nanny needs to be developed to adequately identify the new nanny. 

For implementing an emergency infant and young child feeding project, it is possible to find a mother for a non-breastfed child in order to breastfeed that child. However, the social aspects must be respected because it is not allowed in the communities of north central Burkina that any woman breastfeeds that child. A guide for the choice of the new nanny needs to be developed to adequately identify the new nanny. 

For implementing an emergency infant and young child feeding project, it is possible to find a mother for a non-breastfed child in order to breastfeed that child. However, the social aspects must be respected because it is not allowed in the communities of north central Burkina that any woman breastfeeds that child. A guide for the choice of the new nanny needs to be developed to adequately identify the new nanny. 

For implementing an emergency infant and young child feeding project, it is possible to find a mother for a non-breastfed child in order to breastfeed that child. However, the social aspects must be respected because it is not allowed in the communities of north central Burkina that any woman breastfeeds that child. A guide for the choice of the new nanny needs to be developed to adequately identify the new nanny. 

The wet nurses should be screened for HIV infection to avoid passing HIV infection to the babies. Also, the guide should be clear on whether HIV-infected women can be recruited as wet nurses, under which circumstances, and how antiretroviral therapy will be provided to HIV+ wet nurses in emergency situations.

I would be interested to understand  if the impossibilities for an other women to practicise wet- nursing are linked to local beliefs, traditional practices or any other reason. Would there be a possibility to change or overcome? What about if wet-nursing will be done by a sister of the mother or by the grand-mother?

 Small correction: For the implementation of an emergency infant and young child feeding project, it is possible to find a mother for a non-breastfed child to breastfeed that child. However, social aspects must be respected because it is not allowed in the communities of north central Burkina for a "ANY" woman to breastfeed this child. A guide for choosing a new nanny must be developed to properly identify the new nanny.

 Small correction: For the implementation of an emergency infant and young child feeding project, it is possible to find a mother for a non-breastfed child to breastfeed that child. However, social aspects must be respected because it is not allowed in the communities of north central Burkina for a "ANY" woman to breastfeed this child. A guide for choosing a new nanny must be developed to properly identify the new nanny.

For my little experience concerning the breast-feeding of a child by a foster or adoptive mother, generally one identifies in the family of the child one who could accept. In another case one can identify within the same community. As soon as this is done, we do pre-lactation tests, especially for HIV. Then advice to the nanny on hygiene, food, the importance of breastfeeding including breastfeeding positions. If the conditions are met, the mother is supplemented with iron folic acid for 3 months.

Dear Isabelle, 

I have seen a number of noble responses and consideration in the development of operational guidance on Wet Nursing from field practitioners. In my opinion and experiences, Wet Nursing or cross-nursing is culturally and religiously is Taboo, especially in the Middle and Low income countries,1,2. In order to get the best out of the questions you asked and to develop inclusive operational guidance, it would be paramount to conduct a meta-analysis on available evidences, and then further fine tuned through feasiblity and accesbtiblity studies to local contexts. 

1. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03551-9

2. https://jag.journalagent.com/erciyesmedj/pdfs/EMJ_40_4_204_209.pdf

Hello,

wet nursing was oene of the ways that the communities ensured that the child continued to get the benefits of breastfeeding,however where i work currently(kakamega,shinyalu)wet nursing almost never happens and its a practise that is discouraged because the community is yet to fully embrace exclusive breastfeeding.Other factors that makes this practise not to be embraced is the unknown status(HIV) of the one who is to do it .Also culture take center stage on thos issue and the community doesnt embrace this practise as they feel it endangers the life of the baby,especially if the mother died.

I would love to get updates on what other people are doing to encouarge or discourage and the justifications for both.

In my experience when I worked as an IBCLC in Zimbabwe, wet-nursing was not viewed favourably.  It might be considered for an orphaned baby if the mother's sister or grandmother was to be the wet-nurse, ie a very very close family member.  But breastmilk was a very special fluid, not to be expressed in case it could be bewitched, and each mother was to breastfeed her own baby, direct, at the breast.  

Wet nursing is a very useful IYCF-E intervention for children below 6 months who for one reason or another their mothers are not able to breastfeed them. One of the biggest hinderance to establishing this practice is the social- cultural belief and taboos associated with breastfeeding. For example, in some cultures, it is believed that if a man sucks the breast of the mother the child cannot suck it again as it will lead to death of the infant unless they seek the intervention of the herbalist. There is also a belief that if a man is unfaithful to his wife while the infant is still breastfeeding it may lead to the child getting sick often and even death. In addition, it could be a challenge if the wet nurse is married. This is because not all partners would support and follow the guidelines required to ensure the wet nursing infant is not affected by infections such as HIV. Wet nursing requires the commitment of both the wet nurse and her partner for the practice to be successful.

Regarding that, I have heard some constraints from the field practices. Mostly grandfathers in Muslim communities do not appreciate the ideas of wet nursing, and they assumed that if their grandson will suck from another mother, both families will be relatives, and children cannot get married when they become adult. One of the biggest hindrance is that influence of health care professionals in the hospital and clinic that when adopted children receive treatment at those clinic, health care professional instructed to follow BMS instead of trying at least wet-nursing.