Breastfeeding support: The Infant and young child feeding interventions 

Breastfeeding support and Infant and Young Child Feeding (IYCF) interventions are crucial in low-income countries, like Ethiopia and other countries particularly those affected by drought and conflict crises. Some insights are presented below:

Support for Breastfeeding: In these situations, programs for education and counselling are frequently used to support the best possible breastfeeding practices.

Breastfeeding Support: To promote optimal breastfeeding practices, these contexts typically involve education and counselling programs. These interventions have been shown to significantly improve breastfeeding rates, with a 100% increase in exclusive breastfeeding at 3 months and a 53% increase at 6 months recorded (Hwang et al., 2021). However, difficulties can occur, such as when governments and humanitarian organizations accept donated baby formula and distribute formula without a specific purpose, in violation of The International Code of Marketing of Breastmilk Substitutes, and lack of appropriate breastfeeding interventions.

Infant and Young Child Feeding (IYCF) Interventions: IYCF interventions in these settings include breastfeeding education, complementary feeding education, and supplementary food provision. Their goals are to enhance breastfeeding practices and complementary feeding for infants and young children.  In food-secure settings, complementary feeding education interventions have demonstrated an increase in Weight-for-Age Z-score (WAZ) of 0.41 standard deviation (SD) and Height-for-Age Z-score (HAZ) of 0.25 standard deviation (SD). These interventions have shown a significant impact on linear growth, weight gain, and reduced rates of stunting, indicating their effectiveness in improving the nutritional status of children in food-secure populations (Lassi et al., 2020).

In summary, the success of any intervention during emergencies depends on its ability to adapt to the local context, ensure cultural appropriateness, and be practically feasible. The effectiveness of interventions does vary depending on the particular context and the particular needs of the affected population, so these factors must be taken into account when designing and implementing any intervention to ensure its relevance and impact.

References

Hwang, C. H., Iellamo, A., & Ververs, M. (2021). Barriers and challenges of infant feeding in disasters in middle- and high-income countries. International Breastfeeding Journal, 16(1). https://doi.org/10.1186/s13006-021-00398-w

Lassi, Z. S., Rind, F., Irfan, O., Hadi, R., Das, J. K., & Bhutta, Z. A. (2020). Impact of Infant and Young Child Feeding (IYCF) Nutrition Interventions on Breastfeeding Practices, Growth and mortality in Low- and Middle-Income Countries: Systematic review. Nutrients, 12(3), 722. https://doi.org/10.3390/nu12030722

Hi Chantal

The Operational Guidance on Infant and Young Child Feeding in Emergencies (OG-IFE), states that the use of breast pumps should only be considered when their use is vital and where it is possible to clean them adequately, such as in clinical settings. In terms of hygiene, pumps are similar to feeding bottles and teats which are discouraged due to high risk of contamination and difficulty in cleaning.

Manual/hand pumping into a bowl is far preferable in terms of hygiene, and possibly also in terms of facilitating the milk ejection reflex.

I would be very cautious in the assessment of need.  Things to consider are whether mothers are separated from their babies (eg. at work) for long stretches (4-8 hours).

Feel free to contact me on bindi_borg@yahoo.com.au if you want to discuss.  

Best.

bindi

Hello Chantal, In which country do you work?

Nutrition sans Frontières has a head office in Canada, one in France and representatives in Africa. I can put you in touch with the appropriate people to help you with your search if you wish, for documents in the language you prefer.

coalitionnsf@gmail.com

Dear both, thank you Bindi & Marie-france for your feedback. I know it's a tricky question and I know the IFE very well. I'll be in touch with you both, but I'm already in contact with another IFE/IYCF & BMS specialist. This is a very specific context and a one-off action. Thanks again for your feedback.

hello Chantal

I fully support the answer of Bindi Borg. Breastpumps are difficult to clean and using cups is more hyginic than bottles. Learning how to hand express is a technique that can be used everywhere and bear no risk of having parts of the pumps no lomger functioning well to create a vacuum. Moreover the one size funnels on manual hand pumps might not fit all breasts/ nipples and present a risk of tissue damage on the breast.

Feel free to contact me to further discuss, French is OK too maryse.arendt@pt.lu 

Dear Maryse,

I appreciate your recommendation, and I'm already in touch with a lactation specialist. I understand the risks involved, and I recognize that this is a sensitive topic. The context in which this occurs allows for good hygiene practices and support from a lactation specialist. Additionally, it has only happened a few times over the last year. However, we wanted to gather perspectives from others to ensure that we frame the situation appropriately from our standpoint as well.

Thanks a lot

Chantal

Breastfeeding support encompasses a range of services and resources aimed at helping mothers successfully breastfeed their infants. Here are some key aspects of breastfeeding support:

1. Education: Providing mothers with accurate and evidence-based information about breastfeeding during pregnancy and after childbirth is essential. This includes understanding the benefits of breastfeeding, proper latch techniques, positioning, milk production, and common challenges.

2. Lactation Consultants: These professionals are trained to provide individualized support and guidance to mothers experiencing difficulties with breastfeeding. They offer assistance with latch issues, low milk supply, nipple pain, and other concerns, often through one-on-one consultations.

3. Peer Support Groups: Connecting with other breastfeeding mothers can be incredibly helpful. Peer support groups provide a platform for mothers to share experiences, offer advice, and receive encouragement from others who have gone through similar challenges.

4. Online Resources: There are numerous websites, forums, and social media groups dedicated to breastfeeding support. These platforms offer a wealth of information, tips, and support from experts and other mothers.

5. Breastfeeding Classes: Prenatal and postnatal breastfeeding classes can help mothers prepare for breastfeeding and address any concerns they may have. These classes often cover topics such as breastfeeding basics, common challenges, and strategies for success.

6. Support from Healthcare Providers: Obstetricians, pediatricians, nurses, and midwives play a crucial role in providing breastfeeding support. They can offer guidance, monitor infant growth and development, and refer mothers to lactation consultants or support groups as needed.

7. Access to Breastfeeding Supplies: Ensuring that mothers have access to essential breastfeeding supplies, such as breast pumps, nursing bras, nipple shields, and breast pads, can facilitate successful breastfeeding.

8. Cultural Sensitivity: Recognizing and respecting cultural beliefs and practices surrounding breastfeeding is important. Providing culturally sensitive support ensures that all mothers feel comfortable seeking assistance and guidance.

Overall, comprehensive breastfeeding support involves a combination of education, professional guidance, peer support, and access to resources to help mothers overcome challenges and achieve their breastfeeding goals.

Dear Chantal

This is a good initiative and in addition to training mothers to use the breastpumps it would be good that in your SOP you include training of all the mothers to use handexpression since its a skill that must be taught and with very good results if done well.

Thanks

Rosemary

If your intervention is already systematic (distributed to all targeted mothers) this means that you have assessed the situation of your beneficiaries and precisely identified their needs before the start of the action. Despite everything, reassure yourself with a checklist (favorable environment) that use will be correct and will not harm children in terms of hygiene.

Dear Rosemary,

Yes, indeed, this is part of the process, as this option (provide manual breast pump) is the last one considered.

Thank you for your feedback.

Best regards

C.,

Dear Abel,

Thank you for your understanding. The distribution process is not systematic and is determined based on specific criteria as mention, including the capacity for washing and managing all aspects effectively. However, as mentioned earlier, we are proceeding cautiously, and this initiative only involves 4 mothers over the last two years. Additionally, it's worth noting that the country's nutrition sector has recently taken the lead on this matter.

Best regards,

C.