By Avril Isaac Communications Officer, Caribbean Public Health Agency (CARPHA)

Tuesday, August 4, 2020 — In the Caribbean, breastfeeding initiation within the first hour of birth is fairly high, however, continued exclusive breastfeeding for 6 months is low at approximately 39%. The benefits of breastfeeding are tremendous for both mother and baby. 

This nutrient-rich product is the first line of a baby’s defence against infections.  Packed with many properties, breast milk is ultimately the best source of nutrition for a new baby.  Antibodies protect against allergy and infection, and Vitamin A prevents eye disease.  As the baby’s first immunity it also helps prevent jaundice and contains fats that are necessary for brain development. 

Breastfeeding can also help to prevent childhood obesity and maternal obesity, which are important risk factors for Type 2 diabetes.  If we are to reduce the prevalence of childhood obesity and other non-communicable diseases (NCDs) later in life, mothers should try to feed their babies exclusively on breast milk for the first six months of life.  Ending breastfeeding too early and introducing other foods into baby’s diet at the wrong time, remain one of the greatest threats to a child’s health.  

Breastfeeding provides a healthy, non-polluting, sustainable and natural source of nutrition, and also provides a great way for mothers to bond with their babies.  Costing far less than an artificial product, very little is wasted as baby stops feeding when satisfied, once correctly positioned and attached.  Breastfeeding also has health benefits for the mother. Mothers who breastfeed have lower rates of breast cancer, ovarian cancer, Type 2 diabetes, and high blood pressure. 

This year’s theme for World Breastfeeding Week (WBW)Support Breastfeeding for a Healthier Planetis aligned with United Nations Sustainable Development Goal 3 – Good Health and Well-being.This theme focuses on the impact of infant feeding on the environment in this era of climate change and the importance of promoting, protecting and supporting breastfeeding to ensure and maintain good health. 

This is in keeping with the Caribbean Public Health Agency’s life course approach for the prevention of NCDs of which breastfeeding is a key factor.  In recognition of WBW, CARPHA encourages mothers to see breastfeeding as the optimal feeding method for infants from the first hour of their birth, to at least six months after, with continued breastfeeding up to age two or beyond along with complementary food. 

During this COVID-19 pandemic, it is only natural for new mothers or expectant mothers to have concerns about their breast milk, breastfeeding and transmitting the virus to their babies.  There is no evidence to date of COVID-19 presence in breast milk or transmission via breast milk.  Because of the benefits of breast milk and breastfeeding, and the negative effects of stopping it, it is recommended that mothers continue to breastfeed.

Breastfeeding continues to protect baby against death and morbidity throughout infancy and beyond due to the anti-infective properties of breast milk, including colostrum, and the long-lasting transfer of immunological competence and memory.  Standard feeding guidelines should continue with appropriate precautions for infection, prevention and control.  Protocols and guidelines for standard infant feeding should be adhered to for mothers with suspected, probable or confirmed COVID-19 infection.

As with all confirmed or suspected COVID-19 cases, symptomatic mothers who are breastfeeding or practicing skin to skin contact should practice respiratory hygiene during feeding (e.g. wearing a mask), perform hand hygiene before and after contact with the child, and routinely clean and disinfect surfaces which the mother has been in contact.  Trained health professionals should also provide appropriate support to mothers in maternity facilities to initiate breastfeeding and to assist with common breastfeeding difficulties.  In situations when severe illness in a mother due to COVID-19 or other complications prevent her from caring for her infant or prevent her from continuing direct breastfeeding, mothers should be encouraged and supported to express milk, and safely provide breast milk to the infant, while applying appropriate infection prevention and control measures.

It is advised that maternity facilities continue to adhere to the Ten Steps to Successful Breastfeeding and Baby Friendly status. Mothers and infants should be enabled to remain together and practice skin-to-skin contact, and to remain together and to practice rooming-in throughout the day and night, especially immediately after birth during establishment of breastfeeding, whether they or their infants have suspected, probable or confirmed COVID-19 virus infection.

The World Health Organization (WHO) Global Strategy on Infant and Young Child Feeding Practices aims to renew efforts to promote, protect and support appropriate infant and young child feeding. Based on this strategy, governments are asked to develop and implement comprehensive policies on infant and young child feeding of which the implementation of the Baby-Friendly Hospital Initiative (BFHI) is important.

CARPHA supports breastfeeding which can be seen as a long-term strategy for a more productive and healthier Region.

CARPHA has supported its Member States in numerous activities related to breastfeeding.  These include technical support for the development of National Infant and Young Child Feeding Policies; Hospital Breastfeeding Policies; and National Food and Nutrition Security Policies.  Additionally, the Agency has provided technical support to the development of Child Clinic and Take-Home Records and assessed the growth and development of children in CARPHA Member States: this involved observations at Health Centres and the review of the Clinic Records.  CARPHA led training in the WHO/UNICEF 40 Hour Breastfeeding Counselling Course; and training of Health Professionals in the 20-Hour Course for BFHI implementation and certification.  The Agency is also part of the Assessment Team for Baby Friendly Status of the Region’s Hospitals.

The agency has developed interim guidelines for anyone involved in the care and management of newborns and pregnant or nursing women suspected or confirmed cases with coronavirus disease (COVID-19).  The Interim Guidance for Management of Pregnant Women and Newborns with Coronavirus Disease which is based on currently available scientific evidence and expert opinion, can be found on CARPHA’s dedicated COVID-19 website https://www.carpha.org/What-We-Do/Public-Health/Novel-Coronavirus

World Breastfeeding Week (WBW) is celebrated during the first week of August every year since 1992.  It aims to highlight the benefits of breast milk and breastfeeding to both baby and mother as well as to reinforce the importance of maternal health on infant nutrition and health and the reduction in poverty and food insecurity. WBW is a global campaign to raise awareness and stimulate action on themes related to breastfeeding.