Denise Iraguha, a mini-supermarket owner in Gikondo, a Kigali city suburb, and a mother of four, says exclusive breast feeding for 6 months is a tall order especially for a busy person like her.

None of her children enjoyed the medically recommended exclusive breast feeding for the first six months of a new born.

"I breastfed all my children for three months before introducing them to the bottle,” Iraguha says.

Like Iraguha, many working mothers say they are given a short maternity leave, making exclusive breastfeeding hard.

Annette Uwimana, a 30-year-old mother and resident of Kanombe, works as a receptionist for a clearing and forwarding firm. She says the time which was allocated for maternity leave by her employer was too short for her to manage exclusive breast feeding.

"I was given only seven weeks of maternity leave, making it hard to breast feed exclusively for the first six months. Because of the tight work schedule, I was left with no choice but to feed the baby on supplements like cow milk,” Uwimana says.

Benefits of breastfeeding

However, health experts warn that mothers who don’t breast feed expose their children to so many dangers some of which have lifelong effects. And now, new research has also pointed to a link between breast feeding and intelligence.

The research published in Lancet last week found those who had breastfed for longer went on to score higher on IQ tests as adults.

Health experts argue that breast milk is a super food that a new born requires in plenty at least for the first six months. Breast milk contains a substance called colostrum, the most potent natural immune system booster known to science.

Babies are supposed to breastfeed after every two to three hours daily in order to keep healthy and get all the required nutrients — newborns should not go for more than 4 hours without feeding.

According to Audrey Mutabazi, the director of Gasp, a food science consultancy firm based in Gikondo, during breastfeeding, a mother passes antibodies to the child hence strengthening the immune system. He adds that children who were breast-fed are significantly less likely to become obese later in life.

"Diarrhea is three to four times more likely to occur in infants fed on supplement foods than those fed on breast milk,” Mutabazi reveals.

He observes that significant evidence suggests that breast-fed children develop fewer psychological, behavioural and learning problems as they grow older. Cognitive development is increased among children whose mothers choose to breastfeed.

The United Nations Children’s Fund (UNICEF) recommends initiation of breastfeeding within the first hour of birth, exclusive breastfeeding for the first six months and continued breastfeeding for two years or more

Breast feeding linked to high IQ

Now new research has pointed to a link between breastfeeding and intelligence.

The research done in Brazil traced nearly 3,500 babies, from all walks of life, and found those who had breastfed for longer went on to score higher on IQ tests as adults.

Experts say the results, while not conclusive, appear to back current advice that babies should be exclusively breastfed for six months.

Regarding the findings – published in The Lancet Global Health — they stress there are many different factors other than breastfeeding that could have an impact on intelligence, although the researchers did try to rule out the main confounders, such as mother’s education, family income and birth weight.

Dr Bernardo Lessa Horta, from the Federal University of Pelotas in Brazil, said his study offers a unique insight because in the population he studied, breastfeeding was evenly distributed across social class — not something just practiced by the rich and educated.

Most of the babies, irrespective of social class, were breastfed — some for less than a month and others for more than a year.

Those who were breastfed for longer scored higher on measures of intelligence as adults.

They were also more likely to earn a higher wage and to have completed more schooling.

Dr Horta believes breast milk may offer an advantage because it is a good source of long-chain saturated fatty acids which are essential for brain development.

Growth and development

Away from that, the American Academy of Pediatrics (AAP) observes that breast milk without supplements during the first six months reduces the possibility of food contamination due to tainted water or malnutrition as a result of over-diluted formula. Therefore, the child should be nursed without the interference of water, sugar, water, juices, or formulas, unless a specific medical condition indicates otherwise. The AAP asserts that breast milk has the perfect balance of nutrients for the infant.

UNICEF and the World Health Organisation (WHO) discourage giving early supplements such as powdered milk or semi-solid complementary food because it exposes infants to bacteria or viruses that are capable of causing disease.

The health body further points out that malnutrition in the first 1,000 days can cause irreversible damage to the growth and development of the child while a baby who is not breastfed is 15 times more susceptible to death from pneumonia and 11 times more likely to die from diarrhea.

Benefits of breast feeding to mothers

Annabel Akimana, a public health specialist working with Dama Clinic in Remera, says breastfeeding is good for a mother’s health as it helps them lose weight after birth. She points out that a lot of calories are burned during lactation, as their bodies produce milk.

"The emotional health of the mother may be enhanced by the relationship she develops with her infant during breastfeeding, resulting in fewer feelings of anxiety and a stronger sense of connection with her baby,” she notes.

Umubyeyi adds that studies indicate that women who lactate for a total of two or more years reduce their chances of developing breast cancer by 24 percent.

She encourages nursing mothers to drink plenty of fluids to replace the fluids lost through breast-feeding. And these include water, juice, milk or soup. She also recommends taking in foods high in vitamin A, iron, vitamin E and potassium, to boost nutrient content in the body, and these may include carrots, meat, legumes, oranges, tomatoes and milk.

According to UNICEF Rwanda, marked reductions in child under nutrition can be achieved through improvements in women’s nutrition before and during pregnancy, early and exclusive breastfeeding.

According to the Save the Children’s (an NGO that promotes children’s rights) February 2013 report, 85 percent of mothers in Rwanda breast feed their new born babies exclusively in the first six months, ranking among the highest globally.

Global magnitude of the problem

According to the Lancet, suboptimum breastfeeding results in more than 800,000 child deaths every year, globally.

It is estimated that 3.1 million children die from malnutrition each year. Despite significant progress in reducing child mortality, 1 in 9 children in Africa still do not live to see their fifth birthday, according to the same journal.

According to the Lancet, Rwanda has the highest rate of children breast fed exclusively for the first 6 months in the region with 85%, followed by Burundi at 69%, Uganda 62%, Tanzania with 50%, and then Kenya at 32%.

Government efforts to promote breast feeding

Alexis Mucumbitsi, who works with the Nutrition Desk at the Health Ministry, says a sensitisation campaign of employers countrywide is on going to help them understand the importance of introducing a breast feeding room at every work place.

He remarked that about 25,000 community-based health workers countrywide were trained as regards the importance of breastfeeding, information they later shared with people at grass roots level in 2013.

In line with improving child nutrition, organisation’s like UNICEF also assist government in aspects like policy development, planning, legislation and building capacity of health workers.