Janet Umutoni, a mother of a 2-year-old baby has made endless trips to hospital. Her child is always falling sick despite the several trips. She only discovered recently the root cause of her child’s frequent poor health. She didn’t exclusively breast feed her baby for the first six months after birth. 

Like Umutoni, many women are finding it hard to exclusively breast feed because of the rigorous daily schedules like work and other challenges. But Health experts warn that ignoring breast feeding is a time bomb.

As part of the International Week of Breastfeeding, Rwanda has dedicated this year’s week to breastfeeding awareness, a campaign that was launched last year.

The Ministry of Health, with its various development partners, are set to sensitise the population on the importance of exclusively breastfeeding babies for the first six months.

Last year, the Ministry of Health put in place advocates for breastfeeding (women employed in both private and public sectors) to modify the law in favour of breastfeeding. 

Women in Rwanda are entitled to a paid maternity leave and are also given an hour (when they report back to work) to go and breastfeed. 

In an interview with Women Today, Jeanne D’Arc Nyirajyambere, Nutrition Advisor at Ejo Heza Programme, highlights what women can do to follow a baby’s feeding pattern. 

"In the breastfeeding campaign, we sensitise mothers on the importance of breastfeeding despite their busy schedule. When doing house chores, there are positions that they can use to breastfeed while doing a specific house chore like cooking or peeling,” Nyirajyambere explains. 

Ejo Heza, literally translated as Bright Future, is a five-year-project funded by USAID in eight districts. It handles several campaigns, breastfeeding being one of them.  

"In Rwandan culture, women don’t like undressing in public to breastfeed.  But a baby is supposed to breastfeed anytime so we advise mothers to feed their babies whenever there is need to. We also teach working mothers the ways they can provide breast milk for the baby instead of providing them with alternative foods when they are away,” says Nyirajyambere.

The 45-year-old Nyirajyambere also says that mothers opt for alternatives like baby formula for various reasons. 

"Most working mothers say it’s not easy for them to leave pumped breast milk because they don’t fully trust the caretakers. So they resort to baby formula and breastfeed the baby when they go back home. However this kind of strategy affects a baby’s feeding pattern,” she reveals. 

The 2010 Demographic Health Survey showed that about one in ten Rwandan children were underweight, and about 40% of children under five were shorter than expected of their age. Both indicators are taken as signs of malnutrition that can be attributed to lack of breastfeeding.

The exclusive breastfeeding percentage of children under six months in Rwanda was last reported at 84.90 in 2010, according to a World Bank report published in 2012.

Some women have opted for baby formula because of their lifestyle. They also claim that if they breast feed, their breasts will sag. 

Breastfeeding is a basic child right.  Experts have shown that if a child is not breastfed exclusively for at least the first six months, they are likely to be vulnerable to various chronic diseases and there is a possibility of being overweight, slow in school, and socially retarded while growing up. 

Dr. Joseph Nkurunziza, a general physician at Rwanda Military Hospital, Kanombe, says that there is no reason for a mother not to breastfeed. 

"Unless if the woman does not have breast milk.  In the past, women who were HIV positive were recommended not to breastfeed so as not to risk transmitting the virus to the baby. But with the available medication now, HIV positive mothers can breastfeed for 18 months,” Dr Nkuruziza explains. 

He adds that breast milk provides high immunity for a baby than alternative foods. 

"Breast milk is very nutritious compared to alternative foods. Some mothers provide children with these alternatives because they are probably working and they don’t have enough time to fully breastfeed the baby,” Dr Nkuruziza says. 

Dr. Stephenson Musiime, a paediatrician at King Faisal Hospital says that mothers on certain medication should not breastfeed. 

"Certain medication that is secreted in breast milk like anti thyroid drugs, some anti cancer, HIV drugs and Hepatitis B infections  are not strong contrasts to breast milk if the baby and mother take appropriate medication,” Dr. Musiime discloses. 

He also says that breast milk is free and in addition to the strong bond between mother and baby, it enhances brain development. 

"The alternatives to breast milk don’t have useful bacteria which protect the body, are easy to digest and protect the baby from some allergies related to formula. Formula may cause diseases of the intestines and necrotising enterocolitis in babies who are born prematurely,” Dr. Musiime warns. 

He adds, "The benefits of breast feeding are quite many because babies who are not breastfed are prone to infections, lack the mother-baby bonding and the baby is likely to suffer malnutrition, overweight or underweight.” 

According to UNICEF 2011-2012 Communication for Development in Infant and Young Child Feeding Programme, breastfeeding has profound benefits for infants that extend beyond childhood, numerous benefits for mothers and benefits for the family. Beyond these well documented positive aspects for long term health and well being, breastfeeding has a beneficial impact on the workplace, the health care system and the larger society.

The programme showed that the initiation of breastfeeding immediately after delivery helps to contract the uterus, expel the placenta and reduce bleeding. Breastfeeding may lead to a more rapid return to pre-pregnancy weight.

Exclusive breastfeeding in the first six months may delay the return of fertility, thus reducing exposure to the maternal health risks associated with short birth intervals. In the longer term, mothers who breastfeed tend to be at a lower risk of premenopausal breast cancer and ovarian cancer.

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Quotes from prominent people about breastfeeding 

James P. Grant, former UNICEF Executive Director was quoted, "Breastfeeding is a natural safety net against the worst effects of poverty. If a child survives the first months of life, exclusive breastfeeding goes a long way towards cancelling out the health difference between being born into poverty or being born into affluence.”

Michael C. Latham, Cornell University Program of International Nutrition, said, "We should not be lauding the advantage of breastfeeding any more than we praise the practice of breathing air. Rather we should be articulating clearly the harm and disadvantages of any alternative.”