Exclusive Breastfeeding for a Healthy Start in Life
“Breastfeeding provides an excellent start of life for newborn babies,” says Lena Davidsson, an expert in nutrition from the IAEA’s Department of Nuclear Sciences and Applications, “and with exclusive breastfeeding during the first 6 months of life, infants are given the best opportunity to grow and develop normally, regardless of where they live.” The WHO and UNICEF have recommended that women practice exclusive breastfeeding—which means that women feed their children only human milk—from birth up to six months of age. Much of the IAEA’s work in nutrition involves feeding infants and young children. In many countries, these projects focus on breastfeeding by HIV infected mothers and therefore deal with the complex issues related to transmission of the HIV virus via human milk.
During the last few years much effort has been made globally to find ways to minimize the risk of HIV transmission during pregnancy and breastfeeding, and the World Health Organization provides updated recommendations and guidance on these issues. For example, in settings where safe replacement feeding is available, HIV positive mothers are counselled not to breastfeed. However, for many women in low and middle income countries the reality is that there is very little choice because safe replacement feeding (based on access to clean water, good quality infant formula, the possibility to sterilize utensils, etc.) is not available. Therefore, with breastfeeding the important issue is to reduce transmission as much as possible.
Based on work conducted a few years ago in South Africa, it was demonstrated that infants who were exclusively breastfed –had a lower risk of becoming infected with the HIV virus as compared to babies who received mixed feeding, in which additional foods or liquids are also given to the infant. More recently, the results from a large study in sub-Saharan Africa, called the Kesho Bora study (‘a better future’ in Swahili), gave cause for more hope. The Kesho Bora study found that the risk of HIV infection in breastfed infants is cut by almost half when mothers are given an extended treatment of anti-HIV drugs—during both pregnancy and lactation—as compared to standard treatment. These new guidelines allowed national health authorities to make a better decision as to which strategy is most suitable for their local situation;: breastfeeding with an antiretroviral intervention to reduce transmission or avoidance of all breastfeeding.
The IAEA works closely with the WHO and Member States to address infant nutrition by contributing technical expertise in the use of stable isotope techniques in order to gather information on the breastfeeding practices of mothers, and the volume of human milk consumed by infants. As opposed to interview based surveys, projects using stable isotope techniques can provide important, new information to better inform health authorities in Member States. The IAEA promotes the use of this methodology as a tool for Member States to monitor and evaluate interventions and improve the nutrition of infants and young children, thus contributing to the achievement of the Millennium Development Goals. Now, for the first time ever, this methodology is being used in fifteen African countries to collect a large data set on human milk intake and the prevalence of exclusive breastfeeding. The study is supported by the IAEA’s technical cooperation programme, which also helps Member States to set up laboratories and train local scientists on how to use stable isotopic techniques in nutrition.
“The importance of breastfeeding for a healthy start in life cannot be underestimated”, says Ms Davidsson. “In fact, all babies have a right to be fed and cared for so that they can grow and develop to their full potential. The renewed emphasis on good nutrition during pregnancy and the first 2 years of life is adding momentum to the fight against child undernutrition.” The IAEA’s support to Member States in the use of stable isotope techniques for nutrition is an important part of these global efforts.