In celebration of International Breast Feeding Week- let's take a look at the strides made in Sierra Leone to increase breast feeding and maternal and infant health. In recent years, Sierra Leone has made significant progress in breastfeeding rates, exceeding the World Health Organization's (WHO) target of 50% exclusive breastfeeding by 2025 by achieving a rate of 52.7% in 2021, according to the 2021 Sierra Leone National Nutrition Survey. The country has also witnessed a rise in the prompt initiation of breastfeeding, with 89% of infants commencing breastfeeding within the first hour of birth in 2021, a notable increase from 57% in 2017. Sierra Leone aims to raise the rate of exclusive breastfeeding to a minimum of 70% by 2030.
Breast milk provides the optimal nutrition for babies, and breastfeeding is a highly effective method to promote a child's well-being and survival. Breast milk is safe, always served at the right temperature, readily available, even in unsanitary conditions with unsafe water supplies, and it includes antibodies that guard against numerous common childhood illnesses. Based on this, the World Health Organization (WHO) and the United Nations Children’s Fund advocate for exclusively breastfeeding all infants for the first six months of life, even in cases of maternal HIV infections treated with antiretroviral therapy. Besides the advantages for the child, breastfeeding also benefits the mother by reducing the risk of postpartum hemorrhage, potentially improving birth spacing, and lowering the chances of breast and ovarian cancers.
Breastfeeding is essential in Sierra Leone, as well as in other places, for preventing child malnutrition. Presently, in Sierra Leone, close to half a million children under the age of five are stunted, and 30,000 are malnourished and face immediate risk of death due to insufficient nutrition and high disease rates among young children. Stunting is a consequence of chronic malnutrition that is mostly irreversible. The situation couldn't be more critical, and the solution more straightforward. However, the rates of exclusive breastfeeding for six months are just above fifty percent, and only 30% of children are breastfed until they reach two years of age.
In order to improve the EBF rates, the government made two important changes. First, it enacted a strong response to the aggressive marketing of infant formula. In 2021, Sierra Leone passed the Breastmilk Substitutes Act to protect breastfeeding, limit the type of advertising messaging around breast feeding and support these gains. The act aims to improve the nutrition of infants and young children, and could potentially save around 820,000 child lives each year.
Next, the Ministry of Health workded closely with the WHO to establish and implement the Baby Friendly hospital initiative (BFHI) in regional maternity and referral hospitals to promote, protect and support breastfeeding with the WHO BFHI competency-based verification tool kit introduced to monitor progress. Components of the campaign included:
collaboration with Directorate of Food and Nutrition, UNICEF, Focus 1000 (CSO platform) and hospital partners:
on the “no water, stronger with breastmilk only“ campaign to promote breastfeeding.
WHO training of nursing staff and management on the elements of the BFHI approach
Sierra Leone has made great progress in the arena of breast feeding yet infant malnutrition continues at alarming rates- especially in rural settings. The current goal of increasing EBF to 70% by 2030 is achievable with increased work place and public spaces accomodation and family leave legislation.
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