I'm no mail at the moment, so please forgive me if this has already
been posted.
from the NY Times.
Naomi
http://www.nytimes.com/2011/06/23/opinion/23kristof.html?_r=1&emc=eta1
The Breast Milk Cure
By NICHOLAS D. KRISTOF
DOGON DOUTCHI, Niger
What if nutritionists came up with a miracle cure for childhood
malnutrition? A protein-rich substance that doesn’t require
refrigeration? One that is free and is available even in remote towns
like this one in Niger where babies routinely die of hunger-related
causes?
Impossible, you say? Actually, this miracle cure already exists. It’s
breast milk.
When we think of global poverty, we sometimes assume that the
challenges are so vast that any solutions must be extraordinarily
complex and expensive. Well, some are. But almost nothing would do as
much to fight starvation around the world as the ultimate low-tech
solution: exclusive breast-feeding for the first six months of life.
That’s the strong recommendation of the World Health Organization.
The paradox is that while this seems so cheap and obvious — virtually
instinctive — it’s also rare. Here in Niger, only 9 percent of babies
get nothing but breast milk for the first six months of life,
according to a 2007 national nutrition survey. At least that’s up from
just 1 percent in 1998.
(In the United States, about 13 percent of babies are exclusively
breast-fed for six months, according to the federal Centers for
Disease Control and Prevention. Then again, most of the rest get
formula, which is pretty safe in America.)
Next door to Niger in Burkina Faso, fewer than 7 percent of children
get breast milk exclusively for six months. In Senegal it’s 14
percent; in Mauritania, 3 percent.
These are some of the countries we’re passing through on my annual win-
a-trip journey, this year with a medical student from Atlanta, Saumya
Dave, and a teacher from Newark, Noreen Connolly. It’s heartbreaking
to see severely malnourished children and to meet mother after mother
who has buried children when such a simple life-saving solution is not
applied.
The biggest problem is that many mothers believe that breast milk
isn’t enough, and that, on a hot day, a child needs water as well.
On a rural road near the remote town of Dogon Doutchi, in southern
Niger, we ran into a family of Tuareg nomads traveling north.
“On a hot day, babies need water,” Gayshita Abdullah, the mother, told
me. She said she tries to get water from a well, but if there is no
well nearby she gets it from a mud puddle.
In fact, most nutritionists are adamant that babies are best off with
nothing but breast milk for the first six months of life (they used to
recommend four months, but now say six months). And water in poor
countries is often contaminated and dangerous for a baby.
Even when the mother is herself malnourished, her body will normally
provide enough milk for a baby, nutritionists say.
A 2008 report in The Lancet, the British medical journal, found that a
baby that is partially breast-fed is 2.8 times as likely to die as a
baby that is exclusively breast-fed for at least five months. A child
that is not breast-fed at all is 14.4 times as likely to die.
Over all, The Lancet said, 1.4 million child deaths could be averted
each year if babies were breast-fed properly. That’s one child dying
unnecessarily every 22 seconds.
“As far as nutritional interventions that have been studied, we have
crushing evidence of breast-feeding’s efficacy in reducing child
mortality,” said Shawn Baker, a nutrition specialist with Helen Keller
International, an aid organization that works on these issues.
“It’s the oldest nutritional intervention known to our species, and
it’s available to everybody,” Baker added. “But for a development
community too focused on technological fixes, it hasn’t gained the
traction it should.”
The challenges with breast-feeding in poor countries are not the kinds
that Western women face, and many women in the developing world
continue nursing their babies for two years. The biggest problem is
giving water or animal milk to babies, especially on hot days. Another
is that mothers often doubt the value of colostrum, the first milk
after childbirth (which is thick and yellowish and doesn’t look much
like milk), and delay nursing for a day or two.
One mother near the town of Dosso, Fati Halidou, who has lost four of
her seven children, told me that after childbirth, it is best to give
a baby sugar water or Koranic water. This is water made by writing a
verse of the Koran on a board and then washing it off; the inky water
is thought to protect the child.
It’s not clear why a human instinct to nurse went awry. Does it have
something to do with the sexualization of breasts? Or with infant
formula manufacturers, who irresponsibly peddled their products in the
past but are more restrained now? Or is it just that moms worry that
their babies need water on hot days? Nobody really knows.
But what is clear is that there’s a marvelous low-tech solution to
infant malnutrition all around us.
•
I invite you to visit my blog, On the Ground. Please also join me on
Facebook, watch my YouTube videos and follow me on Twitter.
------------------------------------------
Naomi Bar-Yam Ph.D.
Executive Director
Mothers' Milk Bank of New England
[log in to unmask]
617-527-6263
www.milkbankne.org
------------------------------------------
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