Every year I choose a university student to accompany me on my win-a-trip journey, which is meant to highlight issues that deserve more attention. My latest winner was Trisha Mukherjee, a recent Columbia graduate and a budding journalist — and with that, I’m handing the rest of the column to her.
By Trisha Mukherjee, reporting from Nairobi, Kenya
Here’s a riddle: What is available worldwide, requires no new technology, costs no money and could save more than 800,000 children’s lives a year?
If you answered “breastfeeding,” you’d be correct. Optimal breastfeeding around the world could reduce child mortality by at least 10 percent for infants and young children. The instructions are simple: Breastfeed within an hour after birth, exclusively breastfeed for six months, then introduce solid foods while continuing to breastfeed until 2 years of age.
As Nick and I traveled through Kenya and Madagascar, many women told us they gave their babies water during the first six months. This water can be contaminated with pathogens that babies’ developing immune systems can’t fight off. And because babies have tiny stomachs, anything other than breast milk effectively replaces it, depriving the baby of its essential nutrients. The women we interviewed thought they were helping their babies cool off during hot days, but unknowingly, they were hurting them.
Research shows that breastfed babies are at a lower risk of illness, infectious disease, diabetes, asthma, obesity and sudden infant death syndrome. They also appear to have fewer behavioral problems and higher I.Q.s. Modeling suggests that a lack of optimal breastfeeding costs the global economy an estimated $341 billion per year.
The benefits of optimal breastfeeding multiply in developing countries, especially in contexts where families don’t have access to sterilized bottles, adequate formula and clean water. And when medical care is practically nonexistent (some clinics have no medicine but pain relievers), every bit of additional nutrition and immunity matters. Given the often deadly risk of water-based pathogens and the lack of nutritious alternatives, breast milk is the ideal diet for babies — safe and supercharged with essential nutrients.
“It’s one of the most cost-effective things in all of global development,” said Shawn Baker, the chief program officer at the nonprofit Helen Keller Intl, which supports several health centers in Kenya and promotes breastfeeding as part of its efforts to improve nutrition.
Yet fewer than half of babies worldwide are optimally breastfed.
The point is never to shame moms; breastfeeding can be painful, exhausting, difficult or, in a small percentage of cases, physically impossible. Especially when employers refuse to allow pumping or feeding, breastfeeding can be an arduous juggling act for working mothers.
The lesson, I think, is for the rest of us to support mothers to make it easier to breastfeed their babies. As a Lancet study on breastfeeding put it, “Success in breastfeeding is not the sole responsibility of a woman — the promotion of breastfeeding is a collective societal responsibility.”
But in many cases, moms aren’t aware of the benefits.
When she had her first baby, Faith Syokau Mbovu, a resident of one of Nairobi’s poorest neighborhoods, started feeding her baby store-bought milk and porridge at 4 months old to help him grow stronger. “I didn’t have the knowledge,” she said.
Ms. Mbovu is now a community health promoter in her Nairobi neighborhood, and her gentle presence shines as she visits families to provide basic health assessments, preventive care and education. As part of her work, she teaches pregnant women how to breastfeed. “We walk with them throughout the journey,” she said, adding that community health promoters provide guidance from pregnancy until the child turns 5.
In a maternity ward in Ms. Mbovu’s neighborhood clinic, Ruth Chepleting, 27, gazed down at her day-old daughter’s tiny nose and lips in awe. Her mother, a nurse, advised her on optimal breastfeeding. Otherwise, she said, she wouldn’t have known.
Each new mother I interviewed in the clinic planned to exclusively breastfeed her baby for six months, then supplement with solid foods until at least 2 years of age. Amid the gurgles of the swaddled newborns, the women in the ward told me how much community health workers’ breastfeeding support meant to them.
Empowering women with information about optimal breastfeeding and employing community health workers to promote the practice have significantly lifted rates of breastfeeding in countries such as Vietnam and Burkina Faso.
In the United States, moms still face many struggles, not least because most states don’t guarantee paid parental leave.
My mom had to commute four hours a day to a full-time job in the pharmaceutical industry when I was born. In the late 1990s breast pumps — much lower quality than modern iterations — were just being introduced for use outside hospitals. She recalled preparing bottles of formula for me and my younger brother before she left at dawn. “I really wanted to breastfeed, and I feel like I deprived my children,” she told me. “I feel so much regret.”
The good news is that there are so many ways we can support breastfeeding. We can employ community health promoters like Ms. Mbovu to educate women in their communities with empathy and understanding. We can desexualize and normalize public breastfeeding so mothers can nourish their babies without stigma. Spouses or family members of breastfeeding women can take on additional household and child-rearing responsibilities. We can formalize paid parental leave and lactation policies in workplaces so mothers can focus on caring for their babies rather than stress about finances or getting fired.
We can also consider creative ways to educate families about breastfeeding. In Tajikistan, for example, USAID partnered with imams to teach men before or after Friday prayers about the importance of breastfeeding. A global review of studies suggests educating grandmothers allows them to pass on accurate information to younger women who go to them for advice. And studies suggest that breastfeeding support programs can be scaled up quickly and successfully.
In many ways, breast milk is miraculous. It’s been custom designed for babies’ health over thousands of years. Given that it can also save more lives than many of the other interventions we have poured billions of dollars into, we have an imperative to make optimal breastfeeding easy for mothers — and let them take it from there.
From Nicholas Kristof: Applications are now open for my 2025 win-a-trip contest. Students at any American university are eligible. The winner may, like Ms. Mukherjee, have the chance to write for The New York Times. To apply, visit nytimes.com/winatrip.
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