Last week, we celebrated the annual World Breastfeeding Week, raising awareness and support for mothers to breastfeed anytime, anywhere. The promotion of early initiation of breastfeeding, exclusive breastfeeding and timely and safe complementary feeding, have been identified as essential practices to tackle the double burden of malnutrition. These are not new approaches and are key UNICEF and WHO recommendations for optimal infant nutrition. The immediate and long-term benefits of breastfeeding to the mother, child, economy and populations have been well supported by an overwhelming body of evidence.
In 2013, the Lancet series on Maternal and Child Nutrition reported that annually, 3.1 million child deaths were as a result of insufficient breastfeeding, maternal under-nutrition, stunting, wasting and deficiencies in essential nutrients. In addition to the heavy impact on child mortality, childhood stunting has also been attributed to obesity and non-communicable diseases in adulthood and is the result of maternal under-nutrition and infant under-nutrition in the first two years of life.
The global strategy addressing maternal and child malnutrition targets the first 1000 days of life (from pregnancy to two years of age) as having the greatest impact on a child’s ability to develop, grow and learn. This is termed the crucial “window of opportunity” in which an undernourished child has the capacity to get back onto their genetic growth trajectory when given essential nutritional support. Recent studies prove that universal breastfeeding alone can prevent as many as 823,000 child deaths and 20,000 maternal deaths each year.
Involving fathers in breastfeeding education is recognised as an important factor influencing the practice of exclusive breastfeeding in developed countries. Research has shown that fathers have a major impact on their partner’s decision to start and continue breastfeeding and that fathers are interested in and want to participate and support the mother.
However, gaps remain in the uptake of exclusive breastfeeding and optimal infant and young child feeding practices, especially in low-income countries. Research cites poor government policies, limited community support and aggressive formula marketing as contributing factors. The social and economic barriers to exclusive breastfeeding in low-income countries have been assessed with gender inequality, social influence and traditional practices shown to hinder feeding practices.
Involving fathers in maternal and child nutrition isn’t a new idea but requires the challenging of societal norms in order to achieve gains of stronger families and the promotion of gender equality. Growing research and paradigm shifts in restricted gender roles, sees male engagement integral for complex public health interventions traditionally targeting females-only in developing countries. Public health interventions such as those aimed at reducing gender-based violence and prevention of mother-to-child transmission of HIV with complexities of social, cultural and economic challenges, have seen success with the assessment of power and gender roles, inclusion of communities and both male and female partners.
Viewing men as “agents of positive change” rather than obstacles, along with identifying how best to target interventions and messaging for a given population, have proven successful approaches to increase exclusive breastfeeding support. Including positive images of men and women both participating in caring activities for their children helped to promote the national ‘Zero Malnutrition’ programme in Bolivia, proving that it is not necessary to create complicated or costly campaigns to elicit positive change.
Engaging fathers in a meaningful way can be a critical link in addressing the double burden of malnutrition in developing countries. With the potential for greater parental knowledge on best infant feeding practices, joint decision-making and strengthened family units, we create the opportunity for crucial support to breastfeeding mothers.
Let’s commit to protect, promote and support breastfeeding for a sustainable world.
The writer is a public health specialist