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School of Public Health
College of Health Sciences, Makerere University

HEALTH POT SHOW: Why Protect Breastfeeding?

Posted on : Wednesday, August 18, 2021


Every year the world celebrates Breastfeeding Week from August 1 to August 7 to encourage breastfeeding and improve the health of mothers and babies around the world. This year’s theme: Protect Breastfeeding: A Shared Responsibility is aligned with thematic area 2 of the WBW-SDG 2030 campaign which highlights the links between breastfeeding and survival, health and wellbeing of women, children and nations.

According to World Health Organisation, breastfeeding is one of the most effective ways to ensure child health and survival. However, nearly 2 out of 3 infants are not exclusively breastfed for the recommended 6 months—a rate that has not improved in two decades. It also says that if breastfeeding were scaled up to near universal levels, about 8,20,000 child lives would be saved every year.

Research shows that although over 90% of children in Uganda are breastfed at some point, the percentage of children exclusively breastfed decreases sharply with age from 83% in infants 0–1 month to 69% among those 2–3 months and further to 43% among infants aged 4–5 months.

Studies have also shown that several factors have been found to be associated with infant feeding practices including but not limited to income, education, wealth and employment. In fact, researchers say work has also been found to hinder Exclusive Breast Feeding as mothers stop breastfeeding soon after returning to work especially when the environment at work is not conducive for continued breastfeeding. UNICEF, a United Nations agency responsible for providing humanitarian and developmental aid to children worldwide notes that the lack of exclusive breastfeeding has in turn been associated with increasing child malnutrition.

In this episode of the Health Pot, we discuss the importance of protecting breastfeeding in our communities, workplaces and everywhere. We are pleased to host friends from the International Baby Food Action Network, IBFAN,

Host: I am Edrine Osteen Mukalazi and welcome to the show.

Guests: John Musisi and Racheal Alweny from IBFAN (International Baby Food Action Network)

John Sisiya is the Program Implementation Support at IBFAN Uganda

Recheal Alweny is the Program Officer at IBFAN Uganda


 Host:  Why is the Breast-feeding week commemorated?

John Musisi:  Breast feeding week is celebrated every First week of August. However in Uganda we extend it to cover the whole month. Ideally it’s a week where we focus our efforts as a country on protecting, promoting and supporting breast feeding at all levels and different fora. The theme of this year is A SHARED RESPONSIBILITY. We have been in challenging times with the lockdowns where services have been hindered with breakdowns in the different systems. One of the key areas is maternal and child health especially looking at the good start we want to give the children. We look at getting everyone involved in playing a role in taking part in actions to support a mother and child have a good start especially in these abnormal circumstances.

Host: Why should we protect breastfeeding?

Rachel Alweny: We protect breastfeeding because of its benefits. Breastmilk has all the nutrients that a baby would need and it’s the best start for the baby’s life. In these challenging times, people are not doing things which are right e.g., they are aggressively promoting breastmilk substitutes which derails mothers from breastfeeding. Attention has been given to COVID forgetting other health requirements like breastfeeding could become secondary because of such situation and in the end, mothers are left out without getting the knowledge they need. This is why we are here to push forward and see that we continue protecting breastfeeding by calling upon the different stakeholders.

Host: At our work places, very many mothers would wish to breast feed their babies but they also need to work because some of them are the breadwinners. Sometimes circumstances don’t permit them to do effective breastfeeding like the work environment. So, what is a breastfeeding friendly environment?

Rachel Alweny: A breastfeeding friendly environment would be an environment that protects mothers or all women from economic losses, gender discrimination, and health risks related to maternity. We follow the maternity protection convention put in place by the International Labor Organization that gives guidelines and requirement that should be followed e.g., maternity leave/ parental leave for both the father and mother of the baby. The mother is supposed to get sixty working days in Uganda. The father is supposed to get four days. We also have maternal-child health care where work places should give health insurance to their employees. We also have employment protection and non-discrimination.

Host: By saying employment protection, does that mean a mother’s job is safe?

Rachel Alweny: Yes, but also it means that even just by saying she’s pregnant she’s not terminated. Her job should be protected. There should also be breastfeeding arrangements at work. It should be okay for a mother to come to come work place and be able to breastfeed. The work place should organize for mothers a breastfeeding area where they can feed their babies or extract breastmilk and store it safely for the child. There should be health protection at work. If I come to work and I am pregnant, then the bosses should be able to protect me and the unborn child from for example chemicals for fumigation.

Host: What is the current situation in Uganda?

John Musisi: Racheal has exhaustively talked about a law in place like the employment Act where we draw from the maternity leave sixty working days. Although it’s still lower than the ILO provided.

Host: Is there any mechanism that supervises this ILO law?

John Musisi: That is where the gaps are. As of now, we don’t have any regulators and enforcers. As a country, we have not ratified the convention so it’s more or less good will and some companies are just adopting it maybe because they are international companies and they have policies that guide them. However, in Uganda as of now it’s a big challenge for mothers because the law is provided but the sector is fluid. Look at the big gap in the informal sector. People work for long hours; the environment is not conducive. The implementation in Uganda is still lacking. Few companies give fathers that leave. Actually, even men, few of them know that they are entitled to the four days of leave to support their wives once they give birth. Very few people actually are aware it exists and they don’t know that it is actually their right to support their wives during that start of a child’s life.

Host: Is there any where that someone can report if they are denied this chance and they have the job security?

John Musisi: I think it comes down to the contract and the things you negotiated for in the contract. So, if it wasn’t provided for in the contract then it’s very difficult. Many people out there are working without contracts. For instance, maids in homes don’t have contracts. Your livelihood depends on the job which doesn’t segregate mothers.

*****Commercial Break******

Host: Why should there be a need of creating a breastfeeding friendly environment?

Rachel Alweny: The benefits of breastfeeding outweigh so many challenges that we face including by the way COVID-19. Breastfeeding is the best start for the baby because it has all the nutrients. The child’s immunity is protected and they won’t be attacked easily by the infections. The mother recovers faster. The reason why some mothers die is postpartum bleeding. Therefore, when you put your child on the breast immediately after delivery it helps on contraction and stops the bleeding. Breastfeeding also creates mother-child bond as well as lowering risks of breast and ovarian cancer. At the work places, some employers are not aware of the penalty when you deny a mother maternity leave, health protection, discrimination.

John Musisi: When you look at our policies, Ministry of Health recommends exclusive breastfeeding for six months. The labor laws also provide for maternity leave. So there is still a gap and there is a need for continuity that is required and it is very important because breastmilk plays a very important role in that child's life at that time.

Host: How can employers support breastfeeding at work places?

John Musisi: Support by allowing the mother come to work a little late to allow her time tend to the child more and also allowing her leave work early to meet her child. And remember if you allow her that time it will promote a give and take relationship where she will give in her entire input. You can also give her an opportunity to work remotely. Setting a lactation area at work to allow mothers freely come to work with their child so that she works freely and happily. Also provide a secure and safe environment for the mother to express her milk to her baby. Employers also shouldn’t fear to employ female staff due to that whole process of child birth. For corporate social responsibility purposes, it gives the organization a good image.

Host: What is it that an employer is supposed to do in order to create this breastfeeding environment a convenient environment?

Rachel Alweny: The employer should make sure that the employees get parental leave. It’s important to note that Ministry of Gender is working to see that there is a regulation that caters for breast feeding arrangement. We also look at Maternal and healthcare; the employer should invest in Health insurance of their staff. Employment protection where the pregnant woman and the mother is assured of her job and her salary. A nondiscrimination policy. Health protection where the employee is not put at risk. Arranging breast feeding breaks, allow flexibility of workers.

Host: What should trade unions do in endeavor?

John Musisi: These are usually the linkage between the employer and employees. Trade Unions have a big role to play in terms of advocacy and lobbying when it comes to government policies. That is where they come in strong because they are able to influence legislators, they try to ensure that workplaces have environments that are good and are safe for a mother. They should ensure that they advocate for government to invest in these ventures. Insurance policies at work places. They should also follow-up to see enforcement of some of these laws to protect these mothers and the babies.

Host: What should our viewers expect from the Government?

They need to be aware of their rights like we discussed above at work places to be able to freely breastfeed their babies to grow into healthy babies.       

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