Infant Feeding Practices in Africa

Infant Feeding Practices in Africa

Africa is considered to be one of the least developed areas in the world at the moment. Despite the fact that is represents one of the richest parts of the globe, it suffers from great shortage of food, water, and minimum decent life conditions. Nonetheless, the international community is either powerless, or unwilling to properly and successfully intervene in this continuous crisis. Although most of the population suffers from the lack of adequate resources for a decent life, these shortcomings are most visible at the young population especially infants.

The paper will present the feeding practices in Africa, with a focus on infants who suffer the most. It will underline the conditions and the specific elements which unfortunately characterize the African environment.

The situation with children on the African continent is considered to be one of the most worrisome issues entangling the international aid agencies because the amount of pressure surrounding the issue, as well as the problems caused by economic distress and scarcity of natural resources such as water makes the efforts of the international organizations to have a limited effect. In this sense, the statistics are indeed relevant. Thus, "aid agencies estimate that tens of thousands of children are in the advanced stages of starvation. Children are dying daily in the few feeding centers there are, where their place in the queue could make the difference between life and death" (Andersson, 2005). Although these estimates are not the latest, the situation in the field is more or less the same as years ago. This is largely due to the fact that the starvation problem as well as the lack of food and supply occurs in states which do not benefit from a strong political system. In this sense, examples such as Sudan's region of Darfur or Nigeria are relevant (Andersson, 2005).

In order to have a better view of the situation with children in Africa, it is important to consider the 2005 drought in Niger and to analyze it had on the children of the country. Indeed, the 2005 experience was related to a situation that was somewhat out of the state control; however, the events which followed the drought pointed out the limited possibility of failed states to protect its citizens. In this sense, "Massive amounts of foreign aid have flowed into Niger since the world woke up to the crisis, but the food has not yet reached around a million people. It arrived too late and is still being distributed" (Andersson, 2005). Therefore, it must be pointed out from the beginning that any lack of possibility to assist those in danger of starvation is limited by the impossibility of the state to insure proper resources and a proper environment for their distribution. Even more, the state itself does not encourage a healthy development of children as it promotes a series of actions which cannot be adapted to the poor environment of most of the countries in Africa. In this sense, for instance, in Niger, "a policy, encouraged by the Western world, of privatized health care so that it costs $14 (£8) for a mother to get a baby a medical consultation. That means almost no-one in the country can afford to see a nurse or a doctor" (Andersson, 2005). In any situation, the main responsible when discussing either the feeding practices of children or the supply of resources is the state itself. And in the conditions in which the state does not have the power and the means to create a viable system, the results are minimal to say the least.

The first source of food for new born children in Africa represents the family environment. In this sense, breast feeding, as in any general situation, is the primary source of food. Studies have been made related to the importance of breast feeding. In this sense, "The World Health Organization and United Nations Children's Fund say breast-feeding babies immediately after birth can prevent many neonatal deaths in developing countries" (Schlein, 2007). This idea is relevant first and foremost for countries in Africa because statistics have pointed out that the top ten countries with the highest mortality rate is clearly and without doubt dominated by African countries. Thus, among the countries with the highest infant mortality rate is Angola, Sierra Leone, Mozambique, Niger, Somalia, and Guinea Bissau (Aneki, 2008). Therefore, from the perspectives of this first statistics it must be pointed out that there is a great need for countries such as those to consider a viable system of infant feeding that would reduce the number of deaths. At the same time, it hints to the importance of care and breast feeding has for new born children especially in underdeveloped countries such as those in Africa.

The efficiency of breast feeding has been proven by scientists who point out the fact that the enzymes and the elements contained in the milk of the mother are essential for the early days, weeks, and months in the life of a child. More precisely, experts cited by Schlein argued that "mother's milk confers natural immunities to the baby. This is all that the child needs. It is like the first immunization. The first shot you give the baby. It has all the immunological factors that could save and protect the neonatal, the newborn from infectious disease - mainly diarrheal disease and acute respiratory infections" (2007). In the conditions present in Africa and the precarious means of hygiene, such diseases are quite common. One of the most discussed about issue concerning the health of infants in Africa is malaria, which in the western world has long been eliminated from the society. Nonetheless, due the precarious means of existence, in Nigeria for instance, malaria affects anemic children from early ages, a situation which draws an alarm signal as to whether the children the current health condition of the children is adequate for their own physical requirements (Afolabi, 2001). Therefore, it is important to consider the risks such children are faced with in the conditions in which a proper alimentation is not provided.

This perspective offers a negative image over the situation of children in Africa. From this point-of-view, breast feeding represents, according to specialists, a good means to improve their conditions. More precisely, "The World Health Organization estimates the lives of 1.3 million children under the age of five could be saved each year by exclusively breast-feeding babies for the first six months. (...) the issue is particularly relevant in Sub-Saharan Africa, which has the highest infant mortality rate in the world. It says about 10% of all babies die before the ages of one and most neonatal deaths occur at home" (Schlein, 2007).

The difference breast feeding makes in the first days of the infant are defining for the possibility of children to live or to day. Although it may see rather hard to consider this situation, the first hours in the life of an infant are crucial. In this sense, it has been concluded that there are different results in the evolution of a child depending on the feeding process. More precisely, "the longer the delay between birth and the start of breast feeding, the greater the likelihood that infants will die before they are four weeks old (...) the odds of neonatal death for infants who began late remained elevated" (Digest, 2006). Therefore, infants who are breast fed from the beginning of their lives, meaning the immediate hours after their birth, stand better changes of survival than those who are breast fed at a later stage. The explanation stands in the vitamins the infant receives in the early hours of his life which are essential for establishing a healthy contact with the outside world.

Although breast feeding is essential for the development of children there is also the eventuality in which children cannot receive breast milk due to the various conditions of their mothers. In this sense, these are related primarily to the poor condition of their health or the diseases they might have. There are certain cases which may prevent mothers from breast feeding or, more likely, some that would determine them to limit the amount of time they choose to breast feed. Therefore, it can be argued that breast feeding is not necessarily a matter of will, but rather a matter of possibility.

On the one hand, there are the cases which prevent mother infected with HIV. Africa is one of the worst regions in the world affected by this virus, especially taking into account the fact that the region is poor and there are limited resources for trying to improve this situation. Therefore, the issue of breast feeding under these circumstances is rather sensitive. More precisely, breast feeding "creates a dilemma for HIV-positive mothers who have limited access to clean water and sanitation (...) new mothers have to weigh the risk of passing on the infection to their infant against the risk of denying them breast milk. Exclusive breast feeding by the HIV-infected woman for the first six months of life is safer than mixed feeding" (Schlein, 2007).

There have been numerous debates over the right choice between breast feeding and other substitutes in the conditions of mothers infected with HIV. Due to the possibility of infecting the infant with the virus, many women prefer bottled milk or other substitutes. However, unlike western countries where the issue of hygiene is no longer a problem, not even in the remotest corners of the countries, the situation is Africa is greatly related to the idea of a clean environment for women and their newborns. In this sense, the lack of financial possibilities determines the state and the population to be unable to provide a proper environment and to be unable to afford one respectively. Thus, the milk other than the maternal one is subjected to all sorts of bacteria, viruses, and even diseases. Therefore, on the one hand, there is the risk of the child to become infected with HIV; on the other hand, there is the great possibility of infants to get sick from alternative milk. These conclusions are the results of different tests which argue that "children exclusively breastfed to at least 3 months were less likely to be infected than those receiving mixed feeding before 3 months" (Coutsoudis, 2000)

On the other hand, in order to improve the supply of milk, breast milk is most of the times combined with animal milk and formula mils. This is largely the result of a precarious feeding system of the mature population, especially of pregnant women who do not benefit from any additional food supplies in order to insure that they are strong enough to produce natural milk. Therefore, they are often forced to dilute the quantity of breast milk with other types of milk. Specialists argue in this sense that "the worst thing the mother can do is mixed feeding, which means a bit of breast feeding, a bit formula feeding, because this is the worst condition we can have. (...) during the first two months of life, a bottle-fed baby is nearly six times more likely to die from diarrhea and a host of other infections than a breast-fed child. (...) contaminated water often is used in mixing the formula. (...) poor mothers often will dilute the infant formula with a lot of water to make it last longer. She says this provides the baby with fewer nutrients, leading to malnutrition" (Schlein, 2007).

The issue of malnutrition is a common topic for discussion in Africa at the moment because of the large numbers of children and adults faced with this situation. This is why most sources related to the issue of infant feeding take into consideration the situation in which children are underfed or suffer from malnutrition. However, it is a generally acknowledged fact the idea that breast feeding reduces the eventuality in which children may suffer from malnutrition, breast milk being the only resource available of vitamins for infants. However, the decisions which must be made by the mothers are rather limited and are done without knowing the full range of the consequences. Therefore, in order to reduce the risks of infants being infected with HIV through breast feeding, nut at the same time, to increase their chances of living in an infectious environment, action must be taken to educate the female population on the one hand, and to reduce the danger of infection on the other hand. More precisely, "When children born to HIV-infected women can be assured of uninterrupted access to nutritionally adequate breast milk substitutes that are safely prepared and fed to them, they are at less risk of illness and death if they are not breastfed. However, when these conditions cannot be met (...) artificial feeding substantially increases children's risk of illness and death. The policy objective must be to minimize all infant feeding risks and to urgently expand access to adequate alternatives so that HIV-infected women have a range of choices." (Latham and Peble, 2000)