RotaFlash, April 2016
Knowing all of the health benefits of breastfeeding, there was no question that I wanted to breastfeed my son. I was lucky. He was born healthy and full term; and while we had our challenges initiating breastfeeding, we had all of the advantages of being in a supportive environment which enabled me to exclusively breastfeed (including lots of pumping!) for his first six months of life.
Ask any breastfeeding working mom about the logistics of pumping and she will regale you with stories. I know other working mothers who have pumped in fast food restrooms, in post-offices and even in a Congressional hearing room. In addition to childcare, the logistics of pumping at work is a major topic of conversation (and source of anxiety) for new moms in the office.
While most traditional workplaces in the US are required to provide time and a clean place to express milk, those of us who spend part of the work day out of the office must plan ahead to find a clean (ideally private) place to pump, be flexible when plans change, and be prepared with all the necessary supplies – including a cooler with an ice pack to store and transport milk until a refrigerator is available.
Since becoming a breastfeeding mom, I’ve lived first-hand all that is necessary to create the enabling environment to make breastfeeding work – even in (theoretically) high-resource settings. I can only imagine what this would be like for working mothers in the developing world – especially considering that 75% of jobs are in the informal sector, where there is no employer to provide time and a clean space to express and safely store milk, let alone affordable access to pumping supplies, electricity, clean water and soap to sterilize supplies, and refrigeration. We must do a better job to make it easier for breastfeeding working moms if we want the world’s children to reap the benefits of exclusive breastfeeding for the first six months of life.
I can’t help but think if our situation were different. What if my son had been born premature or with a health complication where he could not nurse? What if I wasn’t able to breastfeed? What if we lived in a low resource setting?
When mothers want to give their children the benefit of breastfeeding, but are unable to provide their own milk, donor milk is the preferred option. And increasingly, this option is becoming available to mothers and babies facing breastfeeding challenges, no matter where they live.
Human milk banking is particularly important for babies born prematurely with low birth weight or other conditions that leave them unable to breastfeed, as they are more vulnerable to sickness and death. Providing donor breast milk to these babies can save newborn lives, improve newborn health and development, and improve overall breastfeeding rates—not to mention put anxious mothers somewhat more at ease. Human milk banks enable mothers to donate their extra breastmilk to special facilities where it is tested, treated and distributed to vulnerable newborns who don’t otherwise have access to their own mother’s milk.
With the imminent launch of the new Sustainable Development Goal to end preventable newborn and child deaths by 2030, PATH has joined other organizations around the world to call upon governments, the United Nations and its agencies, civil society and business leaders, and all institutions with a stake in healthier generations of children to commit to ensuring that all newborns have access to human milk by increasing investments in human milk banks as part of integrated breastfeeding, newborn care, and infant nutrition programs, with a special focus on the countries where newborn deaths are concentrated.
I am grateful for all of the factors that enable me to breastfeed my baby. All mothers and babies around the world deserve the same.
Photo: PATH/Tony KarumbaRead more
Counseling mothers on the benefits of breastfeeding will help transfer the knowledge to communities.
Located in the heart of Bangladesh’s capital city, icddr,b’s Dhaka Hospital specializes in the treatment of one condition—diarrhea. Known locally as “The Cholera Hospital”, the facility admits between 250 and 1,000 patients a day. Many patients are from families earning less than US$5 a day. Over half are children under five years of age.
As one of the leading public health research institutions located in the Global South, icddr,b has long advocated for the benefits of breastfeeding—which is why mothers with sick children under 6 months of age admitted to its hospital can expect a daily visit from a breastfeeding counselor.
On her rounds, Parvin listens and advises mothers on the benefits of breastfeeding.
Once of those counselors is Parvin Kathun, who has worked at icddr,b for over 15 years. “Many women discontinue breastfeeding when their child has diarrhea,” she says. “There’s a common myth that breastfeeding causes diarrhea, when in fact nothing could be further from the truth.” It is Parvin’s task to convey to mothers the results of icddr,b’s research: that breast milk is an important component of oral rehydration therapy for infants, which is more effective than other treatment in tackling the severe dehydration that diarrhea can cause.
“We try to encourage mothers to exclusively breastfeed their infants until at least six months of age,” says Ms. Kathun. “Sometimes it is difficult – in particular for first-time mothers – to recognize the importance of breastfeeding, and to do it properly. Our breastfeeding clinic provides counseling for these mothers and, in extreme cases, we try to re-initiate lactation in mothers who have abstained from breastfeeding for too long.
The World Health Organization recommends breastfeeding exclusively up to the age of six months minimum, preferably until 24 months. In fact, little more is needed by an infant in these first six months of life, and the nutritional benefits of being breastfed will continue until the child is two years old. Breast milk, even when a mother is malnourished, provides the baby with the nutritional and immune protection needed to ensure benefits later in life, including the essential nutrients that help prevent diarrheal disease and malnutrition.
“We provide mothers with extra support, such as counseling, technique training and family counseling, to continue breastfeeding once they leave the hospital,” says Parvin Kathun. “We train doctors, nurses and staff from NGOs around Dhaka in breastfeeding counseling. We hope they will also act as ambassadors to encourage breastfeeding back in their own communities.”
“icddr,b has conducted extensive research on the impact of breastfeeding infants until six months,” adds Dr. Tahmeed Ahmed, director of icddr,b’s Centre for Nutrition and Food Security. “A key study of ours published in the Lancet showed that extra support – both lay and professional – to promote breastfeeding, increased the length of breastfeeding, which contributed to reduced child morbidity and mortality. The benefit breastfeeding brings to the well-being of children in terms of immunity against diarrheal disease, pneumonia, and improved nutritional gains has been well documented.”
“Optimal feeding practices, including breastfeeding, in the first 24 months of life can promote healthy growth in late childhood and development in adulthood.” Dr Ahmed continues. “In fact, the Lancet study to which we contributed revealed that promotion of breastfeeding contributed to averting 21.9 million disability-adjusted life-years (DALYs) in 36 high-burden countries– a reduction of 8.6%; making it the most effective nutrition-related intervention in that study to reduce mortality and growth-stunting. Previous studies have also proven that optimized breastfeeding practices achieved a reduction of 13% in child mortality.”
“icddr,b is committed to finding new ways to encourage exclusive breastfeeding “ Dr Ahmed concludes. “Breastfeeding is more than just nutrition, it is ultimately about empowering women and saving children’s lives.”
Research generated by institutions such as icddr,b, have created a strong evidence base that has informed national policies to support mothers breastfeeding. In Bangladesh, the Lancet series was a catalyst for the government to extend the length of maternity leave from four to six months, which Prime Minister Sheikh Hasina announced as a nationwide initiative during World Breastfeeding Week 2009.
Back in the Dhaka Hospital, Ms. Parvin continues her hospital rounds—ensuring that all mothers of infants who have been admitted are aware of the benefits of breastfeeding. “Infants actually need little more than breast milk to provide them with essential immunity, including against certain diarrheal infections, as well as core nutrients,” she says. “We want to give mothers every opportunity to ensure their children grow up healthy.”
Photo credits: icddr,b / Sadia Mariam, DRIK.Read more
Since 1990, nearly 100 million children around the world have been saved due to global efforts to reduce child mortality, and maternal deaths have been cut nearly in half. The US government has played a large role in this great success story.
Yet still, each day, more than 17,000 children’s lives and nearly 800 mothers’ lives are lost due mostly to preventable causes. If you’re like us, you think this is unacceptable. The good news is, history has shown us what we can do when we work together – and research has backed it up. We can end preventable maternal, newborn, and child deaths within a generation. But we must all play our role to make it happen!
The opportunity: a more coordinated US strategy
The Reach Every Mother and Child Act will be introduced in Congress calls for the scaling up of simple solutions and requiring a coordinated, streamlined strategy to end preventable maternal, newborn, and child deaths by 2035. Learn more about the bill here. A group of over 20 diverse nonprofits are advocating for the United States Congress to fulfill its promise to save the lives of moms, kids, and babies around the world– and you can add your voice to the call.
How you can help #SaveMomsandKids
We are advocating for this bill because we believe that moms, children, and babies are best served when resources and expertise are brought together to achieve maximum impact. The same is true for our voices, and that’s why we need your help.
We are starting a virtual “chain” around the world comprised of people who believe we must do all we can to #SaveMomsandKids. Join our global chain to show policymakers that US citizens, along with others around the world, support coordinated efforts for maternal, newborn, and child health. It’s easy:
Colleagues in PATH's Kenya office have joined the global chain to #SaveMomsAndKids.
1. Take a photo linking arms with your friends, family, colleagues – anyone you want.
2. Share the photo on Twitter using the hashtag #SaveMomsAndKids with a message sharing why you are joining the initiative. Or, use one of these sample messages:
· Today we are coming together to #SaveMomsAndKids around the world. Will you join us? [PHOTO] http://bit.ly/1IqC0gD
4. Follow #SaveMomsAndKids for other opportunities to share information, graphics, and other content. Be part of the conversation!
Why we need you:
In the coming weeks, advocates will go to Capitol Hill to educate policymakers about the bill and will point them to the #SaveMomsAndKids Twitter campaign, where they will see your photos as evidence of your support for the issue.
Help us show members of Congress that there’s a growing chain of people around the world urging them to #SaveMomsAndKids!Read more
Photo credit: FreeImages.com/monique72
Hey, book lovers! As a follow up to our summer movie list, I thought I would develop my own list for the bookworms among us—an alternative summer reading list of books ranging from whimsical, to informative, to heartbreaking that relate to diarrheal disease (DD) and what we can do about it.
So get comfy on your favorite chair, beach blanket, or toilet, dive into these books, and let the inspirational DD advocacy ideas flow!
The Big Necessity: The Unmentionable World of Human Waste and Why It Matters by Rose George
This book is a sanitation advocate’s bible. Rose George travels the world and presents impressive research about the current state of sanitation. She shares colorful (and sometimes humorous) encounters with people and places alongside dismal facts about global lack of access to toilets and resulting waterborne illness, which kills about 7000 people every single day. She contends that, although flush toilets with sewers have helped decrease the burden of DD, they won't be sustainable in the long term due to their overuse of water. She asks readers why such a fundamental aspect of our lives remains on the margins of polite conversation and argues for sanitation to “be unshackled from shame.”
The DD take away: Rose George is basically my hero, and this book is a phenomenal overview of most of the issues around DD and sanitation. It also provides some (unsavory) food for thought to spark discussion around future sanitation solutions. To defeat DD and prevent the hundreds of thousands of deaths it causes every year, we need to start talking about it! Check out our advocacy toolkit for useful tools to spread the word on DD—and what can be done about it—and remove the taboo around poo.
Gulp: Adventures Along the Alimentary Canal by Mary Roach
In similar fashion to Rose George, Mary Roach tackles another taboo and often uncomfortable topic—digestion. The alimentary canal, or the “tube from mouth to rear,” has been the subject of much malice and misunderstanding, and Roach introduces us to the scientists who have taken the “plunge” and tackled questions no one else thinks—or has the courage—to ask. How much can you eat before your stomach bursts? Can constipation kill you? How have ideas about digestion and fecal matter differed across time and culture? And what on earth is a fecal transplant?? Prepare to be thoroughly intrigued, disgusted, and enlightened.
The DD take away: Be careful what you put in your mouth! The digestive tract is a strange and fascinating world, and if the wrong thing gets in it, you can be downright miserable. Diarrheal disease can be caused by a wide variety of nasty viruses, bacteria, and parasites—all of which travel through your alimentary canal by way of ingestion. Learn about the different causes of diarrheal disease through this infographic.
The Help by Kathryn Stockett (2008)
When 22-year-old Skeeter returns home to rural Mississippi after graduating from college in the early 1960s, she becomes interested in the plight of the African-American maids employed by most white families in her town. Skeeter writes and publishes their stories of mistreatment and abuse, including how most white families required separate toilets—often outhouses without plumbing—for these women. Furious, she takes action by asking people to donate their old toilets in lieu of the annual coat drive. An unpleasant woman thus wakes up to find her front yard full of toilets—and hilarity ensues. Also, there’s a story about a pie… but I won’t give that away.
The DD take away: Basic sanitation is a fundamental human right, and lack of access to toilets creates serious health risks; open defecation is a major contributor to diarrheal deaths. Even though over 50 years have passed since Skeeter’s time, 2.5 billion people worldwide still lack access to appropriate sanitation facilities or latrines today.
The Ghost Map by Steven Johnson
This book tells the true story of the cholera epidemic that occurred in London in 1854 and how it changed science, cities, and the modern world. At the time of the epidemic, London was dirty, overcrowded, and lacked a sewage system. When a mother washed her baby’s dirty diapers at a commonly used water pump, unaware of the danger, cholera spread like wildfire. It took innovation, science, and a simple, hand-drawn map for Dr. John Snow to discover the source of the cholera, stop the epidemic, and, in the process, form the “germ theory” of disease and the foundations of modern epidemiology.
The DD take away: Cholera and other diarrheal disease epidemics are terrifying, and they still take place today where people lack access to sanitation. Because of the pioneering work of Dr. Snow and his followers, however, we now know that cholera and other diarrheal diseases are caused by germs, preventable through sanitation, and treatable through oral rehydration therapy and zinc.
The Poisonwood Bible by Barbara Kingsolver
Sometimes the best how-to guides elucidate, step-by-step, what not to do. This work of fiction, a story of a missionary and his family who relocate to the Belgian Congo in 1959, is a great “how-not-to” guide for international development and global health programming, from the impractical items the family packed, to the inappropriate crops they planted, to their blatant disregard for the practical advice and wisdom of the community. And yet, through the death of one of the characters, the family learns that the anguish of parental grief at the loss of a child crosses all cultures.
The DD takeaway: The tragedy of preventable child deaths, no matter where they take place, is why we are fighting to defeat diarrheal disease. Diarrheal disease, which killed nearly 600,000 children under five years of age in 2013, is one of the most common illnesses among children in the developing world. The good news? This crisis can be solved with an integrated prevention and treatment approach.
Honorable mention: Everyone Poops by Taro Gomi
I couldn’t not include this classic illustrated children’s book celebrating one of life’s most common, natural, and important processes. Simple, straightforward, and delightful, this book will educate youngsters on the diversity—“an elephant makes a big poop, a mouse makes a tiny poop”—and commonality of pooping across the animal kingdom.
The DD take away: Well… everyone poops!
-- Laura Edison, Scientific Communications Associate, PATH
For more information:
-- More of a movie person? You're in good company. Check out our list of 5 films rated using our proprietary "toilet seats up" rating system.
-- Speaking of cinema, here are 5 celebrities who aren't afraid to put diarrhea in the spotlight.Read more
It started with more than 500 global health innovations submitted by people in more than 50 countries.
Filtered through more than 60 independent health experts and a rating scale measuring factors like affordability, accessibility, and effectiveness, 30 high-impact innovations rose to the surface. The result: Reimagining Global Health, the inaugural report of the PATH-led Innovation Countdown 2030 Initiative (IC2030) to assess the innovations that hold the most game-changing potential for the global health landscape over the next fifteen years.
We know that investments in child health are some of the most practical investments that nations can make for their futures. So, our DefeatDD team was pleased to see that there are innovations in this report that directly address diarrheal disease.
Some of you may be thinking, “Now, hang on a minute. Don’t we already know how to prevent and treat diarrheal disease?” True enough, savvy advocate. We know what works, and we’ve dedicated our DefeatDD Initiative to raising awareness about how these solutions can prevent needless morbidity and death due to diarrhea.
But that’s not the end of the story. The solutions are essentially end goals, but the means are numerous. And an ongoing commitment to innovation – and conversation – about how to make their use practical, affordable, and accessible for the people who need them most is the best way to make the greatest impact.
You can find the diarrhea-specific innovations on page 17-18 of the report. Here’s a summary of what we’ll call “diarrhea solutions 2.0” and how they can complement and enhance our tried-and-true toolbox:
· New treatments for severe diarrhea – specifically, treatments to supplement oral rehydration solution (ORS). ORS isn’t going anywhere; true to its name, its remarkably effective rehydrating properties have saved millions of lives. But despite its effectiveness, studies have revealed that demand is low in certain settings because it doesn’t reduce stool output: a main priority for many caregivers. There are also challenges regarding the ambitious recommended dosage. New treatments highlighted in the report aim to complement ORS and tackle these barriers.
· Rice fortification – Malnutrition and repeated bouts of diarrhea create a vicious cycle that can threaten physical and cognitive development, education, and future productivity. But figuring out how to ensure adequate nutrition can be a tough nut to crack. Rice is a staple food in many parts of the world, making rice fortification a cost-effective and easily accessible wayfor families to ensure their children get the nutrition they need.
· New tools for small-scale water treatment – Small-scale, BIG need. We’re not surprised it made the short list of innovations, because the best way to save lives, money, and suffering from diarrhea is to prevent it from happening in the first place. Simple, powerful technologies (like the SE200 Community Chlorine Maker) that can disinfect hundreds of liters in one use hold truly exciting potential.
Like I said, innovation is about conversation. Download the report and give us your take. Which innovations do you think hold the most potential? What would you like to see featured in a future report? (Innovative sanitation solutions would get my vote!) Join the conversation at #IC2030.Read more