Im my previous post (which I encourage you to read if u have not), I introduced the topic of breastfeeding with a focus on an African mother. I discussed the technique of breastfeeding, introducing supplementary feeds as well as formula feeding. As promised I will conclude that discussion in this second part, which is just a continuation, by discussing breastfeeding for mothers who are HIV positive as well as the process of weaning.
Breastfeeding and HIV/AIDS
In Zimbabwe we have made great strides in reducing the transmission of HIV from mother to child. We started off with incidences as high as as 50% before the era of antiretroviral treatment to current ones of close to 5% (which is still coming down). HIV can still be transmitted during breastfeeding and in other settings mothers choose not to breastfeed as a way of protecting their babies. Makes sense doesn’t it?
In Zimbabwe however we encourage all mothers to breastfeed, regardless of HIV status, provided they are on treatment with a suppressed viral load. Research in Zimbabwe and other low income countries has shown that babies who are not breastfed have a higher risk of dying than those who are breastfed by HIV positive mothers. In the previous post I made reference to an article about Botswana published by the WHO, please make time to go through it. A lot of similar studies have proven that babies who are not breastfed, in resource limited countries (aka poor), will be at risk of diarrhoeal diseases and malnutrition. These two kill more children under the age of five than any other disease, including HIV. Provided all appropriate precautions are taken, the chance that a baby will acquire HIV from their mother during breastfeeding is less than 1%.
Breastfeeding should continue up to the age of 2, not just for African women but for all mothers. I will list a few of the benefits of extended breastfeeding and you may realize that you were depriving your babies of something important.
- Convenient and cheap – I probably do not need to continue stressing this obvious point
- Provides nutrition for the baby – why should you continue to crack your head about sources of calcium, vitamin A, protein etc. If you are not breastfeeding, chances are you are depriving your baby of something essential.
- Boosts the immune system – babies who breastfeed have lower chances of getting infections and other illnesses.
- Boosts brain development – studies have shown this to be a fact, bottle fed babies generally have lower IQs than breastfed babies.
- Creates a bond between mother and baby and can also be soothing to the babyin times of distress
The list does not end here, and it is important to remember that the benefits are cumulative, for example a baby who breastfeeds for 2 years benefits more than one who breastfeeds for a year.
The next question becomes, how should I wean my baby. Typical African mothers, mine included, used to put chilli on the nipples. Effective but pretty cruel if you ask me. The babies would wean themselves after that experience.
We advise that the process be done gradually while the baby adjusts to a new feeding schedule. Abrupt weaning can result in a drop in weight and can even progress to malnutrition because the baby was not ready for the transition. I have often noted that most cases of malnutrition are triggered when solids are introduced ( previous post) and at weaning, mostly because these 2 are often done wrongly.
As a doctor I will say breastfeeding has many benefits, both to the mother and to the baby. It may be the best thing that you ever do for your baby because it gives them a head start in life. As a father I also noted that when we discipline our 4 year old daughter with my wife, it takes me longer to be forgiven, unless I buy her with candy, you probably guessed it right, I didn’t breastfeed her.
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