The challenges of breastfeeeding in poor urban areas in sub-Saharan Africa

Abstract
Optimal breastfeeding has the potential to prevent more than 800 000 deaths in children younger than five years; 500 000 neonatal deaths; and 20 000 deaths in women every year. Despite these benefits, evidence from Sub-Saharan Africa shows that breastfeeding practices remain sub-optimal with only 25 per cent of children exclusively breastfed for the first six months, while six per cent of infants in these countries are never breastfed. For example, although the proportion of children who were exclusively breastfed in Kenya improved from 32 per cent in 2008 to 61 per cent in 2014, pockets of suboptimal breastfeeding practices are documented in urban slums. Exclusive breastfeeding in some of the urban slums in Kenya is as low as two per cent, with the age of introducing complementary foods being onemonth post-delivery, while about a third of children are not breastfed within one hour of delivery as recommended by the World Health Organization (WHO). Urban slums are faced by unique social and structural factors that hinder optimal breastfeeding including poverty and non-conducive livelihood opportunities, poor living conditions, food insecurity, poor professional and social support to breastfeeding mothers and knowledge deficit coupled with negative cultural beliefs and misconceptions about breastfeeding. This situation calls for macrolevel policies and interventions that consider the ecological setting. Promising interventions may include global initiatives such as the Baby-Friendly Hospital Initiative, the Baby-Friendly Community Initiative, Human Milk Banking and the Baby-Friendly Workplace Initiative. However, innovations in their implementation need to take consideration for the contextual complexities. This chapter explores breastfeeding practices, associated challenges and interventions that could promote breastfeeding in urban slums.
Description
CITATION: Kimani-Murage, E. W. et al. 2020. The challenges of breastfeeeding in poor urban areas in sub-Saharan Africa, in Macnab, A., Daar, A. & Pauw, C. 2020. Health in transition : translating developmental origins of health and disease science to improve future health in Africa. Stellenbosch: SUN PReSS, doi:10.18820/9781928357759/07.
Keywords
Breastfeeding
Citation
Kimani-Murage, E. W. et al. 2020. The challenges of breastfeeeding in poor urban areas in sub-Saharan Africa, in Macnab, A., Daar, A. & Pauw, C. 2020. Health in transition : translating developmental origins of health and disease science to improve future health in Africa. Stellenbosch: SUN PReSS, doi:10.18820/9781928357759/07.