Breastfeeding is an effective method of ensuring child health and survival. World Health Organization (WHO) recommends exclusive breastfeeding during the first 6 months of life as a source of nourishment for infants and young children (1). In-order to meet the infant’s needs for growth, health and development, breastfeeding should continue for at-least 2 years of life combined with appropriate complementary feeding that is introduced at 6 months. It is estimated that 1.4 million child-lives could be saved by improving breastfeeding practices (2). The rates of breastfeeding are generally high in Kenya with a reported 97% of children ever breastfed while initiation of breastfeeding is 86% within one day of birth (3). However, exclusive breastfeeding rates are still very low in the country estimated at only 32% of children age 6 months (3). Exclusive breastfeeding rates vary widely across the country with even lower rates of up to 2% reported in informal settlements in Nairobi (4). The main reasons given for discontinued breastfeeding and early introduction of complementary feeding includes mother’s retuning to work, not having enough breast-milk and advice by health professionals (5). The Baby Friendly Community Initiative (BFCI) has been recommended as an appropriate method of promoting and supporting breastfeeding at community level (6).
Breastfeeding is a complex process governed by psychological and physiological factors which are influenced by a wide spectrum of environmental, social and cultural factors (7). These factors have been summarised by Ochola (8) in a schematic illustration shown on Figure 1. Ochola, (8) argues that maternal psychological and physiological factors are affected by maternal socio-economic and demographic factors, contextual factors such as place of delivery, cultural factors and infant characteristics. The maternal psychological and physiological factors in-turn directly affects exclusive breastfeeding practices (Figure 1). This complexity of factors influencing breastfeeding practices requires a tactical approach in-order to increase the uptake of appropriate breastfeeding practices for optimal child growth.
Several models have been tested for promoting exclusive breastfeeding in Kenya. This review will highlight three main ones namely, the counselling of mothers and peer counsellors, Baby Friendly Hospital Initiative (BFHI), and the Baby Friendly Community Initiative (BFCI).
Elizabeth is a Public Health Specialist and is currently heading a project on maternal, infant and young child nutrition (MIYCN), aimed at determining the effectiveness of a community-based intervention to promote optimal infant and young...