My twins came early, bursting into the world sooner than expected at 36 weeks, preterm and quite small. I had always planned on breastfeeding. Yes, because the experts and books said that I should, and also because it was the most natural of maternal impulses to want to breastfeed my children. I was determined to do just that. An alternative never occurred to me.
Giving birth early is overwhelming and quite challenging. My two little boys needed extra care. I'll never forget the moment, three days after they were born, when a midwife rushed into my hospital room saying that Jovin was losing weight fast and needed formula feed immediately. It was so distressing to see him hooked up to a tube. For the next 10 days, the three of us stayed in that hospital room, with frequent visits from the breastfeeding specialist. She patiently taught the three of us how to feed, using cups, naso-gastric tubes and helping the boys learn to attach. I was given a breast pump to help express milk and I pumped many hours, every day, taking the cumbersome machine home with me when we left hospital when the twins were two weeks old. I continued to breastfeed exclusively (except for that one emergency bottle of formula!) for six months, and then for an additional two years thereafter with complementary food. Today, you would never know my twins were born small, and as far as time keeping is concerned...well, that is the earliest they have ever shown up for anything!
According to the World Health Organization, exclusive breastfeeding provides babies with perfect nutrition and everything they need for healthy growth and brain development. Yet globally, only 38% of infants are exclusively breastfed.
And we know that a small, sick and vulnerable baby, more than any other, needs their mother's milk. Breast milk acts as a baby's first immunization by providing protective antibodies and growth factors. Studies have also shown that exclusive breastfeeding can help reduce the incidence of some of the most common and serious intestinal disease among preterm and sick babies as well as improve feeding tolerance and enhance early childhood development. Put simply: a mother's milk may be the difference between babies who survive and babies who don't.
In recent times, there has been an upsurge of awareness campaigns on the importance of exclusive breastfeeding and supporting all mothers everywhere in any setting, to do what is not just natural but important for the mother and her babies.
The Lancet releases a Breastfeeding Series, the first of its kind to evaluate global breastfeeding levels, trends and inequalities, as well as the short- and long-term consequences for both mother and child, regardless of where they live, their income or circumstances. These Lancet papers are the second series in a set of new evidence coming out this year and focusing on key topics highlighted by the Global Strategy for Women's, Children's and Adolescents' Health.
The power of the Global Strategy is in its emphasis on "every": every woman, every child, every adolescent, everywhere. Yet when we look at most of the statistics and guidance on breastfeeding, the historical focus has been on infants born at term with very little information on the nutritional needs of newborns in difficult circumstances: those who are sick, preterm, low birth weight and those living in emergency or fragile settings.
A lot more research is needed, and we also need to reassess current breastfeeding policies and programs so that they are less heavily skewed towards term babies. We need to build better and more information on how to meet the needs of babies at the greatest risk of death and developmental problems.
Mothers of sick and small babies - like mine - have the right to quality, reliable information so they can make informed decisions during this deeply emotional and often frightening time. We need health workers trained to respond to the particular breastfeeding needs of sick and small infants since suboptimal breastfeeding contributes to 800,000 infant deaths annually. And we must put in place systems of support so that once mother and baby leave the hospital both continue to benefit from pursuing exclusive breastfeeding at home, in the community and in workplace. All of these requirements are laid out in The Every Newborn action plan launched in 2014.
My passion for maternal, newborn an child health is because I count myself among the lucky ones. My twins came into the world too soon. Born anywhere else none of us would have survived their early birth. And if we had, we would not have had the excellent help we received to breastfeed, and to give my boys such a great start in life. We were at the right place with the right support and quality information needed. Not everyone has this chance at the start of their life. For the sake of all we have committed to deliver by 2030, this has to change. Our work starts now, using what we know to ensure a healthy start in life for every mother, every newborn, everywhere.