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U.N. report praises Samoa's breastfeeding rates

Samoa is performing better than the regional average in breastfeeding children from an early age through until 23 months, a new child’s nutrition report has found.

The United Nations Children’s Fund (U.N.I.C.E.F.) reports most Samoan mothers are breastfeeding early, exclusively, and continuously into their child’s second year.

Samoa’s best rates are in its early breastfeeding uptake, with 81 per cent of newborns being breastfed compared to just 38 per cent for the region (East Asia and the Pacific), and 65 per cent globally.

Seventy per cent of women commit to exclusive breastfeeding up until six months, and 73 per cent continue breastfeeding until 23 months, compared to just 30 and 60 per cent in the region.

Samoa Family Health Association midwife, Lusi Uelese Tevita, said mothers who come to the clinic are eager to breastfeed, many of them for purely practical reasons.

“You don’t have money to spend on buying formula, you have the milk there, it’s warm, it’s safe, and it’s all the nutrients that are needed for the baby’s life. If you understand the benefits, if you know what is good and what is bad, then you know how to spend your income.”

Ms. Tevita said most mothers do also understand the value of breastmilk and are reporting they feed exclusively for the first six months, and many for longer. 

The Ministry of Health and Yale School of Public Health jointly researched breastfeeding in Samoa between 2017 and 2018, and found Samoa, like other countries, requires a multifaceted approach to promote and support breastfeeding. 

The research found there was no funding and resources allocated towards breastfeeding support, something the team suggested should change.

Among five priority recommendations is the suggestion to hire a national counsellor or trainer for breastfeeding, who would support maternity wards and support systems to help mothers with lactation, ongoing breastfeeding, and include work in this area in the educational training, nursing and medicine training.

Courtney Choy is an Ivy Plus Exchange Scholar with Yale University and was part of the research team alongside Principal Investigator Christina Soti-Ulberg from the Ministry of Health. 

She said anecdotal evidence from the field shows support is the most important part of successful breastfeeding rates.

“From what we have seen, a lot of people see the value in what breastmilk is for. 

People like Salausa Dr. John Ah-Ching, former Associate Minister of Health who said: “breastmilk was created by God for His children's health,” are the kind of champions the Ministry believes will encourage unsure mothers to breastfeed.

But the 19 percent of newborns not breastfed from birth are often more susceptible to health and developmental risks.

While some mothers are not able to breastfeed, and some babies may have unique challenges too, Ms. Choy said some barriers could still be lifted to enable more mothers to breastfeed, and for longer.

“Sometime it can begin from birth. Latching, especially for the first baby is hard, but I know there are great counsellors there that are taught how to show a mother how to do that,” Ms. Choy said.

“But having support, not only from the father, but also the grandparents and even the work environment is so important.”

U.N.I.CE.F. states that breastfeeding could save the lives of 820,000 children annually worldwide because of its “profound benefits” on both mother and baby.

“Breastfeeding has profound benefits for the child, especially in the first hour of life. Colostrum, the first milk produced by a mother, protects an infant’s immature immune system against infection and inflammation.

“Breastmilk is not just food – it’s a powerful medicine tailored to the infant’s needs that can significantly reduce the risk of death. 

“Other benefits include improved school performance and higher adult earnings, as well as improved physical well-being. Growing evidence also points to breastfeeding reducing overweight, obesity and chronic diseases such as diabetes later in life.”

The report states that breastfeeding is especially impactful in lower-income countries where healthcare and clean water can be scarce.

Challenges to keeping babies on the breast in their first two years are plenty, and chief among them is the strongly marketed plethora of milk-based formula substitutes.

U.N.I.C.E.F found that globally, sales have grown by 41 per cent from 2008 to 2013, and here in the region milk-based formula feeds 28 per cent of infants aged 0-5 months. 

“In their first six months, only two out of five children are being exclusively breastfed, depriving them of the best food a baby can get,” the report states.

“When it comes to the ‘first foods’ (or complementary foods) that infants should start consuming at around the age of 6 months, these too are, in far too many cases, not meeting children’s needs.”

In Samoa, midwife Ms. Uelese Tevita said more mothers prefer breast milk to formula, mostly for financial reasons. But as mothers return to work, many are left with no choice but to switch to formula.

According to the World Health Organisation, among Pacific Islands states Samoa is ranked third with 70 per cent of exclusive breastfeeding of up to six months, with Solomon Islands and Vanuatu in first and second with percentages of 76 per cent and 72 per cent.

The region has done poorest in the world at improving its rates over the last 13 years. Since 2005, East Asia and the Pacific have gone from 28 per cent of infants exclusively breastfeeding to 29 per cent.

In South Asia, their rates improved from 45 to 54 per cent, while Eastern Europe and Central Asia went from just 20 to 33 per cent.

But Ms. Choy said with so many countries included in that statistic, something about aggregates

“Samoa has been consistently good at having exclusive breastfeeding rates over the years,” she said.

“So actually that will be the biggest challenge, to maintain that high standard they have had.

“Breastfeeding is natural act but it is also learned, so it’s about making sure we have the people within the village, within the work environment, within the community who are really supporting it in different ways.”

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