East African Breastfeeding Rates Compared to the US
One thing that constantly lives in my mind is the comparison of breastfeeding rates around the world. Growing up in the US, I didn’t see a lot of breastfeeding. Sure, women in the West are typically more reserved in breastfeeding, but even so the first time I remember seeing a woman breastfeed (albeit, under a cover) I was 18. Whereas now, living in Eastern Africa, breastfeeding is the norm. A lot of that has to do with culture and financial ability, but it brings a lot of questions to mind. Is it easier for women here to breastfeed? Is it because it’s all they see their whole lives, so they’ve learned by watching? Is it that there’s an auntie on every corner to help? Why do so many women in the US have low supply? Is it that mothers return to work so fast? Is it because pumping isn’t always as effective?
All these questions used to plague my mind. I’ve spent a lot of time observing breastfeeding and the cultures surrounding it. Eventually I realized that yes, even women here face challenges with breastfeeding. Not every child gets breastfed either. Some mothers return to work early too, and children have other milk while the mother is away. Still, let’s take Rwanda as an example, 87% of babies are exclusively breastfed for the first 6 months of life. In South Sudan, 73%, Kenya, 60%, Ethiopia, 58-60%, Uganda 94% of children — and while there is some confusion in the data on whether that is exclusive breastfeeding or any amount of breastfeeding, the rates are still relatively high. In the US, only about 25-28% of babies are exclusively breastfed for the first 6 months.
Here’s my observation as someone who has lived in both cultures.
Americans like schedules. A lot. I have nothing against schedules, I believe whatever works for your family, works. That’s all that matters. But I also know that breastfeeding is supply and demand. In the context I live in now, any time a baby cries, the baby is given to the mother, and she breastfeeds. I sometimes imagine if this baby was in the US, and on a strict schedule, how that may affect that mothers milk supply. Around 3 weeks, 6 weeks, 3 months, and 6 months a baby often goes through a growth spurt, and they feed more, so that the mother’s milk will increase with their needs. I sometimes wonder if this baby is on a strict schedule, how that may affect that mothers milk supply.
Knowledge runs in the culture. Mothers aren’t even asked if they’re going to breastfeed here, it’s part of having a baby, it’s just in the culture. If there is any issue, a woman may talk among her friends or family for some advice. When that is common, I imagine it’s a lot easier to find your way forward when the resource is everywhere. Sure, some of this advice can be unsolicited and unwanted, just like for any mother. Still, breastfeeding is seen around, and there is so much knowledge that can be absorbed when you’ve seen it your whole life.
American systems are not conducive to breastfeeding. For some women, they may feel okay going back to work after 6-12 weeks, but returning to work can have a huge impact on supply. Many women may pump, but pumping is not always most effective. Finding the right fit, the right size, can have an affect on how much milk a mother can pump. Pumping is also time consuming and can be stressful when counting ounces. Many women where I live now have some sort of job where they either stay with their child all day (selling produce on the streets, or running a small shop) or stay home with their children. Babies are very attached to their mothers here while breastfeeding, it’s just the way of life, and I believe it has a positive affect on ability to keep milk supply.
Things that may help low milk supply:
Getting good nutrition
Feeding on demand
Minimizing pacifier use
Skin to skin with baby
Proper fit with a pump