Why Ghanaian women are struggling to breastfeed their babies for the recommended six months

Originally published on Global Voices

An African woman breastfeeding her baby. Image by Younesse Bourrich from Wikimedia Commons, (CC BY-SA 4.0).

As the global community observes Breastfeeding Week, it is a pivotal moment to assess whether Ghana has taken substantial strides to promote and encourage breastfeeding.

On August 1, a video was posted on Twitter on the United Nations World Food Programme's (WFP) Africa page. It showcased Mutinta Hambayi, a mother and nutritionist from WFP, who emphasized that “for every dollar invested in breastfeeding promotion and protection, a country can generate up to [USD] 35 in economic returns.”

Supporting breastfeeding help mothers AND babies alike. @WFP provides nutrition training and supplements to mothers and their communities.

Our nutritionist Mutinta Hambayi gives 5 THINGS you need to know about #breastfeeding pic.twitter.com/hRwlcT7czO

— WFP Africa (@WFP_Africa) August 1, 2023

According to Hambayi and other credible sources, breastfeeding holds paramount importance for both infants and mothers. One of its primary advantages for children lies in its indispensable role in ensuring their health and survival. When an infant is breastfed they receive colostrum during the initial 72 hours. This substance acts as a shield of immunity and functions as a vaccine, offering essential protection. Early initiation of breastfeeding significantly curtails the risk of infant mortality by an impressive 44 percent. Moreover, breastfeeding contributes to reducing the likelihood of childhood obesity, asthma, cardiovascular diseases, and Type 2 diabetes. An added benefit is that breastfed children tend to excel academically, thus underscoring how breastfeeding also serves as an investment in human capital.

For mothers, breastfeeding offers significant advantages apart from the fact that it creates a special bond between mothers and their babies. It serves as a soothing experience and holds the potential to mitigate the risk of certain cancers. According to Hambayi, the promotion of breastfeeding isn't just a decision; it's one of the most astute investments a nation can undertake to construct its forthcoming prosperity. Beyond economic benefits, it fortifies the resilience of families. Thus, advocating for exclusive breastfeeding isn't merely a practice; it's a means to foster long-term well-being and ensure the growth of future generations.

Despite the manifold benefits of breastfeeding, numerous Ghanaian women encounter significant challenges in sustaining breastfeeding for the minimum recommended period of six months. These hurdles encompass insufficient leave duration, a lack of designated breastfeeding areas in workplaces and insufficient educational orientation in hospitals. In an interview with Global Voices, three Ghanaian women, whose names have been changed to ensure their anonymity – Mavis, Linda, and Bernice –  provide valuable insights by sharing their personal experiences.

Linda, in her early forties and working in the public sector with the Ghana Prisons Service, acknowledges the benefits of breastfeeding:

It aids the child's growth and strengthens bones, while preventing premature pregnancy for the mother.

She attributes her knowledge to midwives at the government hospital where she delivered her child. In contrast, Bernice, who works in the private sector, sought information online:

I googled a lot. Going on YouTube to learn from other mothers. These were my main resources because I did not have older sisters or cousins who gave me first hand information. So for me, YouTube and Google were my friends. And then, I also had this menstrual app I was using, which was informing me about every stage of my pregnancy. So that also gave me some information.

According to Bernice, she wasn't given proper orientation and education at the hospital:

I wouldn’t say I was given that much education at the hospital. On the day I was discharged, one lady came and gave some brief information, so that gave me a fair idea but not in detail. I just had the idea that it was a good thing for her. And I realized that when I breastfed her, I realized the benefits because she wasn’t getting sick or having any challenges. 

Both women highlight the predicament of insufficient maternity leave, which makes it difficult to sustain breastfeeding. With only three months of leave, breastfeeding for six months becomes a formidable challenge. Linda explains:

My workplace provides three months of maternity leave, along with breastfeeding hours. I opt for breastfeeding hours, taking time from 12:30 to 1:00 p.m. to feed my baby. So during that period, from 12:30 to 1:00 p.m. I go to the house and breastfeed my baby. Some pump the breast milk down for the child, but there's a concern about the milk's hygiene if it's not handled properly by the caregiver. This could potentially expose the child to contaminated milk. As for me, I've never expressed breast milk for my babies. On the other hand, not every mother lives close to their workplace like I do, so many may not be able to afford going home to feed their child. And some may not also be able to afford a nanny. So because of that some mothers stop breastfeeding early. But every child is supposed to be breastfed for at least 6 months.

For others who live farther from work or cannot afford childcare support, these options prove challenging. Bernice, who must express milk during work hours, faces additional hurdles which hinder her productivity at work:

In expressing, I needed to express into my sachet and put it in a fridge to keep it for a longer period till I get home. That was not available. And even a place to even express the milk was also another challenge because you have colleagues who are men. You can’t tell them that they should leave the office because you are coming to expose your breast. I ended up always going home with some hard knots in my boobs. It was so painful. So I was always rushing home so I could go and express. So I could not get a lot of work done within that period because I just couldn’t stay.

On a brighter note, it's reassuring to note that breastfeeding in public is generally accepted in Ghanaian society. Mavis confirms:

I don't believe breastfeeding is looked down upon in our culture anymore. Most individuals are understanding, and it's not considered a significant issue when mothers breastfeed their babies in public. However, as mothers, we may occasionally feel uneasy, particularly for first-time mothers. Yet, as time goes on, they become more accustomed to the practice.

The perspectives shared by Mavis, Linda, and Bernice offer valuable insights into the dynamics of workplaces, maternity leave policies, and support systems for breastfeeding mothers. They hope for an extension of maternity leave from three to six months. Bernice said:

In Ghana, an increase is necessary. Even if full salary isn't feasible, a partial payment could be considered. Something is better than the current three months, as we're meant to breastfeed for six months.

Additionally, they express hope for designated breastfeeding areas in workplaces and comprehensive education provided by hospitals to new mothers.

Originally published in Global Voices.