The life-saving value of breastfeeding counselors
Windswept and sandy, with big old homesteads and wide streets, Eddain is the capital city of East Darfur, one of the five states in Sudan’s Darfur Region. East Darfur sits on the edge of the Eastern Sahara; it is beset with on-going tribal tensions and conflicts, and is home to more than 400,000 displaced people and refugees.
In this sub-baked, dry and remote land it is a wonder any mother is able to feed her young children healthily. With safe drinking water a luxury, and no ready-to-use baby foods available in the local shops, the essential and life-saving value of breastfeeding, both exclusive for the first 6 months and then continued until two years, becomes starkly evident.
Somaia Eisa Ahmed is the Infant and Young Child Feeding (IYCF) Coordinator at the Ministry of Health based in Eddain. Born and raised in Eddain, she has worked in Nutrition for the last 20 years, and has been the IYCF coordinator for four years. “I was trained by Afaf, from the Federal Ministry of Health in Khartoum”, she tells me, adding that she gained a lot of knowledge and practice from the UNICEF-supported training.
Two years ago her training was put to use to change a young family’s life. A young mother, Fatouma Adam, was referred by her community midwife from a nearby village to deliver her third baby in Eddain hospital. Fatouma had previously lost her first and second babies weeks after birth because she was not able to breastfeed them. Somaia had trained the hospital midwives on the importance of breastfeeding, and when the midwives saw the difficulties this young mother was facing and heard her history, they knew who to call.
On examination, Somaia found that Fatouma had severely inverted nipples, meaning that the baby was not able to latch on to her breast and suckle. Using a technique she had learnt during her training, Somaia adapted a syringe and applied gentle pressure to gradually suck the mother’s nipple out. By the third day the baby was successfully latched on and feeding well. “I was really happy to see the outcome of my intervention” said Somaia, “the mother and father cried with joy”. Somaia followed up regularly over the next few months and the baby boy is growing up a healthy strong toddler.
In 2015, Sudan’s Ministry of Health endorsed and adopted a new 10-year strategy for infant and young child feeding, aimed at ensuring all babies receive the best start in life. Part of the strategy is to establish counseling services based in the community for new mothers and mothers with children under two years. This is to extend services close to mothers such as Fatouma. These services are being made available through a network of Mothers Support Groups with funding in East Darfur from ECHO. Groups are being set up across the country, made up of volunteers who are trained and coordinated by dedicated staff like Somaia.
In January 2016, Somaia recruited a new volunteer to one of her Mother’s Support Groups. A doctor in Abumatarek, a village near Eddain, refered a new mother and her 5-day old first-born son to the pediatric ward in Eddain hospital. The baby was not breastfeeding and staff contacted Somaia, and once again, she found a problem of inverted nipples. “It is a common problem around here” says Somaia, “I see two to three cases every month”.This case was not so severe. Somaia and the mother were able to hand express some breast milk which they fed the baby using a syringe. With continued massage, they were able to pull out the nipple so that the baby could latch on and suck. Mother and baby stayed with Somaia for four days to ensure that breastfeeding was well established before returning home. This mother has since joined her local Mothers Support Group so she can share her experience and help other mothers with similar problems.
Somaia has one daughter of her own, now 12 years old. “I suffered from *pre-eclampsia during my pregnancy”, she says to me “and my daughter was born premature. We had a lot of feeding issues, and my experience has inspired me to help others”.
- Pre-eclampsia is a disorder of pregnancy characterized by high blood pressure and protein in the urine. The only known treatment is premature delivery of the fetus and placenta.
- Support to IYCF is provided by Japan, ECHO, USAID and DFID.
Written by Mara Nywao, Nutrition Specialist with UNICEF Sudan