Breastfeeding Brilliance
How one Zambian nutritionist is helping to prevent malnutrition
One morning at a health clinic in Lusaka, Zambia, nutritionist Esnart Siyanga prepares to counsel a group of pregnant women on exclusive breastfeeding — when a baby receives only breast milk as their sole source of nutrition.
Like her name, which means serious and determined, Esnart is passionate about preventing malnutrition and improving newborn health outcomes. Esnart has worked as a nutritionist at Bauleni’s Urban Clinic for five years after transitioning from a nursing career. One of her top priorities? Helping new mothers successfully breastfeed.
Breastfeeding helps babies not only survive but thrive.
“Breast milk is very important, apart from the economy part, the socioeconomic part. It’s also about bonding, even the development of milestones, you find that the child will grow without difficulties,” Esnart said.
Exclusive breastfeeding is powerful in protecting infants from malnutrition, and critical for both cognitive and physical development. Breastfeeding also benefits mothers by lowering their risk of developing postpartum depression, cancer, high blood pressure, and type 2 diabetes.
A Day in the Life as a Nutritionist in Zambia
Bauleni’s Urban Clinic sees a lot of expectant and new parents from near and far.
USAID, in partnership with UNICEF and the World Health Organization (WHO), trained Esnart and other healthcare providers at the clinic in the 10 steps to successful breastfeeding and breastfeeding counseling in compliance with the Baby Friendly Hospital Initiative.
Esnart now trains other health care workers using her knowledge from the USAID-led training.
The expectant mothers’ counseling group is one of many tasks Esnart takes on daily. Afterwards, she goes to the maternal and child health ward, clad with USAID training materials on the walls, to perform hands-on assistance with new mothers learning to breastfeed.
Esnart then does private breastfeeding consultations in the nutrition office.
She met with Phebby Tembo, whose newborn was severely malnourished, weighing just 3.3 kilograms (7 pounds) at the two-month mark. The baby was not gaining weight. Phebby was concerned her breast milk didn’t have enough nutrients, so she had been mixed feeding — feeding the baby with both breastmilk and infant formula by way of a spoon.
Esnart showed Phebby how to sit, position the baby, and hold her breast, while imitating the suckling sounds moms should hear when the baby is latching. The baby quickly latched onto Phebby’s left breast and began feeding with no difficulty.
Following baby cues and proper latching, Esnart then went over the importance of exclusive breastfeeding on demand, when the baby’s cues show they are ready to feed, or about nine times a day and three times a night, using a flip-book and wall posters provided by USAID and implementing partners.
“Mixed feeding makes a child more prone to malnutrition,” Esnart said. “If the child is well breastfed, without mixed feeding, they grow well. They grow without illnesses. They are healthy. They grow up, they [come] to be smart, the brain is well developed.”
In Zambia, there is a high newborn and under-5 mortality rate, with a percentage of these deaths attributed to malnutrition. Throughout the country, there is a traditional saying that if the baby’s head is sunken on top, then the baby is dehydrated, and if the baby has an “old man’s face,” then the baby is malnourished.
Esnart shows Phebby the baby’s signs of malnutrition and dehydration, instructing her to bring the baby back to the clinic once a week for a weight check. She then explains why he is not eating enough or properly. Since Phebby doesn’t own bottles or have adequate access to formula, feeding the newborn formula with a spoon will continue to make his nutrition worse.
“The economy is bad, and breast milk is free,” Esnart said. “The temperature is okay, no need to buy charcoal or other things to warm it. No need to buy anything. When a mother is doing mixed feeding, there are times when they don’t have money or resources for food and other things [like a bottle], but for milk, if the mother is able to breastfeed frequently, then the baby is able to breastfeed even when the food is little in the home.”
At the clinic, Esnart and the health care providers emphasize exclusive breastfeeding within one hour of birth and for at least the first 12 months of the baby’s life.
The Importance of Training Health Care Workers
USAID supports the Government of Zambia in implementing Zambia’s Reproductive, Maternal, Newborn, Child, and Adolescent Health, and Nutrition Roadmap, which addresses the root causes of preventable maternal, newborn, and child deaths.
Through this partnership, USAID is investing in affordable, effective solutions to make it easier for pregnant women to access and receive primary health care. This includes training health workers like Esnart, and providing them with the tools and knowledge to implement affordable solutions, such as effective breastfeeding practices, to fight malnutrition. In 2023, U.S. Government-supported programs in Zambia trained more than 2,000 health workers on nutrition and reached more than 22,000 pregnant women with nutrition-specific interventions.
About the Author
Kossana Young is a Strategic Communications Specialist for the Office of Maternal and Child Health and Nutrition in the Global Health Bureau.
