Maternal Health, Breastfeeding and WASH

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By: Katie Millar, Technical Writer, Women and Health Initiative, Harvard T.H. Chan School of Public Health

This week is World Breastfeeding Week! At the MHTF, we love breastfeeding because it not only saves lives, but is also a great example of maternal and newborn health integration. Yet something related that we don’t often talk about in maternal and newborn health is Water, Sanitation and Hygiene or, WASH. Many of the world’s mothers and newborns live in areas where sanitation is poor and clean water is scare, if not absent. A recent post for 1,000 Days by Rebecca Fishman, highlights the important intersection of maternal and newborn health, breastfeeding and WASH.

“The first 1,000 days of a child’s life are critical in fetal and child development; children are especially vulnerable to the adverse and chronic effects of intestinal diseases brought on in part by poor WASH.”

Maternal health and education play an important role in preventing these diseases. What the newborn is exposed to is dependent on the sanitation and hygiene conditions experienced by the mother, conditions that affect her health, as well. A woman’s knowledge of WASH practices, like hand washing, is critical to both her and the newborn’s health. Fishman states, “Mothers who do not wash their hands at appropriate times can pass harmful bacteria and pathogens to their infants while feeding. For infants who are not exclusively breastfed, formula mixed with unsafe drinking water can cause bouts of newborn and child diarrhea, and can lead to stunting, wasting, undernutrition, and even death.”

Educating women on WASH and breastfeeding is critical to infant health.

“Breastfeeding protects infants by decreasing their exposure to food and waterborne pathogens and by improving resistance to infections. Access to proper sanitation reduces exposure to pathogens by separating excrement from a child’s physical environment… A study in Pediatrics found that infants without piped water or toilets and not breastfed are five times more likely to die after one week than those who were breastfed. A Journal of Biosocial Science study showed that infants living in areas with poor sanitation who are mixed-fed (both breast milk and formula) have a higher risk of diarrhea than infants in the same area who are only breastfed. Access to WASH is a critical component of successful breastfeeding. Reductions in diarrheal disease alone through safe WASH can prevent long-term morbidity and at least 860,000 child deaths a year caused by undernutrition.”

Supporting new moms to breastfeed is key to infant and child health. Yet, mothers who want to breastfeed may face many challenges, such as low supply, an infant who doesn’t latch easily, and a need for employment that may preclude her from breastfeeding. As we talk about infant health, breastfeeding, and WASH, let’s not forget that health systems, policies, and programs need to support the mother to address her needs and health. Women who are well-supported and educated will also be able to provide care that promotes and protects the health of their newborn and infant.