The mother of the twins, Saif and Ameen, is unaware that the hunger she is experiencing, due to the difficult economic situation and the years of ongoing conflict in Yemen, will also affect her two young babies. These infants, still in their infancy, will begin their early months deprived of maternal breast milk—their natural and compensatory right for all the devastation surrounding them.
The mother suffers from severe malnutrition, which has affected her milk production and, consequently, left her twins hungry. As a result, she has had to buy formula milk to compensate them as much as possible for the lack of her own milk.
The Beginning of Life
The world celebrates World Breastfeeding Week from August 1 to August 7 every year.
In Yemen, a statistic released by the World Health Organization (WHO) on its official website in mid-July showed a significant decline in exclusive breastfeeding rates in the country. According to the data, in 2023, 21% of children under the age of six months were screened for malnutrition, of which only 14% were exclusively breastfed.
This alarming decline in exclusive breastfeeding rates to concerning levels is likely to contribute to the continued rise in malnutrition rates, according to the World Health Organization. Moreover, it deprives newborns of the benefits of breastfeeding, which include building healthy immunity and strengthening the emotional bond between mother and child. Additionally, breastfeeding reduces healthcare costs for families and health authorities by preventing diseases that stem from weakened immunity due to a lack of breastfeeding.
Exclusive Breastfeeding
To highlight this decline in breastfeeding rates through local statistics, Fahd Al-Nadhari, Deputy Director-General and Nutrition Program Coordinator in Taiz Governorate, mentioned in an interview with "Khuyut" that there are specific data on exclusive breastfeeding during the first six months of a child's life, as well as on the continuous breastfeeding extending up to two years.
Al-Nadhari states: "According to the latest 'Smart Survey' conducted in Taiz in November 2023, exclusive breastfeeding rates in the governorate were 27.7% in certain mountainous areas and 20.7% in some coastal areas. As for continued breastfeeding, the statistics indicate rates ranging from 69% in mountainous areas to 77% in coastal areas."
On the other hand, cultural and social changes impact the amount of time available for breastfeeding. Additionally, habits such as chewing qat and smoking, along with certain beliefs about the physical appearance and body shape of breastfeeding mothers, contribute to this reduction.
The Harsh War Period
Nutrition specialist Zainab Al-Areefi attributes the reasons for this decline to the difficult economic situation and rising prices, which have led to families' inability to afford basic necessities, including essential food items. Consequently, this shortage has deprived mothers of adequate and balanced nutrition, negatively affecting their milk production.
There is no doubt that an individual's psychological well-being significantly affects his overall health, and this is also true for breastfeeding mothers. Al-Areefi confirms this by stating: "Breastfeeding mothers in Yemen endure a difficult period due to the war, which brings about various problems, stress, anxiety, emotional impact, loss, and sadness. All of these factors affect their mental state, which in turn leads to a decrease in the production of prolactin, the hormone responsible for stimulating milk production. Consequently, this results in reduced milk supply or even a milk drought."
Likewise, social specialist Hanan Al-Mohammadi believes that the decline in breastfeeding rates in Yemen is due to several factors, including the mother's constant engagement in work. In an interview with "Khuyut," Al-Mohammadi asserts that the increasing participation of women in the labor market and the need for families to balance job responsibilities with childcare have affected the frequency of breastfeeding sessions for infants.
Al-Mohammadi adds, "Cultural and social changes, including increased maternal interest in recreational activities and luxuries, have reduced the time available for breastfeeding. Additionally, some breastfeeding mothers engage in habits like chewing qat and smoking, which affect their own nutrition and the nutrition of their infants. There are also some misconceptions and false information, especially among younger mothers, regarding the fact that breastfeeding might negatively impact their appearance and body shape."
The Issue of Cesarean Deliveries
For her part, Sahar Al-Qadi, a specialist in obstetrics, gynecology, and infertility, cites additional reasons for the decline in breastfeeding rates in Yemen, represented by the lack of awareness about the importance of breastfeeding, in addition to the availability of an alternative, represented by the formula milk, with its various types and prices in the markets.
Moreover, Al-Qadi emphasizes in her interview with "Khuyut" that the increase in cesarean births also plays a role in harming and compromising the mother's health and her ability to breastfeed. She explains, "Mothers who do not breastfeed their babies within the first few hours after birth often face difficulties with breastfeeding. This is because the newborn loses the ability to suckle after some time, especially when he becomes accustomed to the ease and availability of a bottle with formula milk."
Al-Qadi continues, "There are also other challenges and reasons that breastfeeding mothers may face, such as the difficulty of waking up for night feedings, particularly in the first weeks after childbirth. Some mothers experience nipple pain, breast engorgement, or mastitis. Additionally, in certain medical cases, the immediate separation of the baby from the mother after birth for treatment can also negatively impact the mother's ability to breastfeed."
“Breastfeeding is one of the methods of family planning and spacing between pregnancies. It also reduces the risk of breast and ovarian cancer, according to scientific studies and research.”
Unaware of Benefits of breastfeeding
Many mothers may not be aware of the benefits of breastfeeding for both their health and their child's health. Al-Areefi emphasizes this by stating, "For the mother, breastfeeding reduces postpartum bleeding and helps the uterus return to its normal position more quickly. It also aids in the mother’s return to her pre-pregnancy weight, as breastfeeding burns calories, unlike formula feeding."
Al-Areefi adds: "Breastfeeding is also recognized as one of the methods of family planning and spacing pregnancies. It also reduces the risk of breast and ovarian cancer, according to scientific studies and research."
She continues: "As for the child, breastfeeding promotes healthy growth, as breast milk contains all the necessary nutrients for the child's needs, especially during the first six months, while formula feeding contributes to excessive weight gain in the baby."
Al-Areefi points out that breastfeeding reduces the risk of illnesses such as diarrhea and gastrointestinal disorders in children. It also lowers the likelihood of developing both type 1 and type 2 diabetes later in life.
Mothers Lacking Awareness
Awareness of the importance of breastfeeding is shifting across generations in Yemeni society. In this regard, social specialist Al-Humaidi says: "Mothers from previous generations were well aware of the benefits of breast milk in boosting and strengthening the child’s immunity and health due to its natural, reliable vitamins. In contrast, mothers of the current generation face several challenges due to a lack of awareness about the crucial role of breast milk for the child's natural growth, which affects their willingness and acceptance to breastfeed their children."
For her part, Al-Qadi notes that there is widespread ignorance among mothers, with many believing that formula feeding is sufficient for the child. However, others believe that breastfeeding during the first week or the first six months is adequate to provide the child with the necessary immunity and essential nutrients.
Necessary Advice for Nursing Mothers
The role of raising awareness about the importance of breastfeeding is not limited to a specific entity but is a societal responsibility. In this context, Dr. Al-Qadi stands as an example of many Yemeni female doctors who work to raise and spread awareness about the benefits of breastfeeding among mothers through their daily work in their clinics. Dr. Al-Qadi provides the necessary guidance and advice to mothers on the advantages of breastfeeding for both the child's and the mother's health, and she helps them overcome any obstacles they might face in breastfeeding their infants.
Al-Qadi says: "I work on raising awareness among mothers about the importance of breastfeeding from the beginning of pregnancy by explaining its benefits, which they may overlook. For instance, the fact that breast milk is constantly renewed day by day according to the baby's needs, whereas formula milk has a fixed composition. Additionally, I emphasize the importance of the emotional bond that develops during breastfeeding."
He also explains the correct way of breastfeeding to mothers, as many find it difficult and need more time to practice breastfeeding properly, according to her.
Regarding local efforts and programs aimed at raising community awareness about the importance of breastfeeding, Al-Nadhari discusses the role of the Public Health Office in Taiz. He highlights that the office is working to enhance the counseling department in health centers to support infants and pregnant mothers. He confirms that the plan is to increase the number of counseling corners, ensuring that each health facility will have a dedicated counseling area in the coming year. These corners will target these groups and emphasize the importance of exclusive breastfeeding during the first six months.
Al-Nadhari continues, "The Public Health Office is also working to strengthen the role of community health and nutrition volunteers, referred to as 'second and third line' volunteers, who operate outside of health facilities. Their goal is to target mothers and young children to raise awareness about the importance of breastfeeding and proper nutrition."
Al-Nadhari concludes by pointing out that their awareness efforts also include addressing and correcting misconceptions among some women who believe that breastfeeding may affect the aesthetic appearance of the breast and lead to sagging.
