Abstract

PIP: A survey of breastfeeding practices in the principal cities and towns of Senegal demonstrated that bottle feeding is making inroads. Strategies are therefore needed to maintain breastfeeding and avoid further spread of bottle feeding. Factors unfavorable to breast feeding are essentially socioeconomic and cultural; urbanization, industrialization, increased female labor force participation, hospital organization, lack of health education at all levels, declining interest in and prestige of breast feeding, use of contraceptives which inhibit lactation, and especially the numerous and powerful advertising campaigns for infant formula. 4 types of measures are needed to stem the decline of breast feeding: education, a more complete preparation for maternity among expectant mothers, legislation and social action, and actions by health personnel. Mothers should not just be told to breast feed their infants; the reasons for the superiority of human milk should be explained to them. Educational measures might include strengthening the supportive role of husbands in breastfeeding and increasing the availability of information in urban and suburban areas to make women aware of services available. During pregnancy, all women should be prepared to breast feed and those at risk of not breast feeding should be identified and followed up. Infant-maternal contact in hospitals should begin immediately and efforts to breast feed should commence within 3 hours of birth. Samples of infant formula should not be provided and complementary feedings should be discouraged. Health personnel should provide practical advice on breast feeding and hygiene. Infants should be breast fed exclusively for at least 4 months. Prenatal leave for working women should be increased and the time should be used to prepare women psychologically for breast feeding. Postpartum leave should be increased to 12 weeks for all women. Nurseries should be erected in all workplaces. Midwives and other health personnel should be informed of the need to encourage breast feeding and should set a good example by breast feeding their own infants. Advertising of infant formula should be prohibited and such products should distributed as pharmaceuticals. Health personnel should be knowledgable enough to answer the questions and objections of new mothers.