August 2020 – Centre for Family Health Initiative

MONDAY HEALTH BURST

Breast Care, Gender, Health, WHO, Women / cfhinitiative

MOTHER TO CHILD TRANSMISSION OF HIV DURING BREASTFEEDING

Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system and is spread through the blood and certain body fluids, including breast milk. Mother-to-child transmission of HIV is the primary mode of HIV infection in infants. If neither the mother nor baby is on consistent HIV treatment, there is a high chance that the baby will be infected through breastfeeding.

Several factors can increase the risk of perinatal transmission. Having a high viral load implies that the white blood cells (CD4) which provides immunity to the body is low. A viral load indicates how much of the HIV is present in the body of an infected person. A high viral load may mean a recent HIV transmission, an untreated or uncontrolled HIV. Positive pregnant women and breastfeeding mothers with a CD4 count lower than 200 are at a greater risk of transmitting the virus to their infants.

HIV screening is essential during antenatal appointments at any health centre to ascertain the HIV status because the earlier the virus is detected the better the chances of living longer and enjoying a normal life. Test should also be repeated every three months and a Post Exposure Prophylaxis (PEP) should be received if exposed to an infected blood within forty eight hours.

Accumulating evidence has also shown that giving antiretroviral medicines to the mother or the infant can significantly reduce the risk of HIV transmission through breastfeeding. Antiretroviral prophylaxis should be made available to HIV infected mothers and mothers-to-be in all health settings and should be administered to HIV exposed infants immediately after birth. The duration for antiretroviral care and treatment for the infant is dependent on the mothers’ choice of feeding either exclusive breast feeding or replacement feeding. However, World Health Organisation recommends HIV infected mothers to only do exclusive breastfeeding except replacement feeding is acceptable, feasible, affordable, sustainable, and safe. Mixed feeding on the other hand is strongly discouraged as a breastfeeding option for reactive mothers.

All exposed infants should be tested for HIV at birth, at six (6) weeks and eighteen (18) months. This is done to monitor the HIV status of the newborn.

Monday Health Burst is an initiative of Centre for Family Health Initiative (CFHI) to tackle issues of basic health concerns. Join us every Monday for more health related articles on all our social media platforms.

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SPEAK WEDNESDAY

Gender, Politics, WHO, Women, Women in Leadership / cfhinitiative

GENDER ROLES IN LEADERSHIP

With the increasing interventions and awareness to promote equal rights and opportunities for boys and girls in Africa, more females are raising their voices against gender inequality. Women are now asserting their power as global ground breakers dominating fields and positions of leadership that were exclusively reserved for men. Women are seizing opportunities and attaining heights of success.

Around the world, women are leading countries. Queen Elizabeth II of the United Kingdom has been the reigning queen since 1952. Africa is not left out. Ellen Johnson Sirleaf was the first elected female head of state in Africa. She served as the President of Liberia from 2006 to 2018. Catherine Samba-Panza served as interim President of the Central African Republic from 2014 to 2016. She was the first to hold that position in the country. Dame Virginia Ngozi Etiaba served as the governor of Anambra State, Nigeria, from 2006-2007.

Anyone irrespective of gender who possesses leadership skills and qualities can be a leader. Thus, men and women show distinct leadership traits and qualities. Many argue that women cannot withstand the challenges that come with leadership because their biological formation detests stress and pressure. Women are judged to be reserved and soft so they can be easily swayed. Well, these qualities are more of strengths than weaknesses. The soft nature of women makes them considerate leaders that listen to the plight of the masses and strive to protect the interest of the people they serve. This is a unique leadership quality called selflessness.

Compassion is an asset every leader must possess. A leader must be compassionate, deferential, submissive, self-effacing, and treat everyone with the same level of dignity. A compassionate and humble leader will learn from others and accept mistakes because he/she is not all knowing. Women are not just compassionate and humble, they are innovative, creative, and logical thinkers. Selecting leaders based on these attributes would definitely produce more female than male leaders. These attributes earn female leaders the collaboration and cooperation of the followers to advance for a better future.

Women led nations seem to be particularly successful in fighting COVID-19. New York Times reports that the Chancellor of Germany, Angela Merkel has had fewer death rates than France, Italy and Spain. 34 year old Sanna Marin who is the Prime Minister of Finland with collaboration of 4 female led parties has had far lower deaths than nearby Sweden. Without a total national lock down, Tsai Ing-wen the female president of Taiwan has achieved one of the most successful efforts in the world at containing Corona Virus.

Women should be given more opportunities to occupy positions of leadership. Instead of criticizing the leadership abilities of women, men should be encouraged to embrace unique leadership traits of women leaders. The world will advance for the better when this is achieved.

Speak Wednesday is an initiative of Centre for Family Health Initiative to stop the cycle of domestic violence by breaking the silence around gender-based violence. Join us every Wednesday on all our social media handles for more episodes.

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MONDAY HEALTH BURST

Breast Care, Exclusive Breastfeeding, Gender, Health, Viral Hepatitis, WHO, Women, World Breastfeeding Week / cfhinitiative

BREASTFEEDING WITH HEPATITIS B INFECTION

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV) which is transmitted by blood, semen or other body fluid from an infected person. A pregnant woman with hepatitis B can infect the fetus through the placenta especially in cases of preterm labour, depending on the mother’s viral load. At birth and during breastfeeding, infants may also be infected with the virus through contact with blood and body fluids.

According to World Health Organization, Breastfeeding has been suggested as an additional mechanism by which infants may acquire HBV infection, because small amounts of Hepatitis B surface antigen (HBsAg) have been detected in some samples of breastmilk. This study also found no association between maternal e-antigen status and transmission rates. In other words, any risk of transmission associated with breastmilk is negligible compared to the high risk of exposure to maternal blood and body fluids at birth. This is because breast pathology such as cracked or bleeding nipples or lesions with serous exudates could expose the infant to infectious doses of HBV.

To avoid any form of HBV transmission from mother to child. Center for Disease Control (CDC) opined that all infants must receive hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine within 12 hours of birth. The second dose of vaccine should be given at age 1–2 months, and the third dose at age 6 months. This includes infants born to HBV-infected mothers. The infant should be tested after completion of the vaccine series at age 9–12 months, to determine if the vaccine worked and that the infant is not infected with HBV through exposure to the mother’s blood during the birth process.

In conclusion, the risk of HBV mother-to-child transmission through breastfeeding is negligible if infants born to HBV-positive mothers receive the HBIG/HBV vaccine at birth. Hence, hepatitis B infected mothers can breastfeed the babies provided the necessary precautions are taken. There is no need to delay breastfeeding until the infant is fully immunized.

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SPEAK WEDNESDAY

Cultural practices in Africa, Gender, Health, Hygiene, WHO, Women / cfhinitiative

SPEAK WEDNESDAY – SEXISM

According to Wikipedia, Sexism is prejudice or discrimination based on a person’s sex or gender. Sexism can affect anyone, but it primarily affects women and girls. It has been linked to stereotypes and gender roles, and may include the belief that one sex or gender is intrinsically superior to another.

Sexism manifests in various forms and due to stigmatization from the society, women are forced to accept abuse and neglect. Some females are denied access to proper health care, good nutrition, education and legal rights which is an infringement on their basic human rights as humans. Child marriage, female genital mutilation and other traditional harmful practices, objectification, women trafficking, forced labour, and unequal school participation are other instruments of sexism.

It is pertinent to know that not just violence but other forms of sexism have devastating consequences. Some of these repercussions affect the physical and mental health of the individuals. Sexual transmitted infections, mental disorders, depression, anxiety, low birth weight and sometimes death of the fetus of teenage mothers, obstetric fistula, death of the victim, excessive bleeding, urinary tract infections, neuroses, hatred for any form of sexual relation and psychoses fall into this category.

Education is the key for women to achieve economic independence, yet, Unite Nations (UN) estimates that women make up more than two-third of the world’s 796 million illiterate people. If a nation must achieve sustainable success, education and proper sensitization is essential. According to a popular quote by African Proverb “If you educate a man, you educate an individual. But if you educate a woman, you educate a nation”.

Proper sensitization with full participation of all genders should be encouraged to end gender stereotypes and harmful cultural practices that affect women and girls. The goal is to create a balanced system for everyone.

Speak Wednesday is an initiative of Centre for Family Health Initiative to stop the cycle of domestic violence by breaking the silence around gender based violence. Join us every Wednesday on all our social media handles for more episodes.

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MONDAY HEALTH BURST

Breast Care, Gender, Health, Women, World Breastfeeding Week / cfhinitiative

MONDAY HEALTH BURST – BREAST CARE

Breasts come in different shapes and sizes. Most women have changes in the breasts at different times during their lifetime.

After delivery, the breast naturally produces milk for the newborn to feed and to avoid contaminating the food, breast care is a necessity. Hence, in today’s Monday Health Burst, simple tips that can help prevent issues like cracked nipples, inflammation and relieve discomfort from engorged breasts are discussed below.

Firstly, remember to practice good hygiene: Wash hands before breastfeeding, wash breasts during bath, avoid using soap on the breasts to prevent loss of natural oils and cracked skin over the area.
Support: Wear supportive braziers to keep from developing back ache, but not too tight to allow the breast air. Also, to prevent infection and inflammation of the breast, change braziers or brazier pads regularly.
Latch and release: As earlier noted in the previous article, a child needs to latch properly to the breast during breastfeeding to avoid injuries or pain on the mother’s nipples. Also, the removal of the child from breast or release of the breast is just as important to prevent infection and inflammation.
Moisturize: Moisturize the breast after breastfeeding with the breast milk on the nipples! This helps to prevent drying out and cracking of the skin over the nipple areas.
Swollen? Yes, this may occur during breastfeeding and can cause the breast to harden and the milk ducts to become blocked. A cold compress can help to relieve the pain or inflammation and a warm water breast bath (without soap) can help open up the ducts.

In conclusion, breastfeeding is from the breast and as such regular breast self-examinations is essential. This care can help identify earlier blocked ducts which may appear as lumps that go away with time. Breast lumps, cysts, mastitis and painful breasts can occur in many women. Hence, knowing what is normal, how to conduct a breast check and when to see a doctor is very important especially in cases where lumps persist.

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SPEAK WEDNESDAY

Cultural practices in Africa, Gender, Health, Hygiene, Women / cfhinitiative

HARMFUL GENDER-BASED CULTURAL PRACTICES IN AFRICA

Africa accommodates various cultural, religious and traditional beliefs and practices that encourage discrimination, marginalization and injustice. Women and girls in Africa are mostly subjected to these harmful practices because these cultures encourage male preference and domination.

Female genital mutilation, breast ironing, early marriage, widowhood rites, girls initiation rites, trokosi, sororate, levirate, inability to access good healthcare especially during childbirth, lack of access to education and good nutrition, lip plate, milk teeth extraction, eyebrow incision are some of the harmful cultural practices melted out to women and girls in Africa. Females are groomed to fit into these stereotypes and are stigmatized when they do otherwise.

Female genital mutilation can lead to serious health complications such as infection, infertility, prolonged bleeding and complications during delivery, often leading to death. Infants of teenage mothers are likely to be still born or die in the first month of life. Pregnant and nursing mothers who suffer malnourishment are majorly victims of early marriage, who dropped out of school and may never get the opportunity to return.

Some victims of harmful cultural practices run away to break free from these practices, only to become vulnerable to sexual predators and human traffickers. They could suffer emotional and psychological damage that may lead to depression and suicide. Other effects include pain, resentment for sex, premature birth, low birth weight, increased violence against women and girls, increased risk of contracting HIV and STIs, impaired emotional and sexual relations, social stigma and isolation.

Raising awareness on the dangers of harmful gender-based cultural practices in Nigeria is one of the effective ways to curb this silent menace. Just like Centre for Family Health Initiative, other Community Based Organizations and Non-Governmental Organizations can work with communities to source ways to end harmful practices and promote gender equality. The government should enact policies at all levels to protect women and girls, ensuring that these policies are implemented irrespective of the socioeconomic class.

Free education, skill acquisition trainings, increased access to basic health amenities, especially for the poor and vulnerable are measures that can aid the eradication of harmful practices in communities.

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MONDAY HEALTH BURST

1 Comment / Exclusive Breastfeeding, Health, Women, World Breastfeeding Week / cfhinitiative

EXCLUSIVE BREASTFEEDING

Exclusive breastfeeding is defined as feeding infants with only breast milk, except drops or syrups consisting of vitamins, mineral supplements or medicine. It could be directly from the breast or expressed.

Exclusive breastfeeding is recommended for a period of 6 months after which solid foods can be gradually introduced while still continuing breastfeeding for up to 2 years.

Find below some of the health benefits of breast milk/exclusive breastfeeding:

Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat a baby needs to grow in a form more easily digestible than infant formula.
Breast milk contains antibodies that help babies fight off viruses and bacteria.
It lowers a baby’s risk of having asthma or allergies.
Babies who are breastfed exclusively for the first 6 months have fewer ear infections, respiratory illnesses, and bouts of diarrhea.
Breastfeeding helps burn extra calories, so it can help the mother lose pregnancy weight faster.
Exclusive breastfeeding releases the hormone oxytocin, which helps the uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth.
Breastfeeding lowers risk of breast cancer, ovarian cancer and osteoporosis.
Finally, breastfeeding strengthens bonding by giving regular time to relax quietly with the newborn.

Aside the fact that breast milk is easily accessible and more affordable, it is the best source of nutrition for a healthy term infant.

CFHI Monday Health Burst is an initiative of the organization to tackle issues of basic health concerns. Join us every Monday for more health related articles on all our social media platforms.

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SPEAK WEDNESDAY

Gender, Health, WHO, Women / cfhinitiative

GIRL – CHILD EDUCATION

According to World Bank, Girls’ education goes beyond getting girls into school. It is also about ensuring that girls learn and feel safe while in school; complete all levels of education with the skills to effectively compete in the labor market; learn the socio-emotional and life skills necessary to navigate and adapt to a changing world; make decisions about their own lives; and contribute to their communities and the world.

130 million girls between the age of 6 and 17 are out of school and 15 million girls of primary school age with half of them in sub-Saharan Africa will never enter a classroom according to UNESCO undermining the fact that education is the greatest value a child can receive irrespective of if it is a boy or girl child.

Education is included as a fundamental right every child must receive irrespective of gender, religion, age, race and culture because it is child empowerment. Women should be sent to school not because being a graduate will make them more marketable for marriage but because it empowers them to attain heights of success. The mental, physical, social, spiritual, psychological and emotional developments of a child are dependent on the value placed on them.

A popular philosophy says “When you educate a man, you educate a person but when you educate a woman you educate a nation.” The first form of education received is informal education done at home. The mother is the teacher. An educated mother therefore translates to educated and empowered children who will make positive impacts in the society. Education also presents a girl child the opportunity to compete with the male counterparts for positions and careers of interest. The female acquires knowledge and skills needed to advance their status for self-actualization, self-improvement and social interactions.

The society remains the beneficiary of girl-child education because it produces functional citizens who make informed decisions that promote a healthy society. The boy and girl child in Africa should be given equal rights, resources, protections, and opportunities. Just like the boy child, a girl child has goals she intends to achieve. Equal education for all genders involves quality compulsory education received in a child-friendly environment with equal participation. It is time to join the movement to empower all women and girls through education.

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MONDAY HEALTH BURST

Gender, Health, WHO, Women, World Breastfeeding Week / cfhinitiative

BREAST FEEDING METHODS

Breastfeeding is the act of feeding an infant with human breast milk. According to the American Academy of Pediatrics, the antibodies in breast milk can help a baby resist infections. Hence, it is recommended for all infants.

Successful breastfeeding depends on the positioning and attachment of the baby to the breast. A baby needs to be able to take a large mouthful of breast milk and feed effectively without causing any discomfort. Some of the breastfeeding positions that can be adopted include: Laid-back breastfeeding or reclined position, cradle hold, cross-cradle hold, rugby ball hold, side-lying position, upright breastfeeding or koala hold, dangle feeding, nursing in a sling, and double rugby ball hold.

LAID-BACK BREASTFEEDING OR RECLINED POSITION – The laid-back breastfeeding position, also known as biological nurturing, where baby is placed on mother’s chest or tummy as soon as he is born.

CRADLE HOLD – This is the classic position most people picture when the thought of breastfeeding comes to mind. It involves sitting upright with the baby positioned on the side, and the head and neck laying along the mother’s forearm. The baby’s body should be against the mother’s stomach in a tummy-to-mummy position.

CROSS-CRADLE HOLD – This looks similar to the cradle hold but mother’s arms switch roles so the baby’s body lies along the mother’s opposite forearm. The aim is to support the baby around the neck and shoulders to allow him/her to tilt the head prior to latch.

RUGBY BALL HOLD – In this position also known as the underarm or clutch, mother sits with the baby resting along her forearm. The baby’s body tucks alongside the mother’s side with feet towards the back of the chair or whatever the mother is sitting on.

SIDE-LYING POSITION – Ideal for relaxed night feeds and breastfeeding in bed or on the sofa. Mother and baby need to lie on the sides next to one another, belly-to-belly. Side-lying can be more comfortable than sitting if one had a caesarean or stitches.

UPRIGHT BREASTFEEDING OR KOALA HOLD – In this method, baby sits straddling mother’s thigh, or on her hip, with the baby’s spine and head upright as he/she feeds.

DANGLE FEEDING – It involves lying the baby on the back while the mother crouch over the child on all fours and dangle the nipple in the baby’s mouth.

NURSING IN A SLING – This can be done when carrying a baby in a front carrier or any kind of sling. Mothers must make sure she can see the baby’s face and chin are not pressed against the chest.

DOUBLE RUGBY BALL HOLD – The double rugby ball hold also known as the double clutch is a great breastfeeding position for twins, as the mother can feed them in tandem while having her hands relatively free.

DANCER HAND NURSING POSITION – Cup the breast with hand underneath, fingers on one side and thumb on the other, then edge the hand forwards so the thumb and index finger form a ‘U’ shape just in front of the breast. The three remaining fingers should continue to support the breast underneath. Rest the baby’s jaw on the thumb and index finger as he/she feeds with the chin at the bottom of the ‘U’. The mother’s thumb should gently hold one of the cheeks and index finger the other. This hold gives the baby enough support and the mother can easily have control over the position as well as a great view of the latch.

The most important part of successful breastfeeding is the latch. In a case where the child is not properly latched on to the breast, feedings could be painful which could lead to the baby not getting enough breast milk. Signs to confirm a good latch include; the circular movement of the jaw rather than rapid chin movement, wiggling ears, rounded cheeks, absence of clicking or smacking noises, tongue is seen when the bottom lip is pulled down, sound of swallowing, chin is seen touching the breast, when the baby comes off the breast, the nipple is not flattened or misshaped, any form of discomfort disappears as soon as the baby latches on, baby shows signs of satisfaction after breastfeeding.

In order to breastfeed successfully, it is important that the mothers and babies are relaxed and comfortable. Finding the most comfortable method will go a long way in ensuring successful breastfeeding.

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