Breastfeeding through the pandemic  

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By Lisa Hamilton  

Even with an ongoing pandemic, as new babies are born into the world, health workers globally are highlighting the importance of breastfeeding for newborn as critical to their health and development.

The pandemic is an addition to the many challenges that can affect breastfeeding but, health workers at the Georgetown Public Hospital Corporation (GPHC) said that they are determined to assist and advise parents about overcoming these hurdles.

Sharing their experience and advice in an interview with the Village Voice News were Ann Ferguson and Keisha Roach, both employed as ‘Staff Nurse – Midwife’ at the Maternity Unit of the GPHC. They did so even as today, August 1, 2021, commences World Breastfeeding Week under the theme: ‘Protect Breastfeeding: A Shared Responsibility’. The theme highlights the links between breastfeeding and survival, health and wellbeing of women and children.

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THE IMPACT OF COVID-19 

When COVID-19 hit, like the rest of the world, Ferguson said that Guyana’s health system was unprepared. As soon as they became organised, the Maternity Ward began to separate those who were tested negative for the virus and those who weren’t tested or were showing symptoms. However, while many awaited their results, the environment was tense.

“That was very fearful. It was very scary having to work with these ladies not knowing what their test will come out to be and not having so much information about what COVID-19 really is,” Ferguson recounted. “Nevertheless, we persevered…as nurses, we’re counsellors also so we always supported and encouraged them. If our little intervention wasn’t enough or you see the mother is still worried or has lots more questions, we have our social worker and she would counsel them on a way forward.”

Not long after cases in Guyana began to spread, the hospital introduced its COVID-19 transition and isolation area for the Maternity Ward which helped to prevent the possible spread of the virus. Fast forward to August 2021, there is more information available to the public about how all persons, including pregnant women, can protect themselves and their babies whether positive or negative.

There is still some disagreement among health workers locally about whether positive mothers should be breastfeeding. At the GPHC, if a mother is tested positive after giving birth she is placed in COVID-19 isolation and if the child previously had contact with the mother the child is placed in the Neonatal Intensive Care Unit (NICU) for precaution. However, according to PAHO/WHO, if a mother is confirmed or suspected to be COVID-19 positive, the baby should still be permitted immediate and continued skin-to-skin care as this improves the temperature control of newborns and is associated with improved survival among newborn babies.

“The numerous benefits of skin-to-skin contact and breastfeeding substantially outweigh the potential risks of transmission and illness associated with COVID-19,” PAHO/WHO has stated.

Meanwhile, regarding COVID-19 vaccination, Head of Medical Services and Cardiology at the GPHC, Dr. Mahendra Carpen has assured that the COVID-19 vaccine is safe for pregnant and breastfeeding women as well as their babies.

In fact, he underscored that vaccination is important for pregnant women because pregnant women who become COVID-19 positive can run the risk of becoming severely ill with an increased risk of hospitalisation, developing blood clots and being admitted to the Intensive Care Unit (ICU). He has also stated that if a breastfeeding or a pregnant woman takes the COVID-19 vaccine, the baby develops immunity either transmitted through the breastmilk or in the womb through the blood supply.

CHALLENGES OF THE WORKING WOMAN 

Staff Nurse – Midwife, Ann Ferguson and Staff Nurse – Midwife, Keisha Roach, both employed at the Maternity Unit of the GPHC.

Apart from COVID-19, there are many challenges that still persist around the world and continue to hinder or discourage women from breastfeeding. One such challenge is the unavailability of maternity leave to women involved in informal work. Oftentimes, these women makeup society’s poorest class and exchange the time it takes to breastfeed the child for income through labour which is needed for their survival.

In such cases, Ferguson said that it can be a mental and physical challenge but, to the best of their ability, mothers should not skip breastfeeding especially during the first 6 months of a child’s life. Meanwhile, Roach encouraged mothers who need to work away from their child during these months to set up a system of returning home at specific intervals to breastfeed the child or placing the child in a daycare that is close to their place of work. If a mother expresses breast milk for later use, it is advised that the newborn be fed with a spoon or cup instead of a bottle nipple as it can detach the child from wanting to breastfeed.

WHOSE RESPONSIBILITY 

As mothers manoeuvre their unique challenges that can come along with a newborn, questions have been asked about whether the responsibility to breastfeed only lies in the hands of the mother. To this, Ferguson and Roach say ‘no’. Roach said that fathers can play a role by helping to remind the mother when it is time for breastfeeding; helping to ensure the mother is comfortable to breastfeed and encouraging the mother to breastfeed if she becomes unmotivated.

The United Nations (UN) has also stated: “Breastfeeding is not only time consuming, but also requires a lot of physical energy. Stress, fatigue and anxiety can reduce the amount of milk a woman produces. In both rural and urban areas, women are often overburdened with family responsibilities like cooking and cleaning. For women employed outside the home, there is the added stress and pressure on their time which requires additional support in taking care of the new addition. Studies show that when men have information on exclusive breastfeeding, they can support women by helping with housework, looking after children and even providing the much needed continuous emotional and physical support as a skilled assistant or a partner.”

Still, it is ultimately the woman who must perform the act of breastfeeding. The midwives told the newspaper that there still are some women in the Guyanese society who avoid breastfeeding over concerns that their breasts would become saggy. To a lesser degree, there are also mothers concerned about breastfeeding in public.

However, Ferguson reminded that Guyana has come a long way as it regards infant deaths towards seeing a major positive reduction. It still remains today, she said, that breastfeeding is the best action a mother can do to promote the health and development of her newborn child. She said: “In the earlier centuries we had more maternal deaths, we had more infant deaths because we weren’t knowledgeable about certain things. Now, we have more evidence and research and that’s a plus for the Maternity Unit…breast it the best.”

For World Breastfeeding Week, the GPHC will mount a banner in front of the Maternity Unit with information about the theme and objective. There will also be a symposium, fair and other information-sharing events in collaboration with the Ministry of Health.



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