Zambia Promotes Breastfeeding With Plan for Tougher Ban on Substitutes

LUSAKA, ZAMBIA — While breastfeeding, Pamela Ndalama’s baby, Katie, cuddles the breast and swings her legs.

Ndalama says she exclusively breastfed her baby until she was 6 months old, before introducing her to solid foods. She intends to keep breastfeeding her while continuing to introduce foods until Katie, now 8 months old, reaches the age of 2.

Nutritional experts advise mothers like Ndalama to exclusively breastfeed their babies until they are 6 months old to provide a healthy start.

To promote early exclusive breastfeeding, the Zambian government is proposing to broaden the current ban on formula and other breast milk substitutes to include infant foods. The government also will extend penalties to companies flouting the law.

The Zambia Demographic and Health Survey of 2013-2014 indicates that 40 percent of children under the age of 5 are stunted, which UNICEF defines as having low height caused by insufficient nutrient intake; 6 percent are wasted, which UNICEF defines as having a low weight for their height, a predictor of mortality; and 15 percent are underweight.

Dorothy Sikazwe, chief nutrition officer at Zambia’s Ministry of Health, attributes the stunting, wasting and underweight to the lack of exclusive breastfeeding for infants before they reach the age of 6 months.

Zambia already has regulations that prohibit manufacturers from advertising breast milk substitutes, and now the Ministry of Health wants to toughen the rules by including penalties for violations and by extending the ban to ads for infant foods like cereal, says Mulonda Mate, the ministry’s deputy director for environmental and occupational health and safety.

According to the proposal, no breast milk substitutes or food for infants or young children should be advertised, with young children defined as those less than 36 months.

First-time offenders will face fines not exceeding 600 Zambian kwacha (about $64) or imprisonment for up to six months.

A second offense will result in a fine not exceeding 750 kwacha (about $80) or imprisonment for up to 12 months.

If adopted, the regulation would penalize manufacturers that violate it by cancelling or suspending their licenses.

Mate says the Ministry of Health is still working on the bill and talking with stakeholders before finalizing the expanded regulations. Once the legislation is put into place, the ministry would work with the Zambia Bureau of Standards, and police to ensure compliance, he says.

James Songwe, media manager at Trade Kings, a local company that manufactures a baby cereal known as D’lite, declined to comment on the proposal, other than to say the company was aware of it and is speaking with the government about it. “We do not want to pre-empt our contribution through the media,” he says.

D’lite is widely advertised in Zambia. Its ads include a disclaimer that says breast milk is best for babies, and mothers should introduce cereal to babies only after they are 6 months old.

Ndalama supports the ban. She says advertising breast milk substitutes and infant foods discourages breastfeeding.

“Mothers will be influenced into buying these products,” she says. “Advertisement easily sways people into believing that the product is the best.”

Tina Nyirenda, a mother and retired midwife, says mothers need better information on the importance of breastfeeding and how to accomplish it.

“The best we can do is to teach mothers how best they can exclusively breastfeed,” she says. “Give them the support. Advertising breast milk substitutes will only kill our babies.”

But Martha Soko, a mother of four, says banning advertisements on breast milk substitutes or infant foods would be risky to mothers who can’t exclusively breastfeed and who might be sharing ignorance among themselves.

“I have seen women going to the internet to search what product is good for their babies,” Soko says. “Others share information ignorantly on social networks. And how about those babies whose mothers have died? How do you feed them if you can’t get information on products?”

Sikazwe says the ministry is aware of the challenges some women face in exclusively breastfeeding their babies.

“Breastfeeding is important for the growth of the child, but not without challenges,” she says.

Sikazwe says expressing milk is the best option for working mothers. However, she understands that storage of the milk is sometimes difficult if they work in areas without refrigeration.

“But as much as it is a challenge, mothers must make sure they do the best to breastfeed their babies,” she says, “unless it can’t be done.”