Why do 70% of Cuban mothers not exclusively breastfeed their babies?
World Breastfeeding Week, from 1 to 7 August, has received broad coverage in the national press. Various efforts focus on explaining the benefits that this type of feeding affords mothers and babies, like the celebration of the opening of the country's ninth breast milk bank, this time at the Camilo Cienfuegos Hospital in Sancti Spiritus.
But the promotion of breastfeeding is a task all year round for Ministry of Public Health workers. Family neonatologists, pediatricians, doctors and nurses are working on this issue every day.
Although breastfeeding as a form of exclusive nourishment during the first six months is one of the practices upon which they place the most stress, and all mothers are aware of its benefits, the official figures presented by the media are striking: only 30% of Cuban babies are fed only with breast milk during this stage.
What is going on at at the nursery sections of maternity hospitals?
According to Yasbell Pérez, a neonatology nurse, most mothers do want to breastfeed their children – and are even inclined to helping by donating their milk for other babies.
"Donations received by banks are mainly for low-weight babies, weighing less than 1,500 grams, that need a boost in their nutrition," she explains.
"There are babies who receive milk from the banks in their first hours because their mothers have not yet recovered, due to delivery complications or Caesareans, but then they start up and feed their children without any problems," she adds.
Despite the promotional campaign's insistence that there are no justifications for not exclusively breastfeeding babies, Yasbell recognizes that not all mothers have the same amount of milk, or milk of the same quality.
"In those cases, we assess whether the child actually needs a booster, and then we give the child the milk, but never before it has mother's milk. If, after being breastfed, it is still hungry, it then gets pasteurized milk from the bank."
Dr. Mabel, a GP, explains: "the satiety center in newborns is not yet well developed, such that babies always want to keep getting food. So, you have to determine whether they are crying out of a lack of nutrition or for some other reason."
"A mother who sees her baby crying, non-stop, grows desperate," Yasbell explains. "It is our job to give her direct and specialized care, so that she calms down, but we always insist that the she keep trying to breastfeed, though we give her supplementary milk."
If Cuban mothers prefer to breastfeed, and the specialists continue with their efforts, why are the figures are so low?
"There are lots of reasons why mothers give their children other foods during the first six months of life," says Dr. Mabel. "The least important is that they don´t want to see their breasts deformed. This happens in the case of actresses, models, and women whose work requires a certain physical appearance. Cuban women in general see breastfeeding as something inherent to their roles as mothers."
However, Mabel says that in her practice the figures are even higher than those officially released: 90% of mothers give their babies other foods during the first months.
"Many of my patients are the breadwinners of their households, especially those who have jobs partially paying in cash," Mabel said. "They have to start working as soon as possible after giving birth. Although they have maternity leave, they cannot enjoy it as they should."
Most women simply cannot maintain the balanced diets that the nursing period requires, and this, according to Mabel, is the main reason for the introduction of other foods.
“Cuban women, even before getting pregnant, do not have the required nutrition. At the start of the pregnancy a high-protein diet is necessary, but that's impossible, due to the dearth of food,” the doctor explains. “That same diet is what breastfeeding calls for.”
Cuban women usually have more than one kid, so, if one has a newborn and another young child, for example, if that mother gets some beef, or fruit, do you think she's going to eat it or give it to her other child?" she reasons.
Laura, a young mother, condenses the doctor's contentions: asked why she did not continue to exclusively breastfeed her baby daughter for three months, she replied: "Because there's not enough food for that."