Why promote breastfeeding in diarrhoeal disease control programmes?

Abstract

WHOs Diarrhoeal Disease Control (CDD) Programme encourages national CDD programs to center activities around improving case management practices to reduce mortality from diarrhea since proper case management practices can deliver 90% of children with diarrhea from death. Its 2nd priority is to reduce diarrheal incidence and associated harmful effects especially malnutrition. In fact WHO provides in service training on breast feeding promotion for health workers to support national CDD programs. Eventually it will support research on implementation of breast feeding programs. Research indicates that breast feeding could reduce diarrhea morbidity 8-32%. Further it shows that breast feeding not only significantly reduces the risk of diarrhea for infants especially 1-6 month infants but also can prevent adverse nutritional effects of diarrhea. In addition a child with diarrhea often does not want to eat solid foods but eagerly wants to breast feed. Further the frequency and duration of breast feeding changes little during a diarrheal episode thus the much needed energy intake during sickness remains relatively high. Moreover continued breast feeding during a diarrheal episode reduces the mortality risk greatly. For example the median relative risk of death from diarrhea among 1-6 month old infants who do not breast feed at all is 25 when compared to exclusively breast fed infants. This risk falls to 8.6 among the same age infants who partially breast feed when compared to those that are exclusively breast fed. The benefits of breast milk include its important role in preventing and managing diarrhea related dehydration and in reducing exposure to contaminated foods and fluids. Cost effectiveness studies demonstrate that the cost/diarrhea episode and cost/diarrhea death averted could be greatly reduced if CDD programs promote breast feeding.