Guest Posts

Guest Post: What Sahel is up with Breastfeeding?

Before coming to Burkina Faso, I can’t say that I knew much about breast feeding. I am a gay man from the U.S. who suddenly found myself in the small patch of Sahel above Ghana. I have held at least several hundred more Burkinabé babies than I have ever American ones. I have watched countless mothers breast feed their kids. Babies reach around from behind, sometimes mothers carry babies under their arms and of course the standard cradled feeding. Breastfeeding is so natural in public, women sometimes forget that their chest is exposed after their child unlatches. It is refreshing when you come from the puritanical restrictions of the States.

Before coming to West Africa I had experience in sexual health promotion and HIV prevention. I didn’t think of HIV transmission in terms of mothers and their children. Frankly, I didn’t think of breastfeeding much at all. Now, my concept of breastfeeding has taken a naturally clinical turn, since I am working in public health. I think of breast feeding in terms of nutrition, HIV and malaria.

In Burkina nearly a third of infants are under-nourrished. Some of the issue is a lack of food, but part of the problem is food selection during the weaning process. Babies are often given a plain millet porridge when they need additional ingredients to maintain healthy weight and physical development. Nutritional local ingredients are available. Even wild plants such as the legendary baobab (think the monkey’s tree in “The Lion King”) can be used to ensure optimal nutrition during weaning.

For cultural reasons women often do not allow their babies to take the colostrums (first milk) because it seems to be discolored. This is rather unfortunate for babies that may already be born with a lower birth rate because of their mother’s lacking diet and/or malaria during pregnancy. Also, some believe that a baby should be given water or tinctures that not only prevent a baby’s appetite for milk, but also risk infecting the child with intestinal parasites.

In terms of HIV, mother to child transmission is one of if not the most important area of transmission. Women’s testing is subsidized by international donors and the Burkinabé government. ARVs (anti retro virals) are provided to pregnant women who test positive and they are given instruction on how to breastfeed and wean early to maximize the natural benefits while minimizing the risk of transmission.

At the Stomp Out Malaria Boot Camp I learned that in terms of malaria, babies who are breastfeeding are less susceptible to infection because of the resistance acquired through breastmilk. The most at risk are the children who have been weaned, but haven’t been exposed to malaria enough to develop their own resistance. Pregnant women and young mothers are encouraged to sleep under mosquito nets to prevent infection and are encouraged to take young children with a fever directly to a health agent. Malaria during pregnancy can lead to low birth rates and death of the mother or fetus.

Here breastfeeding is much more than just a natural process. There are layers of cultural expectation, implications of poverty and of course foundational health practices playing a part in a mother’s life. Public health interventions involve a wide range of topics including optimal positioning of the baby, how to know when a baby needs to feed and weaning methods. Without access to formulas (or treated water to mix them with) and with an overall imbalance of nutrients in diets, breastfeeding is paramount to a baby’s success in early years. Women here don’t have the luxury to set breast feeding aside with modern cultural trends like American mothers.

About the Author:
Casey D. Hall is a Health Development Peace Corps Volunteer in Burkina Faso and will be pursuing his MPH beginning the fall of 2012. Observation of breastfeeding has consumed much of the past two years of Casey’s life. As a queer activist and ally to women’s movements, he is passionate about gender studies, race studies, reproductive health, queer theory and international studies. He blogs about his experiences at

2 thoughts on “Guest Post: What Sahel is up with Breastfeeding?

  1. Casey, this is an AWESOME post! And I am super excited you are sharing about your experiences in Burkina Faso and everything you’ve been learning about breastfeeding!
    I have so much to say about this, but I won’t overwhelm you with an extremely long comment.

    From what I’ve learned so far and what you’ve written here, breastfeeding is often the difference between life and death for many babies (and some mothers), and I’ve really been thinking about this — this is what brought me into the realm of breastfeeding initially and everything behind it — the cultural, political and social implications — WHO has access, WHO DOESN’T and WHY!

    It’s amazing to see the different cultural implications behind the ritual, yet it is also in those areas where you understand the importance! I’m very curious to know more about the idea of colostrum being discolored. I always promote breastfeeding for a number of months and even years, but colostrum is undeniably important, and when I hear of someone who is adamantly against breastfeeding, or for whatever reasons, cant or don’t breastfeed, I try to encourage them to AT LEAST nurse for the first few days — If nothing more, to give their baby the first milk!

    With your background and studies, I think you have such an awesome perspective you bring to the realm!! I am so happy for you and your MPH, and know you will make a HUGE impact in public health!! Thank you for doing what you do!! And thank you for sharing this on Lactation Journey Blog!

    P.S., I just can’t get past this line “Breastfeeding is so natural in public, women sometimes forget that their chest is exposed after their child unlatches.” I just recently attended a nurse-in that shows how puritanical indeed The States are!

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