On scorching days in Niger, it is not uncommon for a mother to give water to her infant. After all, she is thirsty so her baby must be, too. But in a nation where sanitation is poor and clean water a rarity, this maternal instinct can be life-threatening to infants by introducing a risk of diarrhea — one of the primary causes of neonatal deaths.
In Niger, 3 million children under the age of 5 years die annually. Since 2008, UNICEF, the Nigerien government and other nongovernmental organizations have developed initiatives addressing infant and child mortality in this desert country where up to 30 percent of children being treated as inpatients for chronic malnutrition are under 6 months old. A key element of the program's eight Essential Family Practices is exclusive breastfeeding for the first 6 months of life, as recommended by the World Health Organization.
While most mothers in Niger breastfeed, it is the exclusive element that the program encourages. No matter the nutritional state of the mother, nursing women are able to produce nutritious, safe milk. Moreover, breast milk adjusts to environmental changes and babies' needs. So when it's extremely hot, as it often is in Saharan Niger, the foremilk is more watery — which hydrates and slakes thirst.
"The [mortality] prevention program has a strong infant and young child feeding promotion and counseling component," says Fitsum Assefa, UNICEF's chief of nutrition in Niger. "Promotion activities take place both at health facilities when children come for treatment or preventive services, and also at community and household levels using community health workers and mothers' support groups."
So far, the program is showing success with rates of exclusive breastfeeding in Niger increasing from 14 percent in 2006 to 23 percent in 2012. Its target is to align with the WHO's universal goals to increase the rate of exclusive breastfeeding in infants up to 6 months by at least 50 percent by 2025.
According to The Lancet, if every mother breastfed their infants exclusively and immediately, Nigerien child mortality could be reduced by as much as 13 percent. "No other intervention comes close to that," says Assefa.