Friday, September 7, 2012

Wet nursing: The modern woman’s option?

By ALEX NDIRANGU

Wet nursing is not a new phenomenon in Kenya, but if you were to ask many pregnant or nursing women if they would hand their child over to another woman to breastfeed, the answer would be an emphatic ‘No!’

And this is even before you consider how much sense it makes: breast milk is the perfect food for baby’s mind and body, but many busy, working women are unable to breastfeed because of work constraints and the subsequent reduced milk production.

Lifestyle and health conditions might also impact a woman’s ability to nurse her child, which is where a wet nurse – a woman who breastfeeds your baby on a permanent basis – steps in.

Linda Oyier is a Nairobi mother whose children have always been breastfed by her younger sister. When she delivered her first child six years ago, for some reason, her breasts could not produce milk.

“I always knew that breast milk was the best for my child, but then I could not produce any. At first I turned to formula milk, but it didn’t work well because my daughter ended up having constipation”.

Coincidentally, when Linda’s first child was a few months old, her younger sister, whom she was living with, also had a baby.

“I gave her my child to breastfeed alongside hers,” she recalls.

By the time Linda was giving birth to her second child, her sister’s firstborn was still breastfeeding, so she nursed them both.

“My sister is currently expecting her second child. I plan to have my third child when my niece or nephew is one year old, so that my sister can nurse my baby, too,” she says.

Ancient roots

It is thought that wet nursing started in ancient times when a mother died during child birth and another woman breastfed and raised the baby. This was especially so in some African cultures where maternal and child mortality was high.

“Most African families were polygamous, and if one of the mothers in the family fell ill or died during childbirth, it was the duty of her co-wives to nurse and bring up the child,” notes Judy Nyonje, a historian.

In some countries like China and the Philippines, and amongst European royal families, giving your baby to a wet nurse was a sign of wealth and social status.

These days, wet nursing is becoming something that high-powered, working mothers on a tight schedule do. Mothers who want to get pregnant soon after delivery have also been seeking the services of wet nurses, as breastfeeding prevents ovulation.

A mother taking drugs (prescription or illegal) may require the services of a wet nurse if the drug changes the content of her breast milk. Breast implants and surgery, in some instances, may also lead to non-production of milk. And finally, multiple births may also necessitate a wet nurse to ensure the babies are sufficiently fed.

In developed countries, agencies that supply wet nurses have reported an increase in the practice which has been highly commercialised. For her trouble, a live in nurse can earn up to $1 000 (Sh84 000) per week.

Experts argue that there is no reason why women should not lactate indefinitely or feed more than one child simultaneously.

“Even women who are not lactating or do not have children can still breastfeed,” says Dr Francis Nyamiobo, a physician with the Kenya Aids Control Project. “Regular breast suckling can elicit milk production through a neural reflex action.”

Some adoptive mothers have also been able to establish lactation using a breast pump.

Extra care

However, there has been growing concerns about milk sharing because some medical conditions like hepatitis B, tuberculosis and most importantly HIV/Aids pose a great risk to the child if the wet nurse happens to be infected.

Dr Nyamiobo notes that in Kenya, about 15 per cent of children who are breastfed by HIV positive mothers who are not on anti-retroviral therapy end up being infected with the virus.

“We have been testing over 95 per cent of expectant women in antenatal clinics,” he adds.

“Those who are HIV positive are put on ARVs, as well as are babies, while ensuring the babies are exclusively breastfed for six months to protect the child from infection.”

This initiates the prevention of mother-to-child transmission of HIV.

However, the success of this initiative might be hindered by wet nurses if they happen to be infected with HIV. This calls for extra care and precaution while choosing a wet nurse.

“Domestic workers should also be considered as they might end up breastfeeding the child while the mother is away,” the doctor says.

Though her children, aged six and four, are healthy, Linda Oyier promises to be extra careful.

“I trusted my sister and did not know of any health risks involved,” she says.

But even with all these precautions, some mothers might still be wary of engaging a wet nurse. Ellen Steinberg, a US-based lactation consultant, puts things in perspective:

“You’re giving a baby some cow’s milk, as opposed to some human milk, which isn’t even species-specific for the baby.” Is wet nursing something that you might consider?

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