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Benefitting Babies and Moms: Nuclear Techniques to Assess Breastfeeding Practices

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The side event 'Nuclear Techniques to Assess Breastfeeding Practices' held during the 60th IAEA General Conference. (Photo J. Krickl/IAEA)

Did you know nuclear techniques can be used to evaluate the success of national breastfeeding programmes? This was one of many topics discussed on the margins of the first day of the 60th IAEA General Conference. A side event titled ‘Nuclear Techniques to Assess Breastfeeding Practices’, jointly organized by the Department of Nuclear Sciences and Applications and the Department of Technical Cooperation, brought together over 80 participants to hear about and discuss the benefits of breastfeeding, national interventions to encourage breastfeeding, and the contribution of nuclear techniques. Speakers included experts from the Federal University of Pelotas, Brazil, the World Bank and the World Health Organization, as well as experts and former national counterparts from Thailand and South Africa, and IAEA staff.

Speaking at the opening of the event, the Kenyan Ambassador, HE Mr Michael Oyugi asked the audience, “How do you measure progress in adequate breastfeeding of babies?” He noted, “Tracking progress in achieving global breastfeeding targets will heavily depend on the collation of accurate data. Applying stable isotope techniques provides us with a unique opportunity to assess breastfeeding practices.”

Cornelia Loechl, Head of the IAEA’s Nutrition Section, explained that stable isotopes can be used to measure the effectiveness of government programmes to encourage breastfeeding, and described how the IAEA is helping its Member States to gain competencies in applying this safe nuclear technique, which provides accurate and objective data on breastfeeding practices.

The latest evidence on the benefits of breastfeeding for children, women and society is remarkable. Every speaker at the event emphasized that breastfeeding is one of the most effective ways to ensure the health of children, and that it also provides health benefits for women and society overall. Breastfeeding protects against childhood infections, reduces mortality and increases intelligence. Breastfed children are also less likely to be overweight and to have non-communicable diseases (NCDs) like type 2 diabetes later in life.

 “When we look at exclusive breastfeeding rates, they are closely associated with both reduced mortality and reduced morbidity, improvement in intelligence, and a reduction in both NCD risk and cancer risk in mothers.” said Dr Nigel Rollins of the World Health Organization.

In addition, breastfeeding provides nursing women with a reduced risk of breast cancer and it improves birth spacing. It might also protect against ovarian cancer and type II diabetes. Scaling-up of breastfeeding to a near universal level could prevent 823 000 annual deaths, or 13.8% of all deaths of children younger than 2 years of age1. However, all panellists emphasized that encouraging exclusive breastfeeding requires an enabling environment.

Investments are needed to scale up proven interventions that will have a direct impact on the nutritional status of women and children. Such investments are necessary to reach the global targets for reducing stunting in children, anaemia in women, exclusive breastfeeding and to mitigate the impact of wasting. The global target on exclusive breastfeeding, which is part of Sustainable Development Goal 2, consists of increasing the rate of exclusive breastfeeding in the first 6 months of life to 50% by 2025. Dr Zia Hyder, a Senior Nutrition Specialist from the World Bank showed that an investment of $70 billion over the next ten years will yield significant returns in saving lives, reducing stunting in children and anaemia in women2. He added that scaling up of breastfeeding promotion initiatives would require an estimated additional investment of $5.7 billion by 2025 in order to have 105 million more children exclusively breastfed and to save 520 000 child lives.

Participants also heard about progress made in improving breastfeeding rates. Counterparts from South Africa and Thailand talked persuasively about their experiences with the IAEA and the application of this stable isotope technique in exclusive breastfeeding and HIV

Dr Emorn Udomkesmalee from Mahidol University in Thailand noted that her country is making a specific effort to meet a number of nutrition targets. She explained, “The data on breastfeeding and complementary food obtained using stable isotope techniques is going to be the game changer for Thailand.”

Professor Anna Coutsoudis of South Africa, who was responsible for the establishment of the first community based breast milk bank in South Africa fifteen years ago, and whose work focuses on preventing mother to child HIV transmission, praised the IAEA for its support in enabling studies to evaluate the effectiveness of breastfeeding promotion interventions, in particular in the context of high prevalence of HIV.

Background

Breastfeeding is one of the most effective ways to ensure the health of children, and provides benefits for women and society as well. Interventions need to be scaled up and breastfeeding patterns should be monitored regularly to provide feedback to programme implementers. Periodic population-wide assessments enable the monitoring of important breastfeeding trends. However, much of the data on breastfeeding practices rely on self-reported habits. This is where nuclear techniques play a key role.

A non-radioactive stable isotope technique, known as deuterium oxide dose-to-mother technique, offers a way to obtain accurate and objective information on breastfeeding practices, in particular on the frequency and duration of breastfeeding. This technique assesses breastfeeding practices by tracking the flow of deuterium, a stable (non-radioactive) isotope of hydrogen, from the mother to her infant. A lactating mother drinks water containing the isotope, which then mixes with water in her body, including her milk, and enters the baby when it suckles. Scientists collect and analyse saliva samples over a two-week period, and the enrichment of deuterium is plugged into a mathematical model to accurately determine the amount of breast milk consumed by the infant and whether the infant is exclusively breastfed. The method is already being successfully used with IAEA assistance in almost 30 countries in Africa, Asia and the Pacific and Latin America and the Caribbean, to objectively monitor and assess the impact of breastfeeding promotion programmes for improving the health of mothers and their babies.

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Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect, The Lancet

2 Investing in Nutrition - The Foundation for Development, World Bank

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