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World Breastfeeding Week: Nuclear Technique Supports More Effective Nutrition Programmes


Research has shown that feeding an infant exclusively with breast milk, no other liquids or solids, during the first six months of their life offers benefits for optimal growth, development and health. The World Health Organization (WHO) estimates that optimal breastfeeding of all children aged 0-23 months could avert over 820 000 infant deaths each year. However, currently only around 44 percent of infants globally are exclusively breastfed for the recommended first six months.

Assessing the rate of exclusive breastfeeding in national nutrition programmes was one of the aims of an IAEA interregional project focused on assisting Governments to assess their programmes aimed at reducing stunting. Stunting is caused by chronic undernutrition and recurrent infections during the most critical period of growth and development in a child’s life. Through the use of a nuclear technique, known as the stable isotope-deuterium oxide dose-to-mother technique, within the interregional project the IAEA supported countries in gathering accurate data regarding the quantities of human milk infants were consuming, and the extent to which nutrition programmes were successful in promoting exclusive breastfeeding.

The technique

Using the dose-to-mother technique, deuterium oxide – a stable non-radioactive isotope of hydrogen – is consumed by the breastfeeding mother and is incorporated into her milk over a few hours. Throughout the next two weeks, saliva samples are collected from both the mother and child showing the concentration of deuterium. The amount of deuterium ingested by the mother compared to the amount in the child’s saliva gives the indication of the amount of human milk that the child has consumed, and based on this, it can be estimated whether or not the child was exclusively breastfed.

“This isotope technique supports the national monitoring of progress towards achieving the global nutrition targets on exclusive breastfeeding, and assists countries in determining which  programmes promoting exclusive breastfeeding  are most effective,” said Alexia Alford, a Nutrition Specialist at the IAEA.  

Benin - a case study

In Benin, one of the countries taking part in the interregional project, the technique was used to evaluate a programme, titled Nutrition at the Centre, carried out in Dangbo and Bonou in the south of the country. As Benin has an exclusive breastfeeding rate of under 50 percent, improving the breastfeeding rate was one of the main aims of the country’s stunting reduction programme.

The nutrition programme was led by national experts and CARE International Benin/Togo, and brought together women in the community to share their experiences and promote best practices in breastfeeding. The dose-to-mother technique was used to compare the feeding practices of the women and children involved in the programme, with a control group. Analysis after six months showed that the mothers involved in the programme were fourteen times more likely to practice exclusive breastfeeding than mothers not involved.

Dansou Victoire, a mother of two, participated in the programme. “I decided to practice exclusive breastfeeding with my second child,” she said. “I fed him only on breast milk for the first six months, and he was healthy and did not regularly fall ill like the other children his age in the neighbourhood who were already being introduced to other foods.” 

The pilot programme, including the use of the deuterium oxide dose-to-mother technique, is now in the process of being extended to other municipalities in localities across Benin.

“This programme is only the beginning,” said Waliou Amoussa Hounkpatin, a professor and researcher at the University of Abomey-Calavi’s Department of Nutrition and Food Sciences, and who facilitated the assessment. “With the IAEA support, through education and training in using the stable isotope technique as well as providing expert advice throughout the duration, the communities’ confidence in the nutrition programme group was built up, which we hope will be a continuing trend in many more communities across the country.”

This World Breastfeeding Week, the WHO and UNICEF are calling on governments to protect and promote women’s access to skilled breastfeeding counselling to support mothers in starting and sustaining breastfeeding of their infants and young children, and to improve monitoring and implementation of national breastfeeding programmes.

The known benefits of exclusive breastfeeding for children include protection against infections and reduced risk of overweight or diabetes, among others. The benefits of breastfeeding for mothers include protection against breast cancer, and possible protection against ovarian cancer and type 2 diabetes, among others.

IAEA assistance

The dose-to-mother isotope technique can assist countries in the accurate monitoring of their breastfeeding promotion programmes.  This project also assessed body composition of the infants using the deuterium dilution technique. The IAEA supports its Members States to implement these techniques through provision of expertise, guidance material and training. Ten countries took part in the interregional project: Benin, Bolivia, Burkina Faso, Malawi, Mauritania, Myanmar, the Philippines, Senegal, Tanzania and Viet Nam.

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