As Kenya celebrates gains in exclusive breastfeeding, experts say the next milestone will not come from asking mothers to do more, but from strengthening the skilled, coordinated support that enables every woman to breastfeed successfully and every baby to thrive.
Kenya has made remarkable progress in breastfeeding. Exclusive breastfeeding rates have risen from just 13 per cent in 2003 to 60 per cent in 2022, exceeding the World Health Assembly’s 2025 target of at least 50 per cent and well above the current global average of 48 per cent.
Yet behind those encouraging numbers lies a quieter reality. For many women, breastfeeding is neither instinctive nor straightforward. Difficulties with latching, fears about low milk supply, painful nipples and the challenge of feeding premature or sick babies can leave mothers overwhelmed during the very weeks they are expected to nourish a newborn.
Health experts say these struggles are often misunderstood. The problem is rarely a mother’s willingness to breastfeed. More often, it is the absence of the skilled support that turns good intentions into successful breastfeeding.
That message underpins this year’s World Breastfeeding Week theme, “Breastfeeding for a Sustainable Start in Life: Strengthen What Works.” Rather than calling for new interventions, the campaign urges countries to invest in measures already proven to improve breastfeeding outcomes, including skilled counselling, baby-friendly health facilities, multidisciplinary care and continued support from pregnancy through the postnatal period.
The case for doing so is compelling. According to the World Health Organization (WHO), initiating breastfeeding within the first hour after birth and exclusively breastfeeding for the first six months significantly reduces newborn illness and death while improving health throughout life for both mother and child.
Breast milk provides all the nutrients an infant needs during the first six months of life, while also protecting babies against infections such as diarrhoea and pneumonia. Its benefits extend far beyond infancy, supporting healthy brain development and lowering the risk of obesity, hypertension, cardiovascular disease and type 2 diabetes later in life. Mothers benefit too. Breastfeeding reduces the risk of postpartum haemorrhage, breast and ovarian cancers, and type 2 diabetes.
Breast milk acts as a baby’s first vaccine, delivering antibodies that protect against infection while supporting healthy growth
For Dr Mary Waiyego, a neonatologist at Kenyatta National Hospital (KNH), the evidence has long been settled.
“Breastfeeding and breast milk feeding save lives,” she said during a breastfeeding webinar organised by KNH and the University of Nairobi on August 3, 2026.
She noted that initiating breastfeeding during the “golden hour”, the first hour after birth, can reduce newborn mortality by up to 30 per cent. Beyond providing ideal nutrition, breast milk also acts as a baby’s first vaccine, delivering antibodies that protect against infection while supporting healthy growth and development.
The challenge, she argued, is ensuring mothers receive enough support to realise those benefits. Dr Waiyego said breastfeeding should be treated as a quality indicator in every health facility, alongside newborn survival, infection prevention and maternal care. That means providing consistent support from pregnancy through childbirth and after discharge, while avoiding unnecessary separation of mothers and babies immediately after birth.
The need for that support becomes clear in the hours after delivery, when many mothers first encounter breastfeeding difficulties. Although breastfeeding is often described as natural, learning to breastfeed is a skill for both mother and baby.
Jane Namu, a neonatal nurse, said nurses are usually the first health professionals to guide women through that learning process. They encourage immediate skin-to-skin contact after birth, help mothers begin breastfeeding within the first hour of life and teach them how to position and attach babies correctly. For many first-time mothers, those first lessons shape the entire breastfeeding journey.
Nurses also teach mothers how to recognise effective feeding, express breast milk safely and identify early signs that breastfeeding is not progressing as expected. They also help dispel one of the most common misconceptions among new parents, where “many mothers assume that a crying baby means they are not producing enough milk.”
Namu said that conclusion is often premature. Before deciding milk supply is inadequate, health workers assess whether the baby is latching properly, swallowing effectively and producing enough wet nappies.
Those concerns about low milk supply are among the leading reasons mothers abandon exclusive breastfeeding. Others stop because of painful nipples, breast engorgement or the belief that unsettled babies require infant formula.
Inadequate milk supply is often linked to delayed breastfeeding after birth, poor positioning and attachment, maternal stress and lack of confidence
However, experts say those problems are usually manageable with the right support. Jane Kamanja, Senior Prenatal Nutrition and Dietetics Officer at KNH, said true biological inability to produce sufficient breast milk is uncommon.
Instead, inadequate milk supply is more often linked to delayed breastfeeding after birth, poor positioning and attachment, infrequent feeding, the early introduction of water or formula, maternal stress and lack of confidence.
“The breast works on demand and supply,” she explained. “The more effectively a baby breastfeeds, the more milk the mother’s body produces.”
For that reason, she said the answer is rarely medication or supplements. Most mothers simply need skilled guidance and encouragement to breastfeed whenever babies show feeding cues instead of waiting for fixed schedules. Frequent and effective suckling stimulates continued milk production.
Kamanja said that preparation should begin well before delivery. Counselling during antenatal care helps mothers understand what to expect after birth, dispels myths surrounding breastfeeding and prepares families to support women through the demanding first weeks of motherhood. She described breastfeeding as one of the most sustainable investments in health.
“Exclusive breastfeeding for the first six months of life is one of the most effective interventions for preventing childhood malnutrition because the breast milk provides all the nutrients that a baby requires, including water,” she said.
Unlike infant formula, breast milk requires no manufacturing, packaging or transportation. It is always available, nutritionally complete and uniquely designed to meet an infant’s changing needs.
Yet experts say the success of breastfeeding ultimately depends on far more than breast milk itself. It depends on whether mothers have the skilled support to overcome the challenges that almost inevitably arise.
Babies may struggle to latch, tire quickly during feeds, choke while swallowing or fail to gain weight adequately
One member of that support system often goes unnoticed. Occupational therapists are commonly associated with rehabilitation after injury or disability, but few people realise they also help babies learn feeding, which is one of their earliest and most important life skills, from them.
According to Paul Kimani, Senior Paediatric Occupational Therapist at KNH, breastfeeding is one of the most complex tasks a newborn undertakes. Successful feeding requires babies to coordinate sucking, swallowing and breathing while maintaining appropriate posture, muscle tone and sensory regulation.
When any of those abilities is affected, breastfeeding can become difficult despite a mother’s best efforts. Babies may struggle to latch, tire quickly during feeds, choke while swallowing or fail to gain weight adequately. Those challenges are particularly common among premature infants and babies born with conditions such as Down Syndrome, cerebral palsy and other neurological disorders.
Occupational therapists assess newborns with feeding difficulties to identify problems affecting oral motor development, muscle tone, reflexes and positioning. They then work with mothers to improve feeding techniques while helping infants develop the coordination needed to breastfeed effectively.
Their role extends beyond the physical mechanics of feeding. Some babies become distressed when touched around the mouth or repeatedly refuse to latch because of sensory difficulties, while others are overwhelmed by noise, light or excessive stimulation during feeding.
Occupational therapists assess those sensory challenges, recommend calming strategies and coach parents on creating environments that allow babies to feed more comfortably. For Kimani, breastfeeding cannot be judged solely by whether a mother is producing enough milk.
“It is about the infant’s ability to move, coordinate, regulate and participate in feeding,” he said, noting that early intervention can make a lasting difference. “Early assessment allows many babies with feeding difficulties to breastfeed safely and efficiently while reducing parental stress and preventing long-term feeding problems.”
Human milk banks, safe breast milk storage and kangaroo mother care help babies continue receiving breast milk even when direct breastfeeding is impossible
Prematurity, respiratory distress, birth complications and some congenital conditions may prevent babies from feeding at the breast immediately after birth. Experts stressed, however, that delayed breastfeeding should never become delayed breast milk.
Instead, mothers should begin expressing breast milk as early as possible so babies can receive it through alternative methods such as cup feeding or nasogastric tubes until they are clinically ready to breastfeed directly. For preterm babies, that early access to breast milk can be lifesaving. It reduces the risk of severe infections and protects against necrotising enterocolitis, one of the most serious intestinal diseases affecting premature infants.
Dr Waiyego believes supporting these vulnerable newborns requires health systems to invest beyond the delivery room. She advocates for greater investment in human milk banks, safe breast milk storage and kangaroo mother care so that babies continue receiving breast milk even when direct breastfeeding is temporarily impossible.
Nutritionists reinforce that continuum of care by teaching mothers how to express, store and safely handle breast milk, ensuring that valuable colostrum, the antibody-rich first milk, is preserved for babies who cannot feed immediately after birth.
When supplementation becomes medically necessary, experts recommend a clear hierarchy. Expressed breast milk should come first, followed by donor human milk where available, while infant formula should be used only when clinically indicated. Taken together, the recommendations challenge one of the most persistent misconceptions surrounding breastfeeding, that success depends almost entirely on maternal determination.
Instead, experts describe breastfeeding as a coordinated process that relies on multiple professionals working together throughout pregnancy, childbirth and infancy. For Dr Waiyego, recognising breastfeeding as a health system responsibility, rather than a personal one, is the next frontier in improving maternal and newborn health.
“We need to stop seeing breastfeeding as the responsibility of the mother,” she said. “It should be the responsibility of the health system.”
