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There's a baby formula controversy in Kenya, too. But shortages are not the issue

Sharon Macharia read in a Kenyan newspaper that baby bottles would be banned. As a working mom, she depends on bottles to feed her youngest baby. She was happy to learn that the report was untrue — although the government is introducing a new law to clamp down on ads that promote the use of baby formula.
Thomas Bwire for NPR
Sharon Macharia read in a Kenyan newspaper that baby bottles would be banned. As a working mom, she depends on bottles to feed her youngest baby. She was happy to learn that the report was untrue — although the government is introducing a new law to clamp down on ads that promote the use of baby formula.

Sharon Macharia juggles work and family as a communication development expert in Nairobi. Now that Macharia's maternity leave is over, her youngest daughter drinks from a baby bottle just as her eldest did. But Macharia has read in a leading Kenyan newspaper that the country will ban bottle feeding for babies at the end of May. "I was shocked indeed," she says.

Kenya's government is not actually banning baby bottles, or baby formula for that matter. So headlines about bans are incorrect. A law coming into effect on May 30 clamps down on advertising for bottles, infant formula and pacifiers. The most visible change will be tougher labeling. Products sold in stores will have a boxed warning similar to that on cigarettes, with messaging like "Breastfeeding is best," or "WARNING: Use of teats can interfere with breastfeeding," referring to the word used in Kenya for the artificial nipple at the tip of a feeding bottle.

The rules come in response to an increase in aggressive marketing of breast milk substitutes on social media platforms like Facebook, says Veronica Kirogo, director of nutrition and dietetics services at Kenya's Ministry of Health.

The issue isn't new. The legislation amends a 2012 law designed to help families make infant feeding choices based on evidence rather than marketing. Kenya's government was the first to vote in favor of the World Health Assembly's International Code of Marketing of Breast-Milk Substitutes, a public health agreement adopted in 1981 to curb inappropriate marketing by the global infant feeding industry. (The agreement emphasizes that substitutes can be used responsibly when milk production or health is an issue, or if work challenges arise.)

Breastfeeding is a central part of the United Nations' 2030 agenda for Sustainable Development. The World Health Organization says breastfeeding is a vital source of nutrition in a child's early years that can save lives and improve outcomes for children and families. In Kenya, according to a 2014 government report, 61%of children under 6 months were exclusively breastfed, higher than the global average of 44%.

Kenya's ministry of health strongly advocates for six months of exclusive breastfeeding. "For a breastfeeding mother at a household level, let us give the support they need to sufficiently breastfeed their children," Kirogo says.

Phillistus Indosh works as an outdoor food vendor, keeps her baby by her side and breastfeeds when necessary. She says her customers understand. She's not a fan of baby bottles because of the need for sterilization.
/ Thomas Bwire for NPR
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Thomas Bwire for NPR
Phillistus Indosh works as an outdoor food vendor, keeps her baby by her side and breastfeeds when necessary. She says her customers understand. She's not a fan of baby bottles because of the need for sterilization.

Some women figure out on their own how to make it work. Phillistus Indosh, a breastfeeding mother from Nairobi's Kibera slum, is an outdoor food vendor. She carries her 1-year-old daughter to her work station, an unmarked open spot next to a road. She attends to customers buying groundnuts or bhajia (fried potato) day in and day out, sometimes tying the baby to her back using a piece of cloth so she can fry potatoes.

When her daughter has the urge to suckle, Indosh places the child on her lap to calmly enjoy breast milk. She says her customers seem to understand and accept that she is a breastfeeding mother.

"All my children have breastfed exclusively for six months," says the mother of four. She weans them completely at about 1 1/2 years of age. For her, keeping baby bottles clean is a challenge, so she isn't in favor of them.

Not everyone is able to breastfeed under challenging circumstances like Indosh's. And in a country where 49% of the labor force is female, the government aims to help.

Laws in Kenya require employers to provide a lactation room and breaks to express milk. They also provide three months of maternity leave and two weeks of paternity leave with full pay – although those benefits do not aid self-employed workers like Indosh.

And there is more that Kenya could do. The country has not yet ratified the U.N. International Labor Organization's Maternity Protection Convention, which sets out measures to preserve workers' rights and protect their jobs during pregnancy and parental leave or when nursing.

But there are other ways in which the government seeks to promote breastfeeding. Kirogo points to the government's Baby-Friendly Hospital Initiative and Baby-Friendly Community Initiative, which support breastfeeding and infant nutrition in hospital maternity wards and in communities where home births are common.

Midwife Nerea Ojanga says the initiatives have helped mothers embrace six months of exclusive breastfeeding. She has spoken to more than 500 women who have been influenced by these initiatives. Ojanga is retired from a post at Kenyatta National Hospital in Nairobi, Kenya's largest public teaching hospital, and is now in private practice providing doula and breastfeeding support services.

The rules taking effect on May 30 are intended to put more emphasis on breastfeeding. Nonetheless, some working moms are concerned that the new laws could stigmatize baby bottles in a way that could prove stressful.

Macharia says that her mother, a teacher, breastfed her after work. But during the day, her mother would leave bottles of formula for a nanny, and Macharia would suckle or eat porridge. When Macharia first erroneously thought that the new law would ban bottles, her thoughts flew to the untold number of children who depend on them as she once did.

"Breastfeeding is my best time with my babies. We get to bond and somehow it calms me down, especially after a long day," Macharia says. She supports regulating inappropriate marketing by the infant feeding industry, but also believes that "for career women and women with health complications, formula is the savior."

Thomas Bwire is a co-founder and editor at Habari Kibra, a news hub that focuses on reporting stories from the Kibera community. He previously worked as a radio journalist at Pamoja FM, a community-based radio station in Kibera, and was the 2019 first prize winner of Media Monitoring Africa's journalism awards for his reporting on children.

Copyright 2022 NPR. To see more, visit https://www.npr.org.

Thomas Bwire