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The online edition of the magazine published by The Johns Hopkins University, Zanvyl Krieger School of Arts and Sciences


Barriers to Breastfeeding

Payel Patel in Kenya

Payal Patel discovered her passion for public health as a sophomore at Johns Hopkins. “When I do medicine, I want to be out in the field,” says the English/pre-med major and senior class president, who graduated in June.

With a Florence “Meg” Long Walsh Leadership Award from the Krieger School’s Second Decade Society, Patel now has the chance to do just that. The award, which granted Patel $20,000, is given annually to a graduating senior who plans an independent research project with an international scope. She is spending the year in Kenya exploring cultural and social impediments to exclusive breastfeeding among Kenyan women. (The World Health Organization recommends exclusive breastfeeding for infants—offering no liquids or foods other than their mother’s milk—for the first four to six months.)

While breastfeeding rates around the world have been on the rise, Patel says, in Kenya the rate of exclusive breastfeeding “has been at about 15 percent for years.” This is low compared to other developing countries: The exclusive-breastfeeding rate (for the first four to six months) is 83.8 percent in Ethiopia and 55 percent in India.

While almost all Kenyan mothers start out breastfeeding, 85 to 90 percent of them will offer their babies fluid other than breast milk by the time their children are a month old, Patel says, increasing babies’ risks of infection, poor nutrition, and diarrhea—a major killer of young children worldwide, especially in developing countries.

Women in Kenya, as in other countries, encounter many barriers to breastfeeding. Increasing urbanization means women may have jobs that separate them from their babies for long days, while the distribution of infant formula in hospitals and the fear of transmitting HIV through breast milk also factor in. Patel believes the barriers in Kenya—which has high infant- and child-mortality rates—are compounded by cultural factors that aren’t yet well understood.

She’s using her Walsh award to test that hypothesis, interviewing women about their beliefs and opinions on exclusive breastfeeding, hoping to discern “how interventions should be tailored” to cultural norms, Patel says.

Patel, who grew up in Texas, believes her family background will aid her research. Her mother grew up in Kenya, and Patel speaks some Swahili. On visits to Kenya, says Patel, “I have found it extremely easy to acclimate to the language as well as the culture.”

—Martha Thomas





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