My Djiboutian counterparts told me the embarrassed woman was being criticized because her 5-year-old son still doesn’t speak. Rather than follow the ancestral tradition of giving water to her newborn, she chose to exclusively breastfeed her last child until he was 6 months old. The group asserted that this choice had led to the child’s developmental problems.
My immediate reaction to the scene was, “Peer pressure is a true obstacle to promoting optimal breastfeeding in Djibouti!”
Healthier child rearing and feeding practices are vitally needed in this country. Only 1% of mothers exclusively breastfeed their child until the age of 6 months (2006 country statistics), per World Health Organization (WHO) recommendations—one of the lowest rates in the world. In addition, scarce food and drinking water translate to rates of chronic malnutrition higher than 40% in several regions, and vitamin and mineral deficiencies are rampant.
With thirst a common concern among the poorest in Djibouti, new mothers often give water to their infants in addition to breastfeeding, but giving unsafe water to children in this setting can be deadly.
The government of Djibouti is trying to correct such behaviors with an innovative, integrated safety net program for families in the poorest and underserved urban and rural areas of the country. The project is funded by the Japanese Social Development Fund (JSDF) and is supported by the World Bank.
Evidence shows that an increase in income doesn’t necessarily translate into improved nutrition outcomes; therefore, the project focuses on improving the human capital of poor families by combining a workfare program with community-driven interventions to prevent chronic malnutrition in those same families.
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