In my travels throughout Botswana, I have met countless women whose devotion to their children is evident at a glance and in the briefest of conversations. They work long hours to help support the family, guide their children away from hazards, help them through homework challenges, and fuel them with nutritious food. They do what it takes to keep their children safe, to nurture their bodies and spirits, and to give them opportunities to grow and learn.
But despite Botswana's wonderfully loving mothers and families, despite its remarkable development gains, and despite the government of Botswana's admirable commitment to investing in its people by investing in healthcare, child mortality rates in Botswana have increased over time.
That means that the percentage of Batswana children dying before they reach the age of five has been on the rise. This trend pushes an important Millennium Development Goal out of Botswana's reach, but more importantly, it points to individual tragedies that have left families grieving and absences painfully felt throughout the country.
One way to start reversing this trend and preventing more tragedy is to empower mothers to give their children the very best right from birth - by promoting and supporting breastfeeding. Reliable scientific studies have shown that breastfeeding protects against chronic conditions such as asthma, diabetes, and childhood cancers.
Breastfeeding can contribute to the early development of an infant's immune system, resulting in fewer hospitalisations due to serious illness, and it decreases the risk of ear infections and diarrhea. Breast milk meets all of a baby's nutritional needs, and can even enhance neurological development. Mothers truly do come equipped to provide for and protect their babies - no additional products required.
Botswana has one of the best records in the world when it comes to preventing the transmission of HIV from mothers to children, and there was a time when HIV-positive women were counseled to avoid breastfeeding as a part of this effort. But conditions have changed, and scientists know better today. Recent studies - including two carried out in Botswana - have shown that with the evolution of ARV treatment, HIV-infected mothers can safely breastfeed their babies with minimal risk of HIV transmission, while still providing their infants all the benefits from breastfeeding.
These studies have not only proven that
breastfeeding can be a safe and effective strategy for infant feeding in HIV prevention programs, but they have also formed the basis for revisions to guidelines on HIV and infant feeding issued by experts from the World Health Organisation and other health authorities.This is especially important, because in Botswana, HIV-exposed infants and children have been disproportionately affected by malnutrition, diarrheal disease, and pneumonia. Overall, malnutrition and severe diarrheal disease have been cited as primary causes of under-five mortality in Botswana, with studies finding that children who were formula fed were more at risk for these conditions.
As a mother, I know how incredibly personal this decision is. Whether to breastfeed, or to use formula to nourish an infant, is a private and individual choice. But as a matter of public health, leaders throughout society - in faith communities, the private sector, and in government - have a role to play in promoting breastfeeding and supporting breastfeeding mothers.
In general, Botswana has been a formula-feeding nation for over a decade. Currently, a national policy on infant feeding does not exist. Change will not occur without leadership and concerted effort. Educating expecting families, providing clear guidance, and supporting those who choose to breastfeed - in the hospital, at home, and in the workplace - are all essential efforts for keeping more of Botswana's children alive. This is especially true in situations where there may not be dependable access to clean water, or where supplies of formula may be unreliable for economic or logistical reasons.
Motherhood is a blessing and an awesome responsibility, and the bond that links a mother with her child is as powerful a force as any on earth. As it turns out, motherhood even comes with the power to protect infants from disease while providing them nourishment. This Mother's Day, Botswana can celebrate a mother's power to protect and care for her child by reinvigorating its efforts to establish a national infant feeding policy that promotes breastfeeding for all infants - regardless of the HIV status of the mother.
That's a move that my government will support, and that will enable more Batswana babies to survive early childhood, reach their potential, and contribute to this country's future.
*Michelle D. Gavin is the United States Ambassador