A few weeks ago, as I was walking along a steep hillside in the Kutupalong Refugee Camp for displaced Rohingya, a worried-looking man asked me for help. He beckoned for me to enter his small bamboo home, where he showed me three small babies sleeping in woven baskets hanging from the low rafters. The Medair Community Nutrition Volunteer alongside me translated his request: “He says he and his wife have triplets, and they need food.”

I smiled and told him that he was in luck: the Medair-supported nutrition centre was less than a five-minute walk away. We could register the babies’ mother immediately and she could pick up bags of premixed, nutrient-rich flour, along with soap.

But the man shook his head – food for the mother was not what he had in mind. I could see tins of infant formula on a shelf on the far wall. In a crowded camp setting like Kutupalong, mixing and giving infant formula can be particularly dangerous due to the high risk of contamination, yet many families feel like they have no choice. I suspected that getting these triplets the nutrition support they needed would take some extra effort.

“Would it be okay if a nutrition nurse comes to visit you and your wife?” I asked. He nodded.

Over 700,000 Rohingya refugees live along the steep hillsides of Kutupalong Camp. Their homes are tiny, cramped bamboo structures, and all water and sanitation structures are communal. The summer is sweltering, and in the monsoon season, endless mud prevails. Although new mothers all over the world encounter barriers that can make breastfeeding challenging, the mothers of Kutupalong are at particularly high risk of giving up on breastfeeding.

Medair staff members attend a training in a Medair-supported nutrition center.

Our nutrition work in Kutupalong is all about saving the lives of women and children. Nutrition-related factors contribute to about 45% of deaths in children under 5 years of age[1]. Lack of nutritious food triggers a vicious cycle of disease and death in small children; malnutrition increases the risk of disease, then disease makes malnutrition worse. And it all starts with improper breastfeeding. An exclusively breastfed child is 14 times less likely to die in the first six months than a non-breastfed child.[2]

In Kutupalong, women often face an uphill battle to exclusively breastfeed their babies: lack of space and privacy, lack of time due to the need to constantly work collecting water and other necessities, and challenges from cultural modesty norms. Often, mothers are malnourished themselves, which leads them to believe (incorrectly) that they are incapable of producing enough milk. Additionally, their recent traumatic experience of escaping from what the UN has described as “a textbook example of ethnic cleansing” can lead to depression and anxiety interfering with the confidence to breastfeed comfortably.

Frustrated families often use their limited resources to purchase tinned infant formula, thinking that this is the best way to make their babies healthy. Nothing could be further from the truth. Lack of hygienic washing facilities and reliably clean water make mixing formula extremely dangerous in Kutupalong.

The good news is that with a bit of help, the vast majority of mothers can breastfeed their babies. Even triplets! But it requires support. Research has shown that mothers are 2.5 times more likely to breastfeed where breastfeeding is protected, promoted, and supported.

At Medair-supported nutrition centres in Kutupalong, all-female teams of breastfeeding counsellors and nurses work to support new mothers. They provide food and soap for the mother, as well as individual, private counselling sessions. All of our nutrition centres have private spaces for breastfeeding, as well as female-only spaces where women can access information and encouragement. When we heard that new mothers had difficulty leaving their homes in the first month after birth, we began designing a programme to bring the services to them. Nutrition nurses and breastfeeding counsellors pair with female Rohingya volunteers to visit new mothers in their homes and offer counselling and advice.

Children walk in front of a Medair-supported nutrition centre in Kutupalong Refugee Camp.

At the same time, male health and nutrition volunteers educate the community on why breastfeeding is good for the whole family. For example, money saved by not having to buy tinned formula can be used to buy extra food for other children. Family support for breastfeeding women can end the cycle of malnutrition and disease.

The theme of World Breastfeeding Week this year is “Empower Parents, Enable Breastfeeding.” To celebrate breastfeeding week, nutrition staff and volunteers are holding community rallies and forums in Kutupalong, to spread the word about the health benefits of breastfeeding and to encourage the whole family to support breastfeeding mothers.

Medair staff members meet with a mother and her child in a Medair-supported nutrition centre. © Medair / Hailey Sadler

Last week I checked back on the family with triplets. After receiving visits from a nutrition nurse, the family is now enrolled in our nutrition programme and the mother is receiving breastfeeding counselling. The family is eligible to receive nutrition support until the children are five years old, providing them with good nutrition that will give a stronger foundation for health for a lifetime. Every baby born in Kutupalong deserves the best chance at living a healthy and full life, and nutrition teams are working tirelessly to make this goal a reality.

Medair is an international humanitarian NGO that provides emergency relief and recovery services to families made vulnerable by natural disasters, conflicts, and other crises. In Bangladesh, Medair works in partnership with World Concern.

This content was produced with resources gathered by Medair field and Global Support Office staff. The views expressed herein are those solely of Medair and should not be taken, in any way, to reflect the official opinion of any other organisation.

[1] “Children: reducing mortality”, World Health Organisation

https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality

[2] “Breastfeeding”, UNICEF quoting The Lancet

https://www.unicef.org/nutrition/index_24824.html