Her resolve to give her children the best start in life was born nine years ago, when she held her firstborn in her arms and vowed to build a strong foundation through breastfeeding.
Teresia Karimi, a resilient 39-year-old mother of four, including a vibrant set of three-month-old fraternal twins, embodies a profound dedication to exclusive breastfeeding.
This early experience also emphasised the importance of introducing complementary foods after six months.
“The nutritionist guided me on what to eat, how to manage stress for optimal milk production, and the importance of beginning to express milk early for consistency,” she says with a smile, recalling how she carefully stored expressed milk in the freezer—a practice that enabled her to exclusively breastfeed her first child for seven months.
Her subsequent children, including her second-born, also thrived on exclusive breastfeeding, a practice she credits with strengthening their immunity and preventing diseases.
The arrival of the twins in April this year ushered in a new, albeit anticipated, set of challenges. Teresia had mentally prepared for the demands of feeding two infants, focusing on maintaining a robust milk supply through proper nutrition and mastering the best postures for tandem breastfeeding.
“As my maternity leave drew to a close, I realized I had not stored enough milk for my rapidly growing twins, and I almost panicked, but I wrote to my Human Resource manager for an extension of the leave to see how I could store some milk for them before resuming work,” she says.
A 20-day extension offered a lifeline, allowing her to increase her milk supply and store more milk through the simultaneous express and breastfeeding model, where she pumped milk while one of the twins breastfed from the other breast.
Luckily for her, Karimi’s workplace provides a lactating room equipped with a fridge, allowing her to express and store milk for the twins to consume the following day. This support system enabled her to maximize feeding opportunities, sometimes even adjusting her schedule to return home earlier.
She appreciates the supportive workplace environment for happier and more productive working mothers.
“I urge employers who have not complied with the Health Act to embrace it and give mothers some time to breastfeed their children, to understand them when they go back to work, because sometimes you may find the baby was awake the whole night and the mother did not rest well,” she says.
She also advocates for public lactation spaces where mothers can comfortably breastfeed and change their children, citing instances of women being shamed or chased away from breastfeeding in public spaces. She encourages employers lacking such facilities to establish them, allowing the mothers to receive their children for lunchtime feeds.
Grace Akinyi, a Community Health Promoter attached to Gatina Dispensary in Dagoretti North, Nairobi County, echoes Karimi’s advocacy through household visits and community mobilizations.
She regularly visits new mothers at home, educating them on proper breastfeeding techniques, including how to achieve maximum latching to prevent cracked nipples and mastitis, especially for mothers with twins and multiples.
“I also guide mothers on optimal nutrition, breaking down the importance of carbohydrates, proteins, vitamins, minerals, and fats from locally available foods,” she adds.
A critical aspect of her visits involves hygiene education, which includes demonstrating proper handwashing before feeding and after diaper changes, and emphasizing the importance of thoroughly cleaning baby utensils to prevent infections such as diarrhea.
The home visits are particularly crucial for casual workers, who often face the daunting challenge of returning to work mere weeks after childbirth due to poverty. Akinyi’s advocacy focuses on consistently reminding these mothers about the importance of expressing breast milk.
“Most mothers return to work earlier than the recommended period, yet many workplaces lack lactation spaces, storage facilities for expressed milk, and flexible working hours,” she explains, while also demonstrating hand-expression techniques as an alternative to pumps.
Akinyi champions the creation of breastfeeding bays within villages or near markets, allowing casual workers to store expressed milk and have their children cared for while they work, offering them peace of mind.
She also notes that exclusive breastfeeding for the first six months can act as a form of family planning, though mothers should still use additional methods.
Akinyi emphasizes that breastfeeding is a communal responsibility, actively engaging male partners and grandmothers during home visits to foster a supportive environment.
Laura Kiige, a Nutrition Specialist at UNICEF Kenya, demystifies a common concern among mothers of twins: the fear of insufficient milk supply.
Kiige notes that breast milk production is demand-driven; the more the breasts are emptied, the more milk is produced.
Kiige stresses the importance of a mother’s confidence in her ability to breastfeed twins for six months exclusively, coupled with proper skills in holding and latching both babies. While simultaneous breastfeeding can foster bonding, she notes it is not a strict rule; mothers can feed one twin at a time, ensuring both babies receive equal time at the breast to prevent preference and promote bonding.
The critical support from family and community in managing household responsibilities such as washing clothes, cooking, and cleaning, is vital to free the mother to concentrate on caring for the babies. Family members can also assist with positioning during breastfeeding by providing pillows or helping to hold the baby.
As mothers transition back to work, Kiige highlights that expected workplace support aligns with Kenya’s Health Act 2017, which mandates employers to provide breastfeeding spaces.
“This includes flexibility in working hours, allowing mothers to come in later, leave earlier, or take an hour over lunch break to breastfeed or express milk. They also need access to a fridge or a cool box for milk storage and a clean, private room with water for handwashing and pump cleaning,” she explains.
She emphasizes that colleagues should be supportive, understanding that a mother’s adjusted schedule is temporary and for the well-being of the child or children.
UNICEF Kenya has played a crucial role in developing the Ministry of Health’s guidelines on workplace breastfeeding support and has partnered with the Kenya Private Sector Alliance Foundation to enhance the private sector’s capacity for establishing and implementing lactation spaces and support programs.
Kiige advises mothers to return to work to organize themselves well in advance, both practically and psychologically.
This includes identifying and training caregivers, as well as proactively expressing and storing milk in small, single-use containers, preferably 60ml, since thawed milk cannot be refrozen.
“If extensive storage is not available, mothers, especially the casual workers, can adjust their schedule to express milk for the next day, and continue with breastfeeding in the evenings,” she advises.
This year’s World Breastfeeding Week 2025 theme: Prioritize Breastfeeding: Create Sustainable Support Systems resonated deeply with Teresia Karimi’s story and the broader advocacy efforts in Kenya.
Her experience with twins, combined with the challenges of returning to work, reflects the broader reality for many mothers—especially working mum who resume their jobs without surplus milk. These gaps underscore the urgent need for stronger policies, workplace protections, and s investments to create sustainable environments that support exclusive breastfeeding.
