Kenya has made commendable strides in improving exclusive breastfeeding practices over the past two decades, with rates rising from 13pc in 2003 to 60pc in 2022 surpassing global targets.
According to a statement, this progress places the country ahead of the World Health Assembly’s 2025 goal of 50pc and the 2023 global average of 48pc, signaling the positive impact of targeted maternal and child health interventions.
However, with rates stagnating since 2014, the Ministry of Health is now turning its focus to revitalizing efforts through the adaptation of WHO’s Baby-Friendly Hospital Initiative (BFHI) to suit Kenya’s local context, alongside the development of updated training materials for health workers.
“This progress is the result of sustained investment in a comprehensive package of maternal, infant and young child interventions. These include breastfeeding counselling at health facilities, implementation of World Health Organization (WHO)’s Baby-Friendly Hospital Initiative, a baby-friendly community initiative and the enforcement of the Breast Milk Substitutes (Regulation and Control) Act, 2012.” Read the statement.
According to a statement from WHO, the renewed push underscores the government’s commitment to protecting and promoting breastfeeding as a critical foundation for child survival, health, and development.
Despite these efforts, exclusive breastfeeding rates have remained at 60pc since 2014.
To reignite progress, the Ministry of Health is currently adapting WHO’s Baby-Friendly Hospital Initiative guidelines to the Kenyan context and developing a training package for health workers.
The initiative, a joint effort by WHO and UNICEF, provides health facilities with a framework to promote, protect and support breastfeeding, while addressing practices which have a negative impact, such as the use of breastmilk substitutes.
In May 2024, WHO, with funding from Irish Aid, supported Kenya’s Ministry of Health to conduct a six-day Baby-Friendly Hospital Initiative training of trainers in Nakuru County, located in the southwest of the country.
Thirty-one-year-old Susan Chepkemoi gave birth to quadruplets in Nakuru County Referral and Teaching Hospital in southwestern Kenya in December 2024.
“When we used to go for scans, I didn’t believe we were actually expecting quadruplets. I thought everyone was just joking with me!” says the quadruplets’ father, Jonathan Mwangi.
The babies were born prematurely and had low birth weight, so Chepkemoi stayed in the hospital until they were ready to be discharged.
During her stay, Chepkemoi was supported by health workers at the hospital to initiate and maintain breastfeeding while managing common difficulties. She was able to produce enough milk for all four babies and even had excess to store.
“At first, I couldn’t believe that I could feed my babies with breastmilk alone. But with support from the nurses at the hospital I learnt it was possible,” she says.
Now that Chepkemoi is back home, she has been able to continue breastfeeding with the support of a community health promoter who visits regularly. “The hospital always calls to see how we are,” adds Chepkemoi.
WHO recommends that breastfeeding is initiated within the first hour of birth and that mothers continue breastfeeding exclusively for the first 6 months of life.
“The benefits of breastfeeding cannot be overstated. For babies, breast milk is the ultimate nutrition for growth, both physical growth and brain development. It also provides immunity against infectious and chronic diseases,” says Dr Alice Nkirote, head of the paediatrics department at Nakuru County Referral and Teaching Hospital.
In Kenya, 60pc of newborns are breastfed within one hour of birth and exclusively breastfed in the first 6 months of life.
Kenya is also among the first countries in the African region to legislate and offer clear guidelines on when to offer breastmilk substitutes, through the Breast Milk Substitutes (Regulation and Control) Act of 2012.
In addition, 90pc of births in the country are attended by a skilled health worker, presenting huge opportunities to promote breastfeeding.
Yet, says Arthur Lord Gichuru, department head of nutrition and dietetics at Nakuru County Referral and Teaching Hospital, before the baby-friendly hospital initiative, “many nurses in this facility didn’t believe babies could survive on breastmilk alone.”
Gichuru and his colleague Veronicah Ongwae, a nursing manager, were among 40 health workers from nine counties trained on the Baby-Friendly Hospital Initiative by WHO and the Ministry of Health in May 2024.
Their nomination for the training was the hospital’s response to the lack of, or delayed, breastfeeding which can cause mothers, family members or health workers to feed newborns food or liquids other than breastmilk, for example, glucose or water.
Some health workers also unnecessarily prescribed infant formula and used cups with spouts in the paediatric ward, practices which actively discourage breastfeeding.
“As a hospital we adopted this initiative to be able to promote, protect and support exclusive breastfeeding for optimal nutrition,” says Gichuru. “In terms of breast milk substitutes enforcement, we made sure that all mothers are able to be supported every morning through health talks, when they deliver and through early initiation of breastfeeding.”
Kenya gives newborns a healthy beginning
The County Government of Nakuru, with support from Nutrition International and other partners, has since trained an additional 32 staff on the baby-friendly initiative and the number of nutrition staff in the maternity ward has quadrupled, from one to four. This includes a nutritionist in the labour ward to support early initiation of breastfeeding.
“The training has really pushed us to increase the baby-friendly initiative implementation at our facility,” says Ongwae. “We are working hard to sensitize our clinical team and the non-clinical team so that we are able to offer breastfeeding support to our babies who are born here.”
These collective efforts are bearing fruit. Between August 2024 and February 2025, early initiation of breastfeeding at the hospital has increased from around 42pc to 75pc.
“Anne Kerubo, a 19-year-old mother of two recently gave birth at the hospital. “I am excited to be a mother. Every time I see my baby, I can’t help but smile,” she says.
“I was told by the nurses that it’s important to only breastfeed my new baby for six months. They explained that breastfeeding will help protect my child against common illnesses like diarrhoea and pneumonia,” adds Kerubo.
The positive changes are felt among patients and staff alike. “As a nurse, I feel proud because when I see a mother smiling with her baby, it means I am smiling too,” says Ongwae.
