Friendly breastfeeding policy can reduce breast cancer burden

By Fadhila Sadala 

Justina Mgisha, a 53-year-old woman with five children and a former secondary school teacher, describes how she exclusively raised her children after giving birth and going on maternity leave for three months. she was returning to work as normal, but her breasts would be clogged milk causing pain, she would only continue to breastfeed her baby in the evening when she returned from work.

A recent UNICEF study found that among women who receive a maternity leave of about six months or more, approximately 30 per cent continue to exclusively breastfeed infants for at least six months.

The rest hours were from morning to evening. When returning from work she bought milk from the store, which her baby continued to use when at work. 

“I raised all my children following the same schedule I grew up with until my last child due to the limitation of the work policy,” she says. 

 “It was 2019 when I discovered a small lump appearing at the bottom of the breast but I did not pay much attention to it at first.” 

“One day I went to the hospital for a checkup to find out what the problem was after I started feeling severe pain, then after the diagnosis results revealed that it was breast cancer,” she said. 

This was the first stage of breast cancer with clinical appointments and treatment continuing until the doctor provided other instructions.  

Justina is currently present at home due to breast cancer. She stopped going to work to continue with her clinical treatment.  

All mothers are advised to consider time to breastfeed and to love their babies by giving them nutrients to achieve better health                     

According to UNICEF policy, six months of paid leave for all parents in total and between those months 18 weeks should be set aside for mothers. The government and business cooperations are urged to provide at least 9 months off for a holiday 

In 2018, UNICEF stated that only 4 out of 10 babies were breastfed in the first six months of their life. 

International Labor Organization (ILO) policy states that there should be at least 14 weeks of paid maternity leave with countries being encouraged to provide 18 weeks plus work support, but so far only 12 per cent of all countries in the world have embraced ILO’s Maternity Protection Convention (No. 183) While the work policy in Tanzania (2004) year says in section 33-(1) an employee shall give notice to the employer of her intention to take maternity leave at least three months before the expected date and support this notice with a medical certificate. A small number of babies are breastfed at birth. And many are weaned after 84 days of birth since mothers have to return to work. 

According to UNICEF 2021 The health, social and economic benefits of breastfeeding are known and accepted around the world, but still, about 60 per cent of infants are not breastfed in the first six-month as recommended  

 Dr Hellen Makwani is a specialist in cancer medical treatment, Clinical Oncology Specialist and the founder of Genesis for Palliative Care Service Foundation in Tanzania has this to say concerning the lack of breastfeeding and cancer. 

“Breastfeeding indeed reduces the risk of breast cancer,” she said 

She adds that if a patient has been diagnosed and found to have cancer, it can be treated in the early stages.   

Major benefits of breastfeeding to a baby and a mother include enhancing mental health development in the child, protecting children against diseases, reducing the risk of measles, reducing child care costs and also protecting breastfeeding mothers against cervical cancer and breast cancer so allowing the mother enough time to breastfeed is important. 

A UNICEF report from 2021 shows that in high- and middle-income countries breastfeeding rates alone in the first six months of a baby’s life are the lowest at 23.9 per cent, worldwide UNICEF reports that only 40 per cent of women with infants worldwide receive even basic maternity leave at work and the gap is even greater among African countries where women who receive the leave at work to continue breast feeding their children are only 15 percentages.  

Increasing breastfeeding rates according to UNICEF will prevent 823,000 annual deaths for children under the age of five and 20,000 deaths each year from breast cancer in mothers 

According to UNICEF 2018, less than half of all babies in the world or 43 per cent were able to breastfeed in the first hour of life after birth which is an important step in building up the baby’s immune system and helping mothers to prepare for breastfeeding her baby for a long time. 

Breast milk according to the World Health Organization (WHO) is more than just food for the baby; it is also a medicine to prevent various diseases and death. 

Near universal levels of breastfeeding could prevent 20,000 annual deaths from breast cancer observation in The Lancet. Breastfeeding statistics in 2022 show that more than 12 months provides a 28 per cent reduction in breast cancer.  

Cancer has been noted as one of the major life-threatening Non-Communicable Diseases (NCD) worldwide. It remains to be the leading cause of death in many developing countries such as Tanzania. The incidences and mortality from non-communicable diseases are rapidly rising further causing strains on the already stretched health systems and resources within those countries. 

A recent World Health Organization (WHO) report stated that cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020 alone.  Cancers cervical and breast are the most common in women; about 2.26 million cases of breast cancer have been recorded across the globe.  

The gravity of the serious condition is a major concern as the number of new cases continues to grow. Every year cancer diagnoses account for almost half of the cases in the world. On top of that, an estimate of 50,000 people develop cancer each year, and an emerging forecast believes that by 2030 that number will increase by 50 per cent.  

This has started to push governments and organisations like WHO to accelerate action to achieve targets specified in the Global Action Plan for the prevention and control of NCDs and also the 2030 UN Agenda for Sustainable Development to reduce premature mortality from cancer. 

About 69 per cent and 46 per cent of breast cancer patients aged between 50 to 69 years old, reported at the tertiary hospitals when the cancer is at stages one and two respectively. These findings imply that patients spend more time seeking alternative treatment which resulted in a presentation at the tertiary hospitals when cancer is at an advanced stage and hence difficult to cure. 

In Tanzania, cancer is recognized as a serious health care problem, according to the Ocean Road Centre Institute (ORCI). Not only is it one of the major causes of mortality and morbidity, but it also causes disease burden.  

There has been a consistent and significant rise in cancer in Tanzania. The International Agency for Research on Cancer (IARC) estimates that there are 42,060 new cases of cancer per year in Tanzania, with a high mortality rate of 28,610 deaths per year, showing that many patients are diagnosed at advanced stages. The most common cancers in Tanzania include breast cancer. 

Because the number of new cancer cases is increasing and Tanzanian hospitals are overcrowded, one could describe the ongoing situation as a “cancer tsunami.”  that those who are caught up in need to be rescued from urgently. 

With a population of 42.5 million people, Tanzania has the largest population in East Africa. Over one-third of its residents live in the urban areas of Dar es salaam, Mwanza, and Dodoma and more than 60 per cent of the population are younger than 25, reflecting Tanzania’s high birth rate (35.3 births per 1,000 people), the high fertility rate (4.71 children per woman), and relatively low life expectancy (61.6 years for men and 64.6 years for women). 

In 2021, the world crossed a sobering new threshold, an estimated 20 million people were diagnosed with cancer, and 10 million died. These numbers will continue to rise in the decades ahead. And yet all cancers can be treated if diagnosed in early stages, and many can be prevented. 

The good news is that studies have shown that breastfeeding has many benefits to the mother and her baby, including strengthening the mental health in the development of the baby protecting children against diseases, reducing the risk of diarrhoea, reducing the cost of child care and also protecting mothers against cervical and breast cancer. This is why women should be given enough time to breastfeed thus lowering their risk of developing breast cancer.