Menu ENN Search

World Breastfeeding Week 2022: How is ENN ‘Stepping up for Breastfeeding’?

By Aisling Daly and Eleanor Rogers on 28 July 2022

World Breastfeeding Week webinar and Q&A

The above video is the Africa, Europe and Asia Pacific recording, with a case study on Rwanda. 

ENN shared information about the MAMI Global Pathway Package on August 3rd as part of the Global Breastfeeding Collective’s webinar “Take ten steps up for breastfeeding” and “Two more reasons to step up”. This 10-minute presentation introduces practical details and examples of applied practice for the MAMI Care Pathway Package, followed by an update on the Infant Feeding in Emergencies (IFE) Operational Guidance and a brief Question and Answer session which is compiled here.

Currently also available in the following languages: 

English - the Americas (with a case study on Colombia) 

Arabic 

Spanish (Español) 

Portuguese (Português) 

Russian 

Further recordings of the webinar in other languages will be forthcoming in the next few weeks. 

For the report released during the webinar, ”Infant and Young Child Feeding in Emergencies Ten Years of Progress” please click here

Blog 

This year, World Breastfeeding Week (1-7th August) focuses on breastfeeding education and support, encouraging everyone to ‘step up’ for breastfeeding. The importance of providing effective, regular breastfeeding support cannot be overstated. Breastfeeding is one of the top interventions for reducing under-five mortality, with breastfeeding practices potentially averting 823,000 deaths annually, if scaled up universally. Where resources are limited, the most vulnerable infants and mothers must be prioritised. Malnourished infants under six months of age, defined as small and nutritionally at-risk, are an especially vulnerable group. Globally, one in five infants under six months are small or nutritionally at-risk, which includes those that are born with a low birth weight, those that are stunted, wasted and/or underweight. Such measures of poor growth in the first six months of life are significantly associated with an increased risk of death. However, we do not yet provide sufficient breastfeeding support to these infant-mother pairs to enable them to survive and thrive.

We have the tools at hand, with UNICEF and WHO’s ten steps to successful breastfeeding proven to increase breastfeeding rates. Yet in practice, the tenth step, which is to ‘coordinate discharge so that parents and their infants have timely access to ongoing support and care’, falls far short in practice. Specifically, we see:

This is where the management of small and nutritionally at-risk infants under six months and their mothers (MAMI) can make a huge difference. The MAMI Care Pathway Package, developed by the MAMI Global Network led by ENN and LSHTM, is a resource material to assist practitioners to identify, assess, and manage small and nutritionally at-risk infants under 6 months of age and their mothers. It places the mother-infant dyad at the centre, with targeted breastfeeding support a key element of care.

The MAMI Care Pathway Package provides a framework for continuity of quality, respectful care for infants under six months and their mothers across maternal and infant nutrition and health services. It is designed to be adapted to each context and to build on and be integrated into existing systems and platforms across primary, secondary and tertiary care. Its primary focus is on providing community-based outpatient care.

The MAMI approach complements existing breastfeeding support services, dovetailing with existing infant and young child feeding (IYCF) interventions, which operate at the primary level of intervention. IYCF and MAMI are both essential initiatives that, together, more efficiently reach and address all infants with appropriate support. The MAMI approach serves to optimise support provided through IYCF services by:

  1. Targeting skilled breastfeeding support to at-risk infants under six months and their mothers, rather than to the general population of infants. 
  2. Providing skilled breastfeeding counselling as part of a larger package of clinical and social care. This may involve referrals to relevant clinical services, specialist maternal mental health services, maternal physical health and nutrition services, and other context-specific support that the pair may benefit from, such as social services.
  3. Providing regular and continuous targeted support, whereby infants and mothers are not discharged. Rather, they are enrolled in care until the infant reaches six months of age, with frequency of care depending on their needs. Combined with early identification, this ensures these at-risk infants and mothers are on the radar of the health service to help identify and respond to problems quickly.

A combined effort between MAMI and IYCF providers is essential to strengthen continuity of optimal breastfeeding support from birth through the first two years of life and beyond, to give these mothers and babies the best possible chance to survive, grow and develop. 

More like this

MAMI News and Events

MAMI News If you would like to receive MAMI Global Network's monthly updates please subscribe here. Past issues of the newsletter can be viewed here. If you would like to...

Video: MAMI Care Pathway Package: from vision to action

Tackling malnutrition is a global health priority, helping children both survive and thrive. A large proportion of infants under six months of age in the world are identified...

Blog post: World Breastfeeding Week 2022: Let's get in step together to support infants and mothers most in need

At the beginning of August, ENN participated in a global webinar to mark World Breastfeeding Week organised by the Global Breastfeeding Collective (GBC), supported by UNICEF....

MAMI Evidence

MAMI Evidence There are a range of ongoing research activities by the MAMI Global Network and its partners. See below for a list of peer-reviewed publications. Upcoming...

MAMI Practice

MAMI Practice The MAMI Care Pathway Package (2021, Version 3) is a set of resources and materials that was co-created by members of the MAMI Global Network. Previously known...

FEX: Carers’ and health workers’ perspectives on malnutrition in infants aged under six months in rural Ethiopia: A qualitative study

View this article as a pdf This is a summary of the following paper: Jibat N, Rana R, Negesse A et al (2022) Carers' and health workers' perspectives on malnutrition in...

FEX: Managing at risk mothers and infants under six months in India – no time to waste

This is a summary of a Field Exchange field article that was included in issue 63 - a special edition on child wasting in South Asia. The original article was authored by...

FEX: Launch of the MAMI Care Pathway

View this article as a pdf The MAMI Global Network, co-chaired by the Emergency Nutrition Network (ENN) and London School of Hygiene and Tropical Medicine (LSHTM), has...

FEX: Management of At-risk Mothers and Infants under six months (MAMI): Update and direction

View this article as a pdf Summary of meeting report1 A two-day meeting of the MAMI Special Interest Group (SIG)2 was held on 12-13 December 2019, organised by Emergency...

Resource: Stronger evidence towards future scale up: Cluster Randomised Trial in Ethiopia - Update 1.0, November 2020

Overview We are a consortium of two universities - Jimma University and the London School of Hygiene and Tropical Medicine a technical charity - the Emergency Nutrition...

FEX: Community-based management of acute malnutrition (CMAM) Conference 2021

View this article as a pdf Concern Worldwide and Irish Aid hosted a virtual conference on the community-based management of acute malnutrition (CMAM) in March 2021. The...

FEX: Managing at risk mothers and infants under six months in India – no time to waste

View this article as a pdf Lisez cet article en français ici By Praveen Kumar, Sila Deb, Arjan de Wagt, Piyush Gupta, Nita Bhandari, Neha Sareen and Satinder...

Resource: MAMI Care Pathway Package, Version 3 (2021)

Dossier disponible en français The MAMI Care Pathway Package provides practitioners with a resource to screen, assess, and manage small and nutritionally at risk...

World Breastfeeding Week at ENN

World Breastfeeding Week at ENN Take Ten Steps Up for Breastfeeding During World Breastfeeding Week, we joined the Global Breastfeeding Collective to learn about the Ten...

Resource: C-MAMI Tool, Version 2 (2018)

The C-MAMI Tool has now been updated as the MAMI Care Pathway Package. Find the updated version here. The C-MAMI Tool provides a health worker with a format to assess,...

FEX: GOAL’s experiences of management of at-risk mothers and infants (MAMI) programming in Ethiopia

This article has been updated since the original version was published in March 2020. View this article as a pdf Lisez cet article en français ici By Alice Burrell...

MAMI Global Network Coordination and Governance

MAMI Global Network Coordination and Governance The MAMI Global Network Strategy for 2021-2025 is now available here. An overview of the Network's governance structures and...

FEX: Piloting the C-MAMI approach in the Rohingya response in Bangladesh

By Anne Marie Kueter, Alice Burrell, Sarah Butler, Mostofa Sarwar and Habibur Rahaman View this article as a pdf Anne Marie is a nutritionist with over five years'...

Stronger evidence towards future scale up: Cluster Randomised Trial in Ethiopia

Collaborators: London School of Hygiene and Tropical Medicine (LSHTM), Jimma University (Ethiopia), GOAL, and the Emergency Nutrition Network (ENN) Donors: Eleanor Crook...

FEX: Special Section on MAMI: Editorial

View this article as a pdf This issue of Field Exchange features six articles on managing nutritionally vulnerable infants under six months of age. This MAMI 1 section...