How blogger helped bring breastfeeding back to Serbia

Aleksandra Milenovic watches her 24 hours old baby Milica after breastfeeding her at the Obstetrics and gynecological Clinic "Narodni Front" in Belgrade on July 31, 2018. (AFP)
Updated 05 August 2018
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How blogger helped bring breastfeeding back to Serbia

  • Breast milk produced during those early days is especially rich in nutrients and antibodies, boosting infants’ chances of survival by protecting them from infections
  • While breastfeeding rates in the first hour after birth have skyrocketed in Serbia, the figures fall off significantly in the following six months

BELGRADE: When Branka Stamenkovic gave birth to her first child in Serbia, the experience was traumatic.
Minutes after the baby was born, nurses bundled up the infant and whisked him away, separating the mother and child for three days.
When they returned, the nurses gave Stamenkovic a cursory lesson in breastfeeding and sent the pair on their way.
Upset, overwhelmed and in pain, Stamenkovic detailed her experience in a blog in 2008 that triggered an outpouring of similar stories from women across Serbia.
It also unwittingly lit the spark for a UNICEF campaign that has turned the Balkan country into a leading example of how to boost early breastfeeding rates.
“I used to write the blogs and cry,” said Stamenkovic, recalling the horror stories that women sent her, including how nurses yelled, humiliated or ignored them, and failed to provide guidance on basics like breastfeeding.
“I published over 700 stories online, and this is how UNICEF actually learned about the sad state of affairs of the baby-friendly program in Serbia,” she told AFP.
The UN children’s agency had first launched its “baby-friendly hospital initiative” in Serbia in the 1990s.
But after it handed the program over to the government in the early 2000s, breastfeeding rates fell off a cliff, plummeting to eight percent in 2010.
The UN agency pointed to the stories on Stamenkovic’s blog to make a case for re-booting the initiative.
By 2014, the percentage of women breastfeeding within the first hour after birth was back up to 51 percent — a leap unseen among other middle and low-income countries.

The World Health Organization (WHO) and UNICEF — who are marking World Breastfeeding Week until August 7 — have long pushed for mothers to exclusively breastfeed babies during their first six months of life, starting within the first hour after birth.
Breast milk produced during those early days is especially rich in nutrients and antibodies, boosting infants’ chances of survival by protecting them from infections.
But health experts must battle a multi-billion dollar baby formula industry, dominated by American firms, that aggressively advertises breast milk substitutes to mothers from day one.
Global debate over the issue was revived last month when a US delegation reportedly tried to water down a WHO resolution that called for the promotion of breastfeeding.
US President Donald Trump added fuel to the fire when he came out in defense of formula, drawing criticism from health experts.

The early form of breast milk, known as colostrum, “is the best food that a human being can ever get,” said Djurdjica Cecez, a neonatologist at Belgrade’s Narodni Front maternity hospital.
It is “precious and irreplaceable,” she added.
One of her patients, 31-year-old Aleksandra Milenkovic, experienced two different approaches first-hand.
Two years ago she was separated from her baby boy immediately after giving birth. He was brought back to her the following morning and was already being fed a formula diet.
Last week, at the same hospital, she delivered a baby girl and began breastfeeding immediately.
“I had the fantastic opportunity to be with this baby and have it touch with me, skin to skin. We spent an hour like that and the baby was breastfed for the first time, which was wonderful,” Milenkovic said.
“I think that is the most beautiful thing that could happen,” she added with a smile, lying down next to her 24-hour-old infant, fast asleep.

Cecez, her doctor, noted that Serbia has made impressive gains in promoting early breastfeeding in recent years.
Today, in order to be accredited, Serbian maternity hospitals must meet the “baby-friendly” guidelines that promote immediate skin-to-skin contact between mother and child after birth, breastfeeding within the first hour and support to keep up the practice.
But Cecez stressed that much more work needed to be done to improve maternity care in the country, from increasing hospital staff to improving the education of both health workers and future mothers.
While breastfeeding rates in the first hour after birth have skyrocketed in Serbia, the figures fall off significantly in the following six months.
According to UNICEF, only 12 percent of mothers in Serbia exclusively breastfeed their children for that period of time.
Breastfeeding can be “a very painful thing sometimes,” said Stamenkovic, recalling the lack of guidance she received at the time.
“You need somebody to provide an emotional support, to cheer you up and say, ‘yes you can do it’.”
The blogger, who has since become a politician, could never have predicted that her online efforts would have such an impact and says she is “glad” to have contributed to the change.
“But we have a long way to go yet.”


Nearly four in 10 US HIV infections from people unaware of infection

This electron microscope image made available by the U.S. National Institutes of Health shows a human T cell, in blue, under attack by HIV, in yellow, the virus that causes AIDS. (AP)
Updated 19 March 2019
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Nearly four in 10 US HIV infections from people unaware of infection

  • The Trump administration has said it will invest $291 million in the next financial year to fight HIV/AIDS, which has plateaued since 2013 to around 39,000 annual transmissions

WASHINGTON: Almost 40 percent of new HIV cases in the US occur because people do not know they are infected, while a similar proportion know but are not in treatment, according to a study released Monday.
The report by the Centers for Disease Control and Prevention (CDC) is based on 2016 data and aims to bolster a strategy outlined by President Donald Trump to end the epidemic within 10 years.
The strategy has two main strands: far more widespread screening, and enabling the infected better access to treatment from the moment they test positive.
The study found that 38 percent of infections came from HIV-positive people who were unaware of their status, and 43 percent from people who knew they were infected but took no anti-retroviral drugs.
The remaining infections came from people who were receiving HIV treatment but were not yet “virally suppressed.”
The CDC blamed financial, social and other reasons for people not using medication, which these days typically comes in the form of a daily pill with minimal side effects.
The study said that the infection rate from the half million people in the United States who take medication and are virally suppressed — meaning they cannot pass on the disease to others — was zero.

The most at-risk group remains homosexual men, with almost three-quarters of new infections coming from men having sex with men, the report said.
Five percent of infections came from intravenous drug abuse among homosexual men, while 10 percent came from injecting drugs among the rest of the population.
Twelve percent of infections were among heterosexuals. Overall, the highest rate of transmission was among 13 to 24-year-olds.
The Trump administration has said it will invest $291 million in the next financial year to fight HIV/AIDS, which has plateaued since 2013 to around 39,000 annual transmissions.
The goal is to reduce that number by 75 percent within five years and by 90 percent in 10 years.
Questioned about the relatively small amount of money earmarked for the multi-billion dollar task of treating HIV carriers, CDC head Robert Redfield said he was “confident that the resources that are required to accomplish this mission are in the long term plan.”
The CDC, based in Atlanta, Georgia, wants doctors to make HIV screening a routine procedure.
“Everyone between the ages of 13 and 64 should get tested for HIV at least once in their lifetime,” said Eugene McCray, the head of the CDC’s Division of HIV/AIDS Prevention.
“Those at higher risk should get tested at least annually,” he said.
“The key to controlling is helping those with HIV to control the virus,” said the CDC’s Jonathan Mermin, who focuses on preventing the spread of the HIV as well as other sexually transmitted diseases, tuberculosis and hepatitis.
“Time spent working closely with patients who are having trouble paying for, picking up or taking their daily medications is time well spent“