As the world marks World Breastfeeding Week 2026, the theme, “Breastfeeding for a sustainable start in life: Strengthen what works,” calls for strengthening proven approaches that help mothers and babies thrive. One such approach is providing continuous breastfeeding support that extends beyond the hospital and into the home.
In low- and middle-income countries (LMICs), post-discharge mortality accounts for up to 20% of infant deaths, while undernutrition contributes to nearly half of all childhood mortality. For infants under six months recovering from malnutrition, leaving the hospital is not the end of their journey, it is the beginning of recovery.
While national guidelines, including Kenya’s Integrated Management of Acute Malnutrition (IMAM) guidelines, recommend re-establishing exclusive breastfeeding (EBF) for these infants, there has historically been limited guidance on how mothers and infants should be supported after discharge.
This gap inspired researchers at the Programme to explore how sustained breastfeeding support could improve recovery outcomes. Dr. Martha Mwangome, a nutritional epidemiologist and Associate Professor at the University of Oxford has dedicated her research to improving the care of vulnerable infants under six months of age.
This work led to the Individualized Breastfeeding Support for Acutely Ill Malnourished Infants (IBAMI) study at Kilifi County Hospital, which explored how breastfeeding peer supporters could help mothers re-establish exclusive breastfeeding among sick malnourished hospitalized infants under six months. The IBAMI study achieved 81% exclusive breastfeeding by discharge.
Despite this milestone, inadequate post-discharge support and poorly articulated follow-up strategies made it difficult for many mothers to maintain exclusive breastfeeding once they returned home. Infant growth also declined during the weeks following discharge. “Our studies showed that infants are discharged stable, not fully recovered,” explains Dr. Mwangome. “Recovery continues at home, yet there was very little guidance on how mothers could be supported during this critical period.”
To address this challenge, researchers developed a structured breastfeeding support intervention centred on trained breastfeeding peer supporters. These peer supporters are experienced mothers from the same communities as the women they support. Sharing similar cultural backgrounds, language and lived experiences enables them to build trust, understand challenges more deeply and provide practical, compassionate support throughout the breastfeeding journey.
During hospital admission, peer supporters help mothers establish proper breastfeeding techniques, including correct positioning and attachment, while providing guidance on hygiene, maternal nutrition and maintaining adequate breast milk production. Rather than offering one-off advice, they spend time with mothers over several days, helping them identify and overcome physical, emotional and practical barriers to breastfeeding.
Recognising that breastfeeding support should not stop at hospital discharge, the research team designed the IBAMI2 study which is a randomized control trial to evaluate whether structured home-based breastfeeding support intervention (BFSI) improves infant growth, exclusive breastfeeding and neurodevelopment among infants recovering from malnutrition.
The same breastfeeding peer supporter who supports a mother during her hospital stay continues to visit and support her after discharge. This continuity of care allows trust established in hospital to continue in the home environment while giving peer supporters a better understanding of the family’s circumstances and any challenges affecting breastfeeding. The intervention also strengthens community support by involving Community Health Promoters and encouraging mothers to identify a trusted “breastfeeding buddy”, a family member or friend who can provide encouragement and practical support throughout the breastfeeding journey.
Breastfeeding is more than a source of nutrition; it is an essential part of treatment and recovery for nutritionally vulnerable infants. It provides nutrients that support healthy growth, strengthens immunity, and significantly improves survival and long-term development.
Dr. Mwangome’s research shows that successful breastfeeding is a learned skill that requires ongoing guidance, patience and encouragement. “Breastfeeding is a behavioural intervention that requires continuous support with mothers often needing time to learn or even unlearn breastfeeding practices before they become confident. Breastfeeding support helps in structuring, documenting and supervising breastfeeding better making it more effective, ” highlights Dr. Mwangome.
As we celebrate World Breastfeeding Week, this work highlights the importance of investing in sustainable breastfeeding support systems that begin in hospital and continue within communities. By strengthening the role of breastfeeding peer supporters and building stronger links between hospitals, communities and families, health systems can ensure mothers receive the knowledge, confidence and encouragement they need giving every child the healthiest possible start in life.