Nuclear Techniques to Assess Breastfeeding Practices General

International Atomic Energy Agency staff (from left) Dr Cornelia Loechl and Dr Thabisile Moleah, with UKZN’s Professor Anna Coutsoudis and Dr Emorn Udomeskalee of Mahidol University.International Atomic Energy Agency staff (from left) Dr Cornelia Loechl and Dr Thabisile Moleah, with UKZN’s Professor Anna Coutsoudis and Dr Emorn Udomeskalee of Mahidol University.

UKZN’s Professor Anna Coutsoudis of the Department of Paediatrics and Child Health attended the 60th International Atomic Energy Agency (IAEA) General Conference in Vienna, Austria, where she gave an address at a side event titled: “Nuclear Techniques to Assess Breastfeeding Practices”.

The event brought together more than 80 participants to hear about and discuss the benefits of breastfeeding, national interventions to encourage breastfeeding, and the contribution of nuclear techniques.

Exclusive breastfeeding during the first six months after birth has been proven to be the most effective way to ensure the health of children. According to the World Health Organization, breast milk is the natural first food for babies, it provides all the energy and nutrients an infant needs in the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life.

‘Breast milk promotes sensory and cognitive development, and protects the infant against infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea or pneumonia, and helps quicker recovery during illness. These effects can be measured in resource-poor and affluent societies.

‘The monitoring of breastfeeding patterns relies heavily on self-reported habits. Limited information is available on the quantities of human milk consumed and the time of introduction of other foods into infants’ diets. The lack of information is, at least partly, due to the difficulties involved in assessing intake of human milk. The conventional technique is to weigh the infant before and after each feed, which is called “test weighing”. However, this technique is time consuming and may disturb the normal feeding pattern. This is where nuclear techniques play a key role,’ the Conference heard.

‘The practical problems associated with test weighing can be overcome by using the stable isotope technique. The amount of human milk consumed by the baby over a period of 14 days can be assessed using the deuterium oxide “dose-to mother” technique, which involves giving the mother a drink of deuterium labelled water and following the disappearance of the deuterium from the mother and its appearance in the baby. Deuterium is a stable (non-radioactive) isotope of hydrogen with the symbol 2 H. It is given orally as deuterium oxide (2H2O) and after mixing with body water is eliminated from the body in urine, saliva, sweat and human milk. Stable isotopes have been used in human metabolic studies for over half a century. Stable isotopes of hydrogen emit no potentially harmful radiation.’

Said Kenyan Ambassador, Mr Michael Oyugi: ‘How do you measure progress in adequate breastfeeding of babies? Tracking progress in achieving global breastfeeding targets will heavily depend on the collation of accurate data. Applying stable isotope techniques provides us with a unique opportunity to assess breastfeeding practices.’

Coutsoudis praised the IAEA for its support in enabling studies to evaluate the effectiveness of breastfeeding promotion interventions, in particular in the context of a high prevalence of HIV.

The non-radioactive stable isotope technique, known as deuterium oxide dose-to-mother technique, is already being successfully used with IAEA assistance in almost 30 countries in Africa, Asia and the Pacific and Latin America and the Caribbean, to objectively monitor and assess the impact of breastfeeding promotion programmes for improving the health of mothers and their babies.

A Fellow of UKZN, Coutsoudis is engaged in extensive research on HIV and nutrition, and especially in breastfeeding.  She has published more than 100 peer-reviewed journal articles and her research work has played an important role in the shaping of the WHO guidelines on HIV and Infant Feeding.

She previously served as President of the Technical Steering Committee of the WHO Child and Adolescent Health Unit.  Currently she is a member of a number of WHO Guideline Development Groups. She is also a recipient of the Science for Society Gold Medal award by the Academy of Science of South Africa.

Coutsoudis established the first community based breastmilk bank in South Africa specifically to provide donor breastmilk to AIDS orphans. She is currently the recipient of the GSK/Save the Children Health Innovation Award which enables her to scale up community based Human Milk Banks in KwaZulu-Natal using low cost technology for pasteurising breastmilk developed by the University of Washington’s Department of Computer Science and Engineering.

MaryAnn Francis