Project Lead(s): Sabrina Rasheed
Issue
More than 9,000 infants die in Bangladesh every year due to suboptimal breastfeeding practices. Mothers working in ready-made garment (RMG) factories in Bangladesh have inadequate access to facilities that allow them to continue breastfeeding and, as a result, their children receive inadequate complementary feeds, leading to malnutrition.
Solution
The objective of the project was to provide garment factory workers with supportive technologies (such as a breast pump and pasteurization device) to encourage breastfeeding and also to assess whether the pasteurization device could increase the shelf life of breast milk at room temperature.
The project team also sought to determine the impact of pasteurization on the nutrients and immune components of breast milk, and whether installing the pasteurization device in a work setting had the ability to increase breast milk production and feeding frequency, to reduce the cost of formula feeding and absenteeism among working mothers.
To establish the shelf life of breast milk, a small sample (10ml) of breast milk from 32 mothers was tested with high-temperature, short-time (HTST) pasteurization. To achieve proof of concept, the team measured bacterial growth, protein and fat content of milk, and killing assays/quantification of immunoglobulin A and complement C3c of pasteurized and unpasteurized breast milk.
Measuring bacterial growth allowed the team to determine the shelf life of breast milk pasteurized by the device, while measuring protein and fat content enabled them to determine whether the pasteurization process destroyed essential macromolecules of the milk.
Outcome
The project team successfully developed a tool to pasteurize breast milk that could extend the shelf life of the breast milk from two hours to 6–8 hours.
Studies also showed that pasteurization did not have a major impact on nutrients and immune components, with the exception of immunoglobulin A (IgA) levels, which were significantly reduced in pasteurized milk.
To assess the direct impact of installing the breast milk-supportive technologies, the team conducted monthly follow-up surveys of enrolled mothers. The team found that pumping breast milk increased breast milk production within a week for all mothers (mean increase from 75 to 165 ml). Mean breast milk feeding frequency increased for mothers with younger children (from 5.4 to 7.4 times) but not mothers with older children.
The cost of buying formula was significantly reduced for mothers of children of more than six months of age, but not with those with younger children. The team also found that the mean absenteeism rate was reduced from six days a month to one day a month for the participating mothers.
With a few exceptions, mothers appreciated the availability of the breast pumps and pasteurization devices. Factory management also liked the program, as they felt that mothers were more comfortable at work and more mothers were able to come back to work because of the program.
The project team intends to apply for Transition To Scale (TTS) funding to further develop the pasteurizing device.