Perspectives in Health Magazine The Magazine of the Pan American Health Organization Volume 8, Number 1, 2003

Rosaura Veliz Rixton. Photo ©La Leche League Guatemala

Rosaura Veliz Rixton sat in a circle with six other women on the patio of a neighbor’s home on the outskirts of El Limón, a low-income district of Guatemala City. The women spoke in low voices, almost whispering so as not to wake up the tiny sleeping babies some of them held in their arms. Veliz listened intently, holding her 25-day-old baby girl Dara close. Leading the meeting was "Doña Amalia," a more experienced mother and the designated monitora, or peer counselor.

Doña Amalia explained that breastfeeding was the best option for both mother and baby, no matter what relatives and friends might tell the young mothers. Other women chimed in their agreement. They assured Veliz that when her baby cried, it was not because she was doing something wrong. And despite what Veliz’s mother-in-law said, it was not necessary to give little Dara infant formula —or water, or juice or anything else for her first six months. "I was glad to hear that I didn’t need to give her a bottle," recalls Veliz. "They explained to me how to breastfeed the baby correctly. I liked the group so much that I continued to go."

Breastfeeding is the healthiest and best way to nourish babies, particularly during the first half-year of life. Breast milk contains all the nutrients babies need, along with mothers’ antibodies that boost the babies’ still-developing immune systems. Research has even shown that breastfeeding makes babies smarter. Moreover, breast milk requires no preparation and therefore cannot be overdiluted or contaminated by dirty water. And it is always just the right temperature.

Starting in the middle of the last century, however, breastfeeding began to decline in both developed and developing countries, the result of a number of factors: the marketing practices of infant formula makers, the social perception that it was somehow more "modern" to give babies formula, and a lack of knowledge about the tremendous benefits of breastfeeding for both mother and baby.

La Leche League was founded in 1956 by seven U.S. women to counter these trends and "rescue" the art of breastfeeding. In the years since, this international nongovernmental organization has worked in a growing number of countries both to encourage breastfeeding and to give support to new mothers.

Today La Leche League International’s programs focus on training peer counselors like Doña Amalia and establishing support groups in which mothers are encouraged to share their experiences and exchange knowledge. The goal is to increase mothers’ selfconfidence, not only to breastfeed but also to practice other maternal skills. New mothers ask questions, and more experienced mothers give advice. Throughout, the group facilitator listens, gently guides the discussion and respectfully corrects any misconceptions she might hear.

"I went to listen to the other mothers’ experiences, but the monitora explains things best," says Karla Duarte, six months pregnant and the mother of a 3-year-old boy and a 2-year-old girl. She recalls how she gave up breastfeeding her first baby, who was delivered by caesarean section. Because of her surgery, she had to go to the doctor for a series of follow-up visits but felt too weak to carry the baby with her. The babysitter gave him formula, and when Duarte tried to nurse again, the baby refused her breast. Duarte believes this had a great deal to do with the nearly chronic stomach infections her son suffered as a small child. Her second child, who breastfed exclusively, was never ill. Duarte swears that now she will feed her baby-to-be exclusively with breast milk.

La Leche League support groups meet in private houses or in health centers and welcome new or soon-to-be grandparents and aunts and uncles along with new parents and parents-to-be. The organization actively encourages fathers to participate, since they can provide breastfeeding mothers with invaluable support.

The role of trained peer counselors in these groups is essential. Their activities range from personal counseling, including home visits, to forming new support groups. "They are women who belong to the community," explains Veliz. "They are leaders by nature, and they know the mothers’ needs."

Veliz was a support group participant for three years before receiving training to become a peer counselor. Last year, she was elected La Leche League coordinator for all of El Limón. Being a peer counselor allows her to do what she finds most fulfilling: helping other mothers in need.

"When I began, as I talked with the mothers, I recalled when I had my first baby and I was just starting. Mothers need help because the influence of others can sometimes be negative," she says.

The peer counselors face their own challenges. One of these is getting young mothers to communicate openly, to discuss their problems and to learn from each other. "Sometimes it’s hard for women to feel comfortable talking about their experiences and their beliefs with people they’ve only just met," says Mimi de Maza, a member of La Leche League International’s board of directors and a promoter of the support group program.

To help, La Leche League Guatemala has developed special cloth posters, called mantas, that provide illustrations of breastfeeding concepts and techniques. The point, however, is less to provide "how-to" instructions than to encourage more open exchange. Says Maza: "The images help women talk about the choices they have made and give them an easier way to connect with other mothers."

María del Mar Mazza is a nutritionist and a program administrator in La Leche League International’s Peer Counselor Program.

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