**2. Challenges with breastfeeding**

 The WHO's recommendation for breastfeeding has been adopted by several countries all over the World and also in West Africa, but this has presented with several challenges, hence reducing the number of children who could potentially be breastfed. In the United States, for example, less than half of infants receive any breast milk at 6 months (49.4%), and approximately one-quarter are breast-fed up to 1 year (26.7%) [4]. Breast discomfort or pain, sore nipples, mastatitis, inverted nipples, presence of breast implants, difficulty getting baby to suck, poor weight gain and hypernatremia dehydration due to insufficient milk intake are rampant challenges encountered during breast feeding [3]. Lactation failure is also common among postpartum women, resulting in insufficient milk supply which is a major reason for early weaning. It has been claimed that at least 5% of women experience lactation failure (agalactias) whiles approximately 15% of women experience inadequate supply of their breast milk (hypogalactias) [5] at 3 weeks postpartum. The number of lactating women who have produce insufficient breast milk is on the rise [2]. There are a number of well-known causes of low breast milk supply that is primarily related to breast feeding management. These factors are difficult to control and require a good knowledge of breastfeeding practices. These factors include; schedule breastfeeding, skipping breastfeeding, supplementing the diet of the baby with infant formulas and poor latching of the baby on the breast. However, there are more complicated causes of low breast milk supply such as; insufficient mammary tissue (hypoplasia), medications (hormonal contraceptive pills), retained placenta, diseases (diabetes, jaundice), metabolic conditions (obesity), previous breast surgeries, cesarean section, thyroid and other hormonal disorders. Another cause is even environmental toxins such as pesticides. A study found that daughters of women who grew up in a pesticide contaminated environment had much higher incidence of insufficient mammary tissue than those living on the hill top of the same an area [6].

#### **3. Solutions to breastfeeding challenges**

To respond to the challenge of insufficient milk production (hypogalactia) or the absence of milk production (agalactia) milk banks are being created and the use of medication that induces, maintains or increases milk production are being used [2, 7].

Throughout history, donor breast milk banks have been the choice of some parents, and it is currently recommended as second choice if the mother's own milk is not available. However, the risk of possible transmission of diseases including HIV, cytomegalovirus, and Creutzfeldt-Jakob disease has induced the need for pasteurization. There are major concerns however as to what extent pasteurized donor breast milk retains the biological properties of mother's milk. Evidence on donor milk quality is limited [3] and operational human milk banks are not able to meet demands for especially the most vulnerable neonates [8].
