Nourishing Hope: Meet a Nutrition Volunteer Supporting Families Through Breastfeeding in Tanzania

For many new mothers, breastfeeding is one of the first ways they nourish and bond with their baby. But for babies born with cleft conditions, feeding can present unique challenges. Difficulty creating suction can make breastfeeding and bottle-feeding more difficult, placing some children at risk of poor nutrition and delayed growth during an important stage of development. With the right guidance and support, families can overcome many of these challenges and help their children grow, thrive and prepare for comprehensive cleft care.

In Tanzania, where access to specialized nutrition support can be limited, trained healthcare providers and volunteers play an important role in helping families access the care they need closer to home. In the Iringa Region, Anna Nombo is helping make that support possible. As a regional nutrition officer and Operation Smile nutrition volunteer, Nombo works alongside multidisciplinary cleft care teams to assess children’s nutritional needs, provide feeding guidance and support parents and caregivers throughout their child’s care journey.

Since joining Operation Smile Tanzania in 2025, Nombo has participated in surgical programs in Tanzania and Ghana and strengthened her expertise in comprehensive cleft care through regional training in Cape Town, South Africa. Her work reflects the importance of investing in local expertise to ensure children born with cleft conditions receive the support they need from their earliest days.

In this Q&A, Nombo shares why nutrition is one of the first steps in a child’s cleft journey, how breastfeeding support helps families navigate feeding challenges with confidence and what gives her hope for the future of comprehensive cleft care in Tanzania.

What inspired you to become a volunteer and support children born with cleft conditions and their families?

As a nutrition professional, I have always believed that every child deserves the opportunity to grow healthy and reach their full potential. When I learned about the feeding challenges faced by children born with cleft conditions, I realized that nutrition support could make a life-changing difference. Volunteering with Operation Smile has allowed me to combine my professional skills with my passion for serving vulnerable children and empowering families.

Working alongside multidisciplinary teams in Tanzania and Ghana has further reinforced my belief that comprehensive cleft care goes beyond surgery; it begins with ensuring every child has the opportunity to feed, grow and thrive.

Many people think cleft care begins with surgery. Why is nutrition and feeding support such an important part of a child’s care journey?

Surgery is only one part of comprehensive cleft care. Good nutrition begins the moment a baby is born. Many infants with cleft conditions struggle to breastfeed or feed effectively, placing them at risk of malnutrition and delayed growth, and increasing risk of infections. A child who is well nourished is more likely to be ready for surgery, recover more quickly and achieve better long-term health outcomes. Nutrition support is therefore essential throughout the entire care journey.

What are some of the challenges babies with cleft conditions and their mothers may experience when it comes to feeding and receiving adequate nutrition?

Many children experience difficulty creating enough suction to breastfeed or bottle-feed effectively. Feeding may take much longer, milk may come through the nose, and mothers often worry that their babies are not getting enough nutrition. These challenges can lead to poor weight gain, stress and anxiety for families if they do not receive timely guidance and support.

What does nutrition and feeding support look like for families participating in Operation Smile programs in Tanzania?

Families receive comprehensive nutrition assessments, individualized feeding counseling, growth monitoring and practical demonstrations on appropriate feeding techniques and positioning. We educate caregivers on breastfeeding options, safe complementary feeding, hygiene and ways to improve dietary quality using locally available foods. Children are monitored before and after surgery to ensure they continue growing well.

The knowledge and skills I gained during the comprehensive Cleft Care Regional Training in Cape Town have strengthened my ability to provide evidence-based nutrition counseling and contribute effectively to multidisciplinary cleft care teams.

How do you and the team help mothers feel confident and supported as they learn feeding techniques that work best for their babies?

We provide one-on-one counseling in a respectful and encouraging environment. We demonstrate feeding techniques, observe mothers while they practice, answer their questions and reassure them that many feeding challenges can be successfully managed. Continuous encouragement and follow-up help mothers gain confidence in caring for their babies.

Can you share a memorable moment with a child or family where nutrition or feeding support made a meaningful difference in their journey?

One experience I will never forget involved a baby who was underweight because feeding had become extremely difficult. The mother had stopped breastfeeding because she believed she was not producing enough breast milk and had started introducing other foods much earlier than recommended.

During an Operation Smile surgical program in Iringa, after the assessment day, our nutrition team identified several children who were underweight and required nutritional support before they could undergo surgery. Among them was a mother and her baby who had traveled from a rural community in Kilolo District in the Iringa Region. The mother was discouraged and believed her child would never become strong enough for surgery.

We provided individualized nutrition counseling, encouraged and supported her to relactate, taught her appropriate feeding techniques, and closely monitored the baby’s progress. Over time, the baby gained enough weight and became eligible for surgery. The smile on a mother’s face when her baby finally reached the required weight for surgery is something I will never forget. Those moments remind me why I continue to volunteer. Watching that child undergo successful surgery and seeing the mother’s renewed confidence reminded me that nutrition support is not simply about helping children gain weight; it restores hope and opens the door to life-changing treatment.

Why is it important to invest in training local healthcare providers and volunteers to provide nutrition support for children with cleft conditions?

Many families first seek care at local health facilities. When healthcare providers and community volunteers have the knowledge and skills to identify feeding difficulties early and provide appropriate counseling, children receive support much sooner. This reduces the risk of malnutrition, improves referrals and strengthens the overall quality of comprehensive cleft care across the country.

In my own region of Iringa, where I work as a regional nutrition officer, there are five councils and 598 villages and streets, but only 28 nutrition officers serving the entire region. This means it is impossible for nutrition specialists alone to reach every family in need. By training local healthcare providers and community volunteers, we extend the reach of nutrition services, ensuring that families receive timely guidance and referrals close to where they live.

My experience in regional training and participation in surgical programs across different countries has shown me that investing in local capacity creates lasting impact. Trained professionals can continue supporting children and families long after surgical programs have ended.

How does strengthening nutrition and comprehensive cleft care today help create a healthier future for children and families across Tanzania?

Investing in nutrition and comprehensive cleft care enables children to survive, grow, learn and thrive. Healthy children are more likely to succeed in school and participate fully in society. At the same time, empowering families with knowledge reduces stigma, builds confidence and strengthens communities.

By strengthening local expertise through training, mentorship and multidisciplinary collaboration, Tanzania is building a sustainable system where more children can access quality cleft care close to home.

What gives you hope when you think about the future of children born with cleft conditions in Tanzania?

I am encouraged by the growing collaboration between Operation Smile, the Government of Tanzania, healthcare professionals and communities. More children are being identified early, more families are receiving feeding support, and awareness continues to increase.

Having participated in surgical and training programs in both Tanzania and Ghana, I have seen firsthand how sharing knowledge and best practices strengthens local capacity. This gives me confidence that the future of comprehensive cleft care in Tanzania is bright and that every child born with a cleft condition will have an even greater opportunity to receive timely, high-quality and compassionate care.

During World Breastfeeding Week, what message would you like to share with mothers and families who have a baby born with a cleft condition?

To every mother and family, please know that you are not alone. A baby born with a cleft condition can grow, thrive and live a healthy life with the right support. Seek care as early as possible, continue feeding your baby with guidance from trained healthcare providers, and never lose hope. Your love, patience and commitment are powerful, and together with the support of healthcare teams, they can make an incredible difference in your child’s future.