OPINION ARTICLE
Exclusive breastfeeding through the community action of the “Luces y Sueños” project
La lactancia materna exclusiva desde el accionar comunitario del proyecto “Luces y Sueños”
Joel Lima Castro 1, https://orcid.org/0009-0009-8438-8420
Lena Alonso Triana 1*, https://orcid.org/0000-0002-1567-8637
David Ruiz Hernández 1, https://orcid.org/0009-0006-4569-7456
Leanis Viltres Camoira 1, https://orcid.org/0009-0005-5384-5044
1 University of Medical Sciences of Matanzas. Matanzas, Cuba.
* Corresponding author: lenaalonsotriana@gmail.com
Received: 20/07/2025
Accepted: 19/09/2025
How to cite this article: Lima-Castro J, Alonso-Triana L, Ruiz-Hernández D, Viltres-Camoira L. Exclusive breastfeeding through the community action of the “Luces y Sueños” project. MedEst. [Internet]. 2025 [cited access date]; 5:e408. Available in: https://revmedest.sld.cu/index.php/medest/article/view/408
ABSTRACT
Exclusive breastfeeding (EBF) until six months is one of the most effective and cost-effective public health interventions, with proven benefits for child survival, maternal health, and cognitive development. However, a significant gap persists between scientific evidence and EBF rates globally. This disparity is not an individual failure, but rather the result of an overly biomedical approach that has ignored crucial social determinants, such as commercial pressures, insufficient labor legislation, cultural myths, and a lack of community support. The objective of this research is to argue for the systematic and funded integration of community-based university outreach projects as an indispensable pillar of national EBF promotion strategies. Projects such as "Luces y Sueños" at the University of Medical Sciences of Matanzas represent a paradigm shift: moving from providing information to creating enabling environments through empathetic dialogue that builds trust, debunks myths, and empowers mothers and their families. These interventions, where students act as agents of change, address not only educational barriers but also the need for practical and emotional support, and can even impact structural determinants through advocacy. There is a need to systematically integrate these projects into the academic curriculum and national health strategies, overcoming their seasonality to achieve sustainable impact through ongoing monitoring and rigorous evaluation, thus transforming EBF promotion into a deeply social and community-based practice.
Keywords: Exclusive Breastfeeding, University Extension, Social Determinants
RESUMEN
La lactancia materna exclusiva (LME) hasta los seis meses es una de las intervenciones de salud pública más eficaces y costo-efectivas, con beneficios demostrados para la supervivencia infantil, la salud materna y el desarrollo cognitivo. No obstante, persiste una brecha significativa entre la evidencia científica y las tasas de LME a nivel global. Esta disparidad no es un fracaso individual, sino el resultado de un enfoque excesivamente biomédico que ha ignorado determinantes sociales cruciales, como las presiones comerciales, legislaciones laborales insuficientes, mitos culturales y la falta de apoyo comunitario. Argumentar a favor de la integración sistemática y financiada de proyectos de extensión universitaria con enfoque comunitario como un pilar indispensable en las estrategias nacionales de promoción de la LME es el objetivo de la presente investigación. Proyectos como "Luces y Sueños" de la Universidad de Ciencias Médicas de Matanzas representan un cambio de paradigma: pasar de informar a generar entornos facilitadores mediante un diálogo empático que construye confianza, desmonta mitos y empodera a las madres y sus familias. Estas intervenciones, donde los estudiantes actúan como agentes de cambio, abordan no solo barreras educativas, sino también la necesidad de apoyo práctico y emocional, e incluso pueden incidir en determinantes estructurales mediante la abogacía. Existe la necesidad de integrar sistemáticamente estos proyectos en el currículo académico y las estrategias nacionales de salud, superando su estacionalidad para lograr un impacto sostenible mediante seguimiento continuo y evaluación rigurosa, transformando así la promoción de la LME en una práctica profundamente social y comunitaria.
Palabras clave: Lactancia Materna Exclusiva, Extensión Universitaria, Determinantes Sociales.
Exclusive breastfeeding (EBF) until six months of age is undoubtedly one of the most effective and cost-effective public health interventions for ensuring the survival, health, and optimal development of children, as well as for improving maternal health. The scientific evidence is overwhelming and constantly evolving, highlighting its role in reducing morbidity and mortality from infectious diseases, preventing chronic non-communicable diseases in adulthood, strengthening emotional bonds, and providing long-term cognitive benefits. (1,2) However, there is a persistent and abysmal gap between what we know to be ideal and what actually occurs in our communities.
Despite decades of promotional efforts and implemented public policies, EBF rates globally are far from reaching the goals proposed by international organizations. This disparity is not a failure of science or of mothers; It is, in our opinion, a reflection of an approach that has sometimes been excessively biomedical, top-down, and disconnected from the social and cultural determinants that truly influence the decision and experience of breastfeeding. (3) Breastfeeding does not occur in a vacuum; it develops in a context of aggressive commercial pressures from infant formulas, insufficient labor laws that fail to protect working mothers, ancestral myths passed down through generations, and a lack of tangible and ongoing community support. (4)
It is in this complex scenario that university outreach, particularly in the medical sciences, emerges not only as a complementary activity but as a fundamental and underutilized strategy. Projects such as "Luces y Sueños" at the University of Medical Sciences of Matanzas, where medical, nursing, and clinical bioanalysis students integrate into communities during the summer, represent an extremely powerful model for closing this gap. This article is justified by the need to critically analyze and assess this type of intervention, arguing that its value goes beyond the occasional promotional activity. It is a living laboratory of innovation in public health, where future health professionals learn, from their training, to practice social, empathetic and community medicine.
The objective of this paper is, therefore, to argue for the systematic and funded integration of community-based university outreach projects as an indispensable pillar of national strategies for promoting breastfeeding, analyzing their foundations, their potential impact, and the challenges that must be overcome to maximize their effectiveness.
The "Luces y sueños" project exemplifies a necessary paradigm shift: moving from providing information about breastfeeding to creating breastfeeding-friendly environments. Its actions, carried out in vaccination centers, specialized clinics, and maternity homes, are not limited to distributing a brochure or a one-way talk. The key to its potential success lies in its dialogic nature. Students, being closer in age and often free from the traditional office hierarchy, can establish relationships of trust with young mothers, listen to their real concerns—often silenced by fear of judgment—and debunk myths through shared experience and scientific knowledge adapted to community language. (Figure 1)
This interaction is not traditional health education; it is a co-construction of knowledge where women feel like protagonists of their process and not merely recipients of orders. Recent qualitative studies, such as that by Acevedo Bedoya et al. (2), emphasize the importance of understanding breastfeeding from the perspective of women's individual experiences, as their emotional and social experiences are critical determinants of its success and longevity. A well-directed outreach project captures these narratives and incorporates them into its strategy, making promotion not only more effective but also more humane.
This community action fully addresses one of the main obstacles to EBF: the lack of practical and emotional support immediately after birth and in the first weeks at home. Evidence shows that interventions such as immediate skin-to-skin contact and support in the practical handling of the newborn are crucial for a successful initiation.
Avalos González et al. (5) directly link this practice with the early initiation of breastfeeding. By training in these techniques, students can be ideal spokespersons for promoting them in health centers and, more importantly, in families' homes, reinforcing the role of the family support network. Pozo Hernández et al. (4) identify "maternal management" as a central element that facilitates a healthy and affectionate interaction. The work of the extension student can be directed toward empowering not only the mother, but also her partner and family members, transforming the immediate environment into a space of support and practical help, which mitigates the anxiety and sense of incapacity that many new mothers report.
However, the true strength of a project like "Luces y Sueños" and its greatest challenge at the same time is its potential to transcend specific care and impact structural determinants. The promotion of EBF must be inextricably linked to advocacy for labor rights that protect it. Sánchez Artigas et al., (6) and Sanmartin Guachizaca et al., (7) highlight the crucial importance of breastfeeding in occupational medicine, underlining how the lack of decent spaces for the extraction and conservation of milk, as well as insufficient maternity leave, are almost insurmountable barriers for many women.
Here, the role of the future community-trained health professional is vital: they can become agents of change who, based on their knowledge of social reality, document cases, generate local data, and advocate for fairer institutional and labor policies within their sphere of influence. Promotional work at a local business, explaining the benefits not only for the child's health but also for productivity (less maternal absenteeism due to the baby's illness), can be as or more important than a talk in a doctor's office.
In the authors' view, for this potential to be fully realized, it is imperative to overcome the inherent seasonality of many summer projects. Trust and health behavior change are built through continuity. A sustainable impact requires a strategy that transcends the weeks of the campaign and is permanently integrated into the curriculum and into the community's outreach to polyclinics and medical offices.
The training of community "breastfeeding brigades," monitoring pregnant mothers until the postpartum period, and the creation of peer-to-peer support groups facilitated by constantly rotating students could be models worth exploring to ensure the intervention's longevity. Furthermore, it is crucial that these activities not remain anecdotal but are systematically evaluated using participatory action research methodologies. (9,10) Measuring not only increased knowledge—a weak indicator—but also changes in early initiation rates, EBF at six months, and mothers' perceived self-efficacy, as Sosa Páez et al. (8) rightly point out, would allow for refining strategies and demonstrating the tangible value of investing in university outreach.
In conclusion, the promotion of exclusive breastfeeding faces a crossroads in the 21st century: continue with traditional models of information dissemination that have shown a ceiling of effectiveness, or decisively embark on innovative, community-based, and deeply social strategies that address the real determinants of the practice.
University outreach projects such as "Luces y sueños" embody this second path, positioning future health professionals as agents of social change, facilitators, and bridges between scientific knowledge and the perceived needs of the population. Their value lies in their ability to humanize health promotion, build trust, empower women and their families, and begin to impact structural barriers.
The challenge for academic and health institutions is clear: they must stop viewing these initiatives as seasonal extracurricular activities and integrate them as a central component of medical training and primary health care strategies. Investing in this means investing in the health of future generations, in the sustainability of health systems, and in building stronger, more informed, and healthier communities.
The debate must now focus on how to scale and sustain these models, ensuring the resources and institutional framework necessary for their impact, demonstrated today in the microcosm of a summer community, to become a reality nationwide.
Figure 1. Student members of the “Luces y sueños” Project
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CONFLICTS OF INTEREST
The authors declare that there are no conflicts of interest.
SOURCES OF FUNDING
The authors declare that they received no funding for the preparation of this article.