Nutrition

Communities supporting breastfeeding

Firdosh and her 2 month old daughter, Sidra Naaz, are surrounded by family—her sister-in-law, her mother-in-law, and most importantly her husband, Naheed Ashar, who have worked together with the supportive staff at the Guru Teg Bahadur Hospital in Delhi, India to help give their child a head start in life by breastfeeding.

Now, Firdosh comfortably breastfeeds her daughter for every meal, giving her the most complete nutrition a child can have. But just 2 months ago, when Sidra was first born, it was a very different story. Breastfeeding did not come easily to Firdosh. “For me, the hardest part of breastfeeding was my nipple shape,” said Firdosh. Like many women, she suffers from flat nipples, which can make initiating breastfeeding difficult. But Firdosh and her husband knew all the benefits exclusive breastfeeding could offer their daughter and were determined to work together to make it happen.

Breast milk is best

Firdosh breastfeeds Sidra Naaz
WHO/Maren Shapiro

Undernutrition is associated with over 50% of deaths in children under 5, but optimal breastfeeding could save around 800 000 lives in this vulnerable age group every year.

Breast milk is the best way to feed a newborn, providing all the nutrients needed for healthy growth and development. It delivers antibodies, which boosts a newborn’s immune system. This offers protection from common childhood illnesses, such as diarrhoea and pneumonia, the leading causes of under-five mortality in WHO’s South-East Asia Region.

Not only is breastfeeding important for a child, but it is an integral part of the reproductive process and has important health implications for mothers. Breastfeeding induces a lack of menstruation, offering longer intervals between pregnancies and reducing the accompanying risk of maternal death. It also provides long term benefits, reducing the risk of chronic diseases such as breast cancer, osteoporosis and even heart disease.

While breastfeeding of any kind is important, to get the full benefit optimal breastfeeding is key—which means exclusively for the first 6 months of a child’s life and then continued with appropriate complimentary foods until at least 2 years of age.

Promoting optimal breastfeeding represents a key step to help us achieve the Millennium Development Goals of reducing childhood mortality and improving maternal health. In the Member States of WHO’s South-East Asia Region, an estimated 51% of newborns are exclusively breastfed, with some countries’ rates as high as 85% but others struggling behind with only 15%. These numbers tell us that while we have made progress, there is still much room for improvement.

Baby-Friendly Hospital Initiative

world breastfeeding week family
Firdosh with family and GTB Hospital breastfeeding nurse
WHO/Maren Shapiro

“Breastfeeding ensures quality survival from neonatal period to adulthood, protects mothers’ health, is eco-friendly and has direct and indirect economic benefits for the family,” says Dr M.M.A. Faridi, Head of the Department of Pediatrics at the University College of Medical Sciences at the Guru Teg Bahadur Hospital, “The health facility is the ideal forum for promoting and initiating breastfeeding.”

In 1991 the WHO and UNICEF developed the Baby-Friendly Hospital Initiative (BFHI), a joint enterprise to implement practices that protect, promote and support breastfeeding in hospitals around the globe. It provides concrete recommendations, such as training all health-care staff to be breastfeeding supports, encouraging breastfeeding on demand, giving no artificial teats or pacifiers to avoid nipple confusion, and practicing “rooming-in” to allow mothers and infants to remain together 24 hours a day to promote bonding. In addition, it offers courses for staff and physicians and field-tested assessment tools to help hospitals implement the program.

In line with these recommendations, the Guru Teg Bahadur Hospital, which has been certified as a Baby-Friendly Hospital since 1993, developed the Infant & Young Child Feeding Counselling Centre, designed to support mothers, like Firdosh, who are having difficulty breastfeeding or simply need more information.

For pregnant mothers, they offer antenatal trainings to promote the benefits of breastfeeding early on and endorse exclusive breastfeeding within an hour of birth. For new mothers who are having difficulty with breastfeeding they have specially trained nurses who teach assistive techniques, such as proper baby positioning or, in Firdosh’s case, using rubber bands to make breastfeeding possible even with flat nipples. With the help of Dr Faridi and the supportive nursing staff, Firdosh is now able to give Sidra the best nutrition possible.

A community-wide effort

While many hospitals are beginning to adopt the principles of the Baby-Friendly Hospital Initiative, few are as successful as the Guru Teg Bahadur Hospital, and there is still much room for improvement.

world breastfeeding week mother father child
Firdosh with her husband, Naheed Ashar, and Sidra Naaz
WHO/Maren Shapiro

“I call upon families, civil society, employers, health care providers, professionals -obstetricians and pediatricians - and governments to partner in providing a supportive environment to promote breastfeeding to ensure the best start to life for all newborns,” says Dr Poonam Khetrapal Singh, Regional Director of the WHO South-East Asia Region. This year, to mark the annual World Breastfeeding Week, the WHO is spreading the message that optimal breastfeeding is more than just a one woman job. It requires the support and teamwork of the entire community.

  • Fathers can recognize that breastfeeding takes time and energy. They can support their wives and bond with their child by caring for their baby in other ways, including changing diapers, giving baths and going for walks.
  • Family members can support a mother to breastfeed by providing practical support around the house. Cooking meals, cleaning up, and caring for other children will give mothers the time they need to exclusively breastfeed.
  • Grandmothers are often the greatest influencers of breastfeeding. They must be armed with correct information so they can boost a new mother’s confidence and encourage breastfeeding.
  • Employers can be supportive by ensuring adequate maternity leave to allow mothers to breastfeed for the recommended 6 months. When a woman returns to work, employers can create a supportive work environment by providing private space and dedicated time for breastfeeding and breast milk storage.
  • Hospitals and healthcare workers can follow the lead of Dr Faridi and his team at Guru Teg Bahadur and adopt the principles of the Baby-Friendly Hospital Initiative.

Firdosh was fortunate enough to have the support of family members who knew the importance of exclusive breastfeeding and Dr Faridi and his dedicated team of nurses who had the training to help her along the way. This inspiring family is now thriving. They teach us all a valuable lesson—nurturing a child takes a community.

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