Breastfeeding - a healthy start to life
Breastfeeding is a cornerstone for child survival and health especially during early life because it provides essential irreplaceable nutrition for a child’s growth and development. It serves as a child’s first immunization - providing protection from common childhood illnesses, such as diarrhoea and pneumonia, few of the leading causes of under-five mortality in WHO’s South-East Asia Region. Breast milk promotes sensory and cognitive development and is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers.
On the occasion of the National Nutrition Week, which is celebrated every year from 1-7 September, WHO calls for special efforts to address the nutritional needs of mothers and infants during the ‘first 1000 days’ of life starting from conception up to two years of age. Promoting and supporting exclusive breastfeeding for 6 months, and continued breastfeeding until age 2 or beyond is of crucial importance to achieve this goal.
Breast milk is best
Reshma Dere, Mother of Siya Dere
My daughter Siya was born as a borderline premature baby weighing 2.2 kg. I was advised by the nursing staff of the hospital to immediately start breastfeeding my baby and give her only breast milk. I was however getting anxious as to whether my baby was receiving adequate milk as she was crying even after I fed her and was continuing to lose weight. The hospital staff gave me assurance and helped me relax. They also taught me the correct positioning and breastfeeding techniques which helped me breastfeed my baby better and also increased my milk flow. I felt happy as I observed that my daughter was now getting satisfied after being breastfed and also started regaining weight by the time she got discharged from the hospital. At the time of discharge, the doctor advised me to frequently feed my baby only breast milk for the next six months. I followed the doctor’s advice after coming back home and Siya continued to gain weight steadily.
Unfortunately, I needed to join back work after 3 months of my daughter’s birth but wanted to continue exclusive breastfeeding for Siya. But since there were no crèche facilities at my office, I sought advice from my doctors who helped me learn how to express my breast milk and store it safely for my family to feed her using a bowl and spoon while I was at office. However, I used to breastfeed her before going to the office and at night. I exclusively breastfed my daughter for 6 months and thereafter, as advised by the doctor, I started feeding Siya complementary foods comprising of homemade gruels along with breast milk. Siya continued to progressively gain weight and weighed 8.2 kg at 9 months, an average expected weight for her age. I continued to breastfeed her till she was 2.2 years.
Enabling every Indian mother to breastfeed her baby
Scientific evidence supports the importance of breastfeeding practices for reducing child mortality and morbidity, malnutrition, and noncommunicable diseases in adult life. This year the World Breastfeeding Week, 1–7 August, focused on “Breastfeeding and Work. Let’s make it work!”, to encourage policies supporting breastfeeding at the workplace. The World Breastfeeding Trend Initiative (WBTi) report released in September 2015 shows that India has made improvement in terms of policy and programmes on infant and young child feeding, however, there are challenges, which need to be addressed to ensure that every child is put to breast immediately after birth and is exclusively breastfed during the first six months of life. The recent Rapid Survey on Children (Ministry of Women and Child Development, 2015) shows that only 45% infants are now being breastfed within an hour of birth in India and just 65% are being exclusively breastfed as per WHO recommendations.
In India, the Infant Milk Substitutes, Feeding Bottles and Infant Foods Act, (IMS Act) 2003 regulates production, supply and distribution of infant milk substitutes with a view to the protection and promotion of breastfeeding. The India Newborn Action Plan (INAP) developed by Ministry of Health & Family Welfare in 2014, is targeting a 75% rate of initiation of breastfeeding within an hour of birth by 2017 and a 90% by 2025. To achieve these rates, there is a need for investing in creating an enabling environment for mothers, especially the working mothers to build upon these achievements.
Healthcare settings encourage breastfeeding
The role of health facility staff and NGOs for supporting community-based interventions for promoting breastfeeding including mobilization of communities and providing counselling to support mothers to breastfeed their children has been highlighted in national policies such as the IMS Act and the Guidelines on Enhancing Optimal Infant and Young Child Feeding Practices issued by the Ministry of Health & Family Welfare (MoHFW).
“In my 30 years of pediatric practice in government hospitals, I have encountered women from different socio-economic backgrounds, with a range of barriers to breastfeeding. From complete ignorance of breastfeeding benefits, complete nonchalance to intense guilt of not doing enough - results in failure to effectively breastfeed. This confusion makes a helpless young mother vulnerable to improper advice resulting in unnecessary infant formula supplements. Therefore, each woman needs her unique situation to be understood, empathized and supported by trained counselors,” says Dr Archana Patel, Program Director, Lata Medical Research Foundation, Nagpur who supports mothers for early and exclusive breastfeeding by face to face counseling at healthcare facilities and using mHealth technology.