Breastfeeding is the cheapest and most effective way to ensure a child’s health and survival. A lack of exclusive breastfeeding during the first six months of life contributes to over a million avoidable child deaths each year. Beyond the immediate benefits for children, breastfeeding contributes to a lifetime of physical and mental health and well being. It is no wonder then that the World Health Organization actively promotes exclusive breastfeeding for the first six months of the child’s birth.
Dr. S.N. Rastogi, a renowned Paediatrician who runs a private clinic in Lucknow says, “Exclusive breast feed is the best feed that can be given to a child.”
Despite the medical fraternity vouching for the efficacy of mother’s milk, less than 40% of infants below six months of age are exclusively breastfed. In fact only 15% to 20% of the mothers coming to Dr Neelam Singh were following this regimen strictly. Support for mothers is essential as many mothers may face initial hiccups to exclusive breastfeeding, like nipple pain; fear that there is not enough milk to sustain the baby; lack of information; and socio cultural barriers.
According to Dr. Neelam Singh, “Not only the doctor, but everyone who converses with a new mother-- the nurse, attendant and her family members--has a distinct role to play. The doctor’s responsibility is to assure the mother that she can give her child complete nutrition by exclusive breastfeeding and to ensure that breastfeeding is started early. The paramedical staff should educate her about the benefits of breastfeeding and help her continue with it. The family’s role is to support her and take good care of her food and nourishment. For working mothers the workplace environment and working conditions should be baby friendly -- flexible working hours that allow mother to breastfeed her baby; separate feeding rooms where the infant can be brought at the time of feeding; and/ or maternity leave for six months. Many nations are working in this direction but in our country a lot needs to be done.”
Dr. S. N. Rastogi feels that, “Some women are figure conscious and think that breast feeding will spoil their figure. But this is a myth. In other cases mothers themselves are under fed and so they are not able to produce enough milk.”
Dr. S. K. Sehta, says, “In India a large number of mothers are undernourished and there is the fear of insufficient lactation, so they switch over to top feed which is absolutely a wrong practice. If the child is being exclusively breastfed for the first six months, the chances of a large number of infectious diseases is drastically reduced. Only in extremely rare (around 1%) cases where we find that sufficient breast milk is not being produced, or if the mother is suffering from some serious ailment, that the doctor allows top feed in the form of the infant formula milk available in the market, if the parents can afford it. But a number of drawbacks are associated with formula milk and bottle feeding. The level of hygiene demanded by bottle-feeding is very hard to meet here. This predisposes the child to infection. They also tend to dilute the milk which leads to undernourishment of the child.”
Dr. Neelam Singh too agrees that, “Infant formula milk may perhaps meet the nutrient requirements but it does not have immune globulins. Also, bottle feeding demands greater hygiene and cleanliness which is not possible in our country. India is a tropical country with high temperature that favours spread of communicable diseases, and formula milk cannot increase a child’s resistance to fight diseases, whereas mother’s milk has.”
In the chaos of ignorance about the benefits of breastfeed, there are some sane voices of mothers like Mrs. Alpana Singh, which are worth emulating. Alpana, a new mother who delivered her second child recently at a private nursing home (City Hospital) in Lucknow, says, “I exclusively breastfed my first child during the first six months, starting from day one, after my caesarean delivery and did not give him even water or top feed. Since I had to join my workplace only after three months of maternity leave, I made use of the breast pump to store my breast milk for 3-4 hours. This way I tried my best to breastfeed my baby for at least one year.”
Health facilities that support breastfeeding - by making trained breastfeeding counsellors available to new mothers - encourage higher rates of the practice. To provide this support and improve care for mothers and newborns, there are now more than 20 000 "baby-friendly" facilities in 152 countries, thanks to a WHO-UNICEF initiative. Public health workers working with the masses have a distinct role to play in dispelling the misconceptions and socio-cultural dogmas associated with breastfeeding. We need to mobilize not only the mothers but also their families about the importance of exclusive breastfeeding. It needs a combined effort from the entire society so that breastfeeding is encouraged.
Somya Arora, CNS
(The author is doing her post-graduation in microbiology from Lucknow University and writes on social justice issues for CNS: www.citizen-news.org)
The Hindustan Times, India: 9 November 2011