Breastfeeding – Time to Make a Change
Breastfeeding is the first form of nourishment that a child receives after birth. Since 1991, World Breastfeeding Week is observed in the first week of August to make people more aware of the importance of breastfeeding, to make society more supportive of breastfeeding, to draw the governments worldwide to invest in maternity facilities and to realize WHO’s goal of increasing the rate of exclusive breastfeeding to at least 50% by 2025. The theme for World Breastfeeding Week 2017 was “Sustaining Breastfeeding Together”.
Despite breastfeeding being a necessity, which is beneficial to both the infant and mother, there are numerous challenges that are faced by lactating mothers that leads to a low number of infants receiving exclusive breastfeeding. Many worldwide Organizations have brought the importance of breastfeeding to the public eye but it still remains a paramount duty to ensure breastfeeding can be sustained together so that all infants have access to life saving breast milk. Despite the worldwide campaigns to Bgenerate awareness about breastfeeding, the statistics in India for exclusive breastfeeding and breastfeeding within the first hour of birth look slim.
In India, less than 50% of the infants are breastfed within an hour of birth while the rate of exclusive breastfeeding is 64.9% in first six months. A data report by the National Family Health Survey-3(NFHS-3) concluded that out of the 26 million babies born annually in India, 20 million are unable to receive exclusive breastfeeding for the first six months after their birth. The report also added that about 13 million infants are unable to get timely and appropriate breastfeeding after the first six months with the continuous breastfeeding.
According to the World Health Organization (WHO), breastfeeding should be started within an hour of the birth, termed as the golden hour and should be continued till first six months. It is during this time that Colostrum is ejected from the mammary glands. Colostrum is the milk produced during pregnancy till early days of breastfeeding. It is yellow coloured and rich in nutrients, proteins, calcium and fats needed by the infant. The antibodies present in the breast milk lower the risk of many diseases such as asthma, jaundice, insulin dependent diabetes, and infections. Additionally, early skin to skin contact that takes place between the baby and mother is said to increase cardio respiratory stability. It also known to reduce the risk of Sudden Infant Death Syndrome. Some studies have also linked breast feeding to good cognitive development in the baby. Given that breastfeeding protects the baby against many diseases, it leads to reduction in medical expenses that have to be incurred if the baby is ill.
While the benefits of breastfeeding for the infants and widely popular, it’s also beneficial for the mother. It has been discovered in numerous studies that breastfeeding leads to the release of oxytocin in both mother and the baby thus having a calming effect on them. Furthermore, studies have also shown that nursing may help to reduce the risk of menopausal osteoporosis, cancers and postpartum depression in the mother.
According to a report by WHO and UNICEF in collaboration with the Global Breastfeeding Collective India, China, Nigeria, Mexico, Indonesia are the five countries that account for more than 2,36,000 child deaths per year that have resulted due to lack of adequate breastfeeding.
There are a number of reasons that have led to India being low on breastfeeding.
- Taboos Associated to Breastfeeding make it difficult for mothers to perform the natural process that is a requirement for the infant. There is uneasiness in people when they see a women breastfeeding her baby in public. Additionally, mothers are also apprehensive of being judged or shamed for something which is a natural process and a necessity. Lack of private space to breastfeed worsens the problem. Women prefer not to breastfeed at all than to breastfeed their baby amongst shocked gazes.
- Women from the underprivileged strata don’t have the access to resources such as medicines and food, which can create difficulty in breastfeeding. The poor quality of nutrition consumed by the mother also affects the nutrition quality of the milk and hence even if the mother is able to breastfeed, the nutrients in the breast milk would be reduced.
- Dependence on infant formula also leads mother to stop the breastfeeding pre maturely. Infant milk formulas are marketed as the “Better choice” for the baby. This is absolutely false as the breast milk is essential to provide the infant the right constituent nutrients in the right quantities. Even when breast milk is not available, breast milk donated at a breast milk bank is the second best choice and not the infant formula milk.
- There is inadequate investment in promotion and spreading awareness about importance of breastfeeding. The magnitude of the problem must be realized and infrastructure to support breastfeeding, sensitization of society and awareness programs must be regularly organized.
Overcoming challenges to breast feeding
- Government aided programs and workshops to raise awareness about importance of breastfeeding to women should be organized. There should be programs designed for community outreach involving peer education, counseling and talk by medical experts.
- Organizing health camps, especially in rural areas where women can talk to doctors and specialists about concerns related to breastfeeding and if they have other illness that could stop them from breastfeeding they should able to find solutions.
- Government should invest in infrastructure to educate society and remove taboos. Innovative methods to impart education on breastfeeding should be employed such as showcasing documentaries, educational videos, and plays. Breastfeeding should be normalized and people should be made to understand that it’s a natural and important process.
- The awareness programs should aim at educating the men too. The men should be sensitized to the health concerns of the mother and her child.
- It is important for women to take good care of her health during and after pregnancy so that there is no hindrance in breastfeeding.
- Woman in both rural and urban set ups are working and need to return to work after maternity leave. Though paid maternity leave has been extended according to the Maternity Benefit act of 2017, many mothers still find it difficult to be around their baby at all times for feeding the baby. In such situations, a breast pump is a highly efficient tool that can be utilized by lactating mothers. Breast Pumps can mechanically extract and store breast milk which can later be fed to a baby by the caregiver. Furthermore, a good breast pump can stimulate lactation, relieve engorgement and allow for some rest to the mother while the baby can be fed the pumped breast milk by a caregiver.
Breaking taboos around breastfeeding is the need of the hour. Removing the discomfort around the topic would pave way for detailed discussions on more concrete topics related to breastfeeding like its health benefits and duration for which breastfeeding should be done. A step in this direction was taken this year by Australian Senator Larrisa Waters when she breastfed her baby while moving a motion in the parliament. This was the first time this happened in the chamber and this move was supported worldwide.
Another such move to eliminate the stigma related to breastfeeding came in the form of apple launching a breastfeeding Emoji on its iPhone and iPad with 11.1. This little addition which can seem insignificant at first was able to stir up discussions around breastfeeding and was widely appreciated globally.
WHO and UNICEF have constantly been working to reach the goal of increasing the rate of infants who are exclusively breastfed. A 40-hour breastfeeding counseling course has been developed by WHO and UNICEF with the objective to train the health workers who can provide skilled support to mothers about breastfeeding. Additionally, The Baby-Friendly Hospital Initiative launched in 1992 to strengthen maternity practices has been implemented in approximately 16,000 hospitals in 171 countries and has been found to have improved the establishment of exclusive breastfeeding worldwide.
Breastfeeding is not only a process of meeting the nutritional needs of the infant but has numerous health benefits for the mother and child. It is important for the governments and healthcare agencies to keep working on raising awareness about its importance and meeting the challenges that breastfeeding in India faces. It’s always better to start early when it comes to health and hence it’s pivotal to make sure that the health of infants and the mothers does not have to suffer to due lack of awareness, stigmatization and ignorance.