Globally, August 1-7 is celebrated as the World Breastfeeding Week (WBW). This is to renew our collective allegiance and spread awareness about the essence of breastfeeding. The campaign dates back to 1992 and since 2016, the WBW is aligned with the Sustainable Development Goals (SDGs).
In 2018, a World Health Assembly resolution recognised WBW as an important breastfeeding promotion event. This year the campaign is themed “Support breastfeeding for healthier planet.” But why the breastfeeding campaign is so essential for India?
It is a well-settled fact that there is no replacement for breast milk and this is the best food for infants as it provides essential nutrients, critically important for optimum growth of the children. The importance of breastfeeding is further amplified in the time of prevailing Covid-19 pandemic as children need a strong immunity to keep the virus at bay.
Incidence of diarrhoea and pneumonia—the two major causes of child mortality—is significantly mitigated when a child is fed with breastmilk according to the norms. The UNICEF and the WHO have recommended to feed mother's breast milk to infants within one hour of birth to ensure that the infant receives the colostrum, or “first milk”, which is rich in protective constituents. Exclusive breastfeeding until six months of a child creates a positive multiplier effect on child and mother’s health, human resources development, and growth of the economy.
A mother when breast-feeding her child gains health benefits of faster maternal recovery, natural birth spacing, lower risk of breast and ovarian cancer.
Latest National Family Health Survey (HFHS)-4 (2015-16) revealed only 41.6% of children received “First milk” i.e mother’s milk within one hour of birth which is up from 23.4% in NFHS-3 (2005-06) and merely 54.9% children got prescriptive exclusive breastfed till six months.
According to UNICEF, 22% of neonatal death (children die within one-month birth) can be prevented if we ensure “first milk” to all new-born babies. The neonatal death rate today stands at abysmal 23 per 1,000 live birth. Stunted growth (38%) and underweight (36%) of children are also evidently linked to non-practice of breastfeeding.
The Government with a slew of public health measures has improved institutional birth rate to 78.9% (NFHS-4) but failed to ensure “first milk” to all children appropriately. The reasons are many—often deep-seated socio-cultural practices and apathy of the Government to respond to the health crisis.
To promote the practice of breastfeeding, a mother needs to be adequately counselled and skilled; this is more so for first time pregnant ladies. Only 51.2% received prescribed four antenatal care visits by frontline health workers. The absence of proper capacity development of health workers poses a barrier to realising all the good effects of breastfeeding. High-burden States like Uttar Pradesh, Delhi, Rajasthan, and Punjab cut a sorry figure on this front.
Owing to widespread misconception and superstition, women in many parts of the country feed just-born babies honey, jaggery, etc which put a child’s health at a greater risk. Extensive social awareness drives round the year in targeted areas must be strategised and rolled out by the Government apparatus in close association with civil society organizations (CBOs) which have good community connections.
Frontline health professionals under ICDS and NRHM programmes are often underpaid and not fittingly skilled for capacity development in many States. Resultantly, they are neither adequately motivated, nor scientifically trained to closely work with high-risk communities to promote breastfeeding. This area calls for intensive efforts to ameliorate the scenario.
Post-delivery visit by health workers is very essential for lactating mothers and caregivers at home to continue practice breastfeeding properly, but due to fragile health service delivery and monitoring system, the required number of visits by health workers is not often conducted and thus the essence of breastfeeding is further diluted. Block and district health administration need to galvanise action on measures to better this situation.
The Maternity (Amendment) Act 2017 has extended the earlier 12 weeks’ leave to 26 weeks (6 months). But this law applies to the only formal sector that absorbs merely 4% of women workforce. Therefore, for 96 per cent of women workforce employed in the unorganised sector, this law doesn't bring many benefits. Even informal sector, due to unfavourable work culture and lack of private space at the workplace for breastfeeding, working mothers fail to ensure breastfeeding optimally. A policy-level arrangement must be drawn up so that women from the informal sector can avail of these benefits.
Exclusive breastfeeding assumes much more significance during this pandemic. While the States celebrate this campaign fervently, they also need to step up all possible efforts and give the much-needed impetus to increase breastfeeding practices because when a child is healthy and secure, the future of the nation is on strong footing!
(The authors are development communication specialists; views are personal)