Polity & Governance Prelims cum Mains

A note to mothers

The topic

  • Relation of breastfeeding with mortality and morbidity in children-under-5.

 

The assessment

  • It is a well-established fact that breastfeeding reduces child mortality and has health benefits that extend well into adulthood.
  • While the benefits of breastfeeding have been known for decades, it is only recently that the association of time-to-initiation of breastfeeding, with mortality and morbidity in children-under-5, has been assessed.

 

Global guidelines

  • This year, the World Health Organisation and UNICEF jointly issued a new 10-point guidance to further raise awareness on the criticality of early breastfeeding.
  • In addition, they noted that breastfeeding for the first two years would save the lives of more than 8,20,000 children annually.
  • The report recommends that mothers should start breastfeeding in the first hour after birth due to following health benefits:
    • The early initiation ensures that infants consume the colostrum which is the first secretion from the mammary glands after giving birth.
    • Early initiation has numerous immunological and nutritional benefits that have been found to reduce mortality in babies under the age of one.
    • Colostrum is high in antibodies that reduces the risk of death from hypothermia, helps in epithelial recovery and protects children from infectious diseases.
    • Infants who are breastfed have a reduced risk of diarrhoea, pneumonia and other infectious diseases in comparison to infants who drink breast milk substitutes.
  • Besides above health benefits, breastfeeding has following significance as well:

 

Significance:

Economic Significance

  • Increasing rates of breastfeeding can help reduce the prevalence of various illnesses and health conditions, which in turn results in lower health care costs.

Environmental significance

  • Breastfeeding confers global environmental benefits; human milk is a natural, renewable food that acts as a complete source of babies’ nutrition for about the first six months of life.
  • Furthermore, there are no packages involved, as opposed to infant formulas and other substitutes for human milk that require packaging that ultimately may be deposited in landfills.
  • It generally requires no containers, no paper, no fuel to prepare, and no transportation to deliver, and it reduces the carbon footprint by saving precious global resources and energy.

Psychosocial significance

  • Breast milk promotes sensory and cognitive development.
  • It fulfills the desire of a mother to experience a sense of bonding or closeness with her newborn.
  • Breastfeeding may help to lower the risk of postpartum depression, a serious condition that almost 13 percent of mothers experience.

 

Status of breastfeeding and IMR in India

  • Children under age 3 years breastfed within one hour of birth are only 41.6 %.
  • Children under age 6 months exclusively breastfed are only 54.9 %.
  • Infant mortality is one of India’s persistent health concerns.
  • While there are multiple factors that lead to infant mortality, breastfeeding rates too play a key role.
  • Infant mortality rate (IMR) in India is 57 and under-five mortality rate (U5MR) is 50.
  • Despite the significant progress made in improving child survival at the national level, infant mortality still remains high in some States in India.
  • It is estimated that only one out three children are breastfed exclusively within six months, which results in a higher risk of death due to various illnesses (diarrhoea and respiratory infection).

 

Government efforts

  • The government is making efforts to promote and organize programs focused on maternal and infant health.
  • Their aim is to educate health-care providers and young parents on the importance of human breast milk.
  • The Health Ministry is also planning to increase the network of human milk banks across the country, which is expected to reduce India’s infant mortality rate.
  • Breastfeeding is a component of the National Nutrition Mission-2022.

 

Challenges

  • There is limited public knowledge.
  • Some social norms trend toward formula feeding.
  • Lack of access to lactation services and education at every level.

 

Way ahead

  • 10 Step guidance of WHO can be followed:
    • Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions.
      • Have a written infant feeding policy that is routinely communicated to staff and parents.
      • Establish ongoing monitoring and data-management systems.
    • Ensure that staffs have sufficient knowledge, competence and skills to support breastfeeding.
    • Discuss the importance and management of breastfeeding with pregnant women and their families.
    • Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
    • Support mothers to initiate and maintain breastfeeding and manage common difficulties.
    • Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.
    • Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day.
    • Support mothers to recognize and respond to their infants’ cues for feeding.
    • Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.
    • Coordinate discharge so that parents and their infants have timely access to ongoing support and care.
  • Even partial breastfeeding has a modest protective effect when compared to no breastfeeding.
  • Every mother-to-be should undergo proper training on breastfeeding, in this, doctors and medical professionals play an important role.
  • Only mothers suffering from severe illnesses or other issues affecting early lactation should go in for bottle feeding or milk substitutes.

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