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.