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Overcoming Disruption Of Programmes And Health Services And Promoting Breastfeeding

The first hour of the newborn should be considered as the golden hour to make sure that essential newborn care services including breastfeeding is provided to the babies, says Mini Varghese, Country Director, Nutrition International in India

World Breastfeeding Week 2021: Overcoming Disruption Of Programmes And Health Services And Promoting Breastfeeding
  • Early initiation of breastfeeding has declined in 12 of 22 states: NFHS-5
  • Exclusive breastfeeding has improved in 16 states and UTs, as per NFHS-5
  • COVID-19 has made a dent in health and nutrition outcomes: Expert

New Delhi: Breastfeeding, also known as nursing, is the way of providing young infants with the essential nutrients required for their growth and development. WHO (World Health Organization) recommends initiating breastfeeding within the first hour of the birth of a child. However, the key findings of the fifth round of the National Family Health Survey (NFHS-5) conducted in 2019-20 for 22 states and Union Territories (UTs) included in phase-1 of the survey show a worrying trend in child feeding practices. A significant decline has been reported in children under three years of age who are breastfed within one hour of birth. NFHS-5 data shows that among the children surveyed, breastfeeding in the first hour of birth had shown a downward trend in 12 states and UTs out of 22. On World Breastfeeding Week (WBW) 2021 that aims to protect breastfeeding, NDTV speaks to Mini Varghese, Country Director, Nutrition International in India to understand the status of breastfeeding in India and ways to overcome the disruption of programmes and health services due to COVID-19.

Also Read: World Breastfeeding Week 2021: What Should The Plate Of A Lactating Mother Look Like Amid COVID-19 Pandemic To Enhance Her Immunity?

The Impact Of COVID-19 On Health And Nutrition

Explaining the impact of COVID-19, Ms Varghese said,

It is an established fact that good nutrition is fundamental for a healthy and productive nation and its people. Despite this understanding, nutrition has been under-prioritised for a very long time. The COVID-19 crisis that started in early 2020 has made a dent in the health and nutrition outcomes that India was aiming to achieve, unwinding the hard-won development gains made over the past decade. The fear of COVID-19 infection coupled with disruption in health services and reduced purchasing power and supply chains disruption has been impacting the overall nutrition aspects of children and women especially.

Ms Varghese further says that the essential health services have been disrupted because of the closure of schools, village health and nutrition days and Anganwadi centers. There has been a decline in uptake for health services such as antenatal check-ups, institutional deliveries and counselling of pregnant women and weighing of children, she adds.

Also Read: World Breastfeeding Week 2021: “Breastfeeding Is Not Something To Be Done In Isolation,” Says Actor Neha Dhupia

The Importance Of Early Initiation Of Breastfeeding

NFHS-5 data reflects that while there has been an improvement in institutional deliveries, early initiation of breastfeeding has fallen drastically. Among 22 states and UTs, Sikkim has reported the sharpest decline of 33.5 per cent in initiating breastfeeding within an hour of birth. Ms Varghese believes that there is a clear failure of enacting the recommended best practices. WHO (World Health Organization) recommends initiating breastfeeding within the first hour of the birth of a child.

Breastfeeding provides the ideal nutrition for optimal growth and development. It also has a protective impact on diseases including SARS-CoV-2. For mothers, it improves birth spacing, helps the uterus return to its pre-pregnancy size. Breastfeeding lowers the risk of certain cancers, including breast and ovarian and may reduce the risk of heart attack and stroke even long after giving birth. Therefore, it is important for us to promote breastfeeding within one hour in the institutional setting both in public and private. The first hour of the newborn should be considered as the golden hour to making sure that essential newborn care services including breastfeeding are provided to the babies, says Ms Varghese.

Also Read: World Breastfeeding Week 2021: How Can COVID-19 Positive Lactating Mothers Exercise Care And Caution While Nursing Their Babies?

How To Protect And Promote Breastfeeding

WHO also recommends exclusive breastfeeding for the first six months after birth. The NFHS-5 data shows improvement in exclusive breastfeeding with 16 states and UTs reporting a rise. To further promote early initiation of breastfeeding, and exclusive breastfeeding for up to months, Ms Varghese suggests practising inclusion of a birth companion for the woman in the labour room, coupled with the ‘zero separation’ policy − which mandates the newborn to be put between the breast immediately after birth.

There is sufficient evidence to showcase that when breastfeeding is initiated within the institution and supported by the health care workers, there is a high likelihood of continuation of breastfeeding even at the home setting when they have been discharged from the health facility. The other thing to look into is the separation of low-birth weight or premature babies because of the special care that they require into the newborn intensive care units (NICU). While we focus on the survival of these babies it is also limiting the chances of breastfeeding. There are evidence on restructuring NICU as M-NICU (maternal and neonatal intensive care unit) to provide skin to skin contact and Kangaroo mother care services at the earliest to babies who need the most, says Ms Varghese.

Also Read: World Breastfeeding Week 2021: Benefits Of Breastfeeding For Mothers and Babies

To be able to continue exclusive breastfeeding beyond the four walls of the labour room, Ms Varghese highlights the need for an enabling environment and the support from the community and the family. To promote the same, she suggests two key interventions; first, counselling of pregnant women on the importance of breastfeeding.

This needs to be established in the antenatal care clinics so that they have adequate information to practice and they’re mentally prepared for that. Second, we need to capacitate the labour room staff to practice what they have learned and the other aspect is, retaining the trained staff within the labour room which is a challenge often in these health facilities, says Ms Varghese.

The expert is of the opinion that often healthcare workers fail to practice the learnings because there is no monitoring or they have not been adequately supported. Hence, it’s important to focus on them as well to improve overall services and essential newborn care including breastfeeding in our facilities.

Children are the future of the country and we must invest adequately to ensure that firm ground is there for their growth and development. Nutrition is fundamental. Nutrition is the foundation, and it cannot wait, says Ms Varghese.

Also Read: Expert Blog: COVID Hit Pregnant And Breastfeeding Mothers And Vaccination For Them

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene


Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 24,50,12,529 and 49,72,271 have died; 20,64,25,824 are active cases and 3,36,14,434 have recovered as on October 28, 2021 at 4:00 am.


3,42,31,809 16,156Cases
3,36,14,434 17,095Recovered
4,56,386 733Deaths
In India, there are 3,42,31,809 confirmed cases including 4,56,386 deaths. The number of active cases is 1,60,989 and 3,36,14,434 have recovered as on October 28, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths

66,06,536 1,485

23,096 3,500

64,43,342 4,947

1,40,098 38


49,38,603 9,445

77,158 2,100

48,31,468 6,723

29,977 622


29,86,835 282

8,459 80

29,40,339 349

38,037 13

Tamil Nadu

26,98,493 1,075

12,288 252

26,50,145 1,315

36,060 12

Andhra Pradesh

20,64,854 567

4,777 122

20,45,713 437

14,364 8

Uttar Pradesh

17,10,114 13

100 6

16,87,115 7


West Bengal

15,89,042 976

7,973 124

15,61,973 837

19,096 15


14,39,709 38

348 25

14,14,270 13



10,39,818 549

4,392 213

10,27,108 334

8,318 2


10,05,926 28

263 14

9,92,088 12

13,575 2


9,54,411 4

20 0

9,45,437 4



8,26,481 17

173 2

8,16,220 15


Madhya Pradesh

7,92,804 20

108 9

7,82,172 10

10,524 1


7,71,204 15

133 5

7,61,022 10



7,26,073 5

41 1

7,16,371 4



6,70,829 186

4,164 63

6,62,714 122

3,951 1


6,09,506 244

3,838 153

5,99,681 391

5,987 6


6,02,289 38

246 20

5,85,487 16

16,556 2


3,48,705 28

160 30

3,43,408 56

5,137 2


3,43,861 17

150 6

3,36,312 23


Jammu And Kashmir

3,31,865 70

838 16

3,26,596 86


Himachal Pradesh

2,23,406 261

1,972 211

2,17,693 48

3,741 2


1,77,969 23

454 29

1,74,152 51

3,363 1


1,27,846 40

443 10

1,25,546 50



1,23,473 70

844 29

1,20,712 97

1,917 2


1,19,496 547

7,320 446

1,11,752 991

424 2


84,438 15

123 1

83,499 14



83,466 51

507 22

81,511 71

1,448 2


65,331 5

29 2

64,482 3


Arunachal Pradesh

55,120 6

115 22

54,725 28



31,925 13

177 1

31,353 12



31,759 12

222 3

30,856 15



20,925 8

47 6

20,670 2


Dadra And Nagar Haveli

10,682 1

6 0

10,672 1




0 0



Andaman And Nicobar Islands

7,650 2

5 1

7,516 1


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