- Start breastfeeding the baby within first hour of delivery; Expert
- Practice exclusive breastfeeding for the first six months: Expert
- Breastfeed beyond 6 months with complimentary diet for 2 or more years: Dr
New Delhi: According to the World Health Organisation (WHO), breastfeeding is one of the most effective ways to ensure child health and survival, however, nearly two out of three infants in the world are not exclusively breastfed for the recommended six months—a rate that has not improved in two decades. Ahead of the World Breastfeeding Week which is observed every year during August 1-7, NDTV spoke with Dr Shariqua Yunus, Head, Nutrition and School feeding unit, World Food Programme, India learns about the things that lactating mothers should know to breastfeed their babies in the times of COVID-19.
While talking to NDTV about the benefits of breastfeeding, Dr Yunus stressed that it is not only important for the baby but also equally important for the mother. She said,
For the baby, breastfeeding provides protection against infections, mortality, and non-communicable diseases like diabetes, obesity in later life. Breastfeeding also protects the baby from diseases like Asthma. As far as the mother is concerned, if the mother breastfeeds, it protects the mother from a post-partum hemorrhage which is a complication in quite a few women post-pregnancy. It also protects the other against ovarian and cervical cancer as well as breast cancer. Breastfeeding also helps the mother avoid unwanted pregnancy and also helps strengthen the bond between the mother and the child.
Dr Yunus highlighted three components to breastfeeding that need to be focused on in order to enhance the rate of breastfeeding in the country:
1. A mother should start breastfeeding her child within the first hour of the delivery
2. She should practice exclusive breastfeeding for the first six months
3. She should continue to breastfeed the baby beyond six months along with a complimentary diet for two years or more
Talking about the state of breastfeeding in the country, Dr Yunus said that the previous NFHS (National Family Health Survey) data which was collected in 2015-16 shows that only about four out of 10 children were breastfed in the first hour of birth, just five out of 10 children were exclusively breastfed for six months. She further said,
The new NFHS data which has come for only 22 states and UTs, show that 88 per cent of pregnant women in India have delivered in hospitals, within this, 51 per cent of women were able to breastfeed within the first hour of delivery. The new data also show that over 61 per cent of children were exclusively breastfed during the first six months. If we compare the two data, we find that we can come down as far as early initiation of breastfeeding is concerned.
Protect Breastfeeding- A Shared Responsibility
Talking about the relevance of the theme of this year’s World Breastfeeding Week which is ‘Protect Breastfeeding- A Shared Responsibility’, Dr Yunus said,
Breastfeeding is a public health issue and there is a need of investment at multiple levels to improve breastfeeding. Breastfeeding is not just the mother’s responsibility, it is also the responsibility of the father, of the family, of the community, and of the policymakers as well. There is a need for investment at all levels to enhance breastfeeding, be it in our healthcare settings or workplaces, communities or homes. So this is what we hope to achieve this year.
In terms of the improvement of breastfeeding in the country, Dr Yunus suggested a variety of actions need to be taken. She said,
We need to provide our hospitals and health facilities with the capacities to support exclusive breastfeeding. There used to be an initiative called the baby-friendly hospital initiative, that initiative needs to be strengthened, revitalized and reinstitutionalised to support breastfeeding. In the curriculum of the healthcare workers and across cadres of healthcare workers, needs to lay adequate stress on breastfeeding and infant and child nutrition. Also, there needs to be large communication campaigns talking to women in the community about the importance of breastfeeding. There is a need for better monitoring for children’s milk substitutes. The countries that have done well in breastfeeding rely heavily on nutrition champions and celebrities who can talk about the importance of breastfeeding. So many steps need to be taken. Most importantly, the concept of breastfeeding should be taken to the community and the importance of empowering the women to exclusively breastfeed and having policies to encourage them to breastfeed both in the workplace as well as in the public.
Breastfeeding Mother Can Continue To Feed Their Children Post Covid Vaccination
According to Dr Yunus, a woman who has been vaccinated and is lactating can continue to breastfeed her baby post-vaccination as well. There is absolutely no reason why a lactating mother should stop feeding her child just because she has taken the Covid vaccine, she said.
Nutrition and Breastfeeding
Talking about the inadequate nutrition status among women in rural areas, Dr Yunus said,
In rural areas, women breastfeed their children for a long time but they lack access to good food and nutrition. Now Covid has worsened the situation. But the community and the policymakers must remember that a mother needs to intake good food and nutrition to be able to breastfeed her child well. Because of the Covid pandemic and the subsequent lockdown, the health and nutrition services in rural areas have been impacted negatively. There have been efforts towards smooth functioning of Anganwadi services so that the pregnant and lactating mothers continue to get the food provided by it under the ICDS (Integrated Child Development Services).
She further said that even at the cost of her own nutrition standards, a mother can continue to breastfeed but, in that case, her body will become weak.
Dr Yunus stressed that there is a need of generating awareness among women on nutrition and health so that they can breastfeed their children in a healthy way.
Factors Responsible For Sub-Optimal Practices Of Breastfeeding In India
Dr Yunus said that there are multiple factors that can affect breastfeeding practices including social, religious, and cultural issues, commercial practice, lack of awareness and health systems. She said,
If we talk about the cultural factors, we know that in many parts of the country, the mother’s first milk, which is the most nutritious milk which comes out but is slightly yellowish in colour, is looked upon as dirty milk and often thrown away. Commercially, there is the aggressive promotion of infant formula, milk powder. Then, our healthcare system is most of the time overburdened. During the training of healthcare workers, there isn’t due emphasis on child’s nutrition. Therefore, the message that they should be giving to the lactating mothers is not necessarily coming forth. The last is the lack of knowledge amongst the community member, the women, the caregivers, families and policymakers about the dangers of not exclusively breastfeeding or not knowing the proper breastfeeding techniques.
How Can Working Mothers Ensure That Their Baby Is Fed Adequately
According to Dr Yunus, during the first six months, if the child naturally comes off the breast, is no longer agitated, has sort of slept off, these are the signs that the child has been fed well and is no longer hungry. She further said that during the period between 6-8 months of age, the child is still dependent on the mother’s breasts and there is a calorie gap of about 200 calories, as per the World Health Organisation, that needs to be met by complementary foods. When the child is about 9-11 months, then the amount of complimentary food is increased to cover the calorie gap of 300 calories and when the child is between 12-23 months then the range of 550 calories. Post first six months, the dependency of the child on breastmilk reduces and other foods grows, she said. Dr Yunus added,
So if you are a working mother and you are breastfeeding your child after six months of age, then the dependency of the child on the breastmilk is reduced. So, whenever you are back home or before going to work, you can breastfeed your child. Also, in India according to the Maternity Leave Act, 2017, there is a provision of six months of paid maternity leave which helps a working woman to a huge extent. However, it helps only those women who work in an establishment that has more than 10 women and does not help women working in unorganized sector, it is still a definitive step forward for working women.
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 (Water, Sanitation 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 pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.