Breastfeeding in India

The recent data released by the National Family Health Survey 4 (NFHS-4) shows that despite of rise in the institutional delivery as to nearly 79% nationally, the number of children breastfed within one hour of birth is less than 42%. In fact, India ranks lowest among South Asian countries, including Afghanistan, Bangladesh and Sri Lanka in breastfeeding practices, with only 44 per cent women being able to breastfeed their babies within one hour of delivery. The statistics shows that though 96% of children (under the age of five) have ever been breastfed, only 29% started breastfeeding within half an hour of birth in urban population and 21% in rural population.

How important is breastfeeding for the child and the mother?

Since time immemorial, the human species has been fed and nurtured by mother’s milk. Breastfeeding is the bond that sustains the mother baby relationship and provides the perfect nutrition, immunological protection and optimal physical and neurological development of the baby for the first years of life.

Breastfeeding plays a vital role in the growth and development of the child. By placing newborns on their mother’s bare chest right after the birth helps in reducing mortality by regulating a baby’s heart rate, temperature and breathing, while also facilitating breastfeeding. In addition to it, the exposure to the bacteria on the mother’s breast helps in colonizing newborn’s digestive system with essential antibodies. And most importantly, immediate skin to skin contact fosters the bonding between newborn and mother. Moreover, Colostrum, the human breast milk is very rich in proteins, vitamin A and sodium chloride, and contains very low amounts of carbohydrates, potassium, and fat than a normal milk. Therefore, it is considered to be more beneficial for the babies in their initials months.

Breastfeeding proves to be beneficial for the health of mother as well since mothers who practices early skin to skin contact and early initiation of breastfeeding with the newborns are more likely to produce sufficient milk to breastfeed the baby in the initial months of their birth and also continue to breastfeed longer.

India lagging behind in breastfeeding- Why?

India is supposed to be a “breastfeeding nation” but the falling breastfeeding rates in the country do not support this claim. Some major reasons behind the falling rates are-

• Traditional practices – The old notion and practices interferes with the early start to breastfeeding, depriving newborns of the essential nutrients, antibodies and skin-to-skin contact with their mother that protect them from disease and death. Especially, in the rural areas, women are taught to discard colostrum, a milk which mother produces right after the child’s birth.
• Lack of support – The mothers lack support from the family, society, medical fraternity and also at their work places. The older women in the family, who keeps a close check on the infant feeding practices for new mothers, cite inadequate breastmilk supply and encourage mothers to switch to infant milk substitutes.
• Lack of maternity protection measures – India lacks a clear policy and plan of action for interventions on breastfeeding. Especially, for the majority of women working in the unorganized sector and private sector who have to combine work and breastfeeding, it is a major challenge. Most often they are even forced to give up on their maternity privileges in the increasingly corporatized and contractualised work place.
• Non-review of the maternity benefit laws – Section 11 of The Maternity Benefit Act provides that “every woman delivered of a child who returns to duty after such delivery shall, in addition to the interval for rest allowed to her, be allowed in the course of her daily work two breaks of the prescribed duration for nursing the child until the child attains the age of fifteen months”. For the possible implementation of this provision, all offices should have creches and day-care facilities.
• Lack of proper information – Unclear messages from several quarters in the absence of state interventions. Moreover, aggressive and inappropriate promotion of breast-milk substitutes makes good breastfeeding choices a huge challenge.

Hence, we can see how despite of a tremendous increase in the institutional deliveries the breastfeeding rates remains low, which brings shame to our health system. However, this problem can be dealt by providing new mothers with guidance on initiating breastfeeding, educating them about non-use of any liquids or foods other than breastmilk and ensuring that hospital staff are appropriately trained to guide the mothers.

Conclusion

Even as we enter 2017, only a minor fraction of India’s infants initiate breastfeeding within an hour, or exclusive breastfed until six months, or would receive good complementary feeding after six months along with breastfeeding.  Therefore, there is an urgent need to fix this problem prevailing in our health system. Breastfeeding is a powerful intervention which is time-tested, backed by research and doesn’t require preparation or expensive new medications. So, it is the need of the hour that the government understands the seriousness of this problem and set aside a budget for breastfeeding interventions.