A case for breastfeeding

 Dr Dharminder Nagar

India lacks public breastfeeding rooms; something which the Delhi High Court enquired about while hearing nine-month-old Ayan’s plea. Of course, the plea was routed through his parents who sought adequate baby feeding and child care facilities to enable lactating mothers feed their children. The response was sought from the Ministry of Women and Child Development, state government and civic authorities.

Breast milk, which is analogous to ‘liquid gold’, is the most significant part of a child’s early upbringing as its impact lasts much longer. While India is still battling with the mindset to promote breastfeeding practices, standards are being set elsewhere.

When Australian MP Larissa Waters breastfed her daughter inside their parliament last year while moving a senate motion, she not only made history but also made a strong statement in favour of the practice.  

Back in India, it is unfortunate to note that mothers in India are not feeding their babies adequately. Only about eight million of the 26 million babies born in India every year are breastfed within an hour of birth. Ranked India at 31st place out of the 51 countries surveyed, the report found that only 46 per cent of the babies born in India were breastfed in the first 24 hours of their birth. Neighbouring countries fared better. The percentage of babies who were breastfed within the first 24 hours in Sri Lanka stood at 75.8 and in Bangladesh stood at 64.

This dismal picture can be corrected if there is a multi-pronged approach to the problem of lower breastfeeding rates in India.

Proper guidance needed

Pregnant women should be given proper guidance during their pregnancy about lactation and its immense importance, practical knowledge, proper feeding practices, pumps and dietary care. It is found that women who are given prior guidance are able to adopt better feeding practices and have better feeding experiences than those who have not been given such guidance. This can be done by both government as well as private players but a proper course to impart guidance should be charted out and public-private partnerships in this direction can go a long way in achieving better results. Private clinics can be roped in by the government and given incentives to provide guiding sessions to women, including those from economically deprived background.

Busting the myths

There are a lot of myths associated with breastfeeding in India and those need to be quelled. First time mothers, even in urban India, experience issues emanating from the lack of knowledge. The fact has to be emphasised to would-be mothers that while breastfeeding might require greater effort from them given their busy schedules, it is the best choice for babies and is absolutely worth the effort. Babies who have been breastfed have better chances of surviving, better immunity, lower chances of acquiring diseases like malnutrition and stunting. Apart from better bonding between mother and baby, it also leads to improvement in a child’s cognitive performance.

Breastfeeding also holds health benefits for women. Women, who breastfeed their babies for sufficiently long period of time, have lower risk of developing breast cancer, ovarian cancer and type 2 diabetes.

Enabling environment for mothers

The India Newborn Action Plan (INAP) developed by the Ministry of Health & Family Welfare in 2014 has been targeting a 90 per cent rate of initiation of breastfeeding within an hour of birth by 2025. To achieve these rates, there is a need for investing in creating an enabling environment for mothers, especially the working mothers.

In Delhi, where the ratio of working women is higher, it was found by a survey that about 41 per cent mothers felt that their offices did not have any nursing facilities. Clearly, there is a need for making laws and regulations for building infrastructure that is conducive for mother to breastfeed their babies. There should be laws for workplaces to have breastfeeding rooms. Government needs to come out with proper feeding rooms at public places. After all, if mother’s milk is helping in achieving lower instances of diarrhea and pneumonia among the babies, government’s overall cost of providing healthcare to citizens will go down by having such rooms at public places.

The human milk bank

Setting up human milk bank is another way India can make her babies stronger. The sad news was that despite its obvious advantages such banks were non-existent in India until a few years ago. The good news is that there is some action now and some banks have come up. The government is also considering a network of banks across 661 newborn care units across the country. The banks collect, pasteurise and store milk and is used to feed babies, who cannot be nursed by their mothers because the mothers are not producing their own milk for whatever reason. It is also given to those babies who sadly lose their mothers right after birth.

India can learn from Brazil, another developing country like India, in this regard. In 2011, Brazil’s milk collection in its milk banks was 1,65,000 litre and was given to 1,70,000 babies. As many as 1,66,000 mothers were donating their milk to these banks. There is no reason why India cannot replicate that success. There has been only a start in India in this field, that too in metros. All we need is a strong will and push towards achieving this goal.

The public and the private can partner on this front as well and plug this crucial gap. While private companies can come to set up such banks, the government can design an attractive policy framework and distribution mechanism, which can make the environment conducive for such endeavours.

At the same time, it is key responsibility of doctors to ensure they administer the right knowledge and guidance to new mothers to groom them towards this practice. The increasing of the maternity leave period to six months will most certainly boost the practice among working women. We must remember that investing in breastfeeding is the single biggest healthcare investment we can make towards improving child health in India. 

The responsibility of educating the mother lies not only with the doctors but with other stakeholders as well, including husbands and other family members. Although mothers would be feeding their children, what India essentially needs is to educate the family more as it is the families which will come together to form societies and make a conducive environment for breastfeeding in public and private space. This is important given the scenario that women actually don’t have the right avenues of childcare in public in the second most populous country of the world. In India, we have dedicated rooms for smoking but not for breastfeeding. Aren’t we missing on something?

— The writer is managing director, Paras Healthcare