Breastfeeding: The Health Promoting and Life Saving Approach
For
proper growth and development, every child needs to be provided adequate
nutrition, proper care, love and affection, particularly during the early years
of life. Breastfeeding lays the foundation for his/her healthy life not only
during infancy/childhood, but during the later years too. Till six months of
age, the baby needs just mother’s milk and nothing else; only the tonics or the
medical supplements can be given to the child, as per the requirement.
For the first six months of life, mother’s milk provides
the infant with all the nutrients that are needed for his/her optimal growth
and development. Therefore, the infant should be exclusively breastfed
during the first six months i.e. the baby should be fed only the
mother’s milk and nothing else, not even water. Apart from nutrition, another
valuable contribution of exclusive breastfeeding is that it fosters constant
positive interaction between the mother and the child which helps in the
emotional and psychological development of the infant with a direct positive
impact on his/her brain development. While breastfeeding boosts physical and
mental growth of an infant; after the age of six months, feeding the child with
adequate and safe complementary foods becomes necessary, so as to bridge the
gap between the nutritional needs of the child and the nutrients provided
through the breast-milk. Thus, early/timely initiation of breastfeeding and
exclusive breastfeeding for the first six months coupled with complementary
feeding (after the age of six months) along with continued breastfeeding are
the cornerstones of child’s proper growth and development. If the children are
healthy, the nation is healthy and this in turn results in improved
productivity and economic growth of the country.
Breastfeeding
is a natural and cost-effective method of feeding the neonates, infants and
toddlers. Compared to artificial/top feeding, breastfeeding is affordable and
does not even disturb the household budget. Breastfeeding enhances mental
development, promotes learning and, thus, helps in facilitating universal
primary education. It can give every child a fair start in life, ruling out
gender inequality. It reduces the chances of child mortality in the first year
of life by nearly 13 percent. It also reduces the risk of next pregnancy; and
thus, helps in increasing the inter-pregnancy interval (child spacing). The
chances of HIV transmission from the infected mother to the child are lowered
if the child is given just the breast-milk during the first six months of life.
Breastfeeding helps in lowering the production of pharmaceutical, plastic and
aluminum wastes and thus, ensures environmental sustainability. It also
promotes community partnership by bringing people from different areas,
disciplines, expertise and experiences to work towards the common goal.
Globally,
out of the 135 million babies born every year, 60 per cent do not receive
optimal breastfeeding; and the price paid for suboptimal breastfeeding is
massive. Apart from economics, suboptimal breastfeeding is associated with
increased risk of infant/child mortality as well as infections and diseases
affecting the psycho-social milieu of the community.
On the
other hand, in case of individuals who receive breast milk and are exclusive
breastfed during the first six months of life, the odds of developing non
communicable diseases like diabetes, cardio-vascular diseases, hypertension
etc. are far lesser as compared to those who do not receive the breast milk or
are not exclusively breast fed for the first six months of life. And, these
dividends of optimal breastfeeding are conferred to the individuals even after
the child grows i.e. during their middle age/old age.
What a
coincidence, breastfeeding and complementary feeding are linked to all the
eight Millennium Development Goals (MDGs) which were set more than two decades
back (1990) by the various governments and the United Nations for fighting
poverty as well as for promoting sustainable development by 2015. Therefore, by
protecting, promoting and supporting breastfeeding, each of us can contribute
to the MDGs in a substantial way by ensuring good health of our children and,
thus, an overall development of our nation.
However,
translating knowledge regarding appropriate breastfeeding and complementary
feeding practices into adoption of these practices requires behavioural change
among the mothers, their spouses, other family members particularly the
mothers-in-law and thus, the community as a whole. Further, inculcating optimal
breastfeeding and complementary feeding practices requires building up the
mother’s confidence so that she can successfully breastfeed her baby. In
addition, it is important that an enabling environment is created for the mother
through a suitable back up support from the father/other family members,
improved working conditions, as well as decreasing her household
responsibilities, so that the nursing mother can devote enough time towards the
breastfeeding activity. In case the mother suffers from breast-milk
insufficiency or she is not able to breastfeed the baby properly, then she
should seek counseling from medical practitioners/peers, so that lactation
failure does not occur and rather the process is re-established at its full
swing. In case of working mothers, adequate maternity benefits and unhindered
grant of extended leave (as and when required) is rather important. In this
regard, government’s initiative of child-care leave is an excellent move;
however, the beneficiaries should use this facility judiciously.
No doubt,
breastfeeding rates are not up to the mark among the rural/urban poor mothers
whose vulnerability is associated with poverty, ignorance, and social
discrimination and gender inequalities. The likelihood of breastfeeding
cessation or sub-optimal breastfeeding practices is even greater in mothers who
are literate, working outside home and fall under high/extremely high wealth
categories. The set of problems are, however, different for the affluent elite
society. Most of the mothers intentionally
discontinue exclusive breastfeeding earlier than six months because they feel
that prolonged breastfeeding could adversely affect their own health as well
as they would have to remain bound to their child. Many of these
mothers also have the apprehensions that they are not able to produce enough
milk for their baby. This perceived breast-milk insufficiency leads to an early
introduction of milk supplements/ breast-milk substitutes; thereby changing the
maternal role and infant care patterns. All this happens due to the
complexities of fast moving modern life rather than insufficient breast milk
production in reality. Researchers throughout the world have proved that
majority of the mothers are able to produce enough milk for their baby and the
feeling of not-enough milk is often triggered due to numerous reasons like
partial breastfeeding from one breast, improper positioning of the baby at the
breast, dryness of the nipples or long gaps between two breastfeeding episodes.
Moreover, the parents/mothers get wrongly influenced by the fancy
advertisements of commercially produced infant milks/ infant foods and their
dependency on breast milk substitutes increases at the cost of breastfeeding.
The preference for these commercial infant formulae is sometimes driven by the
doctor’s endorsements too, as some of them continue to recommend these foods
claiming that the commercial infant milks/foods would be able to provide better
nutrition to their baby. Additionally, the changing lifestyles and an
increasing number of working mothers who want to succeed in their profession,
impulsively push them to look for convenient infant feeding options. Here is a
note of caution for the educated elite! Remember…… adopting optimal
breastfeeding and complementary feeding is an investment in your child’s
nutritional well-being, physical growth as well as psychological, cognitive
emotional and social development; and thus, his/her holistic personality
development for the lifetime.
The mothers need to be highly motivated to sustain optimal infant
feeding practices. Minor day-to-day problems like breast milk insufficiency,
busy work schedules need to be resolved through innovative strategies which can
be implemented as per the need. In addition, adequate support from the father
and the other family members is very important. Psychological and social
well-being of the mother as well as adequate mother-child interaction has a
great impact on lactational performance of the mother. Therefore, it is imperative
that the mother is provided the right kind of environment, particularly
tension-free atmosphere, so that she can successfully breastfeed the baby. The
commercially publicized practices should not be followed blindly; the choices
need to be made only after proper understanding of the implications. Only in
unavoidable circumstances, the drastic action like shift from breastfeeding to
replacement feeding can be taken, when there is no other choice; elsewise,
breastfeeding should be the best approach.
There is no one magic bullet that can resolve all
the breastfeeding related issues/problems. Let us make our best efforts to
foster a society where all women are able to breastfeed their babies; and all
babies can have access to adequate quantities of human milk……
Timely initiation of breastfeeding, exclusively breastfeeding till six
months; and thereafter complementary feeding coupled with continued
breastfeeding till two years or beyond can protect children from a number of
infections and diseases like diarrhoea, dysentery and pneumonia as well as
reduce the risk of mortality!!!
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