२०७९ साल असोज १९ गते बुधबार

तपाईँ सुन्दै हुनुहुन्छः

Breastfeeding in South Asia: Problems and Prospects

Ismail Mamdhooh 1 Aug, 2022 6:17 pm
Photo Courtesy: UN News

Nutrition and a healthy diet are basic necessities for all living beings. As the saying goes, “we are what we eat”. For infants, it starts from a mother’s womb and immediately after birth. Breastfeeding is a baby’s ‘first vaccination’ and the ‘first food’, it is the most effective and least costly life-saver the world has ever known, as it aids in building a strong foundation in the child. Breastfeeding helps in building immunity for children against illness, especially in the early stages of their lives and it ensures proper development of the brain and other vital organs.

A child’s healthy development cannot be fully achieved without breastfeeding. Once the mother and her family understand the value of breastfeeding, she, together will family support, will initiate early and exclusive breastfeeding to ensure her child leads a healthy and sustainable life.

Neonatal death is when a baby dies in the first 28 days of life, and South Asia contributes 35% of annual global neonatal deaths (838,000 out of 2,372,000). Studies show that initiation of breastfeeding within one hour of birth can reduce the risk of neonatal deaths by up to 22%.

Breastfeeding alone can effectively reduce 55–87% of all-cause neonatal mortality, particularly due to infections like pneumonia, neonatal sepsis (a blood infection that occurs in an infant younger than 30 days), and meningitis (swelling of the protective membranes covering the brain and spinal cord) as breastmilk contains antibodies that help protect against many common childhood illnesses.

It is estimated that inadequate breastfeeding is responsible for 16% of child deaths each year and despite all efforts, only 4 in 10 newborns in South Asia are breastfed within one hour of birth and 6 out of 10 are exclusively breastfed. The SDG 20230 target is 70%.

Despite legislations, maternity policies and programmes, there is no country in South Asia where all children – born through skilled birth attendants – are breastfed within one hour of birth nor is any infant exclusively breastfed within the first six months of life. Pervasive marketing of formulae milk is on an exponential rise and knowledge gaps are impeding progress.

As many as 80% of babies are born in health institutions through skilled birth attendance. As high as 62% of babies born through skilled birth attendance are not initiated breastfeeding in South Asia. This must change.

Breastfeeding not only improves an infant’s immunity but also helps mothers to have a reduced risk of breast and gynaecological cancers and type II diabetes. Breastfed children perform better on intelligence tests with an IQ increase of 3 to 4 points and are less likely to be overweight or obese later in life. While it can seem easy to breastfeed, it isn’t always the case. In the first few days or weeks following delivery, many mothers quit entirely feeding their babies. In order for mothers to continue this life-saving activity, they need encouragement and knowledge about breastfeeding.

We need to narrow the missed opportunities gap to protect, promote and support breastfeeding in South Asia. With the help of counselling, education, and family, provider and policy support, we can increase exclusive breastfeeding rates among children less than six months old by up to 90%. For first-time mothers and particularly young adolescent mothers, breastfeeding must be initiated and maintained promptly. Major factors in determining whether an adolescent mother breastfed or not included the support and encouragement of her family and health care providers.

Author Mamdhooh

Most caesarean section mothers and women with pregnancy complications can effectively begin early and exclusive breastfeeding with the help of their care providers and supportive family. For the benefit of mothers who undergo caesarean sections, both planned and unplanned, targeted breastfeeding initiatives are strongly advised.

Countries have seen a considerable increase in breastfeeding rates when they have supportive policies and extensive programs that target all groups. What we need is seven priority actions, and to implement these seven priority actions: donations are required from governments, philanthropies, international organizations, and civil society. The seven priority actions include;

  • – Increase funding to raise breastfeeding rates from birth through two years.
  • – Fully implement the International Code of Marketing of Breastmilk Substitutes and relevant World Health Assembly resolutions through strong legal measures that are enforced and independently monitored by organizations free from conflicts of interest.
  • – Enact paid family leave and workplace breastfeeding policies, building on the International Labour Organization’s maternity protection guidelines, including provisions for the informal sector.
  • – Implement the Ten Steps to Successful Breastfeeding in maternity facilities, including primary and community health care platforms, with additional focused support for mothers with a small and sick newborn.
  • – Improve access to skilled breastfeeding counselling as part of comprehensive breastfeeding policies and programs in health facilities integrated with antenatal care, delivery and immediate post-natal care.
  • – Strengthen links between health facilities and communities, and encourage community networks that protect, promote, and support breastfeeding.
  • – Strengthen monitoring systems that track the progress of policies, programs, and funding towards achieving both national and global breastfeeding targets.

Many health professionals’ networks including community health workers, midwives, obstetricians, nurses, paediatricians, general medical practitioners and anaesthetists are in contact with mothers and their newborn babies at their most crucial time and they play a key role in this warm chain.

Professional Associations such as FIGO; South Asia Federations of Obstetrics and Gynaecology (SAFOG); International Confederation of Midwives and their National Counterparts can play a pivotal role by advocating with their members for universal early initiation of breastfeeding and exclusive breastfeeding for the first six months of life.

We need to fully integrate critical breastfeeding support competencies into pre-service training and in continuing education for all midwives, nurses, and medical professionals including comprehensive specialized training to enable them to address complex breastfeeding situations. We need to fully integrate early initiation of breastfeeding within the quality of care and respectful maternal and newborn care frameworks and guidelines.

Community health workers should be capacitated to support pregnant mothers, families and newborns in breastfeeding counselling and early initiation. And we need to establish legislation to protect breastfeeding in training and work environments by refusing sponsorship from companies that market foods for infants and young children for scholarships, awards, grants, meetings, or events as defined in the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions.

Together, we should allocate adequate staffing levels including lactation counsellors to ensure adequate time for supporting mothers and infants as they begin breastfeeding. We should also strengthen the leadership role of all pregnancy, labour and delivery care providers at national, local, and facility levels to support mothers and newborns to initiate early breastfeeding. And together we must protect, promote, and, support breastfeeding in the South Asian region, reducing current gaps and ensuring universal access to early and exclusive breastfeeding to maximize newborn and infant survival.

The author is the Director of Social Affairs at the SAARC Secretariat. The views don’t necessarily reflect those of Radio Nepal.

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