Kerala has slipped from the top slot on the list of ‘baby-friendly’ States, which is a certification of exclusive breastfeeding for six months. Breastfeeding Promotion Network of India, an independent body of organisations, had reported the downward trend, based on the health indicators in the National Family Health Survey III. In 2002, Kerala had helmed the list. The current topper is Chhattisgarh.
As per the NFHS III figures, the State occupied the ninth position, with exclusive breastfeeding for newborns at 56.2%. In NFHS IV, the health indicators show a further decline, touching 53%. Across India, the figure is 46.4%.
In first hour
M.K. Santhosh, president, Indian Academy of Paediatrics, Kerala, said only 45% of neonates get breastfed within the first hour. The target is to get all the neonates breastfed within 30 minutes of being born, he added.
Paediatricians across the State fail to give mothers the confidence to feed the baby only breast milk for the first six months, said Balachandar D., secretary, IAP, Kerala.
The reticence could be due to fear of legal issues if hypoglycaemia is reported in babies when mothers do not have enough breast milk, said Dr. Balachandar.
Breast milk substitutes
As exclusive breastfeeding has come down, the sale of breast milk substitutes has gone up in Kerala. Industry sources say the top three companies in the formula feed market are doing a monthly business of at least ₹5 crore. There had been a steady growth in sales of about average 6% over the last five years.
Exclusive breastfeeding
Riaz I., associate professor, Thiruvananthapuram Government Medical College, a past secretary of IAP, Kerala, says the whole pre-natal and post-natal care team needs to be involved in motivating mothers and making the family aware of the importance of exclusive breastfeeding.
Only 27% deliveries are happening in government hospitals, where there is exclusive breastfeeding is promoted. Hence, unless the private sector gets involved, awareness creation among most mothers will not happen.
Exclusive breastfeeding was high in the 1990s and the first city to be declared baby-friendly was Kochi in 1994. Ernakulam district followed suit and the whole State was declared baby-friendly in 2002 as 99% of the hospitals in the State were following practices to promote breastfeeding, said S. Sachidananda Kamath, former national president of IAP.
However, now, confidence-building programmes remain on paper as no hospital has been certified baby-friendly for the last 15 years.
Earlier, boards of being baby-friendly were displayed in most hospitals, said Dr. Balachandar. It was a move promoted by UNICEF and the World Health Organization. Various studies were published on the importance of breastfeeding to mother and child.
Reasons for decline
Over the past 20 years the number of working mothers has gone up, says Dr. Balachandar, which too can be cited as a reason for the declining figures. IAP, Kerala, has decided to take up recertification of hospitals for becoming baby-friendly, he said. The IAP is in the process of promoting lactation counsellors for which they have approached the Kerala University of Health Sciences for a training module.
