Infant mortality is one of India’s persistent health concerns. It is a well-established fact that breastfeeding reduces child mortality and has health benefits that extend well into adulthood. While the benefits of breastfeeding have been known for decades, it is only recently that the association of time-to-initiation of breastfeeding, with mortality and morbidity in children-under-5, has been assessed.
Global guidelines
This year, the World Health Organisation and UNICEF jointly issued a new 10-point guidance to further raise awareness on the criticality of early breastfeeding. In addition, they noted that breastfeeding for the first two years would save the lives of more than 8,20,000 children annually. Their report recommends that mothers start breastfeeding in the first hour after birth. The early initiation ensures that infants consume the colostrum — the first secretion from the mammary glands after giving birth. Colostrum is said to be high in antibodies, reduces the risk of death from hypothermia, helps in epithelial recovery and protects children from infectious diseases. Early initiation also has numerous immunological and nutritional benefits that have been found to reduce mortality in babies under the age of 1.
Infants who are breastfed have a reduced risk of diarrhoea, pneumonia and other infectious diseases in comparison to infants who drink breast milk substitutes. Human milk is a rich source of immune and non-immune components which resist infection and also accelerate intestinal maturation in a child.
Despite the significant progress made in improving child survival at the national level, infant mortality still remains high in some States in India. While there are multiple factors that lead to infant mortality, breastfeeding rates too play a key role. It is estimated that only one out three children are breastfed exclusively within six months, which results in a higher risk of death due to various illnesses (diarrhoea and respiratory infection).
Improving India’s breastfeeding rates requires a multi-pronged approach with its focus on educating women and health providers. The challenges of limited public knowledge, social norms that trend toward formula feeding, lack of access to lactation services and education have to be addressed through consistent awareness initiatives at every level. The better the breastfeeding practice, the higher the protection. Even partial breastfeeding has a modest protective effect when compared to no breastfeeding. Every mother-to-be should undergo proper training on breastfeeding. In this, doctors and medical professionals play an important roleThis which will ensure that new mothers are better prepared and are able to adequately feed their child without any delay. Only mothers suffering from severe illnesses or other issues affecting early lactation should go in for bottle feeding or milk substitutes.
Government’s strategy
Some factors that may delay early breastfeeding are caesarean delivery, use of anaesthesia, fatigue and the use of pre-lacteal feeding with formula milk. The government is making efforts to promote and organise programmes focussed on maternal and infant health — especially on the need to encourage early breastfeeding and its various benefits. These programmes aim is to educate health-care providers and young parents on the importance of human breast milk for the survival of the child. Our hospitals are also in desperate need for an improvement in policies and maternity-care practices. The first 24 hours of an infant’s life is considered to be a crucial period. If the child is not breastfed, it is more likely to suffer from various diseases such as asthma, diabetes, childhood leukaemia, obesity and allergies.
Unfortunately, large sections of the society are still lacking in awareness and are unable to access these services. Hence, in addition to these awareness programmes, the Health Ministry is also planning to increase the network of human milk banks across the country. Hopefully, this will reduce India’s infant mortality rate.
Dr. Nirmala Chandrashekhar is a gynaecologist at BGS Gleneagles Global Hospitals, Bengaluru
