One of the first things a newborn baby does is latch on to the mother’s breast for milk. It’s a mammalian instinct we are born with — after all, breast milk is the best source of nutrition for a baby.
In 2014, a study on monkeys by Katie Hinde, an assistant professor of human evolutionary biology at Harvard University, found that the composition of early milk could impact the temperament of the infant: besides providing the baby with nutrients like protein, sugar, calcium, and immunity, a hormone present in milk, cortisol, profoundly effects how babies develop. In fact, marsupials such as kangaroos can even produce milk of different protein and fat composition to be had by the younger joey (baby kangaroo) and its older offspring from separate teats. Yet, the composition of human milk, or how it is both food and medicine tailor-made to meet the needs of the baby, remains a mystery.
Breastfeeding them young
While scientists grapple to understand the complexity of human milk, policymakers in India are grappling with something much more elementary: the need to encourage breastfeeding among new mothers.
Currently, 38% of children are stunted and 35.7% are underweight in India. Experts maintain that inappropriate complementary feeding practices are having a significant impact on the nutritional status of children.
“Most people coming to us tend to have all the information about breast milk. Despite that, we still see that rates of breastfeeding are going down in higher socio-economic group. This is partly because they can afford to buy alternative feeds and partly because most people don’t understand why it is important to breastfeed… we’ve seen mothers who consider breast milk to be the same as any other type of milk!” says Dr. Raghuram Mallaiah, director, neonatology at Fortis La Femme, which runs the not-for-profit Breastmilk Foundation in New Delhi.
When exclusively breastfed, healthy infants double their birth weight by six months of age and triple it by 12 months. “Nutrient requirement is much higher during 0-6 months. Infants should be exclusively breastfed for the first six months to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to be breastfed for up to two years or beyond,” says Dr. Nandan Joshi, head of nutrition science and medical affairs at Danone India, that has given three human milk analysers to various neonatal care centres to facilitate research.
The Rapid Survey on Children (Ministry of Women and Child Development, 2015) shows that only 45% infants are now being breastfed within an hour of birth in India and just 65% are being exclusively breastfed as per World Health Organization recommendations. Further, the NFHS 4 (National Family Health Survey) data reveal that only 42.7% of children received complementary foods at the age of 6-8 months while only 9.6% children received an adequate diet. Experts say ‘adequate diet’ for a baby of 6-8 months should involved four or more of the following food groups — grains; dairy products; meat; eggs; vitamin A-rich fruits and vegetables.
Increasing awareness
“The awareness about breast milk and early nutrition is poor among new mothers. We still see patients who don’t give colostrum to the baby,” says Dr. Mallaiah. Colostrum is a thick milky fluid that comes from the breast soon after giving birth. This is extremely easy to digest, and is therefore the perfect first food for the baby. It has a high concentration of nutrition and has a laxative effect on the baby, helping him pass his early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice.
The India Newborn Action Plan, developed by the Ministry of Health & Family Welfare in 2014, is targeting a 75% rate of initiation of breastfeeding within an hour of birth by 2017 and 90% by 2025. To achieve these rates, there is a need understand the sophistication of human milk, and enable new mothers to make an informed choice about breastfeeding. “This is why we are studying human milk. Analysing composition helps in targeted fortification of mother’s milk, and also helps give appropriate dietary advice to mothers to improve milk quality,” says Dr. Nandan Joshi.
vidya.krishnan@thehindu.co.in
