By Dr. Mangala Wani, President BPNI (Breastfeeding Promotion Network of India) Maharashtra and member FOGSI (Federation of Obstetrics and Gynaecological Societies of India) Breast Committee
Mother’s milk is widely recognized as the optimal source of nutrition for all infants. Breast-milk gives immunity to baby and meets all nutritional needs until six months of age, when complementary foods are added to baby’s diet.
Breastfeeding is an important public health strategy having many benefits to mother, baby and environment. Breastfeeding is associated with reduced risk of gastroenteritis, pneumonia, ear infections, necrotizing enterocolitis, obesity and diabetes in babies and reduced risk of cancer of the breasts and ovaries, diabetes and postpartum depression in mothers.
Most national and international groups recommend exclusive breastfeeding without the use of infant formula or other foods or liquids for the first six months and to continue breastfeeding for up-to two years or beyond.
Despite the overwhelming scientific evidence, about 44% women start breastfeeding within one hour after birth and only 54% are still breastfeeding at 6 months.
Widely available and aggressively promoted formula is seen as a superior alternative for mothers.
However, formula does not have so many things which are important for the growing baby. Additionally, it can lead to malnourishment due to dilution of formula by adding more water to save money, as well as infectious diseases due to challenges of preparing a hygienic bottle in areas with shortages in clean water, utensils, and storage facilities. Formula does not contain antibodies to fight against infections.
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Though motherhood is rewarding, it is challenging too. Her life changes totally after delivery. Breastfeeding is not easy. Sleepless nights, crying baby, changing nappies, postpartum mood changes, backache …are all part of this wonderful package.
Even though the recommendation is to initiate breastfeeding within one hour after birth, the hospital practices many times delay the initiation for various reasons.
Breastmilk produced during those early days, the colostrum, is rich in nutrients and antibodies, boosting child’s immunity and hence survival. It is the best food that a human being can ever get. It is precious & irreplaceable.
Ahana was feeling bitter telling her experience after her first childbirth 3 years ago. She was given medicine to sleep after her caesarean. In the evening, she realized that baby was already fed a formula. Second day, a nurse pinched her nipples and remarked that she has no milk.
So Ahana ended up with not breastfeeding her baby in first 3 days. After going home, she lost confidence too and could not continue breastfeeding. Recently, I delivered her second baby and the hospital team helped her to breastfeed her baby in operation theatre itself and later on when she was shifted to her room.
She says, she had a fantastic opportunity to be with her baby, with skin to skin contact, they spent hours together in initial days. She felt so wonderful. She thought, this was the most beautiful thing that could ever happen.
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Scientifically it has proven that after early initiation and frequently breastfeeding the baby ( if baby is separated from mother or unable to latch, then manually expressing the milk and giving it to the baby), mother gets good milk supply, she develops confidence too and then breastfeeds longer duration.
Health professionals must battle a multi-billion baby formula industry which aggressively advertises breast-milk substitutes to mothers from day one.
Support from family, particularly baby’s father and community is equally important.
Shubha thanked her husband for being so supportive. She added, how he talks her through vulnerable moments and boosts her morale, and that helps her to breastfeed her daughter even after one year after giving birth. She acknowledged her friends too, bringing her food and other groceries, chatting with her when she had difficulties with breastfeeding.
There was a Facebook survey done last year. Fifty per cent of the mothers replied that they never saw anyone breastfeeding, not as a kid or on television or movie. If you haven’t seen anybody breastfeeding around or people don’t talk about it, how you are supposed to learn about it. Many people in our society are actually ignorant about breastfeeding.
If someone has never seen breastfeeding moms or think breasts are being sexual & breastfeeding was something primitive people did in the old days, of course you are going to find breastfeeding disgusting & odd.
If you are an employer that is part of the same society that says babies on formula are just fine, you are probably at loss to understand why your employee may want extra maternity leave or need a proper place in the office to express her milk regularly. Women need support from her colleagues too in her office. The office should provide a room where mother can have a privacy and comfort for expressing her milk and storing it.
Similarly, there should be designated places for breastfeeding in public places like restaurants, malls , gardens. There are instances where mother has breastfed her baby in toilets or autorickshaw, due to non-availability of room or space. If breastfeeding is a part of culture in India, why people feel offended & disturbed when a mother breastfeeds her baby in public places.
Mother should get proper education about breastfeeding during her pregnancy. She should ask hospital about antenatal classes and what help they offer for breastfeeding, whether the hospital adopts baby friendly practices. She should find good lactation consultant ( IBCLC) who will help her for good latching and attachment.
New mom need to know the importance of breastfeeding, how long to breastfeed, what should be frequency & length of feeding, how would she know when baby is hungry, how to know her milk is enough for baby, good latch, where to get the help if she needs etc.
The support in the community can be in several forms, from health facility outreach which includes help from lactation consultants to community mobilized programmes such as mother to mother support groups or lactation clinics or community health workers. If the mother receives multiple contact care, she will have significantly higher breastfeeding rate.
