Making Breastfeeding Work -- With Help From The Government And Community

04/08/2016 8:11 PM IST | Updated 05/08/2016 8:40 AM IST
Ruth Jenkinson

The first seven days of August, marked as World Breastfeeding Week worldwide, present an opportunity to discuss the far-reaching impact of a simple, home-based intervention. This year's theme focuses on the role breastfeeding can play in achieving the Sustainable Development Goals (SDGs), especially Achieving Zero Hunger and Improving Health and Well-Being at All Ages. Home to a sixth of the world's population, India's performance on breastfeeding, among other health and nutrition indicators, has a key role to play in powering the global push for healthier, better-nourished mothers and children. Similarly, with a sixth of India's population, Uttar Pradesh (UP) holds the key to strengthen global efforts in pursuit of the SDGs.

UP has made progress in recent years during its push to reach the targets set under the time-bound Millennium Development Goals (MDGs). Between 1999 and 2015, the under-5 mortality rate in UP reduced from 122.5 to 64 per 1,000 live births. However, UP still has an uphill battle in tackling its health and nutrition challenges. As many as 650 children still die every day due to malnutrition in Uttar Pradesh, according to the State Nutrition Mission Vision Document 2014. Faced with this reality, large-scale, systemic interventions may seem like the only viable way to achieve major SDGs; but low-cost, community-level practices such as breastfeeding can prove instrumental in achieving these goals.

With government interventions already in place, it is our responsibility as a society to prioritize optimal breastfeeding in our homes

Adopting optimal breastfeeding practices is crucial to ensuring that children's nutritional needs are met in the most critical stage of their lives. Receiving the right nutrition in the 1000 days between a woman's pregnancy and her baby's 2nd birthday has a profound impact on a child's ability to grow, learn and thrive. Optimal breastfeeding practices include timely initiation of breastfeeding (within the first hour of life), exclusive breastfeeding for the first six months (with no other food or liquids, including water), and complementary feeding alongside continued breastfeeding from 6-24 months. If universalized, these practices could save the lives of over 800,000 children under the age of five each year across the globe.

Apart from providing children with nourishment and protection from infections and diseases such as diarrhea and pneumonia, breastfeeding benefits mothers and families as well. Women who breastfeed are less likely to develop breast and ovarian cancers and Type II diabetes. Breastfeeding offers a natural, renewable food source that needs no packaging, transportation, storage or cooking, making it environmentally friendly and economical.

However, a lack of awareness of the benefits of optimal breastfeeding practices means that in 2013-14, only 22.5% of children aged 0-23 months in UP were breastfed within an hour of birth, while a third of children aged 0-5 months were not exclusively breastfed. Just 19.1% of women were visited by an ASHA, ANM, or Anganwadi Worker at home within one week of delivery and/or discharge from a health institution. It is important for women to receive counselling from health workers in the post-birth period so that they can begin breastfeeding correctly early on.

To ensure the widespread uptake of breastfeeding, the government has already put into place mechanisms for its promotion at health facilities, during community outreach activities and during community- and home-based care. Programs like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakram (JSS) enable and incentivize women to give birth at institutions and stay the recommended 48 hours after delivery. Community outreach events like Village Health and Nutrition Days (VHNDs) at Anganwadi Centres provide community health workers with the chance to spread correct information, dispel myths and bad practices, and offer counselling on breastfeeding. Finally, the Home Based Newborn Care Scheme requires that every child be visited at home by a health worker six-seven times during the first 42 days of life, helping messages on breastfeeding reach every mother and household. One-to-one counseling during routine home visits by the ANM and ASHA is the best way to reach mothers and caregivers in the community.

This World Breastfeeding Week, let's ensure that no newborn goes hungry, especially when their food source is innate, renewable and close to their mother's heart.

To improve the uptake of healthy breastfeeding practices in UP, action must be taken from both the demand and the supply side. Communities must be made aware of the health services to which they are entitled. Those with prominent voices in their communities should get involved in breaking myths and clarifying age-old misconceptions. Neighbours should support and encourage one another to breastfeed and avail of free community health services. On the other hand, we must also strengthen efforts across state and district levels to ensure breastfeeding counselling reaches the community through well-trained and dedicated health workers.

The benefits of breastfeeding are far-reaching. But the immediate impact of this intervention hits right at home. With government interventions already in place to support healthy breastfeeding practices, it is our responsibility as a society to prioritize optimal breastfeeding in our homes and in our communities. This World Breastfeeding Week, let's ensure that no newborn goes hungry, especially when their food source is innate, renewable and close to their mother's heart.

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