CELEBRATING BREASTFEEDING WEEK
Breastfeeding is the act of feeding babies and young children with milk from women’s breasts. Every year, The world alliance for breastfeeding action (WABA) conducts an event to celebrate breastfeeding week from 1st of Aug to 7th of Aug with the aim to promote, support and encourage breastfeeding throughout the world. The event was first celebrated in the year 1992 and today, more than 170 countries celebrate breastfeeding week every year with a new theme. The theme for the year 2020 was, “Support breastfeeding for a healthier planet”
The theme is celebrated globally by hosting events, programs, raising awareness, and so on. But in the middle of the pandemic, social media for conveying awareness and useful information played an outstanding role reaching out to most of the people as the internet has already become a basic requirement in people’s life by the year 2020. Every year, different approaches like the government, healthcare organizations, breastfeeding groups, and other participants create awareness to reach out to people and educate them about the importance of breastfeeding.
WHO recommends exclusive breastfeeding to start within one hour after birth until the baby is 6 months old. Nutritious complementary food should be then added while breastfeeding for up to 2 years or beyond. According to UNICEF, Nepal in 2018 an estimated 55 babies out of 100, are breastfed within the first hour of their life which is very low and unhealthy to the infants as well. While mothers have been breastfeeding for centuries, we have only recently begun to fully understand it’s vital role in health and development.
Like many of the social organizations to aware people about the importance of breastfeeding, Swastha naari was also one of them. Established with an aim to aware women about the significance of their sexual and reproductive health, Swastha naari posted whole week about the facts on breast feeding.
Besides these amazing facts, the importance of breastfeeding should be known, not only to the mother but also to the father, family members and the community. Increasing breastfeeding rate could save hundreds and thousands of lives each year. It also plays an important role in improving maternal and child health.
Breastfeeding immediately after birth give babies colostrum (first milk). The yellowish colostrum is the first form of milk produced by mammary glands of mammals immediately after the delivery. It contains high amount of proteins and antibodies needed by the infant to fight against infections and possible allergies. Newborns have weakly developed digestive system and with the intake of colostrum, mild laxative action (increase in bowel movement and loosening of stool) is promoted within infant’s body and passing of their first stool, also known as meconium occurs. This clears the excessive dead RBCs in the body produced in large quantities during their birth.
Colostrum contains Immune cells, and other components like lactoferrin, lysozyme, lactoperoxidase, proline rich polypeptides, cytokines and other important components to help infants grow healthy. The perfect mix of vitamins, proteins and fats provide antibodies to the infants to lower the risk of allergies and other diseases. Studies have shown that breastfeeding decreases the rate of diarrhoea and respiratory tract infections in infants by 72% and 57% respectively. Higher breastfeeding rate is also linked to higher IQ level in their later life.
The act of breastfeeding is not only beneficial to the child but advantageous to the mother as well. Breastfeeding the child helps in losing pregnancy weight faster and the hormone oxytocin released during breastfeeding helps return the uterus to its pre-pregnancy size. The incidence of uterine bleeding and risk of ovarian cancer and breast cancer can also be reduced to some extend.
But not all mothers have vaginal deliveries. Due to many medical conditions, C-section or cesarean section must be performed in many women. Globally, the rate of C-section birth is close to 26%. Confusion has created among people whether women with C-section delivery are equally capable of producing enough milk to the newborns or not. It may take a little time for the milk to come out compared to the vaginal delivery but the outcome is not inferior in quality. With an epidural (administration of anesthesia in epidural region near spinal cord) and spinal anesthesia (administration of anesthesia in sub arachnoid region in the spinal cord) used in C-section, a mother can be capable of breastfeeding their child in the operating room as well.
In some cases, like in a working mother, seriously ill mother who is under medications contraindicated during lactation, mothers who can’t breastfeed due to low breast milk supply (lactation failure) or those infants who have lost their mother right after their births, breast milk substitutes must be preferred. In such cases, whole cow milk, evaporated or powdered milk (containing full fat and properly diluted with water) can be used instead of breast milk. If whole goat’s milk is to be used, make sure that the milk is pasteurized and have vitamin D and folic acid added to it. The substituted milk should be properly prepared and stored safely. However, some myths prevail among societies that mother shouldn’t breastfeed while they’re sick. Depending upon the type of illness, mothers can exclusively breastfeed their child. A proper treatment, rest and nutritious foods and drinks are however mandatory. Breastfeeding the child while they’re sick helps release the antibodies produced against certain diseases through milk to the infants building their own defence against the same disease. But breastfeeding while under heavy medication for serious illness must be avoided and switching to breast milk substitutes (BMS) could be the best option.
The American academy of pediatrics (AAP) strongly recommends avoiding infants from direct sun exposure as much as possible and supplementation of 400 IU of vitamin D per day soon after the birth. Supplements should be continued until the infant is exposed to 1L of milk per day.
Human milk contains very little amount of iron so infants who are exclusively breast fed are at higher risk of iron deficiency after 4 months of age. 1mg/kg/day of liquid iron supplement should be administered to the infants until iron containing solid foods are given to them from 6 months of age. The same amount of iron supplement to be administered to the partially breast fed babies and for premature babies, more amount of supplement is needed as their bodies contain even less amount of iron.
Breastfeeding is one of the few positive health behavior which is more prevalent in poor than rich countries. However, obstacles do occur when late initiation and low rates of exclusive breast feeding becomes a major challenge in poorest countries. In middle and high income countries, uneven or limited breastfeeding rate is a major barrier in improving infants health. Countries must invest in the policies and programs that support women’s breastfeeding decision. Conditions for breastfeeding must also be enabled from individual to structural levels.
A major gap in knowledge and skills in supporting breastfeeding are reported at all levels of healthcare staffs. An initiative of baby friendly hospital initiative (BFHI) must be encouraged in every healthcare services and individual counseling or group education, immediate breastfeeding support at delivery, lactation management and training for health staff can help increase the breastfeeding rate.
In some families, colostrum is thought to be harmful and prefer to discard it. Pre lacteal feed (food given to the newborns before breast milk comes out usually on first day of their lives) is also a prevalent practice in Nepal. Exclusive breastfeeding needs to be promoted over pre lacteal feeds. Community based interventions like group counseling, social mobilization and counseling mothers and their spouse about breastfeeding in antenatal clinics should be included as a part of breastfeeding promotion programs.
Major obstacle in exclusive breastfeeding occurs when a mother is a working women. International Labor Organisation recommends 18 weeks of paid maternity leave for working mothers. But it is not prevalent in every organisation (mostly private) specially when the women aren’t at higher levels in their jobs and are compelled either to breastfeed their child at bathrooms or to leave their jobs. But to those who are still willing to work, can store a bottle of breast milk in a room temperature for 4–5 hours and in refrigerator for 2–3 days. In places where refrigerator isn’t available, storing the bottle of milk under water could be an alternative. Breast milk substitute’s importance should also be known to working mothers including their spouse and families. Reducing the barriers to breastfeeding for working mothers by providing lactation rooms and nursing breaks should be considered to put into enforcement law by the concerned authorities.
Breastfeeding reduces child morbidity and mortality decreasing health cost and lessening strain on country’s healthcare system. Despite knowing the fact, we fail to remove structural and societal barrier that interferes with women’s ability to breastfed optimally. So, creation of a new normal where women are supported in their decisions to breastfeed at home, work and community needs to be encouraged. Policies restricting marketing of breast milk substitutes needs to be removed and must be focused on importing a good quality product with decisions being made exclusively based on quality control test results of the product. Financial aid or mechanism to cover the cost and supporting lactation needs a mandatory focus from the government level.
Encouraging and educating the community about the importance of breastfeeding is our responsibility towards humanity.
