Breastfeeding in the Modern World Bridging Gaps and Building Support

Dr Ravinder K Gupta and Dr Anuj Gupta

World Breastfeeding Week (WBW) is held in the first week of August every year, supported by WHO, UNICEF and many ministries of Health and Civil society partners. Celebrated from August 1-7, it is a global event aimed at raising awareness about the benefits of breastfeeding and supporting mothers in their breastfeeding journey. In India, this week serves as a crucial opportunity to address challenges and promote practices that can significantly improve maternal and child health.

BREASTFEEDING WEEK
Aug 1st to Aug 7th

World Breastfeeding Week was first celebrated in 1992, organized by the World Alliance for Breastfeeding Action (WABA) in collaboration with the World Health Organization (WHO) and UNICEF. Each year, a specific theme is chosen to address different aspects of breastfeeding, such as healthcare systems, women’s rights, and community support. In 2024, the WBW theme is “Closing the Gap: Breastfeeding Support for All” highlighting the need for inclusive support systems for breastfeeding mothers.WBW has played a crucial role in raising awareness about the benefits of breastfeeding and the need for supportive environments for breastfeeding mothers. It has led to the implementation of various initiatives, such as the Baby-Friendly Hospital Initiative (BFHI) and the promotion of exclusive breastfeeding for the first six months of life.The Breastfeeding Promotion Network of India (BPNI) is a national organization dedicated to promoting and supporting breastfeeding and appropriate complementary feeding of infants and young children.
Breastfeeding offers many benefits for both mothers and babies. It provides essential nutrients, strengthens the immune system, and fosters a strong bond between mother and child. According to the World Health Organization (WHO), exclusive breastfeeding for the first six months can significantly reduce infant mortality and protect against common childhood illnesses. Optimal feeding has the potential to simultaneously reduce the risk or burden of under-nutrition and overweight, obesity or diet-related NCDs (including type 2 diabetes, cardiovascular disease and some cancers).Embracing breastfeeding is a win-win for the health and well-being of both mother and child. For mothers, it promotes faster recovery by helping the uterus return to its normal size and reducing postpartum bleeding, helps in weight management, reduces health risks, and saves money. It also burns extra calories, which can assist in regaining pre-pregnancy weight, and lowers the risk of certain cancers and osteoporosis. Furthermore, breastfeeding is cost-effective and convenient, eliminating the need for formula and bottles while ensuring that milk is always available at the right temperature. Overall, breastfeeding is a natural, beneficial practice that supports the health and well-being of both mother and child.
Despite the known benefits, breastfeeding rates in India face several challenges. In many areas, there is a need for greater awareness about exclusive breastfeeding and proper breastfeeding practices. Cultural practices, lack of awareness, and inadequate support from healthcare systems and workplaces especially in rural and underserved regions, can impact breastfeeding rates and practices. For example, the practice of giving honey or water to newborns before breastfeeding is still prevalent in some areas. Working mothers often face difficulties balancing work and breastfeeding due to insufficient maternity leave and inadequate breastfeeding facilities at workplaces. Mothers often lack support from family members and the community, which can be crucial for successful breastfeeding. Negative attitudes or lack of encouragement can discourage mothers from continuing to breastfeed.
Separation of babies from mothers especially in caesarean section births, more so in the private sector, inadequately trained health staff, unnecessary use of infant formula due to commercial influence of baby food industry on health facilities, inadequate counselling and support to mothers during antenatal and postnatal periods are some of the barriers to successful of breastfeeding. The aggressive marketing of formula milk by companies can undermine breastfeeding by promoting formula as a convenient and modern alternative.
The National Family Health Survey (NFHS) indicates that while many mothers initiate breastfeeding, the rates of exclusive breastfeeding drop significantly within the first few months. According to the NFHS-5 (2021), 88.6% of women give birth in hospitals, but only 41.6% can start breastfeeding within an hour of birth. In Jammu and Kashmir, 55.6% start breastfeeding within 1 hour of birth.According to NFHS-5, the rate of exclusive breastfeeding in India for the first six months is approximately 62%. This represents a significant improvement from previous years, but there is still a gap between this rate and the WHO’s global recommendation of 70% or higher.A 2019 international study on the cost of not breastfeeding estimates that in India, inadequate breastfeeding results in 100,000 preventable child deaths. Health impact on mothers is more than 7000 cases of breast cancer, 1700 of ovarian cancer and 87000 of type- 2 diabetes and India spends INR 727.18 crores on health care due to these illness.
There have been many recent developments in India related to breastfeeding, including policy changes, new programs, and initiatives that are shaping the landscape. The Government of India launched the Mothers Absolute Affection (MAA) programme in 2016 to improve breastfeeding in the hospitals. In 2023, the Indian government updated its national breastfeeding guidelines to align with global recommendations and address emerging challenges. By mid-2024, more than 500 hospitals in India have been accredited as Baby-Friendly, up from around 300 in early 2023. This expansion reflects the growing commitment to creating supportive environments for breastfeeding in healthcare facilities. In early 2024, the Ministry of Health and Family Welfare launched a nationwide breastfeeding promotion campaign, focusing on Awareness, Community Engagement and Partnerships with NGOs, community health workers, and influencers to amplify the message about breastfeeding. Several state governments and private sector companies have introduced breastfeeding-friendly policies in recent months like Extended Maternity Leave, provision of breastfeeding rooms and flexible work arrangements to support breastfeeding mothers.
The recent developments in breastfeeding practices in India reflect a concerted effort to address challenges and promote better health outcomes for mothers and infants. Continued progress will depend on the effective implementation of new policies, community engagement, and support for healthcare professionals and families.World Breastfeeding Week 2024 presents a vital opportunity to reflect on the progress made in promoting breastfeeding in India and to address ongoing challenges. By continuing to support breastfeeding through education, policy changes, and community initiatives, India can improve maternal and infant health outcomes and build a healthier future for its children.
As we celebrate World Breastfeeding Week 2024, it’s crucial to remember that breastfeeding is not just a personal choice but a collective responsibility. By supporting breastfeeding mothers, educating communities, and advocating for better policies, we can create a nurturing environment where every child has the best start in life. Let’s come together to promote, protect, and support breastfeeding, ensuring a healthier future for our children and generations to come.
(The authors are from Department of Paediatrics, Acharya Shri Chander College of Medical Sciences (ASCOMS), Jammu)