As the world observes another Breastfeeding Week from August 1-7, it is disheartening to note that some 77 million newborns (which means 1 in 2) the world over are deprived of the essential nutrients, antibodies and skin-to-skin contact with their mothers that protects them from disease and death as they are not put to the breast within an hour of birth. This is the finding of the latest study by the United Nations Children Emergency Fund (UNICEF).
The UNICEF report says that infants whose mothers delay breastfeeding for more than 24 hours after birth have an 80 per cent higher risk of newborn deaths than those who are immediately breastfed. Further, if all the babies are fed nothing but breastmilk from the moment they are born until they are six months old, over 8,00,000 lives would be saved every year, it says.
But despite all the media campaigns, advertisements and educational seminars on the benefits of breastfeeding, the progress in getting more newborns breastfed within the first hour of life has been slow over the past 15 years, UNICEF data show.
In sub-Saharan Africa, for example, where under-five mortality rates are the highest worldwide, early breastfeeding rates increased by just 10 per cent since 2000 in East and Southern Africa while these have remained unchanged in West and Central Africa.
Even in South Asia, where a three-times rise is seen in the rate of early breastfeeding initiation in the last 15 years (from 16 per cent in 2000 to 45 per cent in 2015), about 21 million newborns still wait too long before they are breastfed.
The longer breastfeeding is delayed, the higher is the risk of death in the first month of life, say the report. And delaying breastfeeding by 2-23 hours after birth increases the risk of dying in the first 28 days of life by 40 per cent and delaying it by 24 hours or more increases that risk to 80 per cent, it says.
The World Breastfeeding Week 2016 theme is about how breastfeeding is a key element in getting us to think about how to value our wellbeing from the start of life, how to respect each other and care for the world we share. Doctors say now is the time to push for programmes that encourage optimal breastfeeding practices.
The state in India
Breastfeeding rates continue to be dismal in India, which also bears the highest global burden of neonatal deaths (0.78 million), premature births (3.5 million) and low birth weight babies (7.8 million).
The National Family Health Survey data suggests that rates of early initiation, exclusive breastfeeding and complementary feeding stand at 24.3 per cent, 46.9 per cent and 64.3 per cent, respectively, which shows that there is a dire need for effective roll-out of various government initiatives in this direction.
Why breastfeeding is important
Breastmilk is the best milk for a newborn. It is easier to digest, has all the nutrients, calories and fluids a baby needs, has growth factors that ensure sound development of baby’s organs. Studies have shown that breastfed babies are less likely to have ear infections, diarrhea, pneumonia, wheezing, bronchitis, meningitis and other bacterial or viral infections.
Breastfeeding is a cost-effective, life-saving intervention for premature children with low birth weight or those who have an infection.
The Lancet Series on Breastfeeding, 2016, reports that breastfeeding alone can prevent 13 per cent of under-five deaths in developing countries each year.
Breastfeeding is also good for the mother. It releases hormones that promotes mothering behavior, returns the uterus to its size quickly, burns calories which help in weight reduction, delays menstrual periods and thus help keep iron in the body, provides natural contraception, keeps bones strong and reduces the risk of ovarian and breast cancer in mother.
Reasons of not breastfeeding
The UNICEF study says that one of the reasons for less breastfeeding numbers is that women are not getting the help they need to start breastfeeding immediately after birth. Strangely enough, in the Middle East, North Africa and South Asia, it is seen that women who deliver with a skilled birth attendant are less likely to initiate breastfeeding in the first hour of life, compared to women who deliver with unskilled attendants or relatives.
Feeding babies other liquids or foods is another reason early breastfeeding is delayed. In many countries, it is customary to feed a baby infant formula, cow’s milk or sugar water in the first three days of life. Almost half of newborns are fed these liquids. When babies are given less nutritious alternatives to breast milk, they breastfeed less often, making it harder for mothers to start and continue breastfeeding.
Human milk banks
Human milk banks are a viable option for mothers who cannot supply their own breast milk to their child, for reasons such as a baby being at risk of getting diseases and infection from the mother with certain diseases, or when a child has certain medical conditions like necrotizing enterocolitis. This is because any amount of breast milk, from any source (own mother or not), reduces a child’s risk of death.
UNICEF report says that globally, only 43 per cent infants under six months of age are exclusively breastfed. Babies who are not breastfed at all are 14 times more likely to die than those who are fed only breast milk. Babies who received no breast milk at all are seven times more likely to die from infections than those who received at least some breast milk in their first six months of life.
India has 22 human milk banks. The first one was set up way back in 1989 at Sion Hospital in Mumbai, Maharashtra, by neonatologist Dr Armida Fernandez.