Breastfeeding rates rather dismal in India

Breast milk is the complete source of nutrition for a baby from birth till 6 months of age. Breastfeeding is strongly promoted by all obstetricians and pediatricians. Despite all this the rates of breastfeeding are rather dismal in India.

India ranked 56 out of 76 countries on early initiation of breastfeeding, according to the 2018 Global Breastfeeding ranking. According to the National Family Health Survey done in 2015-2016, children breastfed within one hour of birth is only 41.6% and it is almost the same for rural and urban areas.

Provision of mother's milk to infants within one hour of birth is referred to as early initiation of breastfeeding and ensures that the infant receives the colostrum, or first milk, which is rich in protective factors and antibodies. Percentage of children under age 6 months exclusively breastfed are 54.9.

In fact, the percentage is slightly higher in the rural areas. Recent analyses indicate that suboptimal breastfeeding practices, including non-exclusive breastfeeding, contribute to 11.6 per cent of mortality in children under 5 years of age.

World Breastfeeding Week is celebrated every year from 1 to 7 August to encourage breastfeeding and improve the health of babies around the world. The World Breastfeeding Week 2019 slogan "Empower Parents, Enable Breastfeeding" was chosen to be inclusive of all types of parents in today's world.

Focusing on supporting both partners to promote the importance of family-friendly policies to enable breastfeeding and help parents nurture and bond with their children in early life, when it matters most. This includes enacting paid maternity leave , and paid paternity leave to encourage shared responsibility of caring for their children on an equal basis.

Mothers also need access to a parent friendly workplace to protect and support their ability to continue breastfeeding upon return to work by having access to breastfeeding breaks; a safe, private, and hygienic space for expressing and storing breastmilk; and affordable childcare.

Breastfeeding promotes better health for mothers and children alike. Increasing breastfeeding to near-universal levels could save more than 800 000 lives every year, the majority being children under 6 months. Breastfeeding decreases the risk of mothers developing breast cancer, ovarian cancer, type 2 diabetes, and heart disease. It is estimated that increased breastfeeding could avert 20 000 maternal deaths each year due to breast cancer.

Tips for succesful breastfeeding

Insist on feeding baby within first hour of birth. You can do that even if it is a caesarean section. Learn proper technique like latching, positioning from the hospital staff. It may take some time for you and the baby to adjust to breastfeeding. Do not give up in the first few days and avoid using bottles, nipples, pacifiers etc.

First you should be comfortable while breast feeding. Use a good back support. Block out all the negative comments – if your breasts are not overflowing you do not have enough milk, if baby is feeding more frequently means breast milk is not sufficient give formula. These are all myths. If you have any doubts please consult your obstetrician or pediatrician.

Pumping of breast milk. This is very useful especially for working mothers. There are manual and electric breast pumps available in the market. Applying a warm towel to your breasts 15-20 minutes before pumping helps to increase milk volume. You can pump breast milk in your office also.

Storage of breast milk. Breast milk stored at room temperature should be used within 4 hours. In winter season or in cold climate it can be used upto 6 hours. Breast milk should be stored in refrigerator at the back.

Never store milk in the door of refrigerator and avoid opening the refrigerator frequently and do not leave the door open for a long time. Breast milk stored in a refrigerator can be used within 2- 3 days but in a tropical country like India it is better to use the milk within 1-2 days. In refrigerators with separate freezer compartment (temperature of – 18 C) breast milk can be stored for 3-6 months. In places with frequent power cuts and no back up for running refrigerator, it is advisable not to store breast milk.

Using stored breast milk

When the baby needs to be fed, place the milk in a container with hot water or keep it under tap with running hot water for 1-2 minutes. After this the milk should be used within 1-2 hours. Never heat breast milk directly or microwave it.

The cream of the milk may form a separate layer. Before giving it to the baby swirl the milk but do not shake it. Before use, frozen milk should be thawed by placing in the refrigerator. Once the milk has been thawed it can be kept for 24 hours in refrigerator before use. Do not refreeze thawed milk.

There is no shame in breastfeeding in public. Breastfeeding in public should be encouraged and supported by everyone. (Writer is Consultant Pediatrician, KIMS Cuddles, Kondapur)