Showing a healthy habit the door

| | in Oped

It is time to highlight the benefits of feeding mother’s milk to a newborn. The use of of formula milk is on the rise across the world for various reasons. We should not allow market forces to make choices that are unhealthy

The recent call by the UN to view ‘breastfeeding’, as a human rights issue, and one that should be protected and promoted for the benefit of babies and mothers, has come as a welcome step. Few nations have the necessary stringent, comprehensive and enforceable legal measures to curb the menace of infant formula, that is flourishing across the world, and in India, in particular.

There have been numerous instances of newborn babies being fed infant formula substitutes as their first meals, often without the mother’s knowledge. Despite delivering healthy babies, new mothers do not get to hold them, or feed them immediately after birth. Most parents go for formula milk, simply because, the doctors have recommended them to do so. Once dependent on formula milk, mothers face extreme difficulty in getting back to breastfeeding in the long run.

In India, 14 million babies out of 26 million, are exposed to health risks, due to introduction of either powder milk, or animal milk-based formula, within hours of their birth. According to the World Health Organisation (WHO), “Powder infant formula is not sterile.” Yet, we remain silent. Why?

Giving other liquids, and fluids, and food to babies less than six months, is full of risks. According to the WHO, infant formula does not contain the antibodies found in breastmilk. The long-term benefits of breastfeeding for mothers, and children, cannot be replicated with an infant formula. When infant formula is not properly prepared, there are risks arising from the use of unsafe water, unsterilised equipment, or the potential presence of bacteria in a powdered formula. Malnutrition can result from over-diluting formula to ‘stretch’ supplies.

 While frequent feeding maintains breastmilk supply, if formula milk is used, then a return to breastfeeding may not be an option, due to diminished breastmilk production. All this is serious.

In India, about 12 million infants get breastfeeding within an hour, but14 million infants don’t as recommended by the WHO and Government of India’s health guidelines. Are we violating the newborns’ human rights? According to the UN Human Rights principles, “Yes we are.” Keepers of the law that protect their rights in India, are seemingly not aware, a challenge that is so huge, but once we meet that, the story could be reversed and risks reduced.

As per a Euromonitor report, about 27 million containers of infant formula are sold every year in India, meant for babies between zero to six months. This number is staggering — almost equal to the number of babies born. It plays a disrupting role, in breastfeeding practices at a very nascent stage. This is no surprise that, India’s rate of breastfeeding within one hour, is 44 per cent even though 80 per cent women do deliver in health facilities.

The introduction of formula milk to newborns is a serious problem, that leads to drop out of breastfeeding. More worryingly, some private facilities have been accused of initiating babies on formula milk, without the mother knowing. This not only deprives the newborns of highly nutritious, and antibody-laden colostrum or the mother’s ‘first milk’, but contributes to lactation failure.

 Union Health and Family Welfare Minister, JP Nadda, rightly put this point across most succinctly, when he said during the launch of the national programme to promote breast-feeding last August, “What was natural, has been made unnatural by market forces”. Infant Milk Substitutes, Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992, (IMS Act) and its 2003 Amendment Act, should be effectively enforced in its letter and spirit. This strong law restricted the growth of milk formula in India.

From 2008 to 2012, sales grew from 24,428 to 27,783 tonnes. During the same period, in China, where the law is not that stringent, sales went up from 2,94,800 to 5,60,000 tonnes. This means in China sales are twenty times higher.

Can we minimise this problem? Yes, we can. It requires some investment. Women need accurate information about breasfeeding, and risks of formula feeding, before being introduced. Taking consent before introducing something harmful to the baby, should be mandatory, which is not the practice these days.  It is just been given, and accepted as ‘doctors’ or ‘health’, advice and must be good.

There have been few success stories in hospitals, where skilled counsellors have assisted, and supported women at the time of birth, and later during breastfeeding. However, this trend is yet to catch up. Hospitals need to realise that, having such counsellors, could be a good business model for private hospitals, and at the same time help improve their image too. The Union Government had earlier embarked on ‘Baby-Friendly Hospital Initiative’ where ‘10 Steps to successful breastfeeding’ applied, and feeding bottles and infant formula were out. Such programmes must return.

(The writer is national coordinator, Breastfeeding Promotion Network of India)

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