Breastfed children are less likely to be obese or overweight and are less prone to non-communicable diseases later in life. Increasing breastfeeding to near-universal levels globally could save more than 820,000 lives and prevent an additional 20,000 cases of breast cancer in women each year.
World Breastfeeding Week 2021 was celebrated amid different programs throughout the world with the theme “Protect Breastfeeding: A Shared Responsibility” from 1-7 August. Health experts are calling all stakeholders to encourage mothers to continue optimal breastfeeding practices during the ongoing COVID-19 pandemic. Breast milk provides optimal nutrition for babies.
According to Nepal Demographic Health Survey 2016, infant and young child feeding practices are sub-optimal, with about 65 percent exclusively breastfed under 6 months and about 55 per cent colostrum-fed within an hour of birth. Only 41 per cent of children aged 4–5 months were exclusively breastfed compared to 80 per cent in 0–1 months and 72 percent in 2–3 months. However, all infants had received at least some breastmilk by 4–5 months of age.
Nepal Multi Indicator Cluster Survey (MICS) 2019 says about 42 percent of infants were colostrum-fed within an hour of birth and 62 per cent exclusively breastfed for six months after birth. According to the survey, 87.6 percent were breastfed for full term. The national survey shows that breastfeeding culture and frequency are declining due to various reasons. In 2011, it was reported that 70 per cent of mothers breastfeed their babies. In 2016, it decreased to 66 per cent and in 2019 it fell further down to 62 per cent, which is a matter of concern.
Breastfeeding is the best source of nourishment for infants and young children, and a proven life-saving strategy that helps protect children against many illnesses. Breastfeeding is the best and natural vaccine that develops the immune system of a baby. Breastfed children are less likely to be obese or overweight and are less prone to non-communicable diseases later in life. Increasing breastfeeding to near-universal levels globally could save more than 820,000 lives and prevent an additional 20,000 cases of breast cancer in women each year.
It can help reduce the prevalence of various illnesses and health conditions, which in turn results in lower healthcare costs. Breastfed children also have fewer hospitalisations and trips to healthcare providers. Human milk is a natural and renewable food that provides a complete nutritional requirement for about the first six months of life. Breast milk is composed of antibodies that help babies fight off viruses and bacteria. Breastfeeding has been shown to lower the risk of asthma or allergies, fewer ear infections, respiratory illnesses, and episodes of diarrhea. It also reduces the risk of colds and infections, gut infections, intestinal tissue damage, allergic diseases, bowel diseases, sudden infant death syndrome, childhood leukemia and both types of diabetes.
Studies have shown that breastfed children perform better on intelligence tests. extend up to adulthood, with a substantially lower chance of obesity, cardiovascular diseases, diabetes, and even some types of cancers. There are also health benefits for the mother owing to breastfeeding, as it lowers the risk of breast cancer, ovarian cancer, diabetes, hypertension, and heart diseases.
Colostrum, which is nutrition-concentrated pre-milk containing antibodies, growth factors, protein, fat, and white blood cells, provides perfect nutrients for the baby. Crying is the most common way to know that the baby is hungry. Breast milk provides the ideal nutrition for infants. It also helps psychologically as the bonding between mother and child grows through breastfeeding. Breast milk has a perfect composition of vitamins, protein, and fat that is needed for the baby to grow.
Additionally, it contains those essentials in a form more easily digested than any of the infant formulae. Breastfed infants are more likely to gain the right weight as they grow older than become overweight in the future. Breastfeeding is one of the most effective means to improve child health and survival.
The status of breastfeeding has worsened by frequent violations of the International Code of Marketing of Breastmilk Substitutes. Unless the marketing of breastmilk substitutes is banned, it is challenging to ensure complete breastfeeding. The Global Breastmilk Substitute sales increased to Rs 72 trillion in 2019 which had increased from Rs 45 trillion in 2014. This shows the industry’s large competitive claim on infant feeding. The authorities concerned must strengthen the implementation and monitoring of the International Code of Marketing of Breastmilk Substitutes to protect mothers from inappropriate marketing of Breastmilk Substitutes.
The aggressive marketing for lactogen is unethical and causes harm to both mothers and babies. As the bottle nipple is more addictive for babies and it discourages babies from suckling on their mother’s milk, all healthcare providers must discourage bottle-feeding and encourage breastfeeding within the first hours of birth. Nurses, doctors and hospitals must ban recommending lactogen. Every mother must understand that they can produce enough milk for their babies. When one becomes a mother, she can produce milk naturally, which will be more than enough for her baby. Women should be psychologically prepared to feed their babies.
Breast milk bank
Encouraging mothers to breastfeed needs a multidimensional approach such as better public policies like paid maternity leave, access to quality child care services, break time for working mothers and a non-threatening location for expressing the milk. The importance of a breast milk bank has been realised in Nepal and a milk bank is being considered to be opened at the Maternity Hospital in the capital and it is recommended to extend it to all the hospitals in the major cities. It is hoped that the presence of a counselor at each healthcare facility improves the adherence to exclusive breastfeeding in the country.
At last, it is the responsibility of all to protect and support mothers to breastfeed their children. Optimal breastfeeding is so important that it is one of the most effective ways to ensure overall child health. As the benefits of breastfeeding are significant, mothers with confirmed or suspected COVID-19 infections and who are isolating at home should continue breastfeeding with necessary and appropriate health protocols during feeding. It is safe to continue breastfeeding if the baby is suspected or confirmed to have COVID-19.
(Dr Budhathoky is a senior consultant of the Ministry of Health and Population and the Central Treasurer of Nepal Medical Association.)