THINKING ALOUD: Why should we promote breast-feeding? It saves lives

What if there were a remedy that could save more children’s lives in the developing world than the lives claimed by malaria and AIDS combined?

A mother’s breast milk is a miracle substance which reduces ear infections, and improves I.Q. scores. Also, it is available even in the most remote villages, requiring no electricity or refrigeration – and at virtually no cost.

The first week of August 2018 was World Breastfeeding Week (WBW) whose theme this year is ‘Breastfeeding: Foundation of Life’.

Current estimates backed by the World Health Organization and UNICEF are that optimal breastfeeding would save 800,000 children’s lives yearly in developing countries: a 12 per cent drop in child mortality. There is no other such cost-effective intervention known in healthcare.

Thus a simple question here: did we do justice in commemorating the WBW this year – and what should now be done to reach the set targets?

Exclusive breastfeeding for the first six months of life as recommended by WHO is practised by less than 20 per cent in Africa. Therefore, there’s still room for improvements in this area.

Infants who are not breastfed are 14 times more likely to die than those who are exclusively breastfed. Studies from India, Nepal and Ghana show that prompt breastfeeding reduces neonatal mortality by 44 per cent.

However, only 43 per cent of babies born worldwide are put to the breast within an hour of birth, as recommended by WHO.

One reason for the delay is suspicion of colostrum: the first yellowish milk which doesn’t quite look like milk, but which is nonetheless packed with nutrients and antibodies. No wonder it’s called the ‘first immunization.’

Another big challenge is that, in hot-climate countries, villagers often give their newborns water, or start them off on food before they’re six months old. Water displaces milk – and is often contaminated. In contrast, breastmilk is safe even when the mom drinks contaminated water!

Western companies are also to blame.

Manufacturers of infant formulae who face stagnant growth in Western countries calculatingly pursue mega-profits in poorer countries.

Researchers found that 85 per cent of recently-discharged mothers in Phnom Penh, Cambodia, had learned of ‘formula’ baby milk in marketing advertisements.

Some also believe that Western-type entertainment has sexualized the breast in ways that reduce breastfeeding.

Thus during the WBW-2018, the onus was upon the ministry of Health to address these challenges. Should it, perhaps, have hiked all infant formula milk prices – and ban any advertising therefor?

While the obvious benefits of breastfeeding have something to do with saving lives, there is also some evidence of other health and cognitive gains.

Global health experts focus on breastfeeding partly because efforts to support moms in this area pay off surprisingly well.

A recent survey by Acta Paediatrica – a monthly journal which publishes papers in English covering both clinical and experimental research in all fields of paediatrics – found that breastfeeding promotion on average increased exclusive breastfeeding by an astonishing 44 per cent!

There should have been more activities during the WBW, while some of the advocacy measures should be sustained. To start with, there is a dire need to dispel existing myths about breastfeeding.

Among the myths are that ‘small breasts produce less milk than large ones; you can’t breastfeed with inverted nipples; you can’t breastfeed if you’ve undergone surgery; you can’t get pregnant while breastfeeding; and your breastmilk supply is low.’

While more should be done to correct these misconceptions, there’s also the need for a well-considered national breastfeeding policy that should routinely be instilled in healthcare staff, imparting upon them the skills needed to effectively implement the policy.

The sensitisation campaign should inform pregnant women about the benefits of well-managed breastfeeding; help mothers to initiate breastfeeding within half-an-hour of birthing; show mothers how to breastfeed and how to maintain lactation, and prohibit food or drink other than breastmilk unless medically indicated.

Other measures are to practise rooming-in (keeping a newborn’s crib by the side of its mother’s bed); allow mothers and their infants to remain together 24 hours a day; encourage breastfeeding on demand; give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants; fostering the establishment of breastfeeding support groups, and refer mothers to the groups on discharge from the hospital or clinic.

There is a real need to launch a more robust campaign highlighting the health benefits of breastfeeding, and supporting mums to feel more comfortable and proud of breastfeeding –even doing so in public places. After all, it’s only natural to breastfeed.

Support is key to helping mums breastfeed, and encouragement within the family and from the wider community can really make a difference.

Unfortunately, all that was missing during WBW this year. It is as if the powers-that-be in Tanzania treat breastfeeding as a trivial matter.