Give them the best start

Breastfeeding is critical to child survival and gives children the best start in life. This is the message being celebrated during the ongoing World Breastfeeding Week. Globally, 69 lakh children under five years of age die every year. Almost a quarter of these deaths take place in India. This is the highest figure for any nation and amounts to three child deaths every minute. Most are preventable and stem from complications like newborn sepsis, premature birth, pneumonia, diarrhoea and malnutrition.

By reaching out to mothers with advice about breastfeeding and a comprehensive package of interventions, we can save lakhs of lives every year. Breastfeeding ensures optimum growth and brain development because of its unique and human-specific nutrient composition. Breastmilk contains immune active factors and cells that protect against infections like diarrhoea. Breast-fed babies have fewer allergies, are more intelligent and develop a stronger bond with the mother.

Breastfeeding should be initiated within one hour of birth and infants should be exclusively breastfed in the first six months of life. Home-cooked semi solid feeds and milk products should be introduced after six months with breastfeeding continuing until the child is two years old. A Lancet study estimated that breastfed children are at least 14 times more likely to survive than those who are not.

Interventions complement each other. A study in the Journal of Public Health showed that children in India who are vaccinated against tuberculosis, diphtheria, tetanus, pertussis, measles and polio, are less likely to show signs of stunting. Skilled attendance at birth, the care of small babies, breastfeeding, complementary feeding, immunisation, hand-washing, oral rehydration salts and zinc in diarrhoea, and antibiotics for sepsis/pneumonia can together avert most child deaths in India.

For children to survive and develop normally to live healthy lives, multiple interventions are important. However, due to the lack of information and the substitution of breast milk with baby food, only 41% of Indian mothers start early breastfeeding. Breastfeeding must be promoted and efforts must be made to ensure that the infant milk substitutes Act, which bans the promotion of baby foods and feeding bottles, is implemented. Health workers should also advise mothers on how best to breastfeed infants.

Mass media campaigns involving film stars have helped to overcome vaccine myths. The same approach can be used to highlight the proven benefits of breastfeeding and other lifesaving interventions.

Building on the success of the polio eradication campaign, the government introduced a five-in-one vaccine (against diphtheria, tetanus, whooping cough, hepatitis B and Hib infection) in nine states.

A comprehensive approach that integrates preventive interventions (such as breastfeeding and vaccines) with the treatment of sicknesses, will ensure that we save the lives of more children.

Unfortunately, breast milk is not yet optimally available to infants of India. For this to happen, society must strive to attain universal coverage of breastfeeding within the next five years. Breastfeeding messages need to be spread through colleges, women’s groups, youth initiatives, media, panchayats and even political meetings and religious discourses.

Indeed, it is time for a people’s movement to promote breastfeeding.

VK Paul is the head of the Department of Paediatrics, All India Institute of Medical Sciences, New Delhi
The views expressed by the author are personal