Lactation education

Lactation matters

Today is August 1 and every year the day marks International Breastfeeding Week. The slogan for this year’s World Breastfeeding Week “Intensify Breastfeeding – Educate & Support” is simple yet empowering. This is sobering because in a country like India early breastfeeding practices are still low and the lag runs across the social spectrum. Here’s why !

Recently, at a meeting in Bengaluru, I met an international delegate who had worked for an NGO in Bihar and wanted to understand how to increase breastfeeding rates in Bihar. As I write this today, I am deeply concerned and often think “Kya hamara India swasth hai”. Breastfeeding practices such as starting breastfeeding within one hour of birth and exclusive breastfeeding for the first six months of life are of immense public health importance. However, the state of breastfeeding practices is far from satisfactory in India, where the rate of breastfeeding initiation within one hour of birth has declined over the past five years, according to the National Survey. on Family Health (NFHS).

The second phase of India’s Fifth National Family Health Survey (NFHS-5), conducted in 2019-2021, indicated that of the 17 states and five union territories (UTs) whose data have been released by Dadra and Nagar Haveli and Daman and Diu showed the smallest percentage of children under three who were breastfed within one hour of birth. Next come Bihar, Sikkim, Tripura, Telengana and Gujarat.

Why are breastfeeding rates low?

In my opinion, there are 4 critical factors that contribute to low breastfeeding rates. First, there is an increase in institutional births. Although it is absolutely necessary to give birth to a child in a medical facility under the general supervision of trained and competent health personnel, it is important to understand that the most important importance of breastfeeding and lactation is not breast milk alone, but the mechanics of breastfeeding that aids in the overall development of the baby. ? “Mothering” through breastfeeding for the general well-being of the baby is essential.

Second, place of delivery and breastfeeding within one hour of birth are most important (government vs. private hospital). Third, the type of delivery and breastfeeding within one hour of birth (normal vs cesarean section) and finally, mothers who received postnatal care from a health worker within two days of delivery.

In fact, our own unpublished data from the hospital shows 95% exclusive breastfeeding rates and this was all possible thanks to the availability and accessibility to patients of our qualified and trained lactation consultants 24 hours a day and 7 days a week. It is these lactation counselors who hold mothers, educate them and act as counselors to improve understanding of breastfeeding, hygiene, attachment. It is important for new mothers to understand that breastfeeding is not a choice, it is a responsibility. A simple law of nature, and a newborn’s basic right to survive, is also perhaps one of the most misunderstood challenges of early motherhood. Only a small percentage of mothers know the basics and important facts about breastfeeding. There is a lot of data on the importance of breastfeeding but little on breastfeeding techniques and trained people in the field. Our experience shows that

For publication on International Breastfeeding Week 2022: Step Up Breastfeeding | Educate and support.

ASHA nurses/workers trained in breastfeeding technique will go a long way in helping these mothers – unfortunately in a country like India – training to become a lactation consultant is the hardest.

There are currently only 3 lactation consultants trained at IBCLC in Karnataka and of them – 2 are pediatricians and 1 nurse. It is incredibly expensive and very difficult to complete IBCLC training to become a lactation consultant.

What should India do?

One of the greatest challenges is a diminished ability of family members, neighbors and friends to help new parents successfully overcome breastfeeding issues. The need for help and support was always there; but now the need for skilled lactation care was perhaps greater than ever. Premature and low birth weight babies have begun to survive, and research on human milk has proven its value for the survival, growth and good health of all infants. Families needed more than parent-to-parent counseling and support for their breastfeeding challenges. All women should have access to skilled care during pregnancy and childbirth to ensure the prevention, detection and management of complications. The assistance of trained health personnel working in an enabling environment is needed to eliminate preventable maternal and newborn deaths. Strategies to support exclusive breastfeeding therefore need to address the multiple factors that contribute to exclusive breastfeeding, including lack of knowledge and awareness, lack of support and time within the household, insufficient support from health and nutrition programs, maternity leave and/or maternity benefits, infant formula marketing, tracking the code for marketing breastmilk substitutes, etc.

Given the overwhelming evidence available on the impact of breastfeeding in reducing neonatal and infant mortality, it is imperative that continued efforts be intensified to improve optimal breastfeeding practices (early initiation of breastfeeding within an hour, exclusive breastfeeding for the first six months, and continued breastfeeding for at least two years). The promotion, protection and support of breastfeeding is an important activity of health systems. Knowledge is important and breastfeeding is not difficult if managed properly with support. We need to strengthen our existing health care infrastructure to enable breastfeeding in public. New moms should seek support groups to learn how to breastfeed. There is immense potential for lactation consultants in India and we need to open up more opportunities to train more lactation specialists. In addition to all this, with the support of existing state and central governments, we should create an enabling environment for breastfeeding through awareness raising activities, targeting pregnant and breastfeeding mothers, family members and society to to promote optimal breastfeeding practices. Breastfeeding should be positioned as an important intervention for child survival and development and lactation support services should be strengthened in public health facilities through trained health care providers and trained community health workers. Last but not least, encourage and recognize health facilities that have high breastfeeding rates as well as the processes in place for lactation management. Group counseling sessions as well as individual counseling from trained experts are the best way to reach mothers and caregivers in the postnatal period, when they are most receptive to messages about child care and feeding. .



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Disclaimer

The opinions expressed above are those of the author.



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