As the country celebrated World Breastfeeding Week through the first week of August, the status of breastfed children in India still remains far less than promising. Even though breastfeeding practices takes a positive turn across the country, only two in every five children below three years are reported to be breastfed within the first hour of birth. Going by numbers revealed by the latest NFHS survey (round 4) in 2015-16, nearly- 60% of children below three years are denied of their 'first immunization' – as colostrum (the first milk of the mother) feeding is commonly referred to – as in medical terms it is the most effective, naturally available and least expensive life-saver ever.
“The fact that mother’s first milk is of utmost importance to the initial immunity development of the child makes it a mandatory diet for the baby. Mean intakes of mothers milk provide sufficient energy and protein to meet requirements during the first 6 months of infancy. Hence exclusive breastfeeding during her first six months is essential for the overall development of the new-born. However, these are not surely as widespread pieces of information as they should be,” said Puja Marwaha, the CEO at CRY – Child Rights and You.
All major studies on child health and nutrition suggest that the new-born must have colostrum, the first milk of the mother within the first hour of birth, and it is the very first dose of nutrients and immunity-boosters that the new-born can receive. After six months of exclusive breastfeeding, the child should be introduced to complementary feeding, and it should go hand in hand with breastfeeding till the age of at least 2 years.
Overall, as a result of increased efforts and awareness at all concerned levels, breastfeeding practices have improved in many states over the last decade. A comparative analysis of NFHS-3 (2005-06) and NFHS-4 (2015-16) shows that breastfeeding in the first hour of birth has increased 18.2 percentage points (from 23.4% in 2005-06 to 41.6% in 2015-16) at the national level. Also, the other key factor that witnessed some improvement is exclusive breastfeeding for the new-borns during the first six months. While in 2005-06 more than 46% of children below six months were exclusively breastfed, the figure has increased to 54.9% in 2015-16.
However, a worrying trend is observed when it comes to exposing the child to complementary feeding – introducing her to semi-solid and solid food along with breast milk. While in 2005-06 more than 52% of children within the age-group of 6-8 months were reported to receive complementary feeding along with breast milk, the figure has come down to 42.7% in 2015-16. Also, children growing in urban set ups seem to fare poorly than their rural counterparts, when it comes to exclusive breastfeeding in first six months. Data suggests that while 56% children in the rural areas have received exclusive breastfeeding in their first six months, in urban set ups the percentage is 52%.
Also, going by other child health indicators, while institutional birth rate in the country has touched almost 80% (NFHS-4), the breastfeeding rates don’t seem to corroborate the trend, , thereby indicating the fact that a large section of mothers who are opting for institutional birth are still in the dark, when it comes to the virtues of breastfeeding.
“Experiences from the CRY initiatives such as ‘1000 Days Campaign (a programme specially designed to address and monitor child health and nutrition during first three years of their lives) and ‘Poshan Diwas’ (Nutrition Day) in our intervention areas in 19 States, and the wisdom gathered from working with 786 ICDS Centres, 988 adolescent girls’ groups and 1518 children’s groups suggest that intensive advocacy through ICDS and health departments have, to an extent, started taking a positive bend in altering social mind-sets, but there are still a lot left to be done. We are also advocating and working on importance of optimal nutrition of adolescent girls,” Puja said.
She added that, the need of the hour is to reach out to each and every household, in a campaign mode, focusing on appropriate feeding strategy by promoting early initiation of breastfeeding within first hour of birth, exclusive breastfeeding for the first six months followed by continued breastfeeding for up to two years and beyond with appropriate complementary foods after completion of 6 months.
Highlighting findings of studies that exclusively breastfed infants are at much lower risk of diseases like diarrhoea and pneumonia, Puja reiterated India’s commitment towards the SDG (Sustainable Development Goal - 3) – to end preventable deaths of new-borns and under-5 children by 2030. The two targets are to reduce new-born mortality to at least as low as 12 per 1000 live births in every country (SDG 3.2); and to reduce under-five mortality to at least as low as 25 per 1000 live births in every country (SDG 3.2)