RATIONALE
WHO, UNICEF , Government of India recommend optimal feeding practices, which include early breastfeeding within an hour of birth, exclusive breastfeeding during the first six months, continued breastfeeding for two years and beyond along with adequate and appropriate complementary feeding after six months. Optimal feeding is crucial to health, growth and development of babies and health of women. However, feeding practices are not optimal in almost all parts of India because mothers are not well-informed or supported either during pregnancy or after birth. In India, while the majority of mothers deliver in health facilities; only 1 in 2 are able to begin breastfeeding within an hour of birth.
The Ministry of Health and Family Welfare, Government of India in 2016 launched Mothers Absolute Affection(MAA) programme to promote breastfeeding in the health facilities. It also launched a quality labour room programme called ‘LaQshya’. Both these programmes address services to assist women to have skin-to skin contact with their babies at the time of birth and begin breastfeeding within an hour of birth.
In 2019, World Bank Study in South Asia revealed that most pregnant women missed any discussions about feeding their babies during pregnancy. According to the study and several other anecdotal observations, babies are separated from mothers especially in cesarean section births, more so in the private sector. Inadequately trained health staff, unnecessary use of infant formula due to commercial influence of baby food industry on health facilities, and inadequate counselling and support to mothers during antenatal and postnatal periods contribute to lack of awareness and low rates of breastfeeding during first hour of birth and skin-to-skin contact between the mother and the baby.
If pregnant women received information and counseling support by dedicated skilled counsellors during the antenatal period, recent research in India has shown doubling up early breastfeeding rates at birth.
The W.H.O. has recommended that counselling on breastfeeding is an important step during pregnancy. The WHO’s Ten Steps to Successful Breastfeeding and Indian Law (IMS Act) to protect breastfeeding emphasises a discussion on the importance and management of breastfeeding with pregnant women and their families. It guides that breastmilk substitutes should not be used unless there is a medical indication.
Therefore, all pregnant women should be well-informed by a trusted source of information on the benefits of breastfeeding, technique of breastfeeding including correct latching, risks associated with breastmilk substitutes, and the services she requires to be successful. These are the rights of both women and children. However, if the situation arises that she has to give mixed feeding or only formula feeding after birth, she should know how to prepare and feed it safely, its costs, and implications for returning to breastfeeding and hazards of improper use of formula etc.