Nursing the future

Breastfeeding boosts the immune systems of infants and ultimately has a positive impact on public health

 Breastfeeding is essential for the survival and proper development of human beings. In time, the development of society, along with shifting work patterns and societal pressure to follow cultural and religious norms, has devalued breastfeeding. This is true even in urban areas. Although Nepal has a relatively small urban population, campaigns targeted at urban mothers are essential. According to the Nepal Demographic and Health Survey 2011, while breastfeeding within an hour of birth was more common in urban areas (51 percent) than in rural areas (44 percent), exclusive breastfeeding for more than six months was comparatively lower with urban mothers.

 
In the first hours and days after childbirth, a mother produces the first milk, called colostrum—the most potent natural immune system booster known to science. Mothers in rural areas usually throw away this first milk due a deep-rooted generations-old belief that it contains harmful substances. In fact, colostrum is rich antibodies and immune system-boosting cells that make it more difficult for bacteria and allergens to attack the newborn. An infant given breast milk within an hour of birth is up to three times more likely to survive than one breastfed a day later. However, this rudimentary belief is still in vogue in many parts of the country due to a lack of public health workers and proper birthing facilities.

A recent Save the Children report states that health workers are vital in encouraging a mother to breastfeed—even before birth and especially in the first hours and days of an infant’s life. Analysis of data from 44 countries found that the presence of a skilled birth attendant increases the likelihood that an infant will be breastfed immediately and exclusively for six months. Women who had skilled attendants present at birth were twice as likely to initiate breastfeeding within the first hour.

While it is true that fewer mothers in rural areas breastfeed within the first hour of birth due to conventional practices rooted in misinformation, but they breastfeed their newborns exclusively for a longer period. This is quite the opposite with urban mothers, who are left with no choice but to formula feed their newborns due to a lack of proper maternity legislation. The belief that urban mothers have access to information and better public health services is a preconceived notion. When I was expecting, I was never advised to breastfeed exclusively nor given any good reason as to why I should. The importance of breastfeeding immediately became personally scary when I gave birth via Caesarean section and could not produce natural milk. Luckily, my daughter was formula-fed for the first two days. But what about young mothers who give birth in rural areas where they do not have access to such formulas?

Although access to substitute baby formulas saved my daughter’s life, introducing breast milk substitutes to infants before the age of six months can greatly contribute to a failure to breastfeed. Substitutes, such as formulas, other kinds of milk and porridge, are often watered down and do not provide enough calories. Furthermore, possible contamination of these substitutes exposes the infant to a risk of illness. Nepal’s Breast Milk Substitute Act 1992 promotes and protects breastfeeding and regulates the unauthorized or unsolicited sale and distribution of breast milk substitutes. Shouldn’t this information be the mantra of health workers practicing in the best hospitals in the capital?

As a mother from an urban area, I strongly feel that as much as it is important for development practitioners like me to disseminate information on breastfeeding to rural mothers, it is equally important that urban mothers not be left behind. Oftentimes, urban mothers do not automatically breastfeed. Sometimes, she needs to return to work in two months and her doctor still hasn’t advised her on the vital benefits of breastfeeding for the first six months. Urban mothers also have access to all kinds of substitute formulas and do not hesitate to introduce them to newborns.

According to data from a new study carried out in 51 countries by the World Breastfeeding Trends Initiative, exclusive breastfeeding rate averages about 46 percent while breastfeeding within an hour of birth is about 51 percent. East Asia and the Pacific have seen a decline in breastfeeding mothers from 45 percent in 2006 to 29 percent in 2012 while the baby food market is set to grow by 31 percent over the next three years. This is where business interests overpower what should be our natural instinct.

The Save the Children report further states that there are ways to overcome barriers to breastfeeding. Promoting exclusive breastfeeding for urban mothers also lies in the formation of a strong maternity legislation in Nepal. Aiming for a six month maternity leave will not only promote exclusive breastfeeding and save lives but also benefit the country. When working mothers have a stress-free maternity leave, they can breastfeed their newborn exclusively, babies bond with their mothers better and new mothers can balance home and work. Breastfeeding can also combat postpartum depression, which is gaining ground as one of the major killers of women aged 15-25 in Nepal.

As mothers, fathers and citizens of a developing country, it is time we realise that improving breastfeeding rates will have a positive impact on public health. A healthier population means that Nepal will develop better in a progressive manner. By exclusively breastfeeding your child for the first six month, they can gain the best start to life.