Work, myths, markets: What's behind India's declining exclusive breastfeeding?

During the National Family Health Survey NFHS6 survey period 956 per cent of infants under six months were being breastfed which indicates that breastfeeding remains nearly universal in IndiaHowever if exclusive breastfeeding EBF under six months has declined it suggests that more infants are receiving additional foods or liquids along with breast milk before completing six monthsAccording to recent family health surveys there is a decline in breastfeeding in India which is quite paradoxical because there has been a major improvement in the maternal mortality rate because of institutionalisation of childbirth Now why this is happening is probably because the urban caesarean deliveries have increased and hence early initiation of breastfeeding doesnt happen very easily There is a commercial influence on baby food said Dr Abha Majumdar Centre of IVF and Human Reproduction Sir Gangaram HospitalThere is so much baby food available and there are campaigns which sort of undermine breastfeeding practices by saying that formula feeding is the best for the baby And the largest reason is that maternity leave is very limited in India and in some places it may be as little as one month to as much as three months And hence many working mothers face limited maternity leave lack of designated lactation spaces at workplaces and then the family support is also not so much there Dr Abha explainedSo either they express breast milk refrigerate it and leave it for people at home to feed the baby and slowly slowly this becomes very cumbersome and hence they fail to breastfeed the baby beyond the time they have exclusively been with the baby that is for the initial two three months after which the work takes priority in their lives she addedAccording to Dr Sheetal Agarwal consultant Senior Gynaecologist and Obstetrician Rainbow Hospital said The main reason is lack of workplace support with short maternity leave Lactation failure in mothers is mainly due to stress and pain due to mastitis and sore nipples thereby discouraging the mother to breast feedHowever breastfeeding remains widespread and almost all infants continue to receive breast milk Awareness about the importance of breastfeeding appears to be high in some states like Sikkim which registered the biggest improvement rising from 283 per cent to 496 per cent Kerala 555 per cent to 727 per cent which is one of the highest ratesIn Jharkhand the proportion of children under six months who are currently breastfeeding increased from 958 per cent to 964 per cent while in Karnataka it rose from 924 per cent to 938 per cent and exclusive breastfeeding increased slightly from 61 per cent to 616 per centHowever in some states such as Assam exclusive breastfeeding has declined while the proportion of children under six months who are currently breastfeeding has increased significantly to 98437 which is the highest from 954 per cent in NFHS 5Exclusive breastfeeding practices have also declined in Arunachal Pradesh although the proportion of children under six months who are currently breastfeeding has increased significantly from 865 per cent to 951 per cent overall Similarly Bihar has shown an improvement in exclusive breastfeeding rising from 589 per cent to 625 per cent while current breastfeeding among children under six months has also increased from 949 per cent to 969 per centA growing proportion of infants are being given water animal milk formula honey gripe water or complementary foods before six monthsThis reduces the share of exclusively breastfed infants even though they are still being breastfed The challenge is not initiation but adherence Mothers are continuing to breastfeed but many are not following the WHO recommendation of giving only breast milk for the first six monthsPossible reasons for the decline in EBF are increased use of formula or packaged infant foodsEarly introduction of complementary feeding due to cultural practices Return of mothers to work and inadequate maternity support Misconceptions that breast milk alone is insufficientPolicy implication programmes should focus not only on promoting breastfeeding but also on promoting exclusive breastfeeding for the first six months along with counselling families and caregivers say expertsDr Sandeep Chadha senior gynaecologist and obstetrician Cloudnine Noida says Patient doesnt want to do exercise at all during pregnancy and doctors also dont motivate for a normal delivery Most of the time due to a Csection mothers avoid feeding In some cases when a baby is hungry even after being fed family members start giving top feeding which is also a big problem Both the mother and the doctor should make effortsThe percentage of children under the age of six months currently breastfeeding in Goa remains the same 100 per cent Haryana recorded the steepest decline with exclusive breastfeeding dropping from 695 per cent to 412 per cent while Uttar Pradesh saw a decline from 597 per cent to 346 per centWorking parents want the baby not to be dependent only on their feed Increasing choice of formula feeds and ease of administration through feeder bottles An increasing number of cases with delayed ambulation of the patient said Dr Richa Singhal senior consultant Cloudnine Hospital New DelhiAccording to Dr Rahul Verma Director of Paediatrics and Neonatology at Sir HN Reliance Foundation Hospital Mumbai to turn this around we have to act across three distinct levelsAt the national level we need strict zerotolerance enforcement of the Infant Milk Substitutes IMS Act to clamp down on the aggressive digital marketing and indirect promotion of baby formula Paid maternity leave also needs to be expanded and strictly implemented across both the formal and informal sectors so working mothers actually have the time to breastfeedAt the institutional level hospitals and clinics cannot just celebrate a safe delivery and send the mother home Postnatal care must include structured mandatory lactation counselling that involves the family not just the mother Doctors and nurses need to actively counsel grandmothers and husbands during prenatal and postnatal visits educating them on baby cues normal crying patterns and how to track wet diapers to prove the baby is getting enough milk This directly disarms family pressure with scientific factsAt the individual and household level we have to shift the burden off the mother alone Families need to realise that the best way to increase milk supply is to reduce the mothers stress Instead of questioning her milk supply family members should take over household chores manage visitors and give the mother a peaceful environment to bond with her babyTo manage anxiety mothers should be encouraged to practice skintoskin contact which naturally boosts the hormones responsible for milk production and feel empowered to say no to unsolicited adviceThis story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliability and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever