Breastfeeding A key to Sustainable Development
It was a beautiful Thursday morning and 27-year old Angie had just given birth to her second child at the hospital. Her bundle of joy was beautiful. She came out pink and crying and was placed on her chest straight away. Tears of joy rolled down Angie’s cheeks as she was so happy to have a baby girl. Her husband who had been with her throughout was also very delighted. The midwife attached the baby to the breast and she started feeding straight away. Angie had no issues with breastfeeding and continued to breast feed little Isabella exclusively for the first 6 months of life as she had a flexible job and was able to work from home. In the room next door to Angie was 15 year old Mela who gave birth to her first baby, a boy. Mela had an unwanted pregnancy. She did not realise that she was having a baby until she was four months pregnant. She was attending school and was involved with a boy who was new to the school. She hadn’t realise that pregnancy was possible. She hid it from her parents for as long as she could but eventually they found out and so did the school teachers and other students. After going through a traumatising experience giving birth, Mela had no desire to see her baby. The nurses tried to attach the baby to the breast, but Mela refused. She was teary throughout, abandoned by the 16 year old father of the baby and estranged from her family. She decided to give the baby up for adoption. The baby had to be formula fed as Mela was extremely depressed, required antidepressants and counseling and unable to deal with this experience at such a young age. On the other side of town was Rani, 34 year old who had given birth three months earlier. She was breastfeeding her baby boy very well and he was thriving. Rani had to return to work and her workplace did not allow her to bring her baby, so she was unable to continue breastfeeding. Rani tried to express milk for the day, but it was difficult for her so she had to supplement the expressed milk with formula feeding. These situations are common in everyday life and millions of women throughout the world struggle to breastfeed their baby till six months of age. Many people do not realise the challenges women have to endure in the postpartum period. It is overwhelming looking after a little being that depends on you completely. Unfortunately babies do not come with an instruction manual and it’s an extremely challenging situation, especially with the first baby. There is the added challenge of continuing work and breastfeeding in an environment that may not be supportive. Society has many expectations of new mothers, and the question we must pose is: are we creating a supportive environment for mothers to sustain breastfeeding? How can we help? World Breastfeeding Week is celebrated every year from 1 to 7 August to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration signed in August 1990 by government policymakers, WHO, UNICEF and other organizations. Breastfeeding is the best way to provide infants with the nutrients they need. The World Health Organization (WHO) recommends exclusive breastfeeding starting within one hour after birth until a baby is six months old. Nutritious complementary foods should then be added while continuing to breastfeed for up to two years or beyond. More than 120 countries across the world get involved in the celebration and this year’s theme is “Breastfeeding: A key to Sustainable Development”. World breastfeeding week is a time to galvanize a variety of actions and engage with a wide range of stakeholders around the promotion, protection and support of breastfeeding. Breastfeeding lays the foundation for good health for all children both in the short and long term, while also benefitting mothers. New evidence confirms that optimal breastfeeding could save 823,000 child lives from acute and chronic disease, save 20,000 mother lives from breast cancer and add $302 billion to the global economy annually. (Lancet) For the past two decades, global breastfeeding rates have remained stagnant. Less than 40% of infants under six months of age are exclusively breastfed. There are many barriers that women face when it comes to breastfeeding. These include receiving inaccurate information from health care providers, a lack of lactation support from male partners within the household, and little or no access to skilled breastfeeding counseling. Breastfeeding is linked to the sustainable development goals. The world Alliance for Breastfeeding Action (WABA) shows four thematic areas which have the strongest links to breastfeeding: Nutrition, Food Security and Poverty Reduction; Survival, Health and Wellbeing; Environment and Climate Change; and Women’s Productivity and Employment. While looking at nutrition, food security and poverty reduction, it can be said that breastfed infants are provided with optimal nutrition and protection against diseases. Even in times of humanitarian crisis, breast milk is a safe and secure form of food. Breastfeeding is a low cost way to feeding babies without burdening the household budget. While looking at survival, health and wellbeing, it can be said that breastfeeding significantly improves the survival of infants, children and mothers and also improves the health,
development and wellbeing in the short and long term. Evidence suggests that babies who are breastfed have a 2.6-point higher IQ than non-breastfed babies. Breast milk is a natural renewable food that is environmentally safe, produced and delivered without pollution, packaging or waste. On the other hand, formula production and consumption generates greenhouse gas emission, which accelerates global warming. While looking at women’s productivity and employment, employers certainly benefit from having a more contented and productive workforce due to less absenteeism, increased loyalty and less staff turnover. Parental protection and other workplace policies can enable women to combine breastfeeding with paid work. Only 53% of the countries meet the international labour organization 14-week minimum standard for maternity leave. In Fiji we also need a focused campaign targeting mothers and families as well as employers who may need to embrace and encourage breastfeeding for their employees. Adequate maternity leave entitlements, workplace interventions, counseling and educational programs can help improve breastfeeding rates. Reaching the global breastfeeding target will require rapid progress, but experience shows that rates can be improved dramatically and quickly. In Cambodia, imaginative and sustained mass media campaigns saw the rate of exclusive breastfeeding for infants under six months increase from 11% in 2000 to 74% in 2010. Mothers are two and a half times more likely to breastfeed when the practice is protected, promoted and supported. This requires targeted interventions through education and health services, such as accurate information and breastfeeding support from health staff or peers. However, beyond health interventions, it requires a political and societal shift, for example adequate maternity protection policies, and breast-friendly workplaces and public spaces. Organizations need to review and seek to continuously improve their support systems and policies. Governments also have a critical role including regulating the breast-milk substitute industry. So what can we do as individuals to help? At the individual level, think twice before you judge a woman breastfeeding her baby in a public place. Many women feel very uncomfortable when people make nasty comments and judge them for breastfeeding in public. If you really think about it, we all eat at restaurants and public places. Then why should the poor baby go hungry? As a society, we have a duty to ensure that breastfeeding is encouraged, supported and celebrated. Beautiful words by Francis and Mulford “Human milk is not skimmed, processed, pasteurized, stored, transported, repackaged, dried, reconstituted, sterilized, or wasted…It requires no fuel for heating, no refrigeration, and is always ready to serve at the right temperature. In short, it is the most environmentally friendly food available.” (Francis and Mulford 2000). Till we meet next month, stay calm and breastfeed- There is love in every drop!
“If you really think about it, we all eat at restaurants and public places. Then why should the poor baby go hungry?”
DR. KRUPALI RATHOD TAPPOO is an Australian qualified General Practitioner, a Fellow of the Royal Australian College of General Practitioners and the Medical Coordinator for Fiji-based NGO Sai Prema Foundation. Dr. Krupali is based at Mitchells Clinic in Tappoocity Suva and has a special interest in women and children’s health.