Breast­feed­ing A key to Sus­tain­able De­vel­op­ment

mailife - - Health -

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.

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