By Dr Nandkumar Kamat
In this topic I can share my own experience as a father. My wife breastfed our son for three years. It was her own decision on the basis of her studies on the wonderful benefits of human milk. We have seen the positive results - a normal, happy, healthy, intelligent, energetic and creative child, full of zest, who has forgotten art of crying at the slightest pain or injury.
Prolonged breastfeeding makes the child strong, intelligent and resilient. A well breastfed child, as we observed, has no food fads. My son eats everything we eat. And he often demands traditional Goan items like fish curry and rice. Breastfeeding removes all food allergies. The human colostrum – the first exudate after delivery - has been found to be the most complex and miraculous mixture in the universe. It is a life giving cocktail of hormones, proteins, enzymes, antibiotics, probiotics.
Mothers who fail to give colostrum to babies create many health problems. World Breastfeeding Week (August 1-7) is celebrated on a very low key in Goa. Government has laid extraordinary stress in forcing the toxic iodized salt in market. The iodized salt producers have hidden information about stabilizers like paraffin wax, carbonates and silicates.
The Goa Government has hidden the fact that the iodine content in local salt is sufficient for us (16 to 50 ppm) and that it is very stable on cooking and that the best source of natural iodine is the locally produced salt from Curca, Bhatim and Tiswadi. Clinching analytical evidence on the favourable nutritional content and sufficient iodine content in Goa’s locally produced salt has been found by Dr Savita Kerkar at the Goa University. Pregnant and lactating mothers need to be careful about iodized salt if they switch over from traditional local salt, which has many medicinal uses.
Governments do not always tell the truth. The same is applicable when World Breastfeeding Week begins. Goa is not a state friendly to lactating mothers and breastfeeding infants. The WHO data bank on infant and young child feeding for all states in India shows that only in 60 per cent of the cases is breastfeeding initiated early and infants are exclusively breastfed for only 15 days. These are results from the National Family Health Survey (NHFS), 2005-06.
The draft population policy of Goa, 2007 says this on infant feeding practices: ‘Most births (95 per cent) in Goa take place in health institutions. Even among these births, only 35 per cent started breastfeeding within one hour of birth. A higher proportion of children delivered in public health facilities started breastfeeding within the first day of life (70 per cent) than children delivered in private health facilities (61 per cent). 47 per cent women squeezed the first milk from the breast before they began breastfeeding as against 63 per cent for all India."
A 14 percentile gap as compared to all India average is shocking, especially in a wealthy and literate state. In a sense the state government has admitted that Goa is a state which does not promote colostrum feeding. This would increase the disease burden and benefit only the health sector.
The infant entitled to life saving colostrum would become dependant on hospitals for ailments, which are otherwise prevented by that magic cocktail. The health department also reveals that in this wealthy and educated state: ‘29 per cent of children under 3 years of age are under weight and 18 per cent are stunted.’ It is not difficult to see the reasons -bad maternal health and low emphasis on breastfeeding. No wonder such children deprived of prolonged breastfeeding turn anaemic. And this is precisely what is happening in Goa.
The health department has admitted that ‘In Goa, as per NFHS-2, 53 per cent children age 6-35 months have some level of anaemia, including 24 per cent who are mildly anaemic, 28 per cent who are moderately anaemic and 2 per cent who are severely anaemic. Notably, a much larger proportion of children (53 per cent) than women (36 per cent) are anaemic in Goa.’ There is less emphasis on promotion of anaemia preventing iron nutrition, supplements and amendments, fortifications as compared to forcing unsuspecting kids to consume iodized salt.
There is total ignorance among the teenagers, the parents of tomorrow, on the benefits and essentiality of breastfeeding. This is the appropriate time to focus on the wonders of breastfeeding because the state government and the private health sector has consistently failed to promote the wonders of mother’s milk and make it an integral, uncompromising part of state’s health plans.
Why are public and private hospitals not responding to Baby Friendly Hospital Initiative (BFHI)? It is a worldwide programme by the World Health Organization (WHO) and UNICEF, launched in 1991 following the Innocenti Declaration of 1990. It is aimed at improving the role of maternity services to enable mothers to breastfeed babies. It aims at improving the care of pregnant women, mothers and newborns at health facilities that provide maternity services for protecting, promoting and supporting breastfeeding. Why are fewer children breastfed in private health facilities? The health department of Goa needs to declare the progress on the criteria for BFAI.
Actually, as my own experience shows, it is never followed in both the government and private health sector. The criteria for a hospital’s Baby Friendly Accreditation (BFA) include: 1. Have a written breastfeeding policy that is routinely communicated to all health care staff 2. Train all health care staff in skills necessary to implement this policy, 3. Inform all pregnant women about the benefits and management of breastfeeding 4. Help mothers initiate breastfeeding within one-and-a-half-hour of birth 5. Show mothers how to breastfeed and maintain lactation even if they should be separated from their infants 6. Give newborn infants no food or drink other than breast milk, not even sips of water, unless medically indicated 7. Practice rooming in, that is allow mothers and infants to remain together 24 hours a day 8. Encourage breastfeeding on demand 9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic. The program also restricts use by the hospital of free formula or other infant care aids provided by formula companies.
Society needs to demand a compliance audit of the above from Goa’s hospitals.
