National Breastfeeding Week: 1-7August :

Exclusive breastfeeding: strongest predictor of infant survival

by Carol Aloysius

Optimal breastfeeding of infants under 2 years is the greatest potential impact on child survival of all preventive interventions - WHO

Due to the growing concern over misleading labels and advertisements appearing on infant milk substitutes, the World Health Organisation (WHO) met with the world Health Assembly ( WHA) and adopted as a recommendation the International Code of Marketing of Breast Milk substitutes. The Code levies no sanctions, but serves as a foundation upon which individual countries can enact their own legislation according to the Code’s principles. Significantly, it recommends a complete ban on advertisement and marketing of breast milk substitutes. Sri Lanka has also adopted this Code.

One of the most important decisions a new mother needs to make wherever she lives and whatever nationality she belongs to, is, whether or not she should breast feed her baby. While that decision is a personal matter to most (at least in the developed world,) the chances are that the majority of mothers are likely to draw some strong opinions on the subject, from their own families, and even well meaning friends. They argue breastfeeding is a ‘needless waste of time’, given that most new mothers can now have their pick of a range of ready made infant formulae which only required mixing and drinking, with virtually the same effect as giving them mother’s milk!

Yet, studies over the years globally and in Sri Lanka have proved otherwise.

At a discussion held at the Health Education Bureau (HEB) recently, to launch the National Breast feeding Week , a panel of experts unveiled a number of benefits from brestfeeding that both mothers and children could have over a lifetime, while urging mothers not to deprive their children of this precious, natural low cost food. They also lifted the curtain on the hitherto well guarded dangers of artificial formulae which manufacturing companies had hidden from their customers.

The Sunday Observer shares some of the insights with its readers.

Excerpts…

Consultant Community Physician, Family Health Bureau (FHB) Dr Hiranya Jayawickrama said that, subsequent to the eight Millennium Development Goals (MDG) achieved last year, a commitment had been made to achieve seventeen Sustainable Development Goals (SDG) goals to end poverty, protect the planet and ensure prosperity by 2030. “The World Breast feeding Week theme for 2016 is how breastfeeding can be linked to these 17 goals”, she informed, adding that our National Breastfeeding Week was also closely linked to those goals and objectives.

She said breast feeding was a natural and low cost method of feeding babies and children. “It is thus affordable to all mothers irrespective of their economic status. It does not burden the household budget like artificial feeding, hence, contributing to poverty reduction, a goal of SDG.” she observed.

It also met the SDG goal of Zero hunger, since exclusive breastfeeding and continued breastfeeding for two years and beyond, can prevent hunger, under nutrition and obesity, as it provides enough high quality nutrients needed for growing children. urthermore, it ensured the good health and well being of mothers and children- another SDG goal. “Breastfeeding can significantly improve health, development and infant and child survival as well as ensure the well being of mothers”, she emphasised.

Commenting on the benefits for working mothers, she noted, “ Breastfeeding women who are supported by their employers with crèches and a baby friendly environment can enable them to combine breastfeeding and their other work, and will therefore, be more loyal and productive at work”, she pointed out.

Breastfeeding: A Right

“Breast feeding is a Right, both for mothers and their babies”, she emphasized. “It is enshrined in many human rights frameworks and conventions including our own”, she said, adding that national legislation and policies to protect and support breastfeeding mothers and babies were the need of the hour. “There must be proper mechanisms to ensure that these Rights are upheld”, she reiterated.

“It is not easy for a working mother to continue to breastfeed her baby even after she returns to work. But she must put all her effort to make that work due to the overwhelming benefit it gives both, to her and her baby”, Consultant Community Physician Dr Dhammica Rowel, FHB, said in her discussion on how working mothers can optimally breastfeed their babies.” How many mothers know that breastfeeding causes more milk to be produced? A baby needs to suck frequently at the breast so that enough breast milk is produced to meet the child’s needs. Frequent sucking helps to stimulate the production of more milk”, she stressed.

Urging mothers to breastfeed their babies from the moment of birth up to six months and beyond, she said, “Breast milk is all the food and drink a baby needs to grow well. In the early months when the baby is most at risk of diarrhoea and other common infections , it is this precious gift of nature which helps to protect your child and raise his immunity against them.

The protection is greater when it is given exclusively for the first six months “. Bottle feeding on the other hand can lead to serious illness and even fatalities”, she warned.

Asked how the Health Ministry and the FHB which oversee the breast feeding program islandwide helps working mothers to continue breastfeeding even after they go back to work, she mentioned the following inputs: “We conduct antenatal class and antenatal clinics to educate mothers on breastfeeding benefits. In addition, we have Parent Craft classes. The problem is, some mothers rush back to work without waiting for the full lectures and miss out on important points regarding breastfeeding” she lamented. She said, field staff from antenatal clinics made post natal home visits and clinic visits to ensure that newly discharged mothers were continuing to breast feed, if not, why .” Two home visits in the first ten days of delivery is a Must. Mothers are also encouraged to visit the post natal clinic about 6 weeks after delivery. In some of our villages the community has also volunteered to help these mothers who need a great deal of encouragement by forming Mothers support Groups.”

Rejecting excuses of being unable to breastfeed once they have returned to work, she said, mothers can extract milk from their breasts and keep it in the domestic fridge at the right temperature, for even a month.” Never use a bottle. It will confuse the baby and since it is easier for him to drink from a bottle he will stop drinking from the breast. Use a cup that has been kept well cleaned, instead. The ideal cup can hold 50 – 90 ml of milk.

Risks of formalae feeding

Consultant Neonatologist, Neonatologist Unit, De Soyza Maternity Hospital, Dr Nishani Lucas, unveiled a list of 21 dangers of infant formulae, mothers and children face, which has been hidden by infant formulae companies.

The dangers for children included the following: asthma, allergies, ear infections, obesity, iron deficiency anaemia, SIDS (Sudden Infant Death Syndrome, a risk which thankfully is almost non existent in Sri Lanka, she observed, childhood cancers , digestive problems and most common of all, diabetes ( type 1 and 2) , which she said, was now a visible risk among schoolchildren from 10 – 12 years and upwards.

Other risks include; sleep apnea, dental problems and maloccllsions ( irregular teeth). Respiratory infections were also seen more often in formalae fed infants.

“Studies have shown that formulae fed infants suffer more frequently and more severely from respiratory infections both viral and bacterial”, she said. Hypertension was another risk.

“Small for gestation and normal weight infants who gained weight quickly on formula feeding have higher risks of developing hypertension later on in life than breast fed babies, according to proven studies”, she noted.

For mothers who believe they can boost their children’s IQ with those widely acclaimed infant formulae she delivered the following bad news: Formulae fed infants consistently score lower IQ and cognitive tests- once again a scientifically proved fact, she stressed.

Risks for mothers

The risks of formulae feeding are not just for babies but mothers as well, Dr Rowell added.

“When you don’t breast feed , your chances of developing the following conditions increase significantly: diabetes (both gestational as well as type 2), overweight and obesity, osteoporosis, breast cancer, ovarian cancer and uterine cancer, hypertensive and cardiovascular diseases and reduced child spacing resulting in having too many children too soon”.

One of the best-kept secrets about breastfeeding is that, it’s as healthy for mothers as for babies. Not only does lactation continue the natural physiologic process begun with conception and pregnancy, but it provides many short and long-term health benefits.

These issues are rarely emphasized in prenatal counselling by health care professionals and all but ignored in popular parenting literature.

Advertising continues unabated even though there are laws banning it. We need to strengthen those laws”, the panel of speakers asserted, while welcoming the recent decision by the Health Ministry announced by Director General Health Services Dr P.G. Maheepala to re-impose the existing ban on advertising and marketing of any breast milk substitutes.

Their message to mothers?

“Give your child breast milk which is the best, safest and most nutritional food from birth, for a good start in life”.