Most Babies Not Breastfed In Their First Hour | 08 Aug 2018

The 5th Report of Assessment of India’s Policy and Programmes on Breastfeeding and Infant and Young Child Feeding, 2018, was recently released.

• The report has been prepared by a national consortium of public health groups and agencies including government departments, AIIMS and UNICEF, under the aegis of World Breastfeeeding Trends Initiative (WBTI).

Key Findings

• India performs better in terms of infant and young child feeding practices scoring 34 out of 50 on five parameters.
• 6 out of 10 babies born in the country are not able to begin breastfeeding within one hour of birth despite an improvement in institutional deliveries.
  • This is due to a lack of supportive work environment, inadequate skills of health care providers as well as caesarean deliveries.
• The study gives India a score of 45 out of 100 on 10 parameters under the category of policy and programmes.
• India has made some progress over the years and between National Family Health Survey NFHS-3 (2005-06) and NFHS-4 (2015-16), early initiation of breastfeeding has improved from 23.4% to 41.5% children breastfed within one hour of birth. However, this hasn’t kept pace with the increase in institutional deliveries which more than doubled during the same period.
• The report notes that the the Ministry of Health and Family Welfare and the Ministry for Women and Child Development have taken several initiatives on infant and child nutrition but have not adopted an overall official policy, which is hindering action plans and budgets.
• The replacement of the Baby Friendly Hospitals Initiative, which is a worldwide programme of WHO and UNICEF, with the health ministry’s programme called Mother’s Absolute Affection is problematic.
  • The health ministry programme does not provide accreditation to hospitals that are baby friendly and is not applicable to private sector institutions where a large percentage of deliveries and caesarean sections take place.
• India has slipped in regulating the marketing of breastmilk substitutes since the last assessment. The companies are marketing breastmilk substitutes more aggressively since monitoring of the law is weak.
  • Although, India has had a strong law on infant milk substitutes since 1992, it does not have authorised government officers and is dependent on NGOs to check if the law is being followed.
  • Legislative proceedings against violators have also not been quite upto the mark.
• India has performed badly in other key indicators like support for mothers and community outreach, disseminating information on infant and child feeding, feeding children with HIV and feeding children during emergencies.
• India has made significant progress in maternity protection. The Maternity Benefits Act, 2017 passed by the government which increased the maternity leave for women from 12 weeks to 26 weeks, has contributed to it. However, this law does not cover the large number of women who work India’s informal sector.

Significance of Mother’s Breast Milk

• Mother’s breast milk within one hour of birth ensures that the infant receives the colostrum or first milk, which is extremely rich in nutrients and antibodies.
• The WHO and UNICEF also recommend exclusive breastfeeding for infants up to the age of six months and thereafter complementary foods with continued breastfeeding up to 2 years of age or beyond.
• Other than health benefits to children, breastfeeding also reduces the risk of breast and ovarian cancer in the mothers and protects the baby from risks of future obesity and diabetes in children.

Way Forward

• To improve nutrition standards, India needs to elevate its Infant and Child Feeding guidelines to policy.
• The government should also effectively enforce the Infant Milk Substitutes Act with better monitoring and action against violators. The Act calls for specific attention to the Maternity Benefit Act to support women in the informal sector and universal application of the Pradhan Mantri Matritva Vandana Yojana.