With World Breastfeeding Week just behind us, and the news that Sri Lanka is now ranked as one of the best in South Asia for exclusive breastfeeding coverage there is renewed interest in promoting breastfeeding isand-wide and achieving 100% coverage within a short period.
To this end, the Health Ministry is currently conducting several awareness raising programs among mothers, midwives, parents and medical officers while ensuring that all its Health outlets provide counselling, and proper guidelines to mothers to be, as well as new mothers on how to breastfeed their babies.
Family Physician, Health Ministry Dr Ramya L. Premaratne who feels there is still inadequate knowledge among mothers on the benefits of breastfeeding, tells the Sunday Observer why exclusive breastfeeding is important for a child’s growth for six months and beyond.
Excerpts…
Q. World Breastfeeding Week concluded recently. Why is a whole week set aside for breastfeeding awareness?
A. To encourage breastfeeding and improve the health of babies, and to protect, promote and support breastfeeding.
Q. Why is breast milk important to the newborn?
A. Because it is the only complete meal for a newborn baby, providing all the nutrition he/she needs for the first six months of his /her life. Adequate nutrition during infancy and early childhood are essential to ensure proper growth and development. Breastfeeding has short-term and long-term benefits on both child and mother. It helps in the protection of children against a variety of acute and chronic disorders by strengthening the immune system.
Q. What is the most significant benefit of exclusive breastfeeding for six months?
A. Protection against gastrointestinal infections which most newborn babies are vulnerable to, especially, if they are bottle fed.
Q. What makes breast milk unique from any other milk given to babies? Elaborate
A. Breast milk has the perfect combination of proteins, fats, vitamins, and carbohydrates.There is nothing better for the health of your baby. To list some examples :
- Human milk contains two types of proteins: whey and casein. Approximately 60% - 80% is whey protein, while 40% is casein. This balance of the proteins allows for quick and easy digestion. Artificial milk, also called formula, has a greater percentage of casein and would be more difficult for the baby to digest. These proteins have great infection-protection properties. Lactoferrin inhibits the growth of iron-dependent bacteria in the gastrointestinal tract such as coliforms and yeast, that require iron.
- Some immunoglobulins such as Ig A, Ig G and Ig M, in breast milk help to protect against bacterial and viral infections
- Lysozyme is an enzyme that protects the infant against E Coli and Salmonella. It also promotes the growth of healthy intestinal flora and has anti-inflammatory functions.
- Bifidus factor supports the growth of lactobacillus. Lactobacillus is a beneficial bacteria that protects the baby against harmful bacteria by creating an acidic environment where it cannot survive.
- Human milk also contains fats essential for the health of your baby. It is necessary for brain development, absorption of fat-soluble vitamins, and is a primary calorie source. Long-chain fatty acids are needed for brain, retina, and nervous system development.
Q. What about vitamins?
A. The amount and types of vitamins in breast milk is directly related to the mother’s vitamin intake. This is why it is essential that she gets adequate nutrition, including vitamins. Fat-soluble vitamins, including vitamins A, D, E, and K, are all vital to the infant’s health. Water-soluble vitamins such as vitamin C, riboflavin, niacin, and pantothenic acid are also essential.
Q. Carbohydrates ?
A. Lactose is the primary carbohydrate found in human milk. It accounts for approximately 40% of the total calories provided by breast milk. Lactose helps to decrease a large number of unhealthy bacteria in the stomach, which improves the absorption of calcium, phosphorus, and magnesium. It helps to fight disease and promotes the growth of healthy bacteria in the stomach.
Q. Any other unique ingredients in breast milk?
A. Leukocytes are living cells that are only found in breast milk. They are antibodies. They help fight infection. Living cells, enzymes, and hormones make breast milk ideal. These cannot be added to the formula.
Q.The WHO and UNICEF has recommended that babies should be fed with only breast milk for the first six months of their lives. What is the percentage of Lankan women who exclusively breastfeed their babies for the entire six months? Any national studies done recently to find out how many new mothers are doing this? What are the results of such a study?
A. A clinic based cross-sectional study was conducted from August to November 2016, in six randomly selected Medical Officer of Health areas in the Kandy District. The sample was selected proportionate to the population of each MOH area and 354 mothers with infants aged 6 months, attending the child welfare clinics were recruited. Data were collected by an interviewer administered questionnaire using mother recall data since birth. A focus group discussion was conducted on 21 mothers who discontinued exclusive breastfeeding early. The infant taking only breast milk and no additional food, water, or other fluids with the exception of medicines and vitamins or mineral drops for the first 6 months was used as the definition of exclusive breastfeeding.
The Results showed prevalence of exclusive breastfeeding for 6 months was 50.8% (180/354) while the median duration was 6 months.
Q. What factors prompted mothers to give up exclusive breastfeeding earlier than the six months recommended?
A. Mothers who were employed and having to return to work at the end of their three months maternity leave.
Those with poor knowledge on the benefits of exclusive breastfeeding.
Mothers with wrong attitudes towards exclusive breastfeeding.
Early marriage of parents, less educated parents, male child, religious beliefs, working mother, less number of antenatal visits, operative delivery, late initiation of breastfeeding, not feeding colostrum, lack of knowledge about EBF ( Early Breastfeeding) , and poor counselling of mother regarding EBF were identified as barriers to EBF.
Other factors included : Insufficient breast milk, mother’s lack of understanding of the benefits of breastfeeding (often think Formula has more Nutrition with Vitamins added), not receiving antenatal health education, pain and discomfort during BF and being discharged within 24 hours after delivery without proper education on breastfeeding.
All these factors were independently associated with early cessation of exclusive breastfeeding.
Q. What do these results prove and how can they be resolved?
A. It proves the lack of awareness on breastfeeding and its benefits. There is a need for proper information and counselling on breastfeeding during antenatal visits to inform mothers regarding proven facts of the advantages of breastfeeding. Even though many women attended their antenatal visits, hardly a few had received counselling services or advice on breastfeeding. Strategies should be developed, and health education provided about the importance of breastfeeding. Antenatal women are the future mothers, who need to be targeted to bring about a positive change in the awareness of breastfeeding.
Q. In this respect, how relevant is the WHO & UNCEF theme of this year’s World Breastfeeding Week: “Empower Parents, Enable Mothers” to Lankan mothers?
A. This year, WHO is working with UNICEF and partners to promote the importance of family-friendly policies to enable breastfeeding and help parents to keep bond with their children in early life. This includes providing paid maternity leave for a minimum of 18 weeks, and paid paternity leave to encourage shared responsibility of caring for their children on an equal basis. Mothers also need access to a parent friendly workplace to protect and support their ability to continue breastfeeding upon return to work by having access to breastfeeding breaks; a safe, private, and hygienic space for expressing and storing breast milk; and affordable childcare.
Q. It is said that the longer a child is breastfed the more he is able to get optimal benefits. How? To what age should a child be breastfed?
A. Breast-milk is also an important source of energy and nutrients in children aged 6–23 months. It can provide half or more of a child’s energy needs between the ages of 6 and 12 months, and one third of energy needs between 12 and 24 months. Breast-milk is also a critical source of energy and nutrients during illness, and reduces mortality among children who are malnourished. Longer durations of breastfeeding also contribute to the health and well-being of mothers: it reduces the risk of ovarian and breast cancer and helps space pregnancies–exclusive breastfeeding of babies under 6 months has a hormonal effect which often induces a lack of menstruation. This is a natural method of birth control (known as the Lactation Amenorrhoea.)
Q.Your message to new mothers?
A. Breast milk is loaded with antibodies that help your baby fight off viruses and bacteria. It has been proved that Children and adolescents who were breastfed as babies are less likely to be overweight or obese. Additionally, they perform better at intelligence tests and have higher school attendance. So start breastfeeding your child from day one within one hour of birth.