Saving lives of newborns by early initiation of breastfeeding & exclusive breastfeeding

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 Saving lives of newborns by early initiation
of breastfeeding & exclusive breastfeeding
Bottle fed babies are seventeen times more likely to 
develop diarrhea as compared to breast fed babies

By Mubarak Ali

KARACHI: After a long struggle Pakistan had been able to frame a national legislation called “Protection of Breastfeeding and Child Nutrition Ordinance” in 2002 but it could not become a law due to lack of interest of the concerned authorities. The results of prolonged legal inactivity had gone in the favor of exploitative forces and an uninterrupted marketing of breast milk substitutes playing havoc with the life of our children. This was stated by Prof. D.S. Akram, Chairperson of Health, Education & Literacy Programe (HELP) while speaking at an advocacy seminar on saving lives of newborns by early initiation of breastfeeding and exclusive breastfeeding. The seminar was organized by Health, Education and Literacy Programme (HELP) and the South Asian Infant Feeding Research Network (SAIFRN) at a local hotel here on January 11, 2013.
Continuing Prof. D.S. Akram said that the main regulator, Infant Feeding Board announced by the Federal Government in 2006 completed its term without any progress. The worst thing happened in the shape of devolution requiring the transfer of health sector activities to the provinces, she added. The ordinance had become a meaningless exercise in the absence of required validation by the concerned authorities while the provinces, excluding Punjab, were also ignoring the issue of promulgation of a new ordinance. Prof. D. S. Akram urged the Government to adopt and implement Ordinance on ’Protection of Breast feeding and Young Child Nutrition’ passed in 2002 to stop unchecked marketing of breast milk substitutes.
Mr. Saleem Abbasi from SAFRIN speaking about determinants of infant feeding practices in Pakistan said that Infant and Young Child Feeding (IYCF) indicators in Pakistan are undesirably low and need to be improved. It needs an integrated approach to IYCF, communication from pregnancy to early infancy. To improve timely initiation and early breast feeding strategies needs to target working women, health facility deliveries including caesarian sections. To decrease bottle feeding practices strategies should target urban women and higher socio economic strata. To improve timely complementary feeding strategies should include better antenatal counseling of rural and marginalized populations, he added.
Dr. Yasmeen Suleman Senior Programme Manager HELP speaking at the occasion said that forty one out of every one thousand babies die in the first month of life. Half of all global under five deaths occur in just six countries including Pakistan. But 10-15% of under five deaths can be prevented by achieving 90% rate of exclusive breast feeding alone. About 22% of neonatal deaths can be prevented by initiating breast feeding in the first hour of life. Pakistan is culturally a breast feeding nation but only 27% of women in Pakistan initiate breast feeding in the first hour of life. Only 37% practice exclusive breast feeding. These figures are one of the lowest in South East Asia. Hospital deliveries result in higher rates of bottle feeding. It has been proven by medical research that there is a 2.6 fold increased risk of infection if initiation of breast feeding is delayed till day two and 3.6 fold increased risk of infections if delayed till day three. Bottle fed babies are seventeen times more likely to develop diarrhea as compared to breast fed babies. Risk of diabetes is 14% higher in women who do not breast feed. Breast feeding reduces obesity thereby lowering risks of heart disease. Breast fed children have better IQ. Women not breast feeding have more frequent pregnancies thereby more prone to illnesses, malnutrition and death, she added.
Dr. Fehmina Arif, Professor of Paediatrics Dow University of Health Sciences, Karachi addressing the participants said that initiation of breastfeeding and risk of neonatal death has strong evidence which shows that risk of death as a result of infection increased as the delay in initiating breast feeding increased. Overall late initiation of breastfeeding is associated with a 2.6 fold increased risk of infection, specifically neonatal mortality. Breastfeeding enables an equal start for children regardless of family income empower women through health and reproductive benefits like birth spacing. It also enables mothers to be self-sufficient in nourishing their infants without expending economic resources on expensive and inferior breast milk substitutes. If all infants had exclusive breastfeeding for six months and continued breastfeeding for one year under five mortality would reduce by about 14%. Depriving an infant of his/her due share of breast milk is the worst kind of child abuse inflicted at the very beginning of life. The infant feeding should not be a matter of trial and error, she concluded.
Mr. Zekarias Getachew, Nutrition Specialist UNICEF, Sindh speaking at the occasion said that UNICEF is supporting the Government in caring of all nutrition interventions for reducing mortality. Behavioral changes, early initiation of breast feeding and exclusive breast feeding plays important role. Method of complementary food is very important. There is no nutrition policy in Pakistan. Joint efforts are needed to make a programme for nutrition policy by policy makers and politicians. Steering committees and technical groups should be established at provincial level for mother and Child Health programme, he added.
Qari Shehryar, a religious scholar addressing the participants said that code of life is Quran and it is very clearly mentioned in Quran that mothers shall give suck to their children for two years to thirty months. Quran also emphasizes on supporting the lactating mothers, he added. Provincial Minister for Rehabilitation Haji Muzaffar Ali Shujra and MPA Pitanbar Sewani attended the meeting and assured an early introduction of the draft bill on promotion and protection of breastfeeding in the Sindh Assembly.

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