Written By: Debjani Arora | Published : August 1, 2018 2:26 PM IST
The benefits of breastfeeding are immense and the sooner it is started the better. But a recent report on breastfeeding released by UNICEF and WHO jointly pointed out that 3 out of 5 babies are not breastfed during the initial hour after birth. Despite there being enough data to suggest that breastfeeding during the first hour after birth helps to improve infant health and curb the mortality rates. With all the knowledge and awareness all around we are still failing to meet the requirements of breastfeeding that would help the infant (and the mother too) in numerous ways.
The UNICEF and WHO report analyzed data from 76 countries to know what delays early initiation of breastfeeding and why too many newborns are left waiting for too long to get started with it. The reasons were trivial but they overshadow the importance of breastfeeding. The most common reasons that delay early initiation of breastfeeding globally are:
Feeding newborns food or drinks, including formula: In many cultures, it is a community practice, including India, where infants are given special foods before the mother's milk. There are certain conventional beliefs that the mother's milk during the initial hours isn't good enough for the infant, which defies scientific rationale and is a myth. But this myth is accepted in most community as a reality. In fact, colostrum produced during the initial hours (and up to a few days after birth) is vital for the baby.
Common practices, such as discarding colostrum, an elder feeding the baby honey or health professionals giving the newborn a specific liquid, such as sugar water or infant formula, delay a newborn's first critical contact with his or her mother, which can lead to problems of latching, nipple confusion making it difficult to establish smooth breastfeeding later.
The rise in elective C-sections: The report shows that in Egypt, caesarean section rates more than doubled between 2005 and 2014, increasing from 20% to 52%. During the same period, rates of early initiation of breastfeeding decreased from 40% to 27%. A study across 51 countries notes that early initiation rates are significantly lower among newborns delivered by caesarean section. In Egypt, only 19% of babies born by C-section were breastfed in the first hour after birth, compared to 39% of babies born by natural delivery. While many hospitals encourage a mother to breastfeed a baby despite a c-section, not all healthcare centres are game for it. In India, many hospitals have initiated kangaroo care to help c-section mothers get started with breastfeeding right after the surgery.
Gaps in the quality of care provided to mothers and newborns: The presence of a skilled birth attendant does not seem to affect rates of early breastfeeding, according to the report. Across 58 countries between 2005 and 2017, deliveries at health institutions grew by 18 percentage points, while early initiation rates increased by 6 percentage points. In many cases, babies are separated from their mothers immediately after birth and guidance from health workers is limited. In Serbia, the rates increased by 43 percentage points from 2010 to 2014 due to efforts to improve the care mothers received at birth. This gap needs to be taken care off because once the baby is separated from the mother after birth it is natural for attendants to feed baby liquids other than breast milk to ease the newborn's hunger pangs. This is why many NGOs are demanding inclusion of doula services or mid-wife services to bridge the gap.
Earlier studies, cited in the report, show that newborns who began breastfeeding between two and 23 hours after birth had a 33% greater risk of dying compared with those who began breastfeeding within one hour of birth. Among newborns who started breastfeeding a day or more after birth, the risk was more than twice as high.
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