With around 7.8 lakh newborns dying in the first 28 days, India has the highest number of newborn deaths in the world. Of every 1,000 children born in India, 41 infants do not live to see their first birthday. Infant mortality rate—the number of infants dying before the age of one per 1,000 live births—is considered to be an index of social and economic progress. The government, no doubt, is worried. “We have tried to improve, but the number of deaths has not come down,” said Prime Minister Narendra Modi in his recent 'Mann Ki Baat' radio address.
Sadly, most of these deaths could have been prevented. According to health experts, breastfeeding alone can bring down the number of infant deaths. “Fifty per cent of infant deaths in the country are due to respiratory infections and diarrhoea,” says Dr Chitra Nagaraj, a Bengaluru-based certified lactation expert. “Breast milk has antibodies to protect the baby against these common diseases. So, mothers should be encouraged to breastfeed their babies exclusively for six months, which, in turn, will help reduce infant deaths in the country.” The government’s proposal to increase maternity leave to eight months, she says, is a welcome step.
A 2013 study published in The Lancet says exclusive breastfeeding can be more effective than improved sanitation in combating child deaths and diseases in developing countries. In its recent nutrition series, it also states that babies who are exclusively breastfed are 14 times less likely to die in the first six months than their counterparts who have not been breastfed.
Studies, however, indicate that only 29 per cent of babies in urban India are breastfed within the first hour of birth; it is worse in rural areas—only 21 per cent. A study by Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, among 878 first-time mothers found that less than 40 per cent of the babies were breastfed for six months or more. Not that mothers aren't aware of the benefits of breastfeeding. Take, for instance, Jyothika S., an anthropology lecturer at M.G. University, Kerala. She had to introduce formula food for her babies soon after they were born as she didn’t have enough breast milk. “My boys used to be hungry all the time and I would feel so helpless,” she says. Most working mothers face this problem.
Night feeding could be a solution as Nagaraj says the hormones that promote the production of breast milk are secreted more at night. But it could still be challenging for working mothers as they would have to stay up all night, leaving them tired the next day. Also, women can express milk and leave it in the refrigerator while they are at work, says Dr Prashanth S. Urs, senior consultant neonatologist, Apollo Hospitals, Bengaluru.
Women who have children late in their lives find it difficult to breastfeed in the first hour after birth. “Many of these pregnancies have a lot of complications,” says Nagaraj. “So, the baby might be kept in an ICU and exclusive breastfeeding doesn’t happen. Since sucking, which is required to initiate lactation, doesn’t happen, the milk production goes down.” It is more of a demand-supply scenario. “If the demand is more,” says Nagaraj, “the feedback will go to the brain and the milk produce will be more.”
Some names have been changed.