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Why India fails to be a breastfeeding nation

Breastfeeding is important. Credit: 123rf
Image credit: DFID – UK Department for International Development [CC BY 2.0 (https://creativecommons.org/licenses/by/2.0)]
India is failing to be a breastfeeding nation – potentially putting the lives of its newborns at risk.

Just 41.5 percent of newborns in India are breastfed within an hour of being born. This is according to new data released by UNICEF and the World Health Organization (WHO), ahead of World Breastfeeding Awareness Week this year.

On breastfeeding, India fares poorly compared to developing countries like Malawi. There, more than eighty percent of newborns are breastfed in the first hour of their life. 

“Just 41.5 percent of newborns in India are breastfed within an hour of being born”

‘Early initiation’ of breastfeeding is particularly important for child health. “Breastmilk…is extremely rich in nutrients and antibodies,” the WHO says, calling it “the baby’s ‘first vaccine’”. As such, it protects against a range of both infectious and chronic conditions, including pneumonia and diarrhoea – among the biggest killers of children under five.

Better breastfeeding practises in India could save the lives of almost 100,000 children every year and save the country fourteen billion USD in healthcare costs, according to a report published last year. Despite these benefits, the country continues to fall short in this regard.

India’s breastfeeding scorecard reflects the absence of an ‘enabling environment’ for breastfeeding, with inadequate donor funding for breastfeeding programs; the absence of ‘baby-friendly hospitals’ and maternities; and inadequate legislation providing for maternity leave of at least twelve weeks. The same issues were brought up in last year’s report.

The WHO recommends that a child be exclusively breastfed in the first six months of their life, followed by mixed feeding until the age of two. This reaps health benefits not only for the child but also for the mother. For mothers, breastfeeding lowers the risk of diabetes, breast, ovarian and uterine cancer, and postpartum depression.

Infant formula lacks nutrients contained in breastmilk.

“Better breastfeeding practises in India could save the lives of almost 100,000 children every year”

One area where India has been said to excel in the past is its laws restricting the marketing of breastmilk substitutes. However, the country is not wholly free of the influence of the infant formula industry – one which analysts project to be worth more than 66 billion USD by the end of 2027.

It is still possible for free samples of infant formula to find their ways to Indian mothers and children, including in healthcare facilities. Breastmilk substitutes, meanwhile, do not have to carry a recommended age of introduction. There is also no ban on health and nutritional claims idealising substitutes.

India further suffers from inadequacies in its public health system. This can make it difficult for mothers to avail support and guidance on breastfeeding their child. Education and awareness campaigns about the benefits of breastfeeding are also lacking.

Breastfeeding rates in India are on the increase – including in that pivotal first hour after birth. Early initiation covered just 23.1 percent of newborns 2005, compared to 41.5 percent a decade later. Yet there is clearly more work to do to bring India into step with global standards.

India is far from being alone in this. No country meets the minimum support guidelines for breastfeeding outlined by UNICEF and the WHO. What is needed – both in India and globally – is the right amount of investment into ensuring awareness is raised and that mothers can avail the appropriate support and treatment can be availed. If this is the case, the health benefits of breastfeeding can be realised by both India’s newborns and their mothers.

The WHO/UNICEF report can be accessed here.

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