N.S.M. Muzzammel Huq :
Breastfeeding to a newborn child is considered as an unequal ideal food for healthy growth of a child and also an integrated part of the
reproductive process. Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health
it is a global public health
recommendation.
Exclusive breastfeeding from birth is possible except for a few medical conditions and exclusive breastfeeding results in ample milk production. But to meet children’s evolving nutritional requirements, infants should receive nutritionally
adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond.
The expert consultation recommends exclusive breastfeeding for six months with introduction of complementary foods and continued breastfeeding thereafter. The expert consultation recognizes that some mothers will be unable to, or choose not to follow the recommendations: they should be supported to
optimise their infant’s nutrition. The proportion of infant’s exclusive breastfed at six months can be
maximised if potential problems with regard to the following
are overcome:
The nutritional status of pregnant and lactating mothers
Micro nutrient status of infants living in areas with high prevalence of deficiencies such as iron, zinc
and Vitamin ‘A’
The routine primary health care
of individual infants, including assessment of growth and of clinical signs of micro nutrient deficiencies.
In Bangladesh, 4 out of 10 children under the age of 5 are malnourished according to the Demographic Health Survey 2011.The breastfeeding situation in Bangladesh has remarkably improved. Now 9 out of 10 children are being breastfed until age two. Giving only breast milk in the first six months of a baby’s life is rare and the average duration of exclusive breast-feeding is only 3-5 months. Only one in five children
6 to 24 months of age receives a diverse diet with a range of food groups, such as rice, meat or fish, eggs, fruits, vegetables
and breast milk.
Practice of exclusive breastfeeding is strongly recommended by the World Health Organization (WHO). Breast milk is a hygienic source of food with the right amount of energy, protein, fat, vitamins, and other nutrients for infants during the first six months. Breast milk has no substitute. The mother’s milk contains the following important elements: Antibody, Hormones Antivirus, Anti-allergic, Anti-parasitic growth factor, enzyme, minerals, Vitamins, fat, DNA/ RNA, carbohydrate,
protein, water. On the other hand, the power milk available in the market devoid of mineral, Vitamin, fat, DNA/ RNA, carbohydrate, protein and water. This is also a reliable food for infants in an emergency.
Despite awareness of the benefits of exclusive breastfeeding, the actual practice is low. In a recent study it has been revealed that many mothers believe that milk is not found properly, right after the delivery. It leads to late initiation of breastfeeding. Besides many mothers consider colostrums as bad as it looks like pus and don’t give it to their babies. Grandmothers and TBA sometimes restricts babies giving colostrums considering it may upset baby’s stomach.
Though the awareness level of exclusive breastfeeding is great, the practice is not as much. Many
mothers are willing to feed water, honey; sugar lump extract, fruit juice considering these foods as beneficial. Some mothers think or believe that breast milk is not enough to meet a child’s hunger as justification to give extra food. This happens due to lack of proper knowledge about timing of breastfeeding initiation. Now women participation in the socio-economic activities has increased. As a result mothers workload, lack of time or privacy, lack of interest in breastfeeding encourage mothers to switch over to bottle-feeding or
initiation of infant formula. So these mothers should be motivated about the importance of exclusive breastfeeding (EBF) till 6 months. Alongside elder members of the family and husbands must be
motivated to encourage and allow mothers to practice exclusive
breastfeeding.
Rice, fruits, vegetables and animal protein should be given along with breast-feeding after six months for comprehensive growth of children. For exclusive breast-feeding up to six months of infants and sustainability of this for two more years or more along with extra foods, husbands, elderly family members and mothers themselves have an important role. The Family Welfare
Assistants and NGO workers should motivate and sensitise them by organising meetings, discussion
and counselling.
Here communication strategy needs to be developed to make people aware about exclusive breast-feeding. Messages should be developed to make up the knowledge gap related to colostrums and exclusive breast-feeding and also initiation of breastfeeding within one hour of childbirth need to be covered in the messages. These messages should be disseminated through communication campaign. Television programs, short drama, film shows, articles in newspapers, magazines and reading materials, posters, leaflets etc. should be used extensively through illustrations. The needs of the working-women in terms of breastfeeding practice should also be addressed through communication campaigns with employers, senior management and national policymakers.
It may be mentioned that since August 2012, the Government of Bangladesh and UNICEF have been engaging communities for social and behavioural change in 21 upazilas in seven out of the 20 most deprived districts identified by the UN. The aim is to promote key childcare practices and social norm change for improved child well being. It should also be mentioned that for encouraging breastfeeding practice, the Government of Bangladesh has formulated ‘Breast Milk Substitute (BMS) Act’ which prohibited advertisement of alternative baby foods in lieu of mother’s milk. Violation of this act
is punishable under this law.
There are several unanswered questions that are important for
policy making with regard to defining the optimal duration of exclusive breastfeeding and
maximising its benefits.
Therefore, the expert consultation recommends that priority be given to the following to improve precision of estimates and their general
applicability for exclusive
breastfeeding:
Proportion of infants with growth falling and malnutrition at six
and twelve months.
Micronutrient status
Diarrhoea mortality
Neuromotor development
and for the mothers:
Changes in weight,
Lactation amenorrhea.
Identification of biological and social constraints to exclusive breastfeeding up to six months in different geographical and cultural settings, and design of appropriate and effective interventions to deal with the barriers and their
consequences.
Infant feeding is very closely
related with the nutritional aspects of individual social and national development process in the long run. In Bangladesh, more than 75 per cent children are suffering from different types of mal-nutrition. The main cause is poor and unplanned infant feeding.
The role of proper breast-feeding and appropriate complementary feeding can ensure a healthy baby and help to grow up as a physically and mentally strong citizen to play his/ her due role in future. n
Breastfeeding to a newborn child is considered as an unequal ideal food for healthy growth of a child and also an integrated part of the
reproductive process. Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health
it is a global public health
recommendation.
Exclusive breastfeeding from birth is possible except for a few medical conditions and exclusive breastfeeding results in ample milk production. But to meet children’s evolving nutritional requirements, infants should receive nutritionally
adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond.
The expert consultation recommends exclusive breastfeeding for six months with introduction of complementary foods and continued breastfeeding thereafter. The expert consultation recognizes that some mothers will be unable to, or choose not to follow the recommendations: they should be supported to
optimise their infant’s nutrition. The proportion of infant’s exclusive breastfed at six months can be
maximised if potential problems with regard to the following
are overcome:
The nutritional status of pregnant and lactating mothers
Micro nutrient status of infants living in areas with high prevalence of deficiencies such as iron, zinc
and Vitamin ‘A’
The routine primary health care
of individual infants, including assessment of growth and of clinical signs of micro nutrient deficiencies.
In Bangladesh, 4 out of 10 children under the age of 5 are malnourished according to the Demographic Health Survey 2011.The breastfeeding situation in Bangladesh has remarkably improved. Now 9 out of 10 children are being breastfed until age two. Giving only breast milk in the first six months of a baby’s life is rare and the average duration of exclusive breast-feeding is only 3-5 months. Only one in five children
6 to 24 months of age receives a diverse diet with a range of food groups, such as rice, meat or fish, eggs, fruits, vegetables
and breast milk.
Practice of exclusive breastfeeding is strongly recommended by the World Health Organization (WHO). Breast milk is a hygienic source of food with the right amount of energy, protein, fat, vitamins, and other nutrients for infants during the first six months. Breast milk has no substitute. The mother’s milk contains the following important elements: Antibody, Hormones Antivirus, Anti-allergic, Anti-parasitic growth factor, enzyme, minerals, Vitamins, fat, DNA/ RNA, carbohydrate,
protein, water. On the other hand, the power milk available in the market devoid of mineral, Vitamin, fat, DNA/ RNA, carbohydrate, protein and water. This is also a reliable food for infants in an emergency.
Despite awareness of the benefits of exclusive breastfeeding, the actual practice is low. In a recent study it has been revealed that many mothers believe that milk is not found properly, right after the delivery. It leads to late initiation of breastfeeding. Besides many mothers consider colostrums as bad as it looks like pus and don’t give it to their babies. Grandmothers and TBA sometimes restricts babies giving colostrums considering it may upset baby’s stomach.
Though the awareness level of exclusive breastfeeding is great, the practice is not as much. Many
mothers are willing to feed water, honey; sugar lump extract, fruit juice considering these foods as beneficial. Some mothers think or believe that breast milk is not enough to meet a child’s hunger as justification to give extra food. This happens due to lack of proper knowledge about timing of breastfeeding initiation. Now women participation in the socio-economic activities has increased. As a result mothers workload, lack of time or privacy, lack of interest in breastfeeding encourage mothers to switch over to bottle-feeding or
initiation of infant formula. So these mothers should be motivated about the importance of exclusive breastfeeding (EBF) till 6 months. Alongside elder members of the family and husbands must be
motivated to encourage and allow mothers to practice exclusive
breastfeeding.
Rice, fruits, vegetables and animal protein should be given along with breast-feeding after six months for comprehensive growth of children. For exclusive breast-feeding up to six months of infants and sustainability of this for two more years or more along with extra foods, husbands, elderly family members and mothers themselves have an important role. The Family Welfare
Assistants and NGO workers should motivate and sensitise them by organising meetings, discussion
and counselling.
Here communication strategy needs to be developed to make people aware about exclusive breast-feeding. Messages should be developed to make up the knowledge gap related to colostrums and exclusive breast-feeding and also initiation of breastfeeding within one hour of childbirth need to be covered in the messages. These messages should be disseminated through communication campaign. Television programs, short drama, film shows, articles in newspapers, magazines and reading materials, posters, leaflets etc. should be used extensively through illustrations. The needs of the working-women in terms of breastfeeding practice should also be addressed through communication campaigns with employers, senior management and national policymakers.
It may be mentioned that since August 2012, the Government of Bangladesh and UNICEF have been engaging communities for social and behavioural change in 21 upazilas in seven out of the 20 most deprived districts identified by the UN. The aim is to promote key childcare practices and social norm change for improved child well being. It should also be mentioned that for encouraging breastfeeding practice, the Government of Bangladesh has formulated ‘Breast Milk Substitute (BMS) Act’ which prohibited advertisement of alternative baby foods in lieu of mother’s milk. Violation of this act
is punishable under this law.
There are several unanswered questions that are important for
policy making with regard to defining the optimal duration of exclusive breastfeeding and
maximising its benefits.
Therefore, the expert consultation recommends that priority be given to the following to improve precision of estimates and their general
applicability for exclusive
breastfeeding:
Proportion of infants with growth falling and malnutrition at six
and twelve months.
Micronutrient status
Diarrhoea mortality
Neuromotor development
and for the mothers:
Changes in weight,
Lactation amenorrhea.
Identification of biological and social constraints to exclusive breastfeeding up to six months in different geographical and cultural settings, and design of appropriate and effective interventions to deal with the barriers and their
consequences.
Infant feeding is very closely
related with the nutritional aspects of individual social and national development process in the long run. In Bangladesh, more than 75 per cent children are suffering from different types of mal-nutrition. The main cause is poor and unplanned infant feeding.
The role of proper breast-feeding and appropriate complementary feeding can ensure a healthy baby and help to grow up as a physically and mentally strong citizen to play his/ her due role in future. n
(N.S.M. Muzzammel Huq is Asst. Population Programme Officer, Ministry of Information)
