Breastfeeding is at the core of infant nutrition. But mothers in rural areas are avoiding it due to COVID-19 fears
As India celebrated National Nutrition Month under the shadow of COVID-19, it’s time we put the spotlight on breastfeeding, which lies at the core of newborn and infant nutrition.
In a remote village of Sonbhadra district of Uttar Pradesh, Jamuna (name changed), 28, gave birth to her daughter a few months ago. But she did not get vaccinated against the novel coronavirus disease (COVID-19) virus, even when her doctor reassured her that it was completely safe for women who were breastfeeding to get vaccinated.
Confused by her neighbours’ suggestions, she fell for the common myth: That getting vaccinated against COVID-19 would endanger the life of her infant. Several others in her neighbourhood did the same.
On receiving this information, field workers of Sonbhadra Vikas Samiti (SVSS), a partner of non-profit Childs Rights and You (CRY) started a dialogue with Jamuna and other women. In their effort, they included the local Anganwadi and accredited social health activist (ASHA) workers, went door-to-door and explained the health benefits of breastfeeding infants.
Jamuna, however, is not an exception. Many new mothers who contracted COVID-19 infection avoided breastfeeding their kids, thus depriving them of the vital nourishment and antibodies, making them prone to infection and several common childhood illnesses.
The first 1,000 days of life are crucial for newborns and mothers. This period, which starts with the conception of a baby, continues with pregnancy and ends with a child’s second birthday.
This period offers a unique window of opportunity and lays the foundation of a healthier future for children. Breast milk is a vital nutritional component in the first 1,000 days of delivery.
Breast-milk, according to the World Health Organisation, is the ideal food for infants. It provides all nutrients needed for the first months of an infant’s life, and continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life.
Doctors and health experts cannot stress enough the need to breastfeed infants, as mother’s milk contains vital nutrients and antibodies required for them to fight infections. The practice is essential for both mothers and infants.
Breastfeeding adverts the development of cancer, diabetes, heart disease, osteoporosis, and maternal deaths in women. It plays a crucial role in preventing several illnesses and diseases, including sudden infant death syndrome (SIDS).
What do the numbers suggest?
All major studies on child health and nutrition suggest that the newborn must have colostrum, the first milk of the mother within the first hour of birth. The thick, bright yellowish milk is the very first dose of nutrients and immunity-boosters that the newborn can receive.
However, numbers of the latest National Family Health Survey (fifth phase, first round) in 2019-20 don’t paint a promising picture: Children (below the age of three years) were denied their ‘first immunisation’— as colostrum feeding is commonly referred to.
The trend has been on the decline for children in the first hour of birth; only 10 out of 22 states and Union territories (UT) reported an increase.
The picture only gets grimmer when we analyse the state-specific data of NFHS-5 Phase 1 and compare the data of kids (under three years) who are breastfed within one hour of birth. Six states and UTs showed significant drop: Sikkim reported a drop of 33.5 per cent; Dadra and Nagar Haveli 24.1 per cent; Daman and Diu dropped 24.1 per cent; Assam 15.3 per cent; Gujarat 12.1 per cent and Goa 11.7 per cent.
Similarly, comparison of state-specific data of NFHS-5 and NFHS-4 for exclusive breastfeeding up to six months revealed a significant drop in five states in 2019-2020 compared to 2015-2016: Sikkim (drop by 26.3 per cent); Tripura (8.6 per cent), Jammu and Kashmir (3.4 per cent), Manipur (dropped 2.9 per cent) and Andhra Pradesh (dropped 2.2 per cent).
Since the NFHS-5 data reflects trends from pre-COVID-19 times, the fear is that these numbers are likely to drop further as several lactating mothers may have fallen prey to the prevailing misconceptions related to breastfeeding in COVID-19 times. However, raising awareness among mothers / parents / caregivers and educating them in debunking existing misconceptions can help improve the scenario.
Myths versus realities
A couple of common myths discouraging breastfeeding practices during the pandemic are that the COVID-19 infection transmits through breast milk, from mothers to newborns, and that breastfeeding woman should not get vaccinated.
On the contrary, the WHO recommends that ‘mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed. Mothers should be counselled that the benefits of breastfeeding substantially outweigh the potential risks for transmission.’
The Government of India on May 9, 2021, gave a nod to the National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) recommendation of COVID-19 vaccination for all lactating women.
Earlier in October, the Union Ministry of Women and Child Development highlighted that coronavirus has not been found in amniotic fluid or breast milk, which means that the virus is not being transmitted during pregnancy or through breast milk. It instructed all field functionaries and healthcare providers to reassure mothers to initiate and continue to breastfeed their infants as per guidelines even if they have tested positive for COVID-19.
While experts rule out the need to stop breastfeeding— before or after vaccination — it is also alleged that vaccine antibodies are likely to transmit to babies via breast milk, offering protection to the mother and little one from the deadly virus.
Facts and news like these take a long time to reach lactating mothers, who are based in rural areas and have little access to such information.
CRY aims to educate and raise awareness on the best breastfeeding practices and pass on the latest information during the Union government-designated Village Health, Sanitation and Nutrition Day (VHSND), observed mostly on Wednesdays at Anganwadi centres across India.
Besides raising awareness, CRY also trains and builds capacities of the mother, caregivers and village health sanitation and nutrition committee members.
It takes several other initiatives, including bringing in behavioural change for improving maternal and neonatal health, while also educating the fathers / male members of the family to take care of the mothers as much as the newborns during the VHSNDs.
The Union government has taken several significant initiatives fight India’s nutrition crisis programme: POSHAN (Prime Minister's Overarching Scheme for Holistic Nutrition) Abhiyaan or National Nutrition Mission to improve nutritional outcomes for children, adolescent girls, pregnant women and lactating mothers lies at the forefront.
Each September is observed as Poshan Maah (National Nutrition Month) to raise awareness among people around different facets of nutrition. Breastfeeding was the core of this year’s theme.
Both the Union government and civil society organisations can play a key role in generating awareness on breastfeeding during this time.
Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth
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