Sometime back, I got a call from Nepalgunj, from one Chandra who asked me, “How many times should I bottle-feed my newborn baby?” She had just delivered the baby two days back so she should already have been breastfeeding, not bottle-feeding, the baby. I told her as much and asked, “Who suggested that you bottle-feed the baby?” She informed me that she had had a normal delivery at the Nepalgunj Medical College and a nurse on duty had told her to buy Lactogen and a bottle to feed the newborn whenever it cried.

Breast, not bottle

I did not believe her, simply because in medical colleges, a nurse would never suggest that a mother bottle-feed her baby. I thought Chandra must be lying. I assumed that she must have delivered her baby in some private hospital, so I told her that it was impossible that any doctor or nurse from a hospital like the Nepalgunj Medical College would advise a mother to bottle-feed a newborn. I explained to her that doctors and nurses there encourage breastfeeding, not bottle-feeding.

I duly advised Chandra to breastfeed her baby as she was a healthy woman. Then, Chandra’s husband, Ganesh said, “Didi, there are many women bottle-feeding their babies in that hospital. I can even send you photographs of mothers bottle-feeding Lactogen to their newborns.” Following up on his offer, he sent me the photo that appears alongside this article.

Appalled, I told the couple to throw away the bottles and Lactogen milk and immediately start breastfeeding. I advised the mother to start eating soup, vegetables, chapattis, lentils, fenugreek (methi) and drinking milk regularly so as to produce lots of milk. Chandra’s baby was lethargic because he had been given bottle milk since birth and did not want to drink breast milk. If Chandra started to feed the baby breast milk whenever he is hungry then he would definitely start to prefer it over bottle milk.

Ganesh told me that no one in the hospital had given them information about food that should be given to the new mother and the couple was very afraid to ask the doctors and nurses about nutrition. It was a very sad situation indeed as the nurses, who should have provided right information about nutritious food and breast milk, did not bother to tell the new parents about it. I am sure nurses and other health workers in the hospital had been given guidance that every newborn baby should be breastfed one hour after birth and everyone should be given information about proper nutrition. Alas, this was not just the case at the Nepaljung Medical College but also in many other teaching hospitals in Kathmandu and Lalitpur.

Speaking from experience

Ashok Bhurtal, Nutrition Officer at the World Health Organization (WHO), told me that his organisation has issued guidelines about exclusive breastfeeding for the first six months. This is crucial for the survival, growth and development of infants and young children. It lowers the risk of illness, particularly from diarrheal diseases. But not all doctors follow the guidance and big companies like Nestle and Glaxos are making money out of the ignorance of common people with big, flashy advertisements. Many health workers are speaking up against the unethical practice of providing bottled milk to newborns but their voice is too weak to be heard by many. “We have to raise the alarm so that policymakers stop to listen,” said Bhurtal.

I too strongly feel that we need to raise our voices against this practice of bottle-feeding newborns as I was also one of those ‘stupid’ people who fed my baby bottled milk and Lactogen 26 years ago. Twenty-one days after the birth my baby girl, I gave her breast milk for three weeks. After that, since I felt tired, I decided that bottled milk would be sufficient for her. At that time, no one told me that breast milk should be given to the baby all the time. My husband was angry at my decision but I was stubborn and gave in to Lactogen. Though a doctor myself who was working at the Maternity Hospital, I made this mistake. My husband and children now say that I committed a crime by not providing breast milk to my daughter. I do feel guilty about that wrong step and I am doing my best to overcome these feelings of guilt by providing information about breast milk to more new mothers so that they do not repeat the mistake I made.

Five days after talking to Chandra and Ganesh on the phone, I was in Nepalgunj and went to meet them. I was very happy to see that baby was being breastfed and Chandra was also glad that she did not have to spend a lot of money on Lactogen. Now, she knows about the physical and mental health benefits of breastfeeding, not just for her child but for herself too. Looking at Chandra and her baby, I feel that this is the way I can get rid of my guilt for not having breastfed my daughter 26 years ago.

Dr Uprety is a nutrition expert