Mother’s milk is the basic food for an infant and breastfeeding is the safest, cheapest and best way to provide this food to newborns. Due to the superior nutritive and protective value of mother’s milk, it prevents malnutrition and allows the child to develop fully. It meets the nutritional as well as emotional and psychological needs of infants. Breast milk also provides natural immunisation to every child.

Breastfeeding is thus the most effective way to provide a baby with a complete food, along with a caring environment. But nowadays, there is tendency to replace this natural feeding method with artificial substitutes. Therefore, there is a pressing need to encourage breastfeeding among new mothers.

There are three Es to breastfeeding: ‘Early’—within one hour of delivery; ‘Exclusive’—only providing breast milk to the child for up to six months; and ‘Extended’—breastfeeding for upto 24 months of age. Doing so will keep the child healthy and well-nourished.

Feeding babies

According to 2011 Nepal Demographic and Health Survey, nearly three in 10 children (29 percent) are underweight, 8 percent are severely underweight, 11 percent are wasted and three percent are severely wasted. So promoting exclusive breastfeeding until six months of age and controlling protein energy malnutrition (PEM) are major strategies of the Ministry of Health and Population. The Survey also reports that 70 percent of children less than six months of age are exclusively breastfed, the median duration of exclusive breastfeeding is 4.2 months.

The World Health Organisation (WHO) recommends exclusive breastfeeding (only mother’s milk) until a baby is six months and continued breastfeeding, along with appropriate complementary foods, up to two years of age or beyond. Breast milk provides complete nutrition to the infant up to the six months of age, almost half of the nutritional requirements between six-12 months and up to one-third between 12 and 24 months. It contains the adequate calories and provides the right kind of proteins, fats, lactose, vitamins, iron and other minerals, enzymes and water in the amounts necessary for the baby.

In newborn babies, breastfeeding helps prevent hypothermia and hypoglycemia, which contribute to early neonatal deaths, especially among low birth weight and premature babies. Breast milk has many anti-infective properties and protects the child against several infections, including diarrhoea, pneumonia and otitis media. In the neonatal period, most children in developing countries die of infections such as sepsis, acute respiratory tract infection, meningitis and diarrhoea. However, feeding them colostrum—a sticky yellow fluid secreted by the breasts after delivery until a few days later, rich in protective antibodies that boost a newborn’s immune system—can prevent such deaths.

Breastfed babies are also less prone to develop diabetes, heart disease, eczema, asthma, rheumatoid arthritis and other allergic disorders later on in life. Breastfeeding has been shown to enhance brain development, visual development and visual acuity, leading to learning readiness. Breastfed babies have been shown to have higher Intelligence Quotients (IQ), language development and mathematical abilities.

Exclusively breastfed children are six times more likely to survive in the early months than non-breastfed children. Exclusively breasted infants are six times less likely to die from diarrhea and 2.4 times less likely to die from acute respiratory infections in the first six months of life. Under-nutrition in children and women can also be greatly reduced through optimal infant and young child feeding.    

Mothers and breastfeeding

Breastfeeding also protects a mother’s health in several ways and can benefit the whole family, emotionally and economically. It reduces anaemia due to a reduction in postpartum bleeding and reduced blood loss because of delayed menstruation. Breastfeeding can also prevent pregnancy for the first six months if exclusive breastfeeding is carried out. Additionally, it has been shown to reduce the risk of breast and ovarian cancer for the mother. Obesity is less common among breastfeeding mothers; breastfeeding helps the mother regain her normal

figure by consuming the extra fat that is accumulated during pregnancy.

Breastfeeding should be initiated within the first hour of birth or as soon as possible. It is essential to keep the baby with the mother at all times, if possible. Other milk or food should not be given to the baby. Rest and relaxation for the mother are just as important for successful breastfeeding but mothers should not hesitate to suck their babies more. The more a baby suckles, the more the breasts produce. Babies should be breastfed on demand and fed until the baby is satisfied. Once done, the baby will release the breast on their own.

Sick babies or preterm babies who cannot suckle should be fed expressed breast milk (EBM), which can be stored at room temperature for six-eight hours, in a refrigerator for 24 hours and a freezer at -20°C for three months.

Adhikari is a lecturer at the Maharajgunj Nursing Campus and a member of the Nepal Breastfeeding Promotion Forum ([email protected])