KARACHI: Discussing the country’s situation in breastfeeding practice and dangers associated with its decline, most prominently breast cancer, experts at a seminar on Thursday raised alarm over the rising incidence of the disease, which they said was the highest in Pakistan among the Asian nations.

“Pakistan has the highest rate of breast cancer for any Asian population, reporting 40,000 deaths per year,” said Khair-un Nisa, an assistant director in the provincial government directorate of nursing in her presentation at a workshop held to build capacity of nurses from various government hospitals at the Maternal, Neonatal and Child Health (MNCH) Programme’s office.

The workshop was organised by the MNCH and Save the Children as a part of the ongoing campaign to promote breastfeeding.

She said approximately one out of nine Pakistani women suffered from breast cancer at some point in their lives. Cases were generally reported when they already had attained the advanced stage, she added.

“With early diagnosis, a patient’s chance of surviving breast cancer is higher than 90 per cent,” she added.

She said imaging studies that were recommended for early detection for breast cancer could not be routinely applied in countries with restricted health service resources.

“Breast cancer is strongly related to age with only 5pc of all breast cancers occurring in women under 40. However, it can occur in younger age.” The number of cases worldwide has significantly increased and modern lifestyle has partly been blamed for it.

The incidence of breast cancer varies greatly around the world. It is lowest in less-developed countries and greatest in more developed countries, experts said.

Every woman’s hormone levels changes throughout her life for a variety of reasons, and hormone can lead to changes in breasts, they added.

“Hormone changes that occur during pregnancy might affect woman’s chances of developing breast cancer later in life and especially a woman who has her first child after the age of 35 has approximately twice the risk of breast cancer as a woman who has a child before the age of 20,” they said.

“After a woman gives birth, her risk of breast cancer is temporarily increased and lasts only for a few years.

“Similarly, a woman who during pregnancy takes synthetic form of estrogen has a slightly higher risk of developing breast cancer,” they added.

The speakers said breast cancer accounted for 31pc of cancers among women, and 19pc of deaths among women were due to cancer.

Although breast cancer is one of the most common reasons for death among women, diagnosis at an earlier stage of the disease allows women more treatment choices and a greater chance of long-term survival, they added. Iqbal Detho from Save the Children said 22pc of newborn deaths could be prevented if breastfeeding was initiated within first hour after birth, 16pc more lives could be saved if breastfeeding started in the first 24 hours.

He said infants not breastfed were 15 times more likely to die from pneumonia and 11 times more likely to die of diarrhoea as compared to those who were breastfed exclusively.

He said a global movement against formula milk first started in the 1970s.

However the legislation came very late in Pakistan in 2002 when the Protection of Breastfeeding and Child Nutrition Ordinance was passed. But its implementation remained a dream till November 2009 when the Protection of Breast-feeding Rules 2009 were notified, he said.

The meeting participants were told that aggressive marketing campaign and unethical promotional strategies by the formula milk industry had increased the community demand for milk substitutes and health providers were also promoting their products and violating the code.

The experts said that there was a huge private health sector in Pakistan — largely unregulated — and operated for profit and was mostly influenced by the formula milk industry.

Dr Sahib Jan Badar, programme manager, MNCH, asked the participants to disseminate the information they learned in the workshop and applied it aggressively in their respective facilities to ensure that most children were breastfed properly.

Dr Iqbal Memon, president of the Pakistan Paediatrics Association, presided over an interactive session with the participants and gave his input relating to many misconceptions that encouraged bottle feeding at the cost of breastfeeding in the country.

Published in Dawn, August 8th, 2014