- Further, it is of great concern that only less than half of the mothers in Pakistan start breastfeeding within one hour of birth which deprives babies of colostrum — their first defence against killer diseases.
- At the policy level, we need laws ensuring women have maternity leave so they can be at home with their babies for the first few months. When they return to work, they must have arrangements so the mother and child can be together, and offer flexible working hours.
Breastfeeding is a collective responsibility — not just a women's issue.
Angela Kearney, the Unicef representative in Pakistan, shared these views in an interview with Dawn during World Breastfeeding Week that is celebrated every year from August 1 to August 7 across the globe.
"We need champions and ambassadors for breastfeeding, including women athletes, film stars and others, who can openly talk about breastfeeding and encourage other women to do it. But most importantly we need male champions," said Kearney.
"There is a lot of stigma around talking about breastfeeding. Not only mothers and mother-in-laws but husbands, brothers and fathers must also support women in breastfeeding."
The theme for World Breastfeeding Week 2017 is Sustaining Breastfeeding Together which highlights the importance of cooperation and collaboration across all sections of society, especially between governments and the civil society.
Why is it important to exclusively breastfeed infants for the first six months? How does breast milk contribute to better nutrition than formula milk?
Breastfeeding is the most important start for any baby’s life. It functions like a vaccine, passing immunity from the mother to the baby.
A mother’s milk is sterile and always the right temperature. It is free, clean, accessible and healthy, containing all the vitamins and minerals that a baby needs. It passes antibodies from the body of the mother to the baby which formula milk does not contain.
On the other hand, powdered milk does not boost the baby's immunity. Further, in order to be safe, you need a sterile bottle, a nipple and clean water which is not available to all mothers. Mothers also may not be able to afford the right quantity for a baby of that size.
Almost 44pc of the children under five years of age are stunted in Pakistan which impacts the development of the brain. With so many children stunted, the country’s future is at stake.
Breast milk is designed to be everything that a baby needs for the first six months. A baby doesn’t need water or anything else. Colostrum, the thick looking milk produced in the first twenty four hours after the baby is born, is the best kind of milk for a child’s immune system.
Unicef is trying to bust the myth that such milk is bad and should be wasted as data shows that breastfeeding should be initiated within the first hour of a child being born.
It is not just poor women who should be breastfeeding when there are no other alternatives. Women who live in the richest homes in Karachi or Islamabad should also realise that the best nutrition for their child is in breast milk.
Breastfeeding is also good for a mother. I am a midwife myself and I know breastfeeding also helps the mother with hormones, allows the uterus to heal and it helps them lose the extra weight they have put on during pregnancy.
Why has the United Nations been calling upon countries to improve rates of breastfeeding?
UN data from different countries shows that breastfeeding rates are declining in many countries. We are planning to carry out a countrywide nutrition survey, which will allow us to have more up to date data.
In Pakistan, data collected with the help of provincial and federal governments shows that 45 per cent of mothers are feeding their babies with a bottle in the first six months.
Further, it is of great concern that only less than half of the mothers in Pakistan start breastfeeding within one hour of birth which deprives babies of colostrum — their first defence against killer diseases.
Unicef and the World Health Organisation have the science that shows us how important breastfeeding is for babies. Under the Sustainable Development Goals (SDGs), number two is zero hunger and one of the subsections is about good nutrition for babies especially for the first one thousand days of their lives.
We know that if we are unable to provide the right nutrition to a child during this time, we are playing catch up for the rest of the time. When children are not breastfed they are more likely to contract diseases and even die.
Poor nutrition results in stunting which has grave consequences for children’s lives.
Almost 44pc of the children under five years of age are stunted in Pakistan which impacts the development of the brain. With so many children stunted, the country’s future is at stake. It is much more difficult for these children to learn and catch up with their peers later in life.
A stunted child is also at a far greater risk of contracting malaria or diarrhoea or other diseases. There is a greater chance of them being obese later in life and a higher chance of them developing diabetes and heart disease.
UN figures reveal declining rates of breastfeeding in Pakistan. Why are so many mothers hesitant to breastfeed?
Research and data help us understand why mothers may be hesitant to breastfeed. Advertisements for formula milk are one reason. These ads are everywhere and almost always feature fat, healthy, middle-class babies with beautiful skin and hair. This makes formula milk appear to be the best thing for a baby.
Sometimes being able to afford powdered milk is a status symbol. We know that there has been some unethical marketing to promote such ideas. The breastfeeding marketing code which the Unicef and WHO have signed on, requests that no child under two be shown in any advertisement for formula milk.
We need religious leaders to speak up and tell women that the Quran is very supportive of breastfeeding. Women need not think that breastfeeding is immodest.
Pakistan has been good in this regard. While ads no longer feature babies under one, babies between the ages of one and two are still featured and we hope that this will also change.
For working mothers, not having a proper place to breastfeed is the major impediment. We are encouraging all private companies and government offices to have breastfeeding rooms. We recently opened one such room at the National Assembly and are offering this to all provincial assemblies as well.
Many Pakistani women have access to nannies and they can bring their nannies to work and have them look after the children. This way the children can stay at the childcare facility and the mother can just come and breastfeed when needed.
Lack of knowledge is another big reason. This can be tackled with better communication to give mothers the right messages in the local languages, in-line with the local culture.
What can be done at the grassroots and policy levels to encourage more women to breastfeed?
Federal Minister for Health Saira Afzal Tarar has been a real champion of breastfeeding. She is deeply concerned about stunting and she has been talking to the Paediatric Association of Pakistan to ensure that every paediatrician talks to mothers about breastfeeding.
We are trying to ensure that every gynaecologist and every midwife talks about breastfeeding with mothers as part of their prenatal care. Midwives must ensure that breastfeeding is initiated within the first hour.
At the policy level, we need laws ensuring women have maternity leave so they can be at home with their babies for the first few months. When they return to work, they must have arrangements so the mother and child can be together, and offer flexible working hours.
We need religious leaders to speak up and tell women that the Quran is very supportive of breastfeeding. Women need not think that breastfeeding is immodest; it can be done gracefully without breaking cultural, religious and social norms.
We must also equip young women to be prepared to talk to their mothers and mother-in-laws when they are trying to give the baby water or honey instead of breast milk. It can be challenging for newly married women to assert her own opinions so that is something we must prepare them for.