Aiming to breastfeed all newborns

More family-friendly policies, like having all workplaces provide the time and the space for breastfeeding women to express their breast milk and store it appropriately, are still needed to help support continued breastfeeding. — Filepic

It has been several years now since the World Health Organization (WHO) and the United Children’s Fund (Unicef) decided to commemorate World Breastfeeding Week on Aug 1-7 annually.

The benefits of breastfeeding have been repeatedly publicised.

Breastfed babies have a head start in life. Exclusive breastfeeding in the first six months of life ensures optimal infant growth, development and health, as breast milk meets all the baby’s nutritional needs.

It is recommended that breastfeeding be initiated within the first hour of the baby’s life, even for women who have had a Caesarean section, and be continued until the child is at least two years old.

Adequate solid complementary food can be phased in when the baby is about six months of age.

Breast milk contains antibodies that protect against childhood diseases like diarrhoea and pneumonia – two of the most common causes of child death.

The long-term benefits for breastfed children, which carry on into adulthood, include a decreased incidence of overweight, obesity and type II diabetes, as well as better performance in intelligence tests.

Breastfeeding also provides benefits for the mother.

It reduces the likelihood of pregnancy by as much as 98% within the first six months of delivery.

Mothers who have breastfed have a lower incidence of breast and ovarian cancer, type 2 diabetes and postpartum depression.

Breastfeeding mothers also have early bonding with their child, providing long-term benefits.

The benefits of breastfeeding cannot be replaced with infant formula, which do not provide babies with an iota of antibodies.

Furthermore, there are risks in the preparation of infant formula, which include unsafe water, unsterilised equipment, potential presence of microorganisms in the infant formula and over-dilution of the formula.

If infant formula is unavailable, it may be difficult to restart breastfeeding because of reduced breast milk production due to the interim period of no breastfeeding.

In short, breastfeeding reduces child death, and has benefits for both mother and child that extend beyond the period of the child’s infancy.

Family-friendly policies needed

According to the 2016 National Health and Morbidity Survey (NHMS), the frequency of Malaysian mothers initiating breastfeeding within one hour of giving birth to their child was 65.3%.

Less than half (47.1%) of babies were breastfed exclusively in their first six months of life, and the percentage of children still being breastfed at two years of age was 39.4%.

The 2025 targets of the Health Ministry’s National Plan of Action for Nutrition of Malaysia (NPANM) 2016-2025 are: 100% breastfeeding initiation within an hour of birth and at least 70% of babies being exclusively breastfed during their first six months of life.

It is critical that the government institutes family-friendly policies, especially in relation to working mothers who need time off from work to recover from giving birth and getting a successful start to breastfeeding.

When a breastfeeding mother returns to work, continuing breastfeeding depends on access to breaks, e.g. affordable childcare facilities at or near their workplace, and an appropriate and hygienic space for the expression and storage of their breast milk.

An early return to work is a barrier to early initiation of breastfeeding, exclusive breastfeeding in the first six months of life and continued breastfeeding until two years or more – practices that are beneficial for both child and mother.

Fathers also need time off from work for them to bond with their babies, and share in child-rearing and household responsibilities.

As there is no published data on the progress towards the NPANM targets, it is not possible to know whether the targets are achievable with 2025 being just five years away.

Readers can make their judgements on whether current policies are sufficiently family-friendly enough, and if not, advocate for what needs to be done.

World Breastfeeding Week 2020

The theme for this year’s World Breastfeeding Week is Support breastfeeding for a healthier planet.

In line with the theme, WHO and Unicef are urging governments to protect and promote women’s access to skilled breastfeeding counselling – a critical component of breastfeeding support.

Effective and efficient services provided by skilled counsellors can ensure that mothers and their families receive the information, advice, support and reassurance needed for successful breastfeeding.

It can help improve mothers’ confidence and empower them to overcome challenges and practices that impede breastfeeding.

Skilled counselling services can be provided by healthcare professionals, lactation counsellors and peer support groups in a variety of settings.

Access to these counselling services is especially relevant in the ongoing Covid-19 pandemic.

A joint letter from Unicef executive director Henrietta H. Fore and WHO director-general Tedros Adhanom Ghebreyesus in conjunction with this year’s World Breastfeeding Week said: “This is why Unicef and WHO, in line with the policy actions advocated by the Unicef-WHO-led Global Breastfeeding Collective, are calling on governments to:

• Invest to make skilled breastfeeding counselling available to every woman.
  
  Ensuring availability of skilled breastfeeding counselling to every woman will require increased financing for breastfeeding programmes, and improved monitoring and implementation of policies, programmes and services.
• Train healthcare workers, including midwives and nurses, to deliver skilled breastfeeding counselling to mothers and families.
• Ensure that counselling is made available as part of routine health and nutrition services that are easily accessible.
• Partner and collaborate with civil society and health professional associations, building strong collaborative systems for provision of appropriate counselling.
• Protect healthcare workers from the influence of the baby food industry.”

Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email [e-mail]. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.