The under 5 population in India is close to 112 million as of 2015, but we are severely burdened by malnutrition and stunted growth. 38% of the global burden of malnutrition lies in India.
As per the NFHS-3 data, 57% Indian mothers offered prelacteal feeds to their newborns, and around 45% do not start breastfeeding within twenty-four hours of birth. Early initiation of breastfeeding is very important. The colostrum is very nutritious and helps in building the immunity of the child. The rate of early initiation of breastfeeding (within 1 hour of birth) stands abysmally low at 24.5%.
Some of the important reasons for the dismal nutrition status of our infants and young children include inadequate or inappropriate knowledge amongst caregivers regarding correct infant and young child feeding and breastfeeding practices, frequent infections, low social and nutritional status of girls and women, lack of more viable infant and young child feeding guidelines.
Do you know that the first 1000 days of life that is the 270 days in utero and the first two years after birth are considered the - critical window period for infant and young child nutrition. It is believed that maximal brain growth occurs in this period, and malnutrition in this critical period can lead to stunting and suboptimal developmental outcome.
One way of encouraging breastfeeding is by Skin to skin contact with the baby with the mother within 5 minutes of birth. This encourages the baby to start reaching towards the breast for feeding. This early contact should be continued until the first breastfeed is complete.
Another way is called the Kangaroo method where the mother and newborn should be encouraged by ‘bedding in the mother and baby pair’. The mother may bond with the baby by looking into the eyes, touch and caress the baby while feeding. The newborn should be kept warm.
Colostrum - which is the First milk must not be discarded but should be fed to the newborn as it contains a high concentration of protective immuno-globulins and cells.
Babies should be breastfed at least 8-10 times in 24 hours till lactation is established (1-2 weeks) indicated by 5 frequent urination and stooling and adequate weight gain. Mothers get worried about the number of times the baby passes stools. Mothers should be informed that there is a tendency for the baby especially if it breastfed, to pass a stool after almost every feed. This is normal and not a sign of diarrhea. Mothers should be promoted to feed the babies frequently in the early days. A sleepy baby can be easily woken up by removing blankets, removing clothes, changing loin cloth if wet.
Adequacy of breastfeeding in this critical period should be monitored by clinical parameters complemented by weighing on the digital weighing scale on day 1, 4, 7, 14 and 28. If the weight of the baby goes below 10 to 12% of the birth weight, then it needs to be seen by the Doctor to look into the reason for the excessive weight loss.
Mothers need to know about different aspects of breastfeeding - like correct positioning, latching, and treatment of problems, such as breast engorgement, nipple fissures and delayed ‘coming-in’ of milk.
Exclusive breastfeeding(means that no other food or fluids should be given to the infant below six months of age unless medically indicated) should be practiced from birth till the end of six months (180 days). After completion of six months, with the introduction of complementary feeding, breastfeeding should be continued for a minimum of 2 yrs and beyond depending on the choice of the mother and the baby. Even during the second year of life, the frequency of breastfeeding should be 4-6 times in 24 hours, including night feeds. Mothers who need to get back to work can express milk for feeding the baby while they are out at work.
Mothers who are unwell or on medication can continue breastfeeding unless it is medically indicated to discontinue breastfeeding.
