Breastfeeding is one of the most important public health interventions. It is entirely natural, 100 percent nutritionally balanced, and completely cost-effective.
As we commemorate World Breastfeeding Week, which is being observed from August 1 to August 7, we have some achievements to celebrate and some challenges to collectively address.
First, we must congratulate Pakistan for its focus and determination to change what was rightly seen as a woeful situation. All levels of government leapt into action. With Unicef’s support, oversight bodies called infant feeding boards were reinstated. These boards, which are made up of technical experts and operate at the provincial and national levels, are responsible for ensuring that measures are taken to enforce the protection of breastfeeding.
At the federal level, the Ministry of National Health Services Regulation and Coordination (MNHSR&C) initiated breastfeeding awareness activities with a variety of radio and TV spots. Nutrition cells in the departments of health and the planning department’s multi-sectoral teams worked to develop province-specific activities, including awareness campaigns, which can already be seen paying dividends. Unicef was once again pleased to support the development of communications material where required.
It is clear and scientifically undisputed that inadequate breastfeeding – either not initiating feeding in the first hour of birth or not exclusively breastfeeding, which means feeding only mother’s milk and not even water, for the first six months of life – will affect the health, wellbeing and, in some cases, the very life of the child.
Within the first few days, a breastfed child is provided with critical immunity, which provides protection against a host of diseases. A breastfed child is less likely to be obese and develop diabetes or asthma in later life. A mother who has breastfed is less likely to get breast cancer. Research continues to uncover more reasons why we need to encourage and protect breastfeeding.
While less than four in 10 babies are exclusively breastfed on average – a South Asia regional low point – tracking studies have for the first time shown improvements in the rates of exclusive breastfeeding. Studies in Punjab and Khyber Pakhtunkhwa have particularly shown improvements.
Unicef worked with the government to develop and roll out education workshops for paediatricians and obstetricians. We have been delighted to work with their national and provincial associations. The energy and enthusiasm that we witnessed is certainly one of the reasons why we are now seeing positive changes.
Workplace laws are being put in place to protect working women who want to breastfeed. Maternity leave laws are changing. Although more needs to be done in awareness, education, legislation and enforcement, we ought to celebrate these successes.
What remains to be done in terms of the challenges faced in this regard? Despite these welcome signs of progress, we need to continue educating physicians, lady health workers, nurses, community midwives and other professionals on the clear benefits of breastfeeding and the legal environment designed to support breastfeeding. Bottle-feeding with formula milk is vastly common in Pakistan as 40 percent of children under six months of age are fed formula.
We must convince every doctor, child specialist, pediatrician and gynaecologist to stop prescribing formulas and start encouraging breastfeeding. We must get better at providing lactation support to mothers who face difficulties in breastfeeding their babies.
Unicef is working closely with MNHSR&C and the provincial departments of health to update the existing legislation by reflecting the most recent World Health Assembly recommendations. This will further limit the ability of manufacturers to market products for infants, which is illegal under the current law, to include children up to three years of age.
We need to enhance breastfeeding support at facilities and places where women deliver their children so that the rates of breastfeeding a newborn within the first hour post-delivery can be improved. In Pakistan, 50 percent of women deliver at health facilities and this figure is likely to increase. Both Unicef and WHO are advocating measures that enhance support for breastfeeding in hospitals. For women who deliver at home, we will continue to support the training of community workers to assist them and their families during the pre- and post-birth period.
Unicef is working with Pakistan to improve the health and wellbeing of its children. We are pleased to celebrate the early successes in improving breastfeeding and are willing to help achieve the goals that Pakistan has set to ensure the brightest possible future for its children.
The writer is a Unicef representative in Pakistan.