Earlier this month, the world celebrated World Breastfeeding Week, and this year, like every year, it restarted the debate about breastfeeding. Those who promote exclusive breastfeeding risk being called “breastfeeding fanatics,” because some people feel we are opposed to mothers who cannot or choose not to breastfeed. Those mothers who do choose to breastfeed – especially in public – also risk being accused of insensitivity or even indecency.
But many, like UNICEF, who are in the business of helping ensure children survive and thrive, want to make sure that mothers make an informed choice and get the right support to enable them to breastfeed, since doing both gives their children the best chances.
When I had my first child, I was lucky to have given birth in a hospital where a nurse supported me in starting to, and continuing to, breastfeed. I know that this is not always the case.
Why is this important? The benefits of breastfeeding are well known. Breastmilk acts as a baby’s first vaccine, passing on immunities from its mother and giving much-needed protection at each developmental stage. It supports healthy brain development. Exposure to the bacteria on the mother’s breast helps to colonize a newborn’s digestive system with essential antibodies. Also, with breastfeeding, a mother doesn’t need extra supplies – formula, bottles, and the fuel to sterilize them in boiling water, for example – that can be quite expensive.
Skin-to-skin contact – placing a newborn on its mother’s bare chest immediately after birth – regulates a baby’s heart rate, temperature and breathing, actually reducing the chance of mortality. It also makes breastfeeding easier. And the act of breastfeeding itself increases bonding between child and mother, ideally starting from the moment a baby enters the world.
Delaying the start of breastfeeding reduces the chances that a child will benefit from this potentially life-saving intervention. In fact, research shows that in certain contexts, where the risk of child deaths is already high, delaying the start of breastfeeding beyond one day after birth can raise a newborn’s risk of dying by 80 percent compared to those who are breastfed immediately.
Meanwhile, babies younger than a month old account for nearly half of all deaths of children under the age of five. So putting a baby to the breast right after birth can sometimes be the difference between whether they will survive or not.
However, new research from UNICEF shows that more than half of all newborns are not breastfed in the first hour after birth. That means that some 77 million newborns are losing out on what we know to be a greater chance at survival. A study reported by the Lancet earlier this year said that exclusive breastfeeding for the first six months could save some 800,000 children’s lives each year. But we have found that mothers do not receive the support they need to begin and continue breastfeeding.
Globally, over 75 percent of mothers give birth with the help of a skilled attendant. One would think this is associated with a higher proportion of mothers breastfeeding at birth, but this is not always the case. In fact, in the Middle East, North Africa and South Asia, women who deliver with a skilled birth attendant are less likely to start breastfeeding in the first few hours after delivery compared to women who are attended by relatives or persons who are not professional health workers.
The reason stems from the best of intentions. In many hospitals, it is the practice to take the baby away from the mother to allow her to rest, but that means the baby is deprived both of the first contact with its mother and of the nourishment of her milk. The baby’s first feed then is infant formula. When babies are given alternatives to breastmilk, they breastfeed less often, making it harder for mothers to start and continue breastfeeding.
Sometimes cultural norms prevent an early start to breastfeeding. In parts of India, for example, colostrum – the nutrient-rich substance a mother produces right after birth – is seen as useless or maybe even harmful for the baby, so mothers are counseled not to breastfeed until their colostrum supply changes to milk.
In several West African countries, newborns are sometimes given water or tea instead of breast milk, which, with the dangers of contaminated water, puts them at risk of diarrhea and therefore malnutrition.
The aggressive marketing of baby formula in many countries also leads mothers to believe breastmilk substitutes are better for their babies, leading to lowered breastfeeding rates.
But breastfeeding is a powerful and wonderful practice that has linked mother to child for generations, and which is backed by scientific research. There are a small number of mothers for whom breastfeeding isn’t an option, but we need to work to overcome the barriers to breastfeeding so that mothers who can and want to breastfeed are able to do so. And we need to help them to start early, to get the best possible start in life for their babies.
The views expressed in this article belong to the author and do not necessarily reflect those of Women & Girls Hub.