Breast milk is a liquid food produced by the mother’s mammary glands to nourish her baby. Breastfeeding is a natural process which typically begins shortly after birth and continues for several months to years. It is a universal practice, embraced by all living beings since time immemorial.
Breastfeeding offers numerous health benefits for both infants and mothers. Breast milk provides essential nutrients, antibodies, and enzymes that protect infants from infections, reduce the risk of chronic diseases, and promote healthy growth and development. For mothers, breastfeeding can help reduce the risk of certain cancers and aid in postpartum recovery.
Mature human milk contains 3 per cent—5 per cent fat, 0.8 per cent–0.9 per cent protein, 6.9 per cent–7.2 per cent carbohydrate calculated as lactose, and 0.2 per cent mineral constituents expressed as ash. Its energy content is 60–75 kcal/100 ml. Protein content is markedly higher and carbohydrate content lower in colostrum than in mature milk (https://pubmed.ncbi.nlm.nih.gov).
Human milk has essential nutrients from three sources that are nutrients made in the breast, nutrients from the mother’s food, and nutrients from the mother’s stored body reserves. These provide all the baby needs for growth and development. It also contains special bioactive components like immunoglobulins and leukocytes to protect against infections, cytokines to support the immune system, and hormones and growth factors for the baby’s appetite, metabolism, and overall development.
Also, with 88 per cent water, human milk keeps the baby well-hydrated. The first milk produced called colostrum is small in amount but packed with immune-boosting components like Secretion of Immunoglobulin A (sIgA) and lactoferrin, a nutrient content in breast milk that can increase immunity in preventing infectious diseases such as Acute Respiratory Infection (ARI), as well as growth factors like epidermal growth factor.
There are several myths and misconceptions about colostrum. Some mothers believe that colostrum is bad and discarded but it’s rich in essential nutrients and antibodies that are crucial for the baby’s immune system and development. Breast milk has two categories: foremilk, which comes at the start of feeding, is thin and watery, and hind milk, which the baby gets at the end of feeding, is thicker and creamier. Both foremilk and hind milk are needed. Foremilk helps quench thirst, while hind milk provides the energy and fat needed for growth.
To ensure the baby gets both, feeding long enough on one breast before switching is important. This helps balance their diet and reduces fussiness. Breastfeeding, while natural, can come with challenges. Many mothers face difficulties in providing enough milk due to reasons such as job demands, health issues, concerns about milk production, or fears of losing their body shape. Additionally, some struggle due to a lack of knowledge about proper breastfeeding techniques. In these situations, artificial feeding may become a necessity rather than a choice.
The American Academy of Pediatrics and the World Health Organisation recommend exclusive breastfeeding for about the first six months. After that, they suggest continuing breastfeeding while introducing appropriate complementary foods for up to two years or more.
Exclusive breastfeeding indicators in Meghalaya, although showing an increase from 35.8 per cent in the NFHS-4 report to 43 per cent in NFHS-5, still need improvement. In a recent survey among 100 women on “Knowledge and Practices on Breastfeeding in Garo Hills,” we found that 94 per cent initiate breastfeeding within the first hour after birth. However, only 65.7 per cent practice exclusive breastfeeding (feeding only breast milk, not any other foods or liquids, including infant formula or water). Additionally, 61.4 per cent learned about the importance of colostrum from healthcare workers, highlighting the significant role they play.
The survey also revealed that 18 per cent of mothers in Meghalaya encountered issues such as latching difficulties, low milk supply, and pain, indicating the need for workshops on proper latching techniques. Our studies have shown that pre-lacteal feeding is common, and there is a significant disparity in complementary feeding practices. The timing of complementary feeding is not satisfactory.
The survey found that 83.3 per cent of mothers introduced weaning as early as five months, while 15.2 per cent delayed weaning until nine months. This discrepancy suggests that inappropriate complementary feeding practices may contribute to malnutrition in the State. Raising awareness about the appropriate timing for introducing complementary foods is crucial to addressing this issue.
The World Alliance for Breastfeeding Action (WABA), global network of organisations, and MAA (Mother’s Absolute Affection) nationwide programme under the Ministry of Health and Family Welfare focus on promotion of breastfeeding and provision of counselling services for supporting breastfeeding. Every year WABA comes up with a theme and the theme for this year 2024 is “Closing the Gap: Breastfeeding Support for All”.
It highlights the need to ensure that every mother and baby receives the support they need for successful breastfeeding. It also emphasises addressing barriers and disparities that might prevent some families from accessing proper breastfeeding support, such as lack of resources, information, or community support. The goal is to make breastfeeding support universally available and effective, so all families can benefit from its health advantages and ensure equal opportunities for breastfeeding success.
Educational institutions like Community Science/Home Science/Social Sciences can take part in the initiative in raising awareness and supporting breastfeeding. During World Breastfeeding Week, they can organise seminars, workshops, and guest lectures, inviting experts to share the knowledge and experiences in breastfeeding to students who are future parents. Furthermore, they can encourage students and faculty to conduct research on breastfeeding practices and challenges. This can help inform and improve community practices.
So, as we celebrate World Breastfeeding Week 2024 with the theme “Closing the Gap: Comprehensive Breastfeeding Support for All,” let us commit to spreading knowledge, providing support, and creating environments that enable all mothers to breastfeed successfully, thereby nurturing the health and development of future generations.
(The writer is an Associate Professor & Head, Department of Human Development and Family Studies, College of Community Science, Tura, Meghalaya)