Importance of Breast Feeding

Towards a healthy nation:

Original article on Island Newspaper February 22, 2012, 12:00 pm


Dr. Chinthaka Batawala
Dr. (Mrs) Ruwanthi Abhayagunaratne

More than 10 million children die each year, most from preventable causes and almost all in poor countries. Six countries account for 50% of worldwide deaths in children younger than 5 years, and 42 countries for 90%. The causes of death differ substantially from one country to another, highlighting the need to expand understanding of child health epidemiology at a country level rather than in geopolitical regions. Other key issues include the importance of undernutrition as an underlying cause of child deaths associated with infectious diseases, the effects of multiple concurrent illnesses, and recognition that pneumonia and diarrhoea remain the diseases that are most often associated with child deaths.

Undernutrition is associated with 35% of the disease burden for children under five years. Infant and young child feeding is a key area to improve child survival and promote healthy growth and development. The first two years of a child’s life are particularly important, as optimal nutrition during this period will lead to reduced morbidity and mortality, to reduced risk of chronic diseases and to overall better development. In fact, optimal breastfeeding and complementary feeding practices are so critical that they can save the lives of 1.5 million children aged below five years in every year. However many infants and children do not receive optimal feeding; for example, on average only around 60% of infants 0 to 6 months old are exclusively breastfed in Sri Lanka.

Diseases in childhood is a multidimensional phenomenon, and combating those diseases goes well beyond a simple discussion of the underlying characteristics of absoluteness. Rather, it is an issue that needs to be addressed from a broader perspective, reflecting the fact that "individuals, families and communities lack the capacity or the opportunity to gain access to minimum living conditions according to the basic standards of society.

Human development indicators – such as access to education (both primary and secondary) as well as to health services, particularly in rural areas, household ownership of durable goods and housing quality – attest to important positive trends in long-term development, as well as to success in achieving strategic government priorities. Price stability is particularly important to poor people, for whom food is the most important component of their expenditure. The government is striving to articulate fiscal, monetary and exchange rate policies with policies to increase production and productivity in order to cushion the impact of higher inflation. Yet despite this government effort, there is a risk that inflation will exceed forecast levels because of exogenous factors, in particular the combined impact of the international oil market situation and the rising tendency of international food prices, which will eventually confront the whole process of maternal and child health out-comes.

Breast-feeding is the best form of nutrition for infants in first six months of life. Over the past decades, evidence for the health advantages of breastfeeding and recommendations for practice have continued to increase. World Health Organization recommends mothers worldwide to exclusively breastfeed infants for the child’s first six months to achieve optimal growth, development and health. Thereafter, they should be given nutritious complementary foods and continue breastfeeding up to the age of two years or beyond.

Breast milk is the natural first food for babies, it provides all the energy and nutrients that the infant needs for the first six months (180 days) of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life. Breast milk promotes sensory and cognitive development, and protects the infant against infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea or pneumonia, and helps for a quicker recovery during illness. Breastfeeding contributes to the health and well-being of mothers, it helps to space children, reduces the risk of ovarian cancer and breast cancer, increases family and national resources and is a secure way of feeding.

While breastfeeding is a natural act, it is also a learned behaviour. An extensive body of research has demonstrated that mothers and other caregivers require active support for establishing and sustaining appropriate breastfeeding practices which contributes to improving the establishment of exclusive breastfeeding island wide and, coupled with support throughout the health system, can help mothers sustain exclusive breastfeeding.

As mentioned earlier too, breast milk is also a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished. Adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes.

Challenging the Poverty to improve maternal and child health

The challenges in combating poverty are many and complex. The most important ones have to do with transforming the structure of production and economic productivity and their linkages, with a focus on economic development and the people’s well-being. This transformation includes rural development, which embraces family farming so as to make it more productive, strengthening the domestic market and facilitating its integration into the national economy.

Agricultural and fisheries production, in particular at the family level, is crucial for food and nutritional security and the well-being of the population predominantly pregnant and breast feeding mothers. The farming and fisheries sectors have great productive potential, yet their output (particularly of foodstuffs on small and midsized farms) and productivity are still very low. The priority challenges addressed in the present context in Sri Lanka, should include expanding access to factors of production, particularly for women, with greater emphasis on adequate technologies, quality inputs, and enhancing the capacity for surveillance and control of plant and animal pests and diseases, as well as improving and making better use of water for agricultural purposes with effective dissemination of knowledge on agro-chemicals and fertilizer usage.

The lack of opportunities for marketing farm and fishery products constitutes the principal disincentive for intensifying production, and limits the growth of rural family incomes which has a direct impact on maternal health along with infant and young child feeding practices. Improving market access will require upgrading the network of infrastructure for postharvest and post-catch handling, primarily with respect to storage, conservation and processing of products, as well as access to market and pricing information, and involvement of the rural/regional banking sector to improve financial, credit and insurance services for producers in rural areas.

A further challenge is to harmonize investments in infrastructure and essential services and to gear them to reducing transaction costs so as to encourage market participation by the household sector.

The sustainable use of natural resources - effective water and forest cover management- is essential for boosting output and productivity, and will require greater community involvement. It is also important to ensure that the quality of services keeps pace with their expansion, and that user costs are accessible to all segments of the population, measuring both these goals by rates of use.

Then there is the ongoing challenge of expanding the number of beneficiaries covered by social protection programs -Samurdhi- for the most vulnerable, and by community protection networks, taking into account the need to update the amounts of subsidies. It is important to consider the impact of faster population growth, especially in the cities, on the deterioration of urban infrastructure and services. An important aspect of governance is to deepen legislative improvement with respect to legal rules and procedures that are out of phase with the country’s current stage of development, with particular emphasis on economic and social justice matters.

(To be continued)

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