The Rajasthan government has launched a campaign to promote breastfeeding, particularly in the first hour after birth, in a bid to improve the state’s infant mortality rate.
There were 41 infant deaths for every 1,000 live births in the north-east Indian state in 2016, compared with the national average of 34.
The government has already succeeded in increasing the number of hospital deliveries to roughly 84% of all births, but has been far less successful in promoting breastfeeding. An estimated 58% of women in the state exclusively breastfeed in the first six months, and only 28% of babies are breastfed in the first hour – one of the lowest rates in the country.
Breastfeeding in the first hour ensures the baby receives colostrum, which is loaded with nutrients that can protect babies from illness and infections.
The low rate of first-hour breastfeeding is related to a traditional blessing after birth, where a respected member of the family places a drop of honey or sugary water into a baby’s mouth – a blessing known as ghutti. This is supposed to be the first thing a baby ingests.
Under the policy, announced this month, it is hoped that new mothers will be immediately taken to breastfeeding clinics, instead of being kept in the delivery room for relatives to arrive. The clinics will be set up in every major hospital, with trained staff helping mothers to feed their newborn children in the crucial first hour. Only later will mothers and their children be moved to post-natal wards.
Naveen Jain, secretary of the state’s medical health and family welfare department, said the issue of breastfeeding within the first hour was being tackled aggressively: “We want to have 90% of mothers breastfeeding within the first hour by the end of next year.”
Minakshi Singh, a nutrition specialist with the UN children’s agency Unicef in Jaipur, said women don’t always know the importance of breastfeeding or how to do it. “They can be 18 or 19, it’s their first child and they lack confidence. They are not sure they can hold the baby properly or nurse it properly. They have to be shown the right ‘attachment’ – the right posture for holding the baby,” she said.
Breastfeeding within an hour of birth can reduce the infant mortality rate by 22%, Singh said. The mother’s first milk is rich in antibodies that develop immunity in the infant.
For decades, government campaigns across India have recommended breastfeeding, but the figures are still not as high as health officials would like. Nationwide, less than 55% of babies are exclusively breastfed for the first six months, as recommended by the World Health Organization.
The reasons for the low uptake include ignorance of the benefits of breastfeeding (some communities call colostrum “witch’s milk”), a perception in rural areas that formula milk is superior, women being urged by the family to give up breastfeeding if they struggle to produce enough milk, and a lack of designated places for women to nurse.
There are no nursing rooms available in public places such as bus stops, shopping centres or railway stations. The situation is compounded by the fact that Indian women are expected to cover their bodies, particularly their breasts, at all times. Baring a breast to feed a baby could be viewed as promiscuous behaviour.Rajasthan’s new policy makes no provision for nursing rooms to be set up in public places, Singh said, but it does require private organisations to provide such rooms if their female employees need them.
