The writer holds a PhD from the University of Melbourne and is the author of Development, Poverty and Power in Pakistan, available from Routledge
Countries which have not yet been able to provide basic health facilities to their populace usually struggle with high mother and child mortality rates. Pakistan is no exception, given our alarmingly high number of mother and child deaths, even in comparison with other neighbouring countries with the exception of Afghanistan. A range of factors can be cited to explain this dismal situation, including inadequate budgetary allocations for public health, especially for reproductive health and child care, as well as social practices such as early marriages and giving birth to too many children. Overcoming these lingering problems, which contribute to high mortality rates for mothers and children, is not easy. However, an increased emphasis on breastfeeding is one relatively easy way, which can have a significant impact on improving the existing situation, especially the health of newborn children.
According to a new and very comprehensive study by Lancet, the reputable medical journal, if almost every mother breastfed her children, this could prevent more than 800,000 child deaths a year. Children who are breastfed exclusively for the first six months of life have lower death rates and less risk of infection than those who are breastfed for shorter periods, or not at all. Breastfeeding also protects against diabetes and obesity later in life, and breastfed children have also been found to have higher IQs. Breastfeeding is not only immensely beneficial for children, it can also help their mothers. It helps with birth spacing, which is very important for the health of mothers who often do not get enough rest between giving birth and becoming pregnant again. Breastfeeding is also thought to protect against breast cancer and may reduce the risk of ovarian cancer and type-two diabetes.
A major cause of diarrhoea among infants is improper sterilisation or the making up of formula with water unfit for drinking. Breastfeeding needs no such preparation, and instead protects against a variety of infections. It has obvious economic benefits since it doesn’t cost anything. Moreover, it is also environmentally-friendly, given that more than 4,000 litres of water are needed to produce a kilo of formula powder. Despite this wide range of benefits, the World Health Organisation is still struggling to ensure that at least half of all children under six months are exclusively breastfed. While women in poorer countries do breastfeed for longer than those in higher-income countries, this trend is declining, especially with rising income levels. Only 37 per cent of children aged six months and under in lower and middle income countries are exclusively being breastfed. Formula is seen as the modern, convenient and sophisticated alternative to breastfeeding. Aggressive marketing by the formula industry presents it as just as good as, if not better than, breast milk. The formula market is in fact projected to grow significantly in the Middle East, Africa and Asia over the next few years.
The Pakistan Paediatrics Association recently highlighted that only 37 per cent of mothers are exclusively breastfeeding their children across the country. Such poor breastfeeding practices are held responsible for exacerbating a range of other problems, such as children being underweight and malnourished, having weak immune systems and hence being readily susceptible to diseases such as diarrhoea, pneumonia or measles, which often results in fatalities. Pakistan passed the Protection of Breastfeeding and Young Child Nutrition Ordinance in 2002 to promote breastfeeding, and to keep a check on doctors who prescribe formula to mothers instead of encouraging them to breastfeed. However, this has had little impact on the ground. While there are some notable exceptions, such as lactation complications, due to which new mothers cannot breastfeed, factors like convenience or the false impression of formula being a more hygienic or a better alternative, for rich or poorer households alike, are simply false. It is the responsibility of public health officials, doctors, NGOs and even religious leaders to dispel these false impressions, and to instead create awareness about the multiple benefits of breastfeeding children, as intended by nature.
Published in The Express Tribune, February 15th, 2016.
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