Why aren’t Pakistani mothers breastfeeding?

The PPA has been asking for stricter implementation of the breastfeeding laws to protect children

Pakistan’s current rate of child stunting is among the highest in the world. A leading cause of this malnutrition is limited breastfeeding contradictory to the misimpression that most Pakistani mothers breastfeed their children. According to recent estimates, however, less than 40 per cent of babies are being breastfed exclusively during their first six months. Excluding mothers who understandably cannot breastfeed for health reasons, the widespread scale of this problem suggests there is a range of interrelated impediments which are preventing a clear majority of Pakistani mothers from adequately breastfeeding their babies.

The importance of exclusive breastfeeding during the first six months of the newborns’ lives remains unrealised. Instead, many mothers seem to believe that traditional concoctions like battri, crushed herbs and tea, ghee and honey are better than the mother’s own milk. Many mothers do not feed their babies colostrum, which is the mother’s first milk, which contains vital antibodies that protect newborns against diseases.

Besides misplaced local traditions, misleading marketing by the formula milk industry remains another reason why women in developing countries have not been breastfeeding their children as much as they should during the first six months, and thereafter, up till the age of two. International conventions and Pakistani law do prohibit marketing breast milk substitutes. Multinationals claim that they adhere to these laws, and only contact health professionals to advise them on the nutritional facts about their products. A new investigation by The Guardian and Save the Children in the Philippines, for instance, has shown how large formula producing companies (including Nestlé), while ignoring ethical business practices have been found giving doctors, midwives and local health workers a range of gifts for recommending their products.



Many children fall sick when given formula milk using poorly sterilised bottles. The water used to prepare formula is often unclean, as poorer families also often use less than required formula to save money spoon, falsely believing that only this formula can give the required nourishment to babies.

Depriving babies of breastfeeding at a critical stage of their development has serious consequences, including limited height, incomplete brain development, and elevated disease risks. Widespread stunting also has much wider implications, like increased healthcare burden and reducing the productivity of future generations.

The Pakistan Pediatrics Association (PPA) has been asking for stricter implementation of the breastfeeding laws to protect children from malnutrition. Owing to lax government attitudes, bottle-feeding rate in Pakistan is above 40 percent, as per Unicef estimates. Healthcare practitioners need to be less enthusiastic about recommending formula if women are reluctant to give their babies colostrum, instead they should try to convince the mothers about its medical benefits, and emphasise the need for exclusively breastfeeding their children, unless medical reasons prevent them from doing so.

To achieve the goal of reducing the rate of stunting, the government needs to do a lot more, particularly addressing the issues of maternity care, birth spacing and maternal nutrition to ensure that more mothers are healthy enough to breastfeed their newborns. Effective public campaigns to emphasise exclusive breastfeeding, especially in the initial phase of child development, targeting not only mothers, but also husbands and grandparents, who are often proponents of ‘traditional’ concoctions, are needed. Within the formal sector, maternity leave and flexible working hours for new mothers needs to be assured. Presently, there is little public tolerance for breastfeeding in Pakistan, unlike many other Muslim countries. Changing these attitudes is vital, especially within the informal sector.

While ambitious, such a comprehensive approach remains vital to reverse the alarming child stunting rates, which are seriously undermining the future of a large percentage of our population.

Published in The Express Tribune, March 16^th, 2018.

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