Nourishing India’s Future: Exclusive Breastfeeding (EBF) as a Weapon Against Malnutrition

Authors: Deepali Kausshik, Public Health Professional; Kumar Gaurav, Public Health Professional

Malnutrition is a persistent issue in India, with millions of children suffering from undernutrition, leading to stunted growth, wasted bodies, and developmental issues. Breastfeeding benefits infants by providing the perfect blend of nutrients that support gut and immune system development, while also preventing the intake of pathogens[i] found in food or water during exclusive breastfeeding. One of the most effective and cost-efficient ways to combat this crisis is through the practice of exclusive breastfeeding. In this blog, we will explore the significant role exclusive breastfeeding plays in reducing malnutrition issues in India.

The State of Malnutrition in India

Despite India’s rapid development, the country grapples with high malnutrition rates, affecting children’s health and development. According to the Global Nutrition Report[ii], India falls short of the exclusive breastfeeding target, with only 58.0% of infants aged 0 to 5 months being exclusively breastfed. Additionally, 34.7% of children under 5 years are stunted, higher than the Asian regional average of 21.8%. India has made no progress in reducing wasting, with 17.3% of children under 5 years affected, exceeding the Asian regional average of 8.9% and ranking among the highest globally.

Exclusive Breastfeeding: A Lifesaver Instrument

World Health Organisation (WHO)[iii] and UNICEF[iv] recommend exclusive breastfeeding i.e. feeding only breast milk to the infant without any additional food or drink, not even water, for the first six months of life. The WHO advises initiating breastfeeding within the first hour of life because colostrum, the yellowish, sticky breast milk produced in late pregnancy, is the newborn’s ideal nourishment[v]. It serves as the most natural and comprehensive source of nutrition, equipping infants with all vital nutrients for their healthy growth and development.

How Exclusive Breastfeeding Mitigates Malnutrition in India

• Optimal Nutrition: Breast milk offers the perfect nutrient balance, with proteins, fats, carbs, and vitamins, reducing the risk of infant malnutrition. It also bolsters immunity against infections reducing the risk of illness contributing to malnutrition.
• Enhanced Digestibility: Breast milk is easily digestible, vital in areas with limited access to clean water for formula preparation.
• Infection Protection: Breast milk’s immune-boosting properties guard against diseases, particularly crucial in regions with sanitation and healthcare challenges across India.
• Emotional Bond: Breastfeeding strengthens the mother-child bond, fostering a nurturing environment for the baby’s overall development.

Challenges to Exclusive Breastfeeding in India

Despite the clear benefits of exclusive breastfeeding, several challenges exist that hinder its widespread adoption in India:

• Cultural Beliefs and Myths: Many cultural beliefs and misconceptions surround breastfeeding practices, leading some mothers to opt for other feeding methods prematurely.
• Low Exclusive Breastfeeding Rates: According to NFHS-5, just 63.8% of Indian infants are exclusively breastfed for the first six months. This points to a major knowledge and awareness gap. Many caregivers lack information about the benefits of exclusive breastfeeding and its recommended duration in reducing malnutrition and promoting infant health.

• Delayed Initiation of Breastfeeding: NFHS-5[vi] also reveals that only 41.8% of Indian infants are breastfed within the first hour of birth. Immediate breastfeeding is essential for successful exclusive breastfeeding, but this critical step is missed by many Indian infants, hindering the practice.

• Maternal Employment: Working mothers may face challenges in finding a suitable environment and time to breastfeed or express milk at the workplace.
• Lack of Awareness: In some areas, there is limited knowledge about the benefits of exclusive breastfeeding, which can result in the early introduction of complementary foods.
• Social Stigma: There are instances where mothers face social stigma for breastfeeding in public, which may discourage them from practicing exclusive breastfeeding.

Government Initiatives and Support

Acknowledging the pivotal role of exclusive breastfeeding in tackling malnutrition, the Indian government has instituted initiatives to endorse this practice. Within the Integrated Child Development Services (ICDS) program, components focus on maternal education about breastfeeding benefits. Moreover, counselling and support for exclusive breastfeeding are provided through Anganwadi workers (AWWs). Non-Governmental Organizations (NGOs) and healthcare workers also contribute significantly by raising awareness and delivering essential support to mothers.

Conclusion

Exclusive breastfeeding is not just a simple act of feeding; it’s a powerful tool in the fight against malnutrition. It is essential to address cultural beliefs, provide maternal support, and raise awareness among communities to extend its benefits. Only through collective efforts from governments, healthcare providers, NGOs, and society can India hope to reduce the malnutrition issues that continue to plague its children. Nurturing India’s future begins with the first drop of breast milk, and this practice holds the key to a healthier, stronger, and more prosperous nation.

[i] https://pubmed.ncbi.nlm.nih.gov/11115791/#:~:text=Breast%2Dfeeding%20is%20believed%20to,of%20pathogens%20in%20food%20or as on 16^th October 2023

[ii] https://globalnutritionreport.org/resources/nutrition-profiles/asia/southern-asia/india/ as on 16^th October 2023

[iii] https://www.who.int/health-topics/breastfeeding#tab=tab_1 as on 16^th October 2023

[iv] https://www.unicef.org/press-releases/who-unicef-issue-new-guidance-promote-breastfeeding-globally as on 16th October 2023

[v] https://www.unicef.org/press-releases/who-unicef-issue-new-guidance-promote-breastfeeding-globally as on 16th October 2023

[vi] NFHS 5 Report India- https://main.mohfw.gov.in/sites/default/files/NFHS-5_Phase-II_0.pdf