Breastfeeding – Importance and Challenges

Why in News?

Recently, India continues to see a drop in exclusive breastfeeding by six months, despite high initiation rates.

What is breastfeeding?

• Definition – Breastfeeding, also called nursing
• It is the process of feeding a mother's breast milk to her infant.
• It is done either directly from the breast.
• It is also done by pumping out the milk from the breast and bottle-feeding it to the infant.
• Status in India – Only 63.7% of infants meeting World Health Organisation (WHO) guidelines, according to the National Family Health Survey (NFHS) -5.
  • India’s current systems treat it as optional or supplemental.

What are the benefits of breast feeding?

• For child

• For mother

What are the challenges in breastfeeding?

• Physiological barriers – Latching difficulties, maternal nipple pain and low perceived milk supply are primary causes for early discontinuation.

In breastfeeding, latching refers to how a baby attaches their mouth to the mother's breast to feed. A good latch involves the baby's mouth covering not just the nipple, but also a portion of the areola (the dark area around the nipple). This allows for effective milk transfer and minimizes discomfort for the mother.

• Hormonal issues – It can inhibit oxytocin -the hormone essential for milk ejection, further complicating feeding.
  • Stress elevates cortisol, which interferes with prolactin-driven milk production.
• Poor maternal health – Marginalised mothers especially from tribal, migrant and urban poor communities face compounded challenges of malnutrition, low literacy and poor access to health information.
• Lack of Maternity leaves – Women in informal sectors, lack maternity leave which inhibits breastfeeding habit.
• Absence of safe spaces – There is a insufficiency of safe and secure spaces to feed milk.
• It causes early weaning.

Weaning, is the process of switching an infant's diet from breast milk or formula to other foods and fluids.

• Lack of trained staff – Without trained staff to correct positioning and latch, mothers often stop within weeks.
  • They are not equipped to diagnose a poor latch, assess milk transfer, or identify feeding-related weight faltering.
• Psychosocial barriers – It includes lack of support from partner, family and workplace stress.
• Low compliance – Although India’s Maternity Benefit Act mandates breastfeeding breaks and crèche facilities, compliance is low.

What can be done to promote breastfeeding?

• Lactation support – ASHAs (Accredited Social Health Activist) and ANMs (Auxiliary Nurse Midwife) - play a pivotal role in extending lactation support into communities.
• Competency-based lactation training – It provides access to visual tools and referral pathways for unresolved cases.
• Digital aids – Growth monitoring charts and helpline access can increase field-level efficacy.
  • For example, Exclusive breastfeeding at 3 and 6 months can be tracked
• Structural reforms – Access to clean, private feeding rooms increase breast feeding duration.
  • Public-private partnerships and CSR-backed infrastructure in factories and informal work hubs could address these gaps.
• Innovative methods – We need mobile crèches, lactation pods and peer-led support at the community level.
• Targeted advocacy – We need multilingual, audio-visual counselling and incentives embedded in schemes like ,
  • Pradhan Mantri Matru Vandana Yojana (PMMVY)
  • Mothers’ Absolute Affection (MAA) program
  • Indira Gandhi Matritva Sahyog Yojana (IGMSY)
• Establishing as right – Treating breastfeeding as a health right could develop a sense of consciousness among people.
• Social support – Attaching local leaders in programme planning can enhance trust and cultural fit.

What lies ahead?

• The government and health organisations could encourage people to embed lactation science into everyday healthcare delivery.
• Structured, evidence-based support could be made available at every level hospital, home and workplace.

Reference

The Hindu| Structural Reforms to Promote Breastfeeding