Three out of five babies born in India are not breast-fed within hour of their birth. Despite strong laws in place, India records poor breast-feeding practices in it’s mothers and could well derive lessons from Rwanda and Malawi on encouraging breast-feeding.

While in Rwanda and Malawi, over 80 per cent new-borns are put to their mother's breast within one hour of their birth, in India this figure hovers at close 40 per cent, the latest World Health Organisation (WHO) report points out. Such low levels of breast-feeding are a direct implication of aggressive promotion of breast-milk substitutes by big pharma and food multi-nationals globally including India, WHO believes.

In an analysis of 76 countries, based on country data supplied to WHO, the global health body estimates that only 42 per cent babies across the world get access to mother's milk within one hour of their birth. India is at 56th rank in the tally of countries analysed for breast-feeding access.

India has recorded poor figures despite adopting full provisions in law, since 2003, to adhere to 'International Code of Marketing of Breast Milk substitutes,' in principle. However, India does not prohibit pictures and text idealising breast-milk substitutes. Neither does it mandate recommended age of introduction, warning for pathogenic organisms and ban on nutrition and health claims on product labels.

WHO criticises India

WHO has criticised India by saying that the criteria for monitoring mechanism is not independent and transparent. It is also not free of commercial influence. For example, India does not prohibit in law, distribution of free products, samples for infants through health workers in health facilities, as also it does not ban promotional contests in public health facilities. Companies can also possibly distribute free gifts, coupons to parents without any inhibition, according to WHO data.

WHO has released country-wise breastfeeding figures, at a time when United States is stringently opposed to promotion of breast-feeding, where it allegedly bullied smaller countries like Ecuador into not passing a strong resolution in World Health Assembly, earlier this year.

In 2014, global sales of breast-milk substitutes totalled US$ 44.8 billion, and this number is expected to rise to US$ 70.6 billion by 2019, estimates WHO. “The report urges governments, donors and other decision-makers to adopt strong legal measures to restrict the marketing of infant formula and other breastmilk substitutes,” a statement issued by WHO said.

The report also notes that developed countries like the US, New Zealand, Norway amongst others have submitted no data to WHO regarding breast-feeding. This when, in high-income countries, 21 per cent of children are never breastfed, compared with only 4 per cent of children who are never breastfed in low- and middle-income countries. This wide gap means that 26 lakh children in high income countries are missing out completely on the benefits of breastfeeding.

“Beyond survival, there is growing evidence that breastfeeding boosts children’s brain development and provides protection against overweight and obesity. Mothers also reap important health benefits from breastfeeding, including a lower risk of breast cancer, ovarian cancer and type 2 diabetes,” the report states.

Most of the world’s newborns are left waiting too long to begin breastfeeding. In 2017 alone, an estimated 7.8 crore babies had to wait more than one hour to be put to the breast. “This means that only about two in five children (42 per cent), the majority born in low- and middle-income countries, were put to the breast within the first hour of life. While this is a slight improvement from 37 per cent in 2005, progress is slow,” the report notes.

Early initiation rates vary widely across regions – from 35 per cent in the Middle East and North Africa to 65 per cent in Eastern and Southern Africa. “Estimates are not available for any countries in North America or Western Europe, highlighting the concerning data gap in many high-income countries,” it states.

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