Sensitive and compassionate breastfeeding support and counselling is critical to enable women to overcome the challenges of initiating and continuing breastfeeding, leading to healthier babies, better economies and a healthier planet, said experts celebrating World Breastfeeding Week.
Keynote speaker Dr Diane Spatz, professor of perinatal nursing and Helen M. Shearer term professor of nutrition at the University of Pennsylvania School of Nursing, talked about the needs of infants who are separated from their mothers' right after birth and placed in critical care units in hospitals. Her model that focuses on promoting and protecting human milk and breastfeeding in vulnerable infants, popularly known as Spatz 10-step system, has been implemented across 10 countries, including Botswana, Canada, Chile, China, India, Japan, Mexico, Thailand, UK and the USA.
Underlining the need for an alternative approach for healthcare providers, she says: “Families need to learn the science of human milk and the physiology of lactation and that it will take time, effort and commitment, especially if you have a sick child."
In Pakistan, breastfeeding rates are still low. The proportion of children put to breast within one hour after delivery was 45.8% and exclusive breastfeeding was 48.4% according to the National Nutrition Survey, 2018. Dr Umar Khan, representing UNICEF Sindh, called for the revival of the WHO and UNICEF's Baby-friendly Hospital Initiative, BFHI, that was initially launched in the country in 1992 and saw favourable outcomes in the hospitals where it was implemented.
“Lack of institutionalisation and a weak enforcement environment led to the collapse of BFHI. However, if this strategy is integrated into the government's National Vision 2016-2025 to address malnutrition, we can train sufficient health workers and establish an appropriate structure to support implementation and monitor progress," he added.
Recalling the efforts that have gone into supporting breastfeeding and nutrition, Dr Noureen Nishtar, National Professional Officer, Nutrition, Environmental Health and Food Safety, WHO Pakistan said that there are infant and young child feeding, IYCF, strategies at the national and provincial levels as well as breastfeeding promotion and protection act in place. “What we need now is to build alliances, especially with the nutrition industry, without any conflicts of interest to ensure rigorous implementation of these strategies and for better community outreach," she said.
The Government of Sindh's Accelerated Action Plan, AAP, initiative is also working on a multi-sectoral approach, including the nutrition specific and nutrition sensitive sectors to holistically work towards improving the IYCF indicators and reduce malnutrition significantly by 2021.
Dr Sahibjan Badar, the programme coordinator for AAP, elaborating on the impact of the Sindh government's health interventions, said “Our first 1000-day strategy, that begins when a woman conceives until the child completes two years, has shown significant results in reducing anemia in under-fives. More importantly, through the community-based interventions using trained lady health visitors and lady health workers, we can easily double the current prevalence of exclusive breastfeeding in the next couple of years."
The Dean of AKU's School of Nursing and Midwifery, Dr Rozina Karmaliani, spoke about the recent launch of the first nurse-run lactation consulting clinic at the Aga Khan University Hospital, AKUH, which was a milestone for the School and a definitive step forward towards improving mother and child health. She also stressed on the importance of synergizing these efforts and strengthening public-private partnership as a way forward to institutionalise this important initiative.
The online event was organised by the School in collaboration with WHO, UNICEF, AAP, the Aga Khan University Hospital and the Midwifery Association of Pakistan.
Dr Lumaan Sheikh, chair, department of obstetrics and gyneacology, AKUH; Dr Rubina Barolia, assistant dean, clinical practice and Zohra Kurji, assistant professor at the School and lactation consultant AKUH; and Arusa Lakhani, President MAP, also spoke at the event.