CLOSING THE GAP

Breastfeeding is the best source of nutrition for most infants reducing the risk of certain health conditions for both infants and mothers. Every year, the first week of August marks World Breastfeeding Week, a global campaign supported by WHO, UNICEF, and numerous Ministries of Health and civil society partners. The theme for 2024, ‘Closing the Gap: Breastfeeding Support for All’ emphasises the importance of inclusive support for breastfeeding mothers. This year’s campaign celebrates the diverse experiences of breastfeeding mothers while highlighting how families, communities, and health workers can support them.

The initial weeks and months of breastfeeding can be fraught with difficulties, from latching issues to societal pressures. Yet, with the right support, these challenges can be overcome, making breastfeeding a rewarding and bonding experience for both mother and child.

Ayesha Malik, a mother of two, resides in a small apartment. Her journey exemplifies determination and the power of community support. “Breastfeeding my first child was challenging. I felt isolated and overwhelmed, with little support or guidance,” she recalls. “But with my second child, I joined a local mothers’ group where I found incredible support. The difference was night and day. There were times when I wanted to give up,” she admits. “But the support from my mothers’ group kept me going. Now, I’m proud to say that I breastfed both my children successfully,” elucidates Ayesha.

Fatima Hussain, a lactation consultant working at a reputable hospital, emphasises the importance of community support. “Breastfeeding is not just a mother’s responsibility. It’s a collective effort,” she states. “When communities and families stand behind breastfeeding mothers, providing emotional and practical support, we see higher success rates and happier, healthier babies.”

In the heart of Karachi, Abida Begum, a vendor and mother of three, shares her struggles and triumphs. “Balancing work and breastfeeding were tough. But my co-workers, who are all females, provided a private space for me to breastfeed,” she says. “That support and understanding made all the difference.”

According to the Pakistan Demographic and Health Survey (PDHS) 2017-18, the exclusive breastfeeding rate for infants under six months in Pakistan is 48 per cent, with the median duration of any breastfeeding being 19.7 months. Globally, the World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond. However, only about 44 per cent of infants 0-6 months old are exclusively breastfed worldwide. Suboptimal breastfeeding practices, including non-exclusive breastfeeding and early cessation, are responsible for 800,000 child deaths annually across the globe.

Breastfeeding has numerous health benefits, such as reducing the risk of gastrointestinal and respiratory infections in infants. According to a study published in The Lancet, breastfeeding could prevent nearly half of all diarrhoea episodes and one-third of all respiratory infections in low- and middle-income countries. Additionally, breastfeeding is associated with a lower risk of sudden infant death syndrome (SIDS), childhood leukaemia, and obesity in later life.

The economic benefits of breastfeeding are also significant. A study published in Health Policy and Planning estimated that suboptimal breastfeeding costs the global economy approximately $302 billion annually due to lost productivity and healthcare costs. In Pakistan, a study estimated that if the exclusive breastfeeding rate were increased to 90 per cent, the country could save approximately $6 billion over ten years in healthcare costs related to treating childhood diseases preventable through breastfeeding.

Despite these benefits, nursing mothers in Pakistan face challenges such as cultural practices, lack of knowledge, and inadequate support from healthcare systems. Many mothers return to work soon after childbirth, and the lack of workplace support for breastfeeding or expressing milk can hinder their ability to continue breastfeeding. There is also a need for more trained lactation consultants and breastfeeding support programs in both urban and rural areas of Pakistan. This highlights the importance of breastfeeding support and the significant impact that initiatives like World Breastfeeding Week can have on improving health outcomes for mothers and children.

The week long initiative shines a spotlight on the role of healthcare professionals in supporting breastfeeding mothers. “Healthcare workers are on the front lines,” says Dr Amina Hassan, a paediatrician. “Their knowledge and encouragement can empower mothers to continue breastfeeding, even when they face obstacles.”

Dr Amina has seen first-hand the difference that proper support can make. “I once had a patient who was ready to give up on breastfeeding because of pain and frustration. But with the right guidance and reassurance, she persevered and eventually found breastfeeding to be a joyful and fulfilling experience.”

In an underprivileged area of the city, community health worker Rabia Shaikh brings change through grassroots efforts. “We educate both mothers and their families about the benefits of breastfeeding,” she explains. “By involving the entire community, we’ve seen a significant increase in breastfeeding rates and overall child health,” she observes.

Rabia’s work underscores the importance of community-based support in diverse socio-economic contexts. In Karachi, where cultural norms and economic challenges often intersect, tailored support systems are crucial. “We conduct workshops and home visits to ensure that mothers receive the support they need. It’s about creating a network of care,” says Rabia.

Her efforts are endorsed by Farah Khan, a social worker, “In our community, we have established support groups where mothers can share their experiences and learn from each other.”

Farah explains how these groups operate. “We meet regularly to discuss common issues, offer advice, and provide emotional support. The support and camaraderie among the mothers are truly inspiring. It shows that when women come together, they can overcome any challenge.”

Zahra Ahmed shares her experience as a mother with a physical disability. “Breastfeeding with a physical disability can be incredibly challenging. Initially, I was apprehensive about breastfeeding because of my limited mobility. But with the help of adaptive equipment and support from my family and healthcare providers, I managed to breastfeed my child successfully,” she exclaims.

Zahra’s story highlights the need for inclusive support systems. “We need to ensure that all mothers, regardless of their physical abilities, have access to the resources and support they need to breastfeed. It’s about creating an environment where every mother feels empowered and capable,” she emphasises.

Cultural practices also play a significant role in breastfeeding. In some parts of Karachi, traditional beliefs and practices can either support or hinder breastfeeding. “In some families, there’s a strong emphasis on exclusive breastfeeding, which is great,” says Fatima. “But in others, there is a misconception that formula feeding is better or more modern. Education and awareness are key to changing these perceptions,” she stresses.

Salma Baig, a full-time employee at a corporate job, reflects on how cultural practices affected her breastfeeding journey. “In my family, there was a lot of pressure to introduce solid foods early. It was only after I attended a breastfeeding workshop that I realised the importance of exclusive breastfeeding for the first six months,” she recalls.

Educational initiatives are crucial in addressing these cultural challenges. Workshops, seminars, and public awareness campaigns can help dispel myths and promote best practices. “Education is the cornerstone of our efforts,” says Dr Amina. “We need to equip mothers with the knowledge and confidence they need to make informed decisions about breastfeeding.”

One such initiative in Karachi is the Breastfeeding Awareness Campaign, which conducts workshops in various neighbourhoods. “Our goal is to reach as many mothers as possible,” says, one of the campaign’s coordinators. “We provide information on the benefits of breastfeeding, proper techniques, and how to overcome common challenges.”

Technology also plays a role in supporting breastfeeding mothers. Mobile apps and online forums provide a platform for mothers to seek advice and share experiences. “In today’s digital age, access to information is just a click away,” says Zahra. “I found a lot of helpful tips and support through online breastfeeding communities.”

However, Farah cautions that while technology can be a valuable resource, it is important to ensure that the information is accurate and reliable. “Not all information on the internet is credible,” she warns. “Mothers should seek advice from trusted sources, such as healthcare professionals and reputable organisations,” suggests Farah.

As the world celebrates World Breastfeeding Week, the experiences of these different women remind us of the power of support and community. Each of these women faced unique challenges, but with the right support, they overcame them and thrived.

The theme ‘Closing the Gap: Breastfeeding Support for All’ resonates deeply, where diverse socio-economic backgrounds and cultural practices intersect. By recognising and addressing the unique needs of each mother, we can create a more inclusive and supportive environment for breastfeeding.

“Breastfeeding is a journey that no mother should have to undertake alone, With the right support, every mother can succeed” says Dr Amina.

Ayesha reflects on her journey and offers a message of hope and encouragement to other mothers. “Breastfeeding is a journey, and it’s different for everyone. Don’t be afraid to seek help and lean on your support system. We’re all in this together.”

Let’s commit to standing behind breastfeeding mothers, closing the gap, and fostering a world where breastfeeding is embraced and supported.

Names have been changed to maintain privacy.

The writer is a subeditor at You! magazine. She can be reached at wallia_khairi@hotmail.com

Understand the basics of breastfeeding nutrition

If you’re breastfeeding, you’re giving your baby nutrients that will promote growth and health. You might have questions however, about what foods and drinks are best for you - and how your diet might affect your breast milk and your baby.

Do I need extra calories while breastfeeding?

Yes, you might need to eat a little more - about an additional 330 to 400 calories a day - to give you the energy and nutrition to produce milk.

To get these extra calories, opt for nutrient-rich choices, such as a slice of whole-grain bread with a tablespoon (about 16 grams) of peanut butter, a medium banana or apple, and 8 ounces (about 227 grams) of yogurt.

What foods should I eat while breastfeeding?

Focus on making healthy choices to help fuel your milk production. Opt for protein-rich foods, such as lean meat, eggs, dairy, beans, lentils and seafood low in mercury. Choose a variety of whole grains as well as fruits and vegetables.

Eating a variety of foods while breastfeeding will change the flavour of your breast milk. This will expose your baby to different tastes, which might help him or her more easily accept solid foods down the road.

To make sure you and your baby are getting all of the vitamins you need, your health care provider might recommend continuing to take a daily multivitamin and mineral supplement until you wean your baby.

How much fluid do I need while breastfeeding?

Drink when you are thirsty, and drink more if your urine appears dark yellow. You might drink a glass of water or another beverage every time you breastfeed.

Be wary of juices and sugary drinks, however. Too much sugar can contribute to weight gain - or sabotage your efforts to lose pregnancy weight. Too much caffeine can be troublesome, too. Limit yourself to no more than 2 to 3 cups (16 to 24 ounces) of caffeinated drinks a day. Caffeine in your breast milk might agitate your baby or interfere with your baby’s sleep.

Source: Mayo Clinic