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World Breastfeeding Week 1-7 August, 2019. Empower Parents, Enable breastfeeding Now and for the future!. Dr. JP Dadhich MD ( Paediatrics ), FNNF National Coordinator and Technical Director, Breastfeeding Promotion Network of India (BPNI). Cost of Inadequate Breastfeeding?.
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World Breastfeeding Week 1-7 August, 2019 Empower Parents, Enable breastfeeding Now and for the future! Dr. JP Dadhich MD (Paediatrics), FNNF National Coordinator and Technical Director, Breastfeeding Promotion Network of India (BPNI)
Cost of Inadequate Breastfeeding? Source: https://www.aliveandthrive.org/country-stat/india/
Breastfeeding practices are sub-optimal in India (NFHS - 4) Early Initiation – 41.6%; Excl. Breastfeeding –54.9%
Exclusive Breastfeeding falls rapidly! (NFHS -4, 2016)
INR 40 Billion + baby food sales in India which is increasing by app. 15% per year 25 Million Births/Year – A potential market – Largely untapped Source: Euromonitor International 2016 India report
Barriers for successful breastfeeding • Aggressive Promotion of Baby Foods
IYCF Policy and Programmes status - India WBTi report 2018
The Oxytocin reflex Works before or during feed to make milk flow Pain Worry Stress Doubt CONFIDENCE
Breastfeeding Counselling is the KEY • To all pregnant women and mothers with young children as a standard of care • In both the antenatal period and postnatally, and up to 24 months or longer • At least six times, and additionally as needed • Provided through face-to-face counselling, additionally telephonically
Breastfeeding Counselling is the KEY • By appropriately trained health-care professionals • Should anticipate and address important challenges and contexts for breastfeeding – • Primi mothers • Multiple pregnancies • Mothers returning to work
Skilled counselling helps in sustaining exclusive breastfeeding Gupta A, Dadhich JP, Ali SM, Thakur N. Indian Pediatrics, 2019
Infant formula manufacturers have a duty towards the shareholders to maximize profits International Babyfood Action Network (IBFAN) (1983) Action pack “A dangerous trend”
Antenatal counselling • Initiating breastfeeding with in 1 hour of birth and avoiding pre-lacteal feeds • Benefits of exclusive breastfeeding for six mo. • Dangers of artificial feeding and bottle feeding • Correct positioning and attachment • Clarifying myths and doubts
At Birth – Skin to Skin Contact; Initiation of Breastfeeding
Identifying Feeding Cues • Opening mouth • Lip smacking • Protruding tongue • Rooting for breast • Agitated • Crying
No food/fluid other than breastmilk, unless medically indicated • IEM • Galactosemia • MSUD • Phenylketonuria • Maternal drugs • Cytotoxic Chemotherapy • Radio-isotopes • Psychotherapeutic drugs
Among women who initiated breastfeeding and intended to breastfeed for >2 months, percentage who stopped breastfeeding before 6 weeks according to the number of Baby-Friendly Hospital Initiative practices they experienced • USFDA survey of mothers • N = 500,000 • Looked into: 6 practices • breastfeeding initiation within 1 hour of birth • giving only breast milk • rooming in • breastfeeding on demand • no pacifiers • fostering breastfeeding support groups Ann M. DiGirolamo et al. Pediatrics 2008;122:S43-S49
Concluding remarks Thanks!!! Successful breastfeeding is a collective effort Health Care Facilities practices should be breastfeeding friendly Health Care Providers have a special responsibility Counselling is the KEY jpdadhich@bpni.org