GUWAHATI, India, 23 March 2010 - Every year, two million Indian children die before their fifth birthday, most of them from preventable causes.
Global evidence shows that in developing countries optimal breastfeeding is the most important child survival intervention and the earlier the baby is breastfed, within the first hour of birth, the better.
The Government of India and international organizations recommend that infants be fed only breast milk for the first six months of life, with no other foods or fluids added, not even water. This is referred to as exclusive breastfeeding.
However, in India, only 46 percent of infants are exclusively breastfed and rates of exclusive breastfeeding have shown little improvement in the last decade. Some states are an exception to this rule. Assam is one of them.
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In Assam, the rate of exclusive breastfeeding in infants younger than six months increased from 29 percent in 1999 to 63 percent in 2006. This impressive advance is due to a coordinated strategy led by Government of Assam in partnership with UNICEF and a number of NGOs.
The strategy included harmonizing the messages used for the promotion of breastfeeding, building the capacity of village-based health and nutrition workers to counsel mothers and families on breastfeeding, and standardizing the tools they use to support breastfeeding.
"Unquestionable global evidence demonstrates that breastfeeding counselling and support is the most important child survival intervention" says Dr. Victor Aguayo, Chief Child Nutrition and Development Programme with UNICEF.
In each village, all village-based health and nutrition workers meet at the Anganwadi centre on a fixed day each month. There, they draw up a list of the women who are in their last trimester of pregnancy or nursing an infant and establish a schedule for home-visits.
Each mother on the list is visited at her three to four times a month by one of the village-based workers. During these home visits, the mother is helped to solve problems related to feeding and caring for her infant.
“We know how important breastfeeding is for child survival, and now mothers understand how vital breastmilk is to the health of their babies,” said Jeroo Master, the Chief of the UNICEF Assam office. “Having health and nutrition workers actively promoting breastfeeding at the village level will ensure each child has the best start possible in life with exclusive breastfeeding during the first six months of life.”
Mothers who live and work in the tea communities are in special need of support as most of them resume work soon after childbirth. The Government of Assam and UNICEF urge tea companies to allot nursing mothers in nearby tea plantations so that mothers can go home for nursing breaks. If this is not possible, the secondary caregiver – often a senior woman in the family – is encouraged to take the infant to the mother’s workplace for breastfeeding.
Alternatively, mothers are supported to express their breast milk before they go to the plantation in the morning so that the infant can be fed the expressed breast milk while the mother works. In addition, awareness sessions are organized to engage men and families in supporting exclusive breastfeeding.
A recent survey in Dibrugarh – a quintessentially tea garden district – shows that the rate of exclusive breastfeeding doubled in just four years increasing from 27 percent in 2004 to 53 percent in 2008.
The state of Assam is demonstrating that effective partnerships, focused strategies and community-based action can indeed double the rates of exclusive breastfeeding in a relatively short period of time.
As a result of this concerted effort, in the last four years over 1.7 million Assamese infants have been exclusively breastfed, protected against undernutrition and disease, and given the best start in life.
For more information and interviews, please contact:
Angela Walker, Chief of Communication, UNICEF India
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Geetanjali Master, Communication Specialist, UNICEF India
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Alistair Gretarsson, Communication Specialist, UNICEF India
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