Expecting mothers learn the proper way of breastfeeding through illustrative literature and group sessions
By Vidya Kulkarni
Bhadwad village, Nandurbar district, Maharashtra, April 2006: The small group of women huddled with their young babies at the Anganwadi Centre are listening intently to Durga Gavit, as her four month old son Prashant sleeps comfortably in her lap. With a smile on her face, Durga shares her experience with the group: “My baby is healthy and sleeps well. Even his weight has increased. There are no problems so far.” She recalls the Anganwadi worker explaining to her the importance of early initiation and exclusive breastfeeding.
The women nod in agreement. These women are members of the “active mother’s support group” They have similar experiences and can easily identify with what Durga is saying. A seemingly small change, such as exclusive breast feeding, has made a big difference in the health of their babies.
Durga relates her experience with her first child: “I was not so aware then. Whenever the baby cried, I would feel him any kind of food. I didn’t know about exclusive breast feeding. Now I realize that was the reason for ups and downs in his health.’ Durga and many women like her now understand that exclusive breast feeding is critical to the child’s health in the initial years.
Nandurbar district of Maharashtra is one of the most backward districts in the State. Malnutrition amongst children is approximately 62% which includes mild to moderate cases.UNICEF, in partnership with the district administration and the Breastfeeding Promotion Network of India (BPNI), initiated the Infant and Young Child Feeding (IYCF) programme aimed at preventing malnutrition in young children.
In the programme’s initial phase, a team of 60 health and ICDS workers was trained with active involvement of the BPNI. The team of trainers then undertook further training of around 900 Anganwadi (child-care) workers (AWWs). The workers were trained to use informative hand-outs, weighing scales and charts for village level awareness campaigns and growth monitoring. At the ground level, IYCF is implemented through Auxiliary Nurse and Midwives (ANMs) and anganwadi workers who already work with mothers of infants.
IYCF is a component of the Infant and Young Child Nutrition (IYCN) programme which primarily relies on empowering the community through information and mutual support. It promotes activities like mother’s meetings and mother support groups, wherein the women exchange information and learn as well as teach caring and feeding practices.
Learning the correct method of breastfeeding is key to preventing malnutrition in the early years of a child's life
The anganwadi worker in Bhadwad, Nirmala Gavit together with her college-going daughter Archana, held a series of meetings with the women’s self-help group. “I use pictorial charts and demonstrations to explain what proper breastfeeding means. We make sure women properly understand the importance of early and exclusive breast feeding, position of the baby while feeding, intervals between two feeding as well as introduction of complementary feeding after six months. Rural women do not have a concept of month-wise age of their babies, but we know it from our records. Therefore whenever a child completes six-months, we celebrate it as special day, invite the mother and other women in our centre and organise a demonstration of preparing home based complimentary food and how to feed them.” she says
The women too find these meetings enriching. Anusuya Padvi and Manju Walwi, both expectant mothers, were delighted to learn of the technique of expressing breast milk to be fed later, when the mother would beaway for a few hours. In most rural families women need to get back to work very soon after delivery. Anusuya and others felt this information was very useful and worth trying.
In earlier days the newborn was denied the very nutritious initial mother’s milk, the colostrum. It was thought that the thick fluid would be too heavy for the baby to digest. However, misconceptions about breast feeding are slowly fading away through the consistent efforts of many such support groups which are focussed on bringing about behaviour development.
While information and training are important for awareness, follow-up counselling and group sessions are key to ensure desired behavioural changes happen and are sustained. Mother support groups play an important role in this regard. The SHG leaders are especially effective in this task for they enjoy enhanced status and credibility amongst the villagers.