Munshi Jalal Uddin :Proper infant feeding is a crucial issue for child nutrition, survival and development. There are three determinants of good health, nutrition and child survival. These are food security, care and disease control. Breastfeeding is an excellent example of all these three things in one. Breastfeeding makes significant contribution to the success of important public health programs like immunization, control of diarrhoeal disease, management of acute respiratory infections (ARI), Vitamin A supplementation and family planning.Decrease in breastfeeding practices has taken place worldwide during the 20th Century. The first half of the century was particularly marked by declines in breastfeeding in the industrialised world. In Bangladesh by tradition until recently colostrums was largely discarded by mothers. Pre-lacteal feeds are still given to most newborns. There is high prevalence of bottle feeding; unethical marketing of breast milk substitute (BMS) is wide spread; healthcare providers often prescribe BMS; complementary feeding practices are unsatisfactory; there may be withdrawal of breastfeeding during illnesses, especially during diarrhoea and Acute Respirator Infection ARI. The decline and erosion in breastfeeding practices have led to disastrous consequences on the health, nutrition and well being of children, mothers and the world population at large. The benefits of breastfeedingThe ancient practice of breastfeeding has shown many benefits. It is now clear that the beneficiaries of breastfeeding are not only infants but also the mothers, the family and the society as a whole. Human milk not only supplies the full complement of nutrients that are necessary for the first six months of life, but also acts as the child’s ‘first vaccine,’ because of its various immune properties. In the long run breastfeeding also protects from disease in later life.The balanced constituents of breast milk help in easy digestion and make for high bio-availability of most macro and micronutrients. It contains more anti-infective protein. It also contains essential fatty acids that are not present in cow’s milk or cow’s milk products. The enzyme lipase in human milk helps to digest fat and its higher lactose content makes it more palatable. Though iron is present in equal amount in human and cow’s milk, the absorption is five times higher from human milk. Although cow’s milk contains four times more calcium than human milk, the infant fed on cow’s milk may develop tetany because of its high phosphate load, making the calcium less available. Breast milk contains Vitamins A and C in greater amount than cow’s milk, thus breastfed infants are protected from xerophthalmia and scurvy. Breastfeeding protects an infant from morbidity and mortality related to diarrhoea. The risk of diarrhoea is inversely related to the amount of breastfeeding. The protection from diarrhoea with breastfeeding is mediated in two ways: directly, through specific and non-specific immune mechanisms; and indirectly, as no extra water is needed in a breastfed infant which may be the media of infection, particularly in a developing country. Breastfeeding protects infants from acute respiratory infection (ARI) the most common cause of morbidity and mortality in developing countries. A study from Brazil has shown risk of death from severe pneumonia to be 3.6 times higher in artificial fed infants than in breastfed ones. Breastfeeding also influences the antibody response to conjugate vaccine. The antibody level in the initial period may not differ but at 12 months the breastfed infant ultimately has significantly higher antibody than the formula fed infant. There is evidence that breast milk protects against allergic disease. An American study has shown that a baby who is breastfed for more than 12 months has half the risk of developing insulin-dependent diabetes mellitus (IDDM). Breastfeeding may contribute more to birth spacing than all family planning methods combined in many countries. There is now consensus that women who fully or nearly fully breastfeed had a less than 2 per cent risk of pregnancy in the six months after delivery. In addition to the direct health effects, breastfeeding seems to provide a sense of bonding, sense of well-being and an improved sense of self-esteem for many women. Breastfed infants are more intelligent, have less speech difficulties, and achieve a higher score in vocabulary tests and design coping tests than bottle fed children. Breastfeeding also helps the family economically. It saves the cost of artificial feeding as well as the cost of cleaning bottle, nipple, sterilisation and time spent in doing all these things. The total cost per month per baby will be about the monthly pay of a lowly paid staff or a regular paid labourer, which means it is unaffordable.So realising the benefits of breastfeeding, we all should contribute our best to ensure every baby be breastfed appropriately and adequately.
