IT WAS in the 80’s, says Dr Armida Fernandez, a naeonatologist at Sion Hospital, Mumbai, that she was left with an abandoned infant, who had tetanus and was getting weaker despite treatment. “We were feeding the baby formula milk and it was then that an ophthalmology resident, who had recently had her own baby, expressed willingness to feed the infant. The baby was soon on the road to recovery,” Fernandez, the founder of Asia’s first human milk bank, said.
“Back then, Sion hospital had almost 8,000 deliveries every year and over 2,000 babies were referred from outside. We were losing a lot of babies to sepsis and diarrhoea, especially neonates. After much research, the source of diarrhoea was attributed to formulae milk and bottles. There was only one solution to combat this situation: Get mother’s milk to every baby, especially the most vulnerable ones. In a short span of time, we stopped using formulae milk and got healthy lactating mothers to express excess milk. We then saved the milk and used it from one vulnerable baby to another,” Fernandez said.
India continues to bear the highest global burden of neonatal deaths (0.78 million), premature births (3.5 million) and low birth weight babies (7.8 million), and experts like Fernandez are stating that it is imperative to increase access and uptake of mother’s milk.
With World Breastfeeding Week (August 1-7) set to be observed in India and the rest of the world, doctors are now reiterating that there is no time better than now, to push for programmes that encourage optimal breastfeeding practices.
“I understood that human milk banks protect, promote and support breastfeeding as they are ideally positioned to provide lactation support for mothers,” said Fernandez, who set up Asia’s first human milk bank at Sion hospital in 1989.
Mothers were tested for HIV and milk was pasteurised to ensure that babies were fed safe milk. Over the years, safety protocols were set up and 22 human milk banks have come up at various other hospitals. In the process, clinical evidence showed that mortality has decreased.
Fernandez, however, said that it is now time to scale up the number of banks across the country and improve our neonatal outcomes. She added that expanding the setting up of these milk banks has been slow for a variety of reasons, among them, a fear of HIV/AIDS, lack of guidelines and quality control systems, the reservation of authorities, lack of awareness in society and even among the health care professionals and a lack of funding.
Breastfeeding is a cost-effective, life-saving intervention for premature children with low birth weight or those who have an infection. The Lancet Series on Breastfeeding, 2016, reported that breastfeeding alone can prevent 13 per cent of under-five deaths in developing countries each year. In India, however, breastfeeding rates continue to be dismal. NFHS III data suggests that rates of early initiation, exclusive breastfeeding and complementary feeding stand at 24.3 percent, 46.9 percent and 64.3 percent, implying a need for effective roll-out of various government initiatives in this direction.