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To tackle malnutrition, mothers in Nandurbar learn breastfeeding method devised at IIT-B

Like Meenabai’s child, hundreds of newborns across Nandurbar have benefitted from these techniques. For the first time, the district is witnessing a 30-40 gram per day weight gain among newborns, as compared to 10-12 gram earlier.

Breastfeeding, IIT Bombay, breastfeeding method devised at IIT-B, malnutrition, malnutrition rate, Indian Express, India news, current affairs, Indian Express News Service, Express News Service, Express News, Indian Express India NewsAnganwadi workers being trained as per IIT-Bombay modules. These workers later train new mothers. Minal Karanwal

Meenabai Sachin Pawra gave birth to a boy on July 27 in Taloda Taluka of Maharashtra’s Nandurbar district. The child was underweight — like many others in this tribal-dominated district, among those with the highest burden of malnourished children in the country.

But just within the first week of August, his weight increased from 2.18 kg to 3 kg, a much faster rate of weight gain than the earlier norm, thanks to a set of modified breastfeeding techniques developed at Indian Institute of Technology, Bombay (IIT-B).

Like Meenabai’s child, hundreds of newborns across Nandurbar have benefitted from these techniques. For the first time, the district is witnessing a 30-40 gram per day weight gain among newborns, as compared to 10-12 gram earlier.

“We have seen such weight gain in a limited period for the first time. It is helping us reduce as well as prevent undernutrition in the district,” said Dr Ashwini Desale, chief health officer, Nandurbar.

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Rupal Dalal, an associate professor from IIT-B’s Centre for Technology Alternatives for Rural Areas (CTARA), has developed these new breastfeeding techniques.

So how are they different from existing ones? Dalal told The Indian Express over email that the technique improvised on the “cross-cradle hold”, mentioned in WHO guidelines for low birthweight babies. With the U-shape contouring of the breast so that the mother’s fingers are parallel to the baby’s lips, this helps with proper attachment of the baby’s mouth to the lower part of areola.

“In this position, the baby is brought very close to the mother and also the baby’s head is well controlled by the mother’s hands to allow extension of the neck backward. This makes it easy for the baby to swallow,” she said.

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IIT-B’s CTARA has made several animated tutorials on the techniques which are being translated into 20 Indian languages. Researchers under Dalal use these videos to educate Integrated Child Development Services (ICDS) supervisors who, in turn, sensitise the mothers. The ICDS staff are trained with dummy babies and breast-shaped props.

Minal Karanwal, a sub-divisional officer who is heading the project, said: “The videos helped us to understand at the macro-level that a simple extension in the neck of the child during breastfeeding helps the babies in easier swallowing — just like we extend our necks while drinking water.”

Anganwadi workers and health officials regularly visit the new mothers to check if they are using the right technique.

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Dalal, who has years of experience in child nutrition, says the techniques have helped in weight gain of around 900 grams a week for newborns. The government’s module says 500 grams weight gain per month, “… which is too low in my opinion”, she said.

An earlier study conducted by Dalal showed that 90 per cent of babies gained more than 25 grams/day in weight in their first three months with these techniques.

Karanwal said the district has an exclusive breastfeeding rate of 86.6 per cent. By this calculation, the incidence of malnutrition should have been minimal. But as per NFHS-5 data, Nandurbar’s stunting, wasting and underweight indicators are unsatisfactory. As per the records for the district, 30.7 per cent children are wasted, 57.2 per cent are underweight and 45.8 per cent are stunted.

“We found that the high exclusive breastfeeding rate wasn’t helping in reducing the malnutrition among children. When we came across the tutorials of IIT-B, we realised that due to incorrect breastfeeding techniques, the milk wasn’t reaching the babies’ stomach,” said Karanwal.

While the National Nutrition Mission guidelines of the Centre recommend 28 grams weight gain per day, the Health Spoken Tutorials have helped the district to achieve weight gain of 35-50 gram per day.

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“To know if the mothers are correctly breastfeeding, we also have to check the growth velocity which wasn’t being done to such an extensive matter earlier as compared to the present situation. Dalal is also developing a mobile application which will further help us better data collection,” said Karanwal.

District collector Manisha Khatri said the app will now be developed in eight tribal languages of the region.

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In June, she spoke about the initiative to Modi in Chief Secretaries’ conclave in Dharamshala in Himachal Pradesh. “It was well-appreciated by the Prime Minister,” said Khatri.

According to Dalal, it is important to implement the techniques across the nation, including in urban areas as even educated mothers are unaware of proper breastfeeding techniques.

First published on: 03-10-2022 at 04:03 IST
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