First human milk bank doctor on Padma Shri: ‘Mother’s milk is the first immunisation a child receives’
Dr Armida Fernandez, 83, looks back at building systems that transformed newborn and now, end-of-life care
Dr Fernandez began her journey in neonatology at Mumbai’s Sion Hospital in 1972–73, when neonatal mortality rates were extremely high. (Express Photo, enhanced with AI) As Dr Armida Fernandez turns 83 this July, the top neonatologist, who will be conferred the Padma Shri for her transformative contributions to health care, including setting up Asia’s first human milk bank, says she still works very hard and is deeply honoured with the award.
“However, I truly believe this is never a one-man or one-woman show. Reducing neonatal mortality was a collective effort. There was a wonderful department behind me, and every success belongs to the entire team,” Dr Fernandez told The Indian Express.
Bringing down neonatal mortality rates
Dr Fernandez began her journey in neonatology at Mumbai’s Sion Hospital in 1972–73, when neonatal mortality rates were extremely high. Newborns and babies were most vulnerable to sepsis and diarrhoea. “After much research, the source of diarrhoea was attributed to formula milk and bottles,” she recalls and began introducing low-cost, practical solutions. “The only solution I realised was to get mother’s milk for every baby, especially the most vulnerable ones. That alone is their first shield,” Dr Fernandez adds.
Mother’s milk is crucial in the first four weeks of a baby’s life because it provides colostrum, a nutrient-dense, antibody-rich “first immunisation” that builds immunity, prevents infection and kick-starts the infant’s digestive system. It aids the maturation of the infant’s gut, providing nutrients that are easily absorbed and digested, which is vital for premature or low-birth-weight babies. It stabilises blood sugar, and fosters crucial bonding while aiding the mother’s postpartum recovery. Although babies may lose weight initially, colostrum and mature milk provide the perfect, evolving nutrition to help them regain it.
The first human milk bank
So, Dr Fernandez got healthy lactating mothers to express excess milk, which could be used for babies whose own mothers did not produce enough milk or whose health was compromised. She even urged them to feed babies who were in the neonatal intensive care unit. That was then saved and used from one vulnerable baby to another and soon enough, Asia’s first human milk bank was set up in 1989. With support from the Taj Group of Hotels and others, the milk bank got upgraded and no formula milk was ever used at Sion again.
The model spread, first to KEM and JJ hospitals in Mumbai and later, with the involvement of Rotary Clubs, to other centres. Once the idea caught on, it grew rapidly. Today, there are over 100 human milk banks across the country. “Breastfeeding and newborn survival have gained strong momentum,” says Dr Fernandez, who has delivered several lectures on breastfeeding and milk banking in India and abroad.
With support from UNICEF, she prepared a Breastfeeding Manual called the Blue Module, and educational videos. These materials have been used to train doctors, nurses and hospital staff in Maharashtra and other states.
Now as per the Sample Registration System (SRS) report 2021, released by the Registrar General Of India in May 2025, India has witnessed a significant improvement in key maternal and child health indicators with Maternal Mortality Ratio dropping from 130 to 93 per lakh live births, Infant Mortality Rate declining from 39 per 1,000 live births in 2014 to 27 per 1,000 live births in 2021 and Neonatal Mortality Rate falling from 26 per 1000 live births in 2014 to 19 per 1000 live births in 2021.
Hospital-based care not enough
Yet she realised that “if one truly wanted to make a difference and save babies, hospital-based care was not enough.” Mothers were arriving late, stillbirths were common and the roots of the problem lay in the community. So, she stepped outside the hospital and into Dharavi. That was when the Society for Nutrition, Education and Health Action (SNEHA) was born — an organisation focussed on maternal and newborn health, child nutrition and violence against women.
“We spent time in Mumbai’s low-income settlements, learning about compounding challenges of lack of information, resources and access to quality health services,” she says. Today, SNEHA is a more than 500+ person-strong organisation helping build healthy lives of women and children.
Personal crisis and focus on palliative care
Dr Fernandez’s life took a deeply personal turn 13 years ago when she lost her daughter to cancer. Witnessing the suffering and pain opened her eyes to another unmet need. “Why can’t we address care for those with terminal conditions?” she asked herself. So, she expanded the scope of SNEHA, providing palliative and dementia care services.
Today, patients receive physiotherapy and counselling at the centre in Bandra, while multidisciplinary teams of doctors, nurses and counsellors also conduct home visits, often in the slums of Mumbai.
Dr Fernandez is grateful for the support and partnerships that evolved during this journey as the services at these centres remain free of cost. “The Brihanmumbai Municipal Corporation (BMC) has provided tremendous support across their hospitals and centres,” Dr Fernandez says.
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