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Why many women don’t breastfeed babies within an hour of the birth in Maharashtra?

Pallavi Bendre, delivered baby caesarean in Sassoon General Hospital in Pune had breastfed the baby two days after birth as she was under effect of anaesthesia. Hospital staff did not tell her that she should breastfeed baby within an hour of birth. Bendre, 23 years old wife of farmer from Shirur taluka of Pune had no idea about breastfeeding before she delivered her first baby. Her mother said she breastfed baby on the third day as her daughter was not being able to sit or hold baby in her hands.

Pallavi is not alone who couldnot breastfeed her new born within an hour of birth as recommended under Infant and Young Child Feeding (IYCF) programme launched World Health Organisation. Major component of IYCF are breastfeeding baby within one hour of birth, exclusive breastfeeding for six months and breastfeed baby for two years. Baby Friendly Hospital Initiative is one of the initiative to implement IYCF.

What is Baby Friendly Hospital Initiative?

Baby Friendly Hospital Initiative (BFHI) that was launched by UNICEF, recommends to have written breastfeeding policy of hospitals, training of hospital staff to implement the policy, inform pregnant women about breastfeeding, help mothers to initiate breastfeeding within one hour of birth, show mothers how to breastfeed and maintain lactation, no other food apart from breastfeeding to new-born, baby and mothers to be together 24 hours, foster breastfeeding groups to encourage mothers to continue breastfeeding.

Ayodhya Khedekar, tired and exhausted, along with her four days old baby was resting on a bed in general women ward at Sassoon General Hospital, Pune. Ayodhya breastfed baby 24 hours after the birth as she had delivered baby through caesarean. She said, “I was not in condition to breastfeed and I was not aware that baby should be breastfed within an hour of birth.”

Dr Prashant Gangal who heads BPNI Maharashtra said training for BFHI helps in this conditions. He said, “Relatives of mother should put baby on her body for breastfeeding even though mother is under effects of aesthetic medicines. Every woman who delivers baby face various issues while breastfeeding like a few don’t get milk initially or few don’t know how to breastfeed baby. Training of hospital staff is needed to guide mothers to overcome the problems.”

Not surprisingly, India including Maharashtra has shown poor record of implementing BFHI policy till now. Sadly Arrested Development’, a report published under World Breastfeeding Trend Initiative(WBTi) by Breastfeeding Promotion Network, India and International baby Food Action Network, Asia, has given zero marks out of 10 for BFHI indicator.

The report has recommended that government should revive BFHI. There should be IYCF counselors at health establishments, including mothers to implement the policy, BFHI status should be used as indicator in Clinical Establishment Act.

Dr Ashish Bharti, chief paediatrician, Family Health Welfare Bureau of Health Ministry of Maharashtra, confirmed that not a single government hospital in the state has implemented BFHI. He said, “BPNI has begun to given training to twelve district hospitals and these hospitals will be baby friendly within three months.”

He said that there is no procedure for health ministry to find out how many private hospitals have implemented BFHI. He said, “Private hospitals can tie up with BPNI on their own and start implementing it. But we are not aware how many private hospitals have implemented BFHI.”

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