barriers

1. Barriers'to'Best'
Breast'Feeding''

2. Breast'Feeding'–'Is'it'so'Important?'
• Breast'milk'alone'is'the'ideal'
nourishment'for'infant'for'about'the'
first'six'month'of'life'
• It'combine'the'three'fundamental'of'
sound'nutri7on'—'food,'health,'care'
• It'contain'all'the'–'Nutrient,'
An7bodies,'Hormones,'An7oxidant''
which'An'infant'need'to'Thrive'

3. Breast'Feeding'–'Is'it'so'Important?'
• It'protect'baby'from'diarrhea'and'acute'
respiratory'infec7on'
• S7mulate'their'immune'system'and'response'to'
vaccina7on'
• It'improve'cogni7ve'intelligence'and'development'
• BreasEeeding'aids'in'diges7on''

4. Breast'Feeding'–'Is'it'so'Important?'
• Provide'all'the'micronutrients'and'water'a'baby'
needs'
• Economic'–'save'fuel,'water,'7me'and'money'
• Desirable'mother'child'bonding''
• Long'term'benefit'are'reduced'chance'of''
'metabolic'disorder'and'cancer'

5. • Breast'feeding'is'absolutely'essen8al'for'the'health'
and'survival'of'the'majority'of'children'in'the'
developing'countries'–'WHO,'2011'
• It'increase'family'and'na8onal'resource,'it'is'secure'
way'of'feeding'and'safe'for'environment'–'Kramer'et'al'
2001,'BPNI'

6. Mother'is'also'Beneficiary'
• Immediate'postpartum'–'Prevents'Postpartum'
haemorrhage'
• Quick'return'to'normal'weight'and'figure'
• Contracep7ve'role'
• Protect'against'breast'and'Gynaecological'Cancer'
• Happy'and'peaceful'state'of'mind'

7. • 'What'prevents'us'from'availing'best'??'
• 'What'is'actual'perceived'figure'for'EBF'in'our'
country'??'

8. Challenges'&'Obstacle'
• Lack'of'correct'informa7on'to'mothers'and'community'
• Total'lack'of'skilled'one'to'one'counseling'on'feeding'of'infant'
• Inadequate'health'care'support'
• Inability'of'the'health'care'providers'to'help'mothers'
experiencing'breasEeeding'difficulty'
• Lack'of'family,'community'support'
• Implementa7on'of'legisla7on'at'workplace'

9. • Improved'breasEeeding'prac7ces'could'
save'1.5'million'children'a'year'
• EBF'is'widely'regarded'as'being'one'of'
the'most'natural'and'best'form'of'
preven7ve'medicine''
• Yet'few'of'the'129'million'babies'born'
each'year'receives'op7mal'breast'
feeding'and'some'are'not'breast'feed'at'
all'

10. Do'we'Really'know'our'Food??'
• To'the'Paediatrician'–'
'What%is%considered%best%nutri0on%prac0ce%for%newborn%
and%infant%for%first%2%years??%
%
And%your%percep0on%of%obstetrician%role%to%promote%EBF%
'
'
'''''
'
'
'

11. Op8mal'BreasLeeding'Procedures'
• Exclusive'breast'feeding'(breast'milk'with'
no'other'foods'or'liquid)'for'the'first'six'
months'of'life'without'any'addi7onal'food'
or'drink,'not'even'water'or'honey''
• Followed'by'breast'milk'and'complimentary'
foods'(solid'or'semisolid'foods)'from'about'
six'month'of'age'

12. Op8mal'BreasLeeding'Procedures'
• Con7nued'breasEeeding'for'up'to'at'least'
two'years'of'age'at'beyond,'while'
receiving'appropriate'complimentary'
foods'
'''''''(Source'WHO'2002)'

13. Barriers'to'IYCF'
• Professional'and'commercial'influence'combine'to'discourage'breasEeeding'
• Gaps'in'knowledge'spread,'informa7on'and'communica7on''
• Urbaniza7on''
• Maternal'employment'outside'the'home'
• Customs'and'rituals''
• Con7nued'gaps'in'maternity'legisla7on'
! Early'cessa7on'of'breasEeeding'in'favor'of'commercial'formula'feed'due'
to'various'reason'
! Needless'supplementa7on'
! Poorly'7med'complimentary'food'like'prealacteal'food'
• Exclusive*breast*feeding*is*uncommon*at*most*of*the*places''
Sources:'
• Vyas''et'al;'MJCM;'2012'
• NHFS'3;'Kumar'et'al'

14. • In'India'breasEeeding'is'supposed'to'be''
imbibed'in'our'culture'vs'western'world''
• In'your'percep7on'it'actually'match'our'
performance'in'EBF'??'

15. Indian'Scenario'–'Is'it'Natural'For'Us'
• 90995%*of*children*in*India*are*ever*breas=eed*
• However'posi7ve'influence'and'support'could'help'and'
nega7ve'influence'could''hinder'the'process'of'lacta7on'
• First'hour'ini7a7on'of'breasEeeding'was'~'6.3%'to'more'
than'45%'(DLHS'3)'
• Colostrum'given'to'babies'–'11%'to'87%'

16. Indian'Scenario'–'Is'it'Natural'For'Us'
• Prealacteal'feed'a'55%'to'60%'of'newborn'received'prea
lacteal'feed.%Honey%&%%gurghuA%was%most%popular%preB
lacteal%feed%
• Exclusive'breasEeeding'for'six'months'was'prac7ced'only'
by'30a50%'of'women'
• Feeding'on'demand'–'38%'to'89%'(demand'feeding'is'
common'prac8ce'in'India)'
• Rate'of'bonle'feeding'–'20%'(NHFS'3)'

17. Global'&'Indian'Scenario'
• WHO'2002'–'Despite'demonstrated'benefit'of'
breasEeeding,'breasEeeding'prevalence'and'
dura7on'in'many'countries'are'markedly'
lower'that'the'interna7onal'recommenda7on'
of'exclusive'breasEeeding'for'first'six'month'
of'life'
! However'the'rates'of'early'ini7a7on'of'breast'
feeding'i.e.'within'an'hour'of'birth,'and'
exclusive'breasEeeding'are'far'from'desirable'
Sources:'
Swetha'et'al'2014,Indian'journal'of'contemporary'
pediatrics'

18. To'the'obstetrician'–'
• In'your'antenatal'OPD'do'you'sensi7ze'in'some'way'for'
prepara7on'of'women'for'breast'feeding'?'
• If'yes'how??'

19. Good'Start'–'Half'Done'
• Communica7on'of'benefit'of'breast'feeding'for'baby'
and'mother'verbally'and'write'up'
• Examining'for'any'problem'in'lacta7on'like'retracted'
nipple''
• Sensi7zing'women'for'earliest'start'of'breast'feeding'
and'proper'posi7oning'of'baby'
• Counselling''for''not'using'prelacteal'feed'or'
supplementa7on'
• Take'close'associate'and'care'taker'like'husband'and'
mother/mother'in'law'in'confidence'''

20. Maternity'Ward''
To*audience*–*
'How'soon'you'start'breast'feeding'in'your'
ward''
'Earliest*within*an*hour/*aBer*2*hour/*aBer*
one*day**
From*panellist*–*
'What'instruc7on'you'give'to'women'as'well'
nursing'staff'for'breast'feeding??'

21. Obstetric'staff'is'crucial''
• Earliest'start'of'breast'feeding'gives'higher'successful'breast'
feeding'as'well'con7nua7on'rate'
• Earliest'start'of'breast'feeding'is''irrespec7ve'of'mode'of'
delivery'–'vaginal'or'cesarean'
• Colostrum'provides'an7bodies'for'protec7on'against''
infec7ous'disease''
• Early'feeding'help'in'lerng'down'of'milk'early'and'efficiently'
• Delay'in'breast'feeding'results'in'more'failure'of'lacta7on''
'ObservaGon*for*2*hours*to*one*day,*test*feed,*separaGng*
mother*from*baby*are*few*pracGce*seen*in*many*hospital*
and*need*a*close*review*and*change**

22. Do'we'prac7ce'science'rightly'??'
• Research'have'con7nually'demonstrated'that'
successful'breast'feeding'is'related'both'to'
7me'of'ini7a7on'(within'2'hours'of'birth)'and'
to'frequency'(at'approximately'2'hours'
interval)'
• However'the'exis7ng'postpartum'care'
policies'and'prac7ces'in'hospital'do'not'
always'reflect'needs'of'the'mother'and'
infants'and'are'major'determinant'of'delayed'
ini7a7on'of'breast'feeding''

23. • Proper'posi7oning'or'latching'is'crucial'for'
successful'breast'feeding''
Panellist'–'
• What'do'you'mean'by'proper'posi7oning'and'
how'it'effect'posi7ve'outcome'

24. Proper'Posi8oning''
• Only'2%'of'pairs'achieve'proper'latch'performance'
–'
• Chin'touches'breast,'mouth'opens'wide,'lower'lip'
flared'outward,'moderate'lip'tension,'infant'grasp'
aerola'
• 0.2%*achieved*opGmal*mother*infant*posiGoning'–'
'Mother'in'comfortable'posi7on,'leaving'aerola'free'
and'making'gentle'compression'between'thumb'and'
finger,'infant'head'and'body'aligned'facing'mother''

25. Task'ShiZing'&'Task'Sharing''
• How'osen'you'conduct'sensi7za7on'and'
training'program'for'your'maternity'nursing'
staff'??'
• Do'you'find'it'necessary'??'
• How'is'your'experience'with'these'teaching'
and're'teaching'program'??'

26. Atude'of'Health'Workers'
• Ramchandran'(2004)'iden7fied'that'artude'of'health'workers'
towards'lacta7ng'mothers'in'their'prac7ce'of'EbF'as'being'
unacceptable'since'a'good'propor7on'of'health'officers'lay'
linle'or'no'emphasis'on'the'need'for'adequate'nutri7on'of'
infant'for'EbF'for'six'month''
• Breast'feeding'is'natural'but'it'is'also'learned'behaviour'and'
mothers'caregivers'and'health'prac77oners'require'ac7ve'
support'for'establishing'and'sustaining'appropriate'breast'
feeding'prac7ce'
• The'health'prac77oners'knowledge'should'frequently'be'
updated'through'workshops'and'seminars'
• The'regular'in'job'training'improve'the'knowledge'of'both'
women'and'staff'thus'forestalling'hazardous'consequence'of'
non'EbF'prac7ces'

27. You'can'not'do'it'Alone''
• Proper'Breast'feeding'technique'is'a'
major'component'of'successful'breast'
feeding'and'preven7on'of'breasEeeding'
related'problem'
• Studies'show'a'high'prevalence'of'
inadequate'technique'(Sanches%et%al%
2000,Carvillahaes%Jr.%Ped.%2003)'leading'to'
nipple'trauma'and'breast'engorgement'''

28. You'can'not'do'it'Alone''
• Trained'and'confident'nursing'support'is'a'
proven'strategy'for'increasing'frequency'of'
breast'feeding,'par7cularly'exclusive'breast'
feeding''
• However'only'single'interven7on'specifically'
directed'at'teaching'proper'breast'feeding'
technique'contribute'nonasignificantly''
• Con7nuum'support'from'nurses,'doctors,'family'
members'and'community'health'staff'play'an'
important'role'in'successful'breast'feeding''

29. Challenges'aZer'wards'–'
• Why'women'leave'Exclusive'breast'feeding??'
• How'health'system'can'intervene'to'promote'
Exclusive'breast'feeding??'

30. Postnatal'Challenges'&'Problems'in'
EBF'
• Psychological'problem'–'Worry'and'stress'92%'
• Having'to'breasEeed'at'public'places'–'82%'
• Fear'that'baby'is'not'gerng'enough'nutrients'–'71%'
• Trauma'in'expressing'breast'milk'–'67%'
• Baby'will'dry'up''if'not'given'water'–'50%'
• Fear'of'safety'–'50%'
• Work'place'not'conducive'–'91.6%'
• Lack'of'educa7on'in'antenatal'clinic'–'63%'

31. People'influence'your'mind'
• While'breasEeeding'started'by'>'90%'of'
women'in'hospital,'rapid'decline'during'
first'few'months'and'EBF'rarely'prac7ced''
• 42%'of'mothers'indicated'that'at'some'
point'of'7me'doctors'have'advised'them'to'
cease'doing'so'indica7ng'wide'knowledge'
gap'among'health'care'system'
• Within'family'mother'and'mother'in'law'of'
new'mother'has'the'greatest'influence'on'
feeding'prac7ces'

32. Bo^le'Feeding'should'be'Discouraged''
• Rate'of'bo^le'feeding'(NHFS)3'–'11_20%'
• It'is'difficult'to'clean'&'sterilize'so''an'important'source'of'
infec7on'
• Nipple'confusion'which'interference'with'breasEeeding'
• Maternal'illiteracy'has'been'associated'with'subop7mal'
feeding'prac7ce'
! No'medical'research'support'it,'yet'in'eigh7es'it'was'well'
recommended'by'medical'personnel'
! Maternal'educa7on'plays'a'huge'role'in'increasing''
'the'recep7vity'of'mother'towards'correct''
'prac7ces'and'recommenda7on'

33. Postnatal''Challenges'–'Mother'Starts'but'Leaves'
BreasLeeding'
• Cracked'nipple''
• Sore'nipple''
• Engorged'breast''
• How'do'you'manage'the'problem??'

34. Take'care'of'problems''
• Usually'these'problems'are'due'to'wrong'posi7oning'of'infant''
and'incorrect'breasEeeding'technique'
• Failure'to'latch'on'is'one'of'the'main'reason'for'ineffec7ve'
feeding'and'can'lead'to'infant'health'concern'
• Careful'support'and'training'for'right'posi7oning'helps'in'
minimizing'the'incidence'of'nipple'problem''

35. Take'care'of'problems''
• Lawrence'(2005')'posited'that'when'nursing'mother'is'
emo7onally'calm'and'relaxed,'correct'breasEeeding'
technique'is'enhanced''
• Relaxed'environment'is'also'related'with'enhanced'work'
of'prolac7n'and'oxytocin'which'enhance'quan7ty'of'
breast'milk'produc7on'
• In'case'of'crack'or'sore'nipple'–'Emo7onal'support,'use'of'
aser'milk'as'natural'probio7c'and'an7sep7c'is'bener'
op7on'than'readymade'creams'and'an7bio7c''

36. Postnatal'Issues''
• Baby'is'hungry,'you'have'to'give'
addi7onal'feed'–'formula,'cow'or'
buffalo'or'water''
• These'experience'make'mother'
unresponsive'to'EBF'as'mother'is'in'
bad'mood'and'consider'EBF'a'waste'
of'7me'and'effort'

37. Postnatal'Issues''
• How*you*tackle*these*quesGons*and*concern??*
• Yes*supplement*it*/*No*not*at*all*/*Counselling*for*
signs*of*adequate*nutriGon*

38. Knowledge'makes'you'confident'
• If'baby'is'passing'urine'5a6'7mes'that'means'baby'is'well'
hydrated'and'fed'and'no'need'for'supplementa7on'–'Make'
mother'confident''
• Colostrum'is'in'small'amount'but'it'provides'best'an7bodies'
and'create'immunity'against'many'disease'
• Nature'takes'its'own'course'in'producing'amount'of'milk'
needed'for'that'par7cular'period'
• Close'contact'of'mother'and'baby',frequent'feeding'and'good'
fluid'and'diet''intake'by'mother'''is'the'best'enhancer'of'
lacta7on'
• Drugs'have'minimal'role'–'Metoclorpromide'can'be'
prescribed'10mg'tds',natural'prepara7on'like'Satavari'Jeera'
etc'are'supposed'to'have'posi7ve'effect'

39. Breast'Pathologies'
• Mother'comes'aser'15'days'or'2'month'
with'breast'tenderness'and'fever''
• How'do'you'manage'mas77s'and'abscess'
so'as'to'con7nue'breast'feeding??'

40. Mas88s'&'Abscess'
• An7bio7c'Dicloxacillin'500mg'QID'is'drug'of'
choice'for'7a10'days''with'analgesic'&,'
an7pyre7c''
• Support'to'breast'and'cold'packs''
• Con7nue'breast'feeding'on'unaffected'side'
• If'pus'collec7on'drainage'under'ultrasound'
guidance'saves'many'incision'and'drainage'
• Affected'side'is'manually'pumped'every'2'hours'
and'with'every'let'down'
• Give'her'confidence'to'con7nue'breast'feeding'

41. Eco'System'
• Is'our'society'support'directly'or'indirectly'
exclusive'breast'feeding'for'women'and'infant''

42. BreasLeeding'in'Working'Mothers'
• Work'environment'and'artude'of'colleagues'have'
a'great'role'to'play'in'encouraging'and'suppor7ng'
mothers'in'prac7ce'of'EBF''
• Returning'to'work'is'the'most'common'cited'reason'
for'discon7nuing'breast'feeding'(Galson'2008,'Uchendu'
2009,'Bhuna'2011)'

43. BreasLeeding'in'Working'Mothers'
• Extended'maternity'leave'for'six'month,'facility'of'
crech'at'working'place'are'few'posi7ve'measures'
which'society'as'a'whole'can'take''
'''On'the'contrary'many'women'are'losing'their'jobs'
due'to'maternity''as'companies'take'it'as'the'
burden'to'give'leave'and'salary'to'mothers'due'to'
maternity'leave'''

44. • Not'having'the'full'knowledge'of'EBF'is'as'
good'as'not'prac7cing'it'since'the'mother'will'
be'unaware'of'the'fact'that'she'is'not'doing'
the'right'thing'''

45. ! Each'level'of'support'is'significant'in'its''
sense'
! It'is'interdependent''
! Peer'counseling'from'family,'community'
and'health'facility'member'is'one'of'vital'
interven8on'for'increasing'breasLeeding'

46. '
Commercial'pressure'from'
baby'food'industry''
'
''Role'of'Medical'fraternity'as'well'
media''in'use'of'baby'formula'feeds''
• Your'sugges8ons'to'make'a'posi8ve'
impact''

47. Formula'Feed'
• Interna7onal'code'was'adopted'in'1981'as'a'minimum'
standard'to'help,'protect'and'promote'breasEeeding'in'all'
the'countries'
• It'explain'that'marke7ng'of'breast'milk'subs7tute'require'
special'treatment'which'makes'usual'marke7ng'prac7ce'
unsuitable'for'their'products'

48. Formula'Feed'
• Indian'Parliament'enacted'the'infant'milk'subs7tute,'
feeding'bonles'and'infant'foods'–'Act'1992'and'Amendment'
2003'which'provides'for'regula7on'of'produc7on,'supply'
and'distribu7on'of'infant'milk'subs7tute,'feeding'bonles'
and'infant'food'with'view'to'protec7on'of'breasEeeding'
from'commercial'baby'food'industries'
! Promo8on'of'baby'food'is'more'pervasive'and'lead'to'child'
malnutri8on'and'death'

49. Baby'Food'Marke8ng'–'Monster'is'Hidden'
• Despite'strict'direc7ves'and'laws'baby'food'and'
feeding'bonles'manufacturing'companies'are'
viola7ng'and'bypassing'the'laws'

50. Baby'Food'Industry''
• Implementa7on'of'the'interna7onal'code'of'
marke7ng'of'breast'milk'subs7tutes'–'
Interna7onal'code''
• Implementa7on'of'Baby'Friendly'Hospital'
Ini7a7ve'(BFHI)'to'ensure'that'–'
– All'hospital'and'maternity'facili7es'become'centre'of'
breasEeeding'support'
– Refusal'to'accept,'distribute'or'promote'free'or'low'
cost'breast'milk'subs7tute''
– Adop7on'of'protec7ve'maternity'legisla7on''
! Government'are'also'obliged'under'ar7cle'24'of'
the'conven7on'on'the'Rights'of'the'Child,'to'
ensure'that'all'sector'of'society'know'about'the'
benefits'of'breasEeeding'

51. '''
• It'is'good'8me'for'good'change'at'least'for'
mothers''
• 'How'the'laws'and'resolu8ons'in'our'country'
in'recent'years'has'effected'the'maternal'&'
child'health'including'promo8on'of'breast'
feeding'??'

52. Global'&'Na8onal'Strategy'for''
Promo8on'of'Op8mum'IYCF'
• Global'strategy'for'infant'and'young'child'
feeding'launched'by'WHO'&'UNICEF'in'2002'
• Na7onal'guideline'on'infant'and'young'child'
feeding'in'India'were'formulated'to'achieve'
op7mal'growth,'development'and'health'of'
children'
• MOHFW'has'also'launched'the'enhancing'
op7mal'infant'and'young'child'feeding'
prac7ces'–'opera7onal'guideline'in'2013'for'
improving'breasEeeding'prac7ce'

53. Maternity'Benefit'&'Legisla8on'
• Employees'State'Insurance'Act'1948'
• Na7onal'Food'Security'Act'2013'recognizes'
maternity'protec7on'a'legal'right'via'sec7on'
6'providing'for'minimum'of'Rs.'6000'to'be'
given'as'maternity'en7tlement'to'all'women'
including'unorganized'sector'

54. Maternity'Benefit'&'Legisla8on'
• The'Act'provide'for'accurate'informa7on'and'support'to'all'
women'of'India,'free'from'commercial'and'biased'informa7on'
• Maternity'benefit'Act'of'1961,'GOI'provides'12'week'
maternity'leave'to'all'women'with'formal'employment'in'
Govt.'as'well'Non'Govt.'sector,'which'has'now'extended'to'six'
month'maternity'leave'and'15'days'paternity'leave.'The'Act'
extends'to'whole'of'India'and'applies'to'every'establishment'
• JSY/'IGMSY'(Indira'Gandhi'Maternal'Sahyog'Yojna)'by'GOI'is'
also'reaching'women'who'are'not'covered'by'such'
recommenda7on'through'a'scheme'to'provide'some'cash'
grant'in'lieu'of'wage'loss'

55. G.O.I'Commitment'
• 12th'5'Years'Planning'Commission'of'India'
recognized'need'of'peer'support'for'IYCF'
• ICDS'–'Restructuring''plan'focus'on'the'cri7cal'
age'group'(under'3),'pregnant'and'
breasEeeding'mother'and'child'care'and'
nutri7on'counseling'for'mother'of'children'
under'3'years'for'integrated'early'child'
development'
• IMS'(Infant'Milk'Subs8tute)'Act'_'provides'
regula7on'against'the'commercial'influence'of'
baby'food'industry'on'people'with'a'view'to'
protect'and'promote'breasEeeding'

56. What'is'Stopping'Us''
• Dismal'rates'of'infant'feeding'prac7ce'
which'are'not'increased'as'per'our'hopes'
and'expecta7on'in'last'2'decades'
• India'lacks'progress'in'all'its'policies'and'
programs'that'prevent'rise'of'breasEeeding'
rates'(WBTI;'India'Report'2012;'NIPCCD;'BPNI'
a2012)'

57. Women'Deliver'–'Challenges'for'
Women'
• A'woman'plays'a'dual'role'of'homemaker'
and'breadwinner'since'a'long'7me'
• Achieving'harmony'in'these'two'
respec7ve'roles'is'nothing'less'than'a'
banle'for'her'
• Arduous'domes7c'chores'like'fetching'
firewood'and'water'to'maintain'
household'and'care'of'sick'and'elders'are'
les'to'women'in'our'country''

59. Mothers'at'Workplace'–''
Human'Rights'&'Responsibility'
• Availability'of'Creche'facility'at'work'place'
• Nursing'breaks'
• Promote'ac7on'by'employers'to'become'baby'
and'mother'friendly'
• Inform'people'about'the'available'maternity'
protec7on'en7tlements''
• To'gain'mul7dimensional'support'from'all'
sectors'to'enable'women'to'work'and'breast'
feed'

60. Way'Forward''
• Obstetrician'and'women'doctors'can'play'the'most'
important'role'in'enhancing'op7mal'breast'feeding'
prac7ces.'
• Professional'body'partnership'–FOGSI'with'Indian'
Academy'of'Pediatrics,'Breast'feeding'Promo7on'
Network'of'India'(BPNI),'can'do'the'miracles.'
• Teach'your'self—Teach'your'nurses'and'staff'for'good'
posi7oning,'demand'feeding'and'management'of'
problems'related'to'breast'problem'
• Reach'the'community—Empower'women'and'families'
with'knowledge,'Educate'one'to'one'and'in'group'
• Community'will'enrich'you'with'healthy'and'happy'
children'and'youth'

61. Where'Do'We'Stand''
• Nearly'half'(60'million)'of'the'children'in'India'are'
underweight,'45%'are'stunted,'20%'are'wasted'
• India'stands'below'150'in'rank'of'child'nutri7on'
and'development'
• The'World'breast'feeding'trends'ini7a7ve'(WBT)'
assessment'of'policy'and'programmes'in'year'2008,'
2012,'2015'revealed'that'India’s'situa7on'remains'
almost'stagnant'over'last'many'years'
• The'provision'for'maternity'benefits'in'country'in'
legisla7on'and'more'so'in'prac7ce'are'very'
inadequate,'esp.'in'informal'sector'

62. 'To'Conclude'
'BreasEeeding'though'is'a'natural'act,'it'is'a'
behavior,'which'need'to'be'learned'
'Mother'and'other'care'givers'needs'ac7ve'
assistance'for'op7mum'breasEeeding'prac7ce'
'Training'of'gross'root'worker'on'IYCF'on'handling'
problem'in'breast'feeding'is'crucial'for'op7mal'
breast'feeding''
'Formula'Feed'Marke7ng'needs'strict'monitoring'&'
Regula7on'
'Implementa7on'of'Maternity'Legisla7on'is'Todays'
Urgent'Need'

63. • Early'and'exclusive'breast'feeding'is'widely'regarded'
as'an'important'interven7on'that'reduces'neonatal,'
infant'and'child'mortality''
• It'remains'a'basis'for'child'survival'strategies''
• It'projects'in'future'for'reduced'incidence'of'nona
communicable'disease'–'Diabetes,'Hypertensions'and'
cancers'(Tyllesker'2011,Bhuna'and'abbock'2011)''

64. Future''
• Addressing'challenges'to'EBF'is'essen7al'to'
reaching'the'World'Health'Assembly'target'to'
increase'rate'of'exclusive'breast'feeding'in'
the'first'six'month'up'to'at'least'50%'by'2025'
(WHO'2016)'
• It'is'more'important'in'USAIDs'ending'
preventable'child'and'maternal'death'priority'
countries'(USAID'2016)'