By Dr. Nuzhat Aziz, Senior Consultant – Obstetrics & Gynecology, Apollo Cradle & Children’s Hospital, Jubilee Hills.

Policy of Zero separation promotes breast feeding

‘In all things of nature, there is something marvelous’ Aristotle

The newborn nurtured and nourished by the mother during pregnancy is now ready to learn to be independent as it starts its new journey in a new world. Naturally, the newborn baby needs nourishment and nurture to help it survive in the new environment. Breastfeeding or lactation is the way that nature uses to ensure that the newborn baby receives all the nourishment it needs and gets all essential nutrients.  Breastfeeding is the gold standard for the baby and the best way to deliver the best possible essential nutrients to the baby. Breastfeeding is a characteristic of all mammals and is a highly evolved process in humans that provides multiple benefits for the mother and her baby.

The trends of breast-feeding rates have declined in the 20^th century, from universal breast-feeding to the lowest rates in mid-century (25% from 1945 to 1950).¹ The start rates started to increase again in the 1970s as more scientific knowledge regarding the benefits of breastfeeding became available. The increasing evidence of benefits led to a motivated effort to educate women. The change in breastfeeding rates varied across the globe.  India has increased the rates from 55 to 64% as per the latest NFHS 5 survey (Telangana 67 to 68.2%).² However, the number of babies breastfed in the first hour (initiation) was 42% for India, with many states and districts showing a decrease. Telangana had initiation of breastfeeding within an hour in 38% of women in urban and 36% of women in rural areas.

Why should we prefer and promote breastfeeding? Breastfeeding is the nourishment part of the entire physical, emotional, and social development of a baby. The onset of this psychobiological development is in the first 1000 minutes. Keeping the baby with the mother in the first hour and promoting skin-to-skin contact promotes breastfeeding and prevents the toxic stress of separation in a baby. The early thick milk, colostrum, is an important source of nutrition and immune protection. Keeping the baby with the mother allows for maternal sensitization and release of the hormones (oxytocin/dopamine) that promote promoting bonding and help to prevent post-partum hemorrhage and depression in the mother.

Exclusive breastfeeding can prevent baby deaths due to respiratory infections and diarrhea. Inadequate breastfeeding in India is believed to contribute to 100,000 preventable deaths, and 37 million cases of diarrhea, and costs billions of rupees in healthcare.

Breast-fed babies are found to have better roots of attachment, emotional security, improved long-term psycho-emotional development, and fewer cognitive disorders due to nutritional causes.³

Institutional birth policies, practices, and protocols can influence and promote early initiation of breastfeeding and lead to increased exclusive breastfeeding. All mothers must be informed of the benefits to the baby and the mother from breastfeeding. As care providers, it is our responsibility to provide an environment to ensure privacy during breastfeeding where the mother feels safe and comfortable. Zero separation should be the principle of care at birth to continue nature’s way of providing the best for the baby and mother. After all, a healthy baby and mother are essential for the long term health of the entire species.