World Breastfeeding Week 1 7 August 2016 Breastfeeding

World Breastfeeding Week (1 -7 August 2016) Breastfeeding A Key to Sustainable Development Name

WBW Theme • This year's World Breastfeeding Week focuses on the 17 Sustainable Development Goals (SDGs) that governments around the world have agreed to achieve by 2030. • The SDGs build on the Millennium Development Goals (MDGs) and cover a range of issues on ecology, economy and equity.

Breastfeeding is relevant to many of the SDGs

Goal 1. End poverty in all its forms everywhere Cognitive losses associated with not breastfeeding impact earning potential, and amount to global loss of $302 billion annually India looses approx. 4300 Crores annually Source: Lancet Series on Breastfeeding 2016

Infant fromula is costly! • An infant with 3. 0 kg weight will require app. 500 ml of prepared formula milk per day. • 500 ml of prepared formula milk costs app. INR 70. 00 per day, app. INR 2000 per month. • The cost doesn’t include expenses on bottles, water, fuel etc. • Average wages of a worker in NREGA are INR 167 - 259 per day.

Goal 2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture • Optimal breastfeeding provides food security for infants and young children • Optimal breastfeeding prevents morbidity and prevent undernutrition • Breastfeeding can reduce 1/4 th of overweight/obesity in children between 5 -17 years in India Source: Lancet Series on Breastfeeding 2016

Breastmilk provides optimum nutrition Nutrients in breatmilk – 2 nd year of life WHO (2009). Infant and young child feeding: Model Chapter

Goal 3. Ensure healthy lives and promote well-being for all at all ages

Risk of neonatal mortality according to time of initiation of breastfeeding Six times more risk of death 22% Newborn deaths can be reduced Source: Edmonds EK et al, 2007 - Pediatrics 2006; 117: 380 -386

Breastfeeding Saves Lives!

In India Annually, Breastfeeding can prevent… Under-5 child deaths* 156, 000 Prevents 1 in 3 new case of type -2 diabetes Source: Lancet Series on Breastfeeding 2016 * UN IGME Report 2015 ** RSOC 2014

Goal 4. Ensure inclusive and equitable quality education and promote lifelong opportunities for all

Breastfeeding leads to high IQ, Educational attainment and monthly Income Victora CG et al. Lancet Glob Health. 2015

Goal 8: Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all

Maternity leave and breastfeeding • Every additional month of paid maternity leave decreases IMR by 13%. (Nandi A. et al. PLOS, 2016) • Provision of maternity leave results in increased duration of breastfeeding and lesser maternal separation anxiety and optimal maternal infant attachment. (Cooklin AR et al. Aust N Z J Public Health. 2012 ) • India provides 12 weeks of maternity leave (MBA 1961) • GOI is contemplating to enhance maternity leave to 26 weeks.

Goal 10: Reducing inequality within and among countries

U H States H R NA ALA GA LA LA KS ND HA DW EE P AS SA M OD IS TA HA M IL NA DU M IZ OR CH AM AN DI GA RH KE ES y A rr he uc RA D LP Pu d 70 HA AC UN UR IP AL AY EG H AN M 55, 956, 256, 4 AR M 41, 9 A 32, 732, 9 38, 639, 139, 9 IM 40 35, 536, 937, 137, 2 45, 5 43, 143, 344, 644, 9 KK 50 GO % 60 SI D AR KH AN D PU NJ AB BI HA R DE TE LH LA I NG AN A HA RY AN RA A JA DA ST M AN HA A N DA N AN M AN D D & IU NI TR CO I BA PUR A R M IS AD LA HY ND A S PR AD W E ES SH T BE NG AL CH I HA NDI A TT IS GA R DA GU H DR JA R A AT AN KAR NA D NA TA GA KA AN R HA DH V RA EL HI I M PR AC AD HA ES LP H RA M DE AH S AR H AS HT RA JH ES AN KH RA TA IR M SH AD PR KA 30 UT R & TA UT M M JA Initiation of breastfeeding within one hour of birth in states of India( RSOC/ NFHS-4/ DLHS-3) 90 84, 8 80 65, 165, 366, 566, 6 0 68, 569, 3 72, 973, 374, 7 58, 3 49, 249, 850, 1 27, 8 20, 822, 6 20 10 NA

M IZ DA O DR D Pu RA A M d A u M AN A ch e N D NA AN rry GA D D UT R H IU TA A RA VE K LI RA HA JA ND ST HA HAN M RYA EG N A H HI M KA ALA AC RN YA HA AT L P AK A R TA AD M ES H IL NA D TR U NA IPU GA RA LA N AR KE D W UN E R AC ST B ALA HA EN L P GA RA L JA DE M S M U PU H & NJ UT KA AB TA SH R PR MIR AD ES H GO A JH SIKK AR IM KH AN AN DA AS D M SA AN M & I ND NI CO MA IA BA NI R PU IS R TE LAN LA D NG S AN A D AN EL DH O HI RA DI PR SHA AD ES M AH B H I H AR AS AR H M AD G TR HY UJ A A AR LA PRA AT KS D E CH HAD SH HA W TT EE CH ISG P AN AR DI H GA RH Exclusively breastfeeding for first six months in states of India ( RSOC/ NFHS-4/ DLHS-3) 90 82, 3 80 70 60 50 % 55, 1 55, 2 53, 6 54, 9 44, 5 45, 5 47 48 48, 1 58, 6 57 57, 7 58, 1 59, 4 59, 8 60, 2 60, 4 64, 3 64, 7 64, 9 62, 2 62, 6 63 0 States 66, 8 67, 3 67, 8 68, 5 69, 2 70, 8 73, 4 74, 8 76, 8 49, 9 40 30 20 10 0

20 UT GA L HA AND TA RY AN R A DH PR NA A RA D PR ESH DA AD AN DR ES H DA A DE M AN AN D G LH & NAG UJA I NI R A CO R AT BA HA R VE IS LI LA ND S B M R I AD AJ HA A R JA HY ST M A P HA M N U RAD & E KA SH SH M M I AH I R N AR D A IA JH SHT AR R KH A AN PU D NJ A O B TE DIS CH LAN HA HA GA UT TTIS NA TA GA RA R KH H A TR ND HI I PU M AC MI RA HA ZO L P RA R M KA AD RN ESH TA AT D M A AR AM IL KA UN A NA AC N A DU HA ND LP D R IU M AD EG ES W HA H ES LA T BE YA NG A SI L KK I KE M RA LA GO A A Pu SSA LA du M KS che HA rr DW y M EE CH AN P AN IPU DI R GA RH NA Complementary feeding (6 -8 months) in states of India ( RSOC/ NFHS-4/ DLHS-3*) * 6 -9 months 90 80 72, 6 70 60 % 50 40, 1 30 28, 7 43, 3 43, 4 43, 5 45, 1 45, 7 45, 9 46, 3 47, 4 50, 5 53, 4 53, 7 53, 8 55, 5 57, 1 59, 9 60, 4 60, 8 60, 9 0 States 61, 8 63, 4 64 64 64, 9 65, 2 75, 6 76, 1 76, 8 78, 5 83 67, 7 68, 8 40 32 18, 7 10 0

Goal 13: Take urgent action to combat climate change and its impacts In an emergency, breastmilk is a safe and secure source of nutrition, instantly available, providing active protection against illness and keeping an infant close to his/her mother.

GHG emissions due to Milk Formula in India Tonnes CO 2 eq. (2012) GHG emission tonnes 120 000 111 226 Total sale of MF 27, 783 Tonnes 100 000 80 000 56976 60 000 42829 40 000 20 000 9628 0 Total Std Milk Formula Follow-on Milk Formula Toddler Milk Formula 1790 Special Bay milk Formula

Emergency and breastfeeding During emergency, breastmilk is: • A safe and secure source of nutrition • Provides active protection against illness • Instantly available

What a country needs to do to enhance breastfeeding rates? Policy, Plan and Coordination International Code, WHA Communication and Information Health, Nutrition care System Maternity Protection Breastfeeding • Protection • Promotion • Support Mother support, community outreach IYCF in difficult circumstances BFHI

Status of IYCF policies and programmes in India World Breastfeeding Trends Initiative-Arrested Development. India’s 4 th Assessment of Policies and Programmes on Infant and young child Feeding 2015. http: //bpni. org/report/WBTi-India-Report-2015. pdf

What Should India Invest in Urgently? • Having lactation counselors in health facilities and peer counselors in community • Implementing BFHI • Providing adequate maternity protection • Enforcing the IMS Act • Sharing correct information • Having regular monitoring

Conclusions • Improvements in breastfeeding would help achieve the SDG targets for • Health • Food security • Education • Reducing inequalities • Development • Climate change • What is needed is political commitment, financial investment and effective coordinated action Source: Lancet Series on Breastfeeding 2016