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Breastfeeding: A global evidence based intervention for child survival
The World Health Organisation (WHO) recommends initiation of breastfeeding within an hour of birth, exclusive breastfeeding of infants till 6 months of age, and continued breastfeeding until 2 years of age or older which are among the global evidence based interventions for reducing mortality and morbidity among young children.
Studies have shown that breastfeeding within the first hour of birth decreases neonatal deaths by 22%. Similarly, exclusive breastfeeding for first six months of life prevents morbidity and mortality due to common childhood illnesses like diarrhoea and pneumonia.

Evidence is also available that optimal breastfeeding practices prevent under nutrition as well as overweight and obesity. However, global progress on this intervention is both uneven and suboptimum as per research and records. The national and state progress is also very slow.

As children are among the most vulnerable groups as far as health and nutrition status is concerned, the survival and good health status of children to be ensured at all levels.

The under five mortality rate of children is still very high in India as compared to other developing countries in the globe. According to the National Family Health Survey (NFHS-3, 2005-06) almost half of children under-five years (44.9%) are stunted, around 40.4% of children are underweight for their age and 22.9% of children younger than five years of age are wasted in India.

Over 6% of children under five of age suffer from Severe Acute Malnutrition (SAM). India has the highest estimated number of SAM children worldwide; 42% of children with SAM in the world are Indian children. Similarly, in Assam around 35.8% of children under three years of age are underweight and 16.7% are wasted according to NFHS-3. Again, around 4% of under five children are SAM in Assam. Though recent RSOC data (Rapid Survey on Children) conducted by UNICEF shows, little improvement in the health and nutrition indicators, still many children are having very poor health and nutrition status.

To address these issues, global evidence based interventions like, early and exclusive breastfeeding, Immunization along with bi-annual Vitamin-A supplementation bundling with deworming, diarrhoea management, timely identification of children with acute malnutrition and their timely treatment and care, etc. are being implemented in all levels in our country and state. But, Assam being the largest state in north-eastern state posses' different capacity and different consumption patterns for Nutrition related behaviours and outcomes.

The state, although progress in key impact area like reducing Maternal Mortality, Infant Mortality and disease incidence, but still, globally proven "High Impact and Low Cost" Nutrition interventions require some more impetus to achieve the desired goals.

Since the inception of National Health Mission in Assam, the capacity of Health sector in terms of Human resource, provisioning of essential services, physical capitals in health facilities and outreach for services has increased. However, the expected improvement in the Nutrition behaviours among the community needs more attention.

While studying the IYCN (Infant and Young Child Nutrition) outcomes from NFHS it was observed, that Behaviour for Early Breastfeeding in past three NFHS has improved along with as per RSOC (Rapid Survey on Children), but the rates for exclusive breastfeeding remains more or less same.

As per NFHS-III (2005-06), the early initiation of breastfeeding rate was around 50.6% which has increased to 74.5% in 2013-14 as per RSOC. The exclusive breastfeeding data has not much improved from NFHS-III (63.1%) to RSOC (65.6%).

So, the thrust area is to focus on successful breastfeeding practices for infants and young children among mothers and caregivers. For that, a constant hammering to change the behaviour of the community needs to be done.

The World Breastfeeding Week, which ended recently, is celebrated globally to make people aware on this high impact though low cost evidence based intervention, which can really change the scenario of mortality and morbidity rates among children under five years of age by reducing under nutrition.

Things can also improve if steps like promoting maternity leave and nursing break can be encouraged. Creating suitable places, like creches near work places or breastfeeding corners in work and public places would also help.

It is therefore crucial that each one of us along with line departments responsible for the welfare of children join hands together for proper implementation of the evidence based interventions to achieve the desired results in the child health scenario.

Editorial NOTE: This article is categorized under Opinion Section. The views expressed in this article are solely those of the author and do not necessarily represent the views of In case you have a opposing view, please click here to share the same in the comments section.
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