Gaping void
UNFORTUNATELY, the world today is a blatant flag bearer of injustice. Whether it is race, religion, gender, or the right to land and liberty, we can effortlessly spot children of a lesser god. If there is anything we need in this day and age of inequality and inequity, it is an equaliser at the core of humanity. It is important to understand that breastfeeding wears various hats not just for individuals — mother and child — but their families as well as society at large.
For the most part, the experience of breastfeeding, while differing in the challenges a mother faces in days early and late, remains similar. There are categories, such as medical issues, which remain limited to the physical and emotional areas they touch upon — for both mother and child. While thousands of mothers in conflict-hit areas today suffer from insufficient access to drinking water and food, the peril doubles when their own body slows down in providing nutrition to their babies, and an additional need — which also remains unmet — for breastmilk substitutes arises. So where a sufficiently hydrated and fed mother could feed another mouth, there is a dearth of another food category, which inevitably results from such a situation.
At its very core, Pakistan is a nation that has been severely deprived of breastfeeding support. “But we are Muslims!” we say. “Religion recommends breastfeeding for two years.” That is where the narrative begins and ends for us.
There is a very widespread belief that the breastfeeding rate in the rural areas is higher. In fact, there is no study that verifies this belief; no data that proves it. The idea stems purely from an assumption based on a grotesque narrative from the 1980s, when formula marketing was peaking in our part of the world, that the poor people feed their own babies. If you are privileged and have enough money to afford better nutrition, then you will not be breastfeeding your child.
Pakistan is severely deprived of breastfeeding support.
Generally, we believe that the rural areas are inhabited by the poor and that the more affluent people live in the country’s urban centres. This is again not necessarily true, but with that understanding we assume that the breastfeeding rates are higher in the rural areas.
In reality, this assumption is far from the truth; in fact, it contributes to another dangerous number: the infant mortality rate. In the absence of appropriate breastfeeding support, not only are dangerous ‘alternatives’, dictated by cultural norms (such as cow’s milk mixed with water, black tea, sugar syrup), fed to the child, but it is also maintained that the child is being ‘breastfed’ even if he or she is having mother’s milk just once a day. While the description — ‘breastfed’ — may be technically correct, it usually implies exclusive breastfeeding, unless a detailed clinical history is taken.
While the urban woman may suffer from a similar level of isolation from the facts and techniques underpinning infant nutrition, it is the rural woman who is at additional risk of things going south because of dearth of education and health facilities to prevent the harmful intake of caffeine, unclean drinking water and sugar etc. This makes the playing field far more uneven than it already is. A small child in the rural area is more prone to suffering from health issues that may go undetected for much longer, as well as imminent death, because of the early signs not being acted upon to prevent further damage to his/her system.
A small child’s gut is not mature enough to process water, sugar, caffeine, etc. Not only do the pathogens saunter across the gut wall and go straight into the bloodstream, causing various illnesses, but caffeine and sugar can weaken and seriously harm the other bodily functions and organs of a small child.
Each year, World Breastfeeding Week (Aug 1 to Aug 7) arrives with a rush of conversations from all over, only to lead to radio silence in the months to follow. Thus, its true purpose is defeated. The week is meant to plan and chart out what we wish to do for the rest of the year to ensure that we support breastfeeding in our communities. This year, it is not just important to ensure that we support breastfeeding everywhere, but also to recognise the gaping void across the world and within our communities so that we can have equal and equitable access to adequate information, support and guidance for new and expecting mothers.
The writer is a public health researcher, a women’s health activist and an International Board Certified Lactation Consultant. She practises at the Sajid Maqbool Clinic in Lahore and does online global consultations.
Published in Dawn, August 6th, 2024
