Global Breastfeeding Week: “What Closing the Gap” Means in Pakistan

Breastfeeding is not a luxury; it is a right of every child and the caregiver. Breastfeeding is done exclusively for the first six months and continued with supplementary food till the age of two.

Breast milk is full of enriched nutrients essential for a young child, their immunity, and early brain development. It is not only helpful for young children’s growth and development but is also beneficial for mothers. Breastfeeding children helps them establish a responsive bond with their young ones, cope with their postpartum mental health, and reduce future potential health risks.

The benefits are not just limited to the mother and the child, but it is very well-researched that investments made in scaling breastfeeding have shown economic returns in the future.

However, various factors hamper this naturally beneficial process of breastfeeding. According to one of the World Health Organization reports, in Pakistan, only 18% of mothers begin breastfeeding within the first hour after birth, and just 37.7% exclusively breastfeed their babies for the recommended six months. Unfortunately, this low rate of early and exclusive breastfeeding is linked to a concerning statistic: 44% of Pakistani children experience stunted growth, meaning they are shorter than expected for their age and may face challenges in cognitive development and other milestones. A wide range of health, personal, socio-economic, cultural, and educational barriers impact breastfeeding.

Some of the most prevalent factors that impact breastfeeding are lack of education and awareness Breastfeeding is not a luxury; it is a right for every child and caregiver. Exclusive breastfeeding is recommended for the first six months, followed by continued breastfeeding with supplementary food until age two. Breast milk is enriched with essential nutrients that are fundamentally important for a young child’s immunity and early brain development. It not only supports the growth and development of young children but also benefits mothers.

Breastfeeding helps mothers establish a responsive bond with their young ones, cope with postpartum mental health issues, and reduce potential future health risks. The benefits extend beyond the mother and child; research shows that investments in breastfeeding yield economic returns in the future.

However, various factors hinder this beneficial process. According to a World Health Organization report, in Pakistan, only 18% of mothers begin breastfeeding within the first hour after birth, and just 37.7% exclusively breastfeed for the recommended six months.

This low rate of early and exclusive breastfeeding is linked to concerning statistics: 44% of Pakistani children experience stunted growth, which affects cognitive development and other milestones. Numerous health, personal, socio-economic, cultural, and educational barriers impact breastfeeding. Key factors include a lack of education and awareness among parents, families, and communities, poor maternal health, insufficient social support at home and in the workplace, stigmas and cultural misconceptions, rural and urban health access disparities, and climate change. This underscores the importance of promoting and supporting breastfeeding practices in the country.

Every year, during the first week of August, International Breastfeeding Week is celebrated globally. This year’s theme is focused on “closing the gap,” aiming to break disparities and inequities to support, promote, and scale breastfeeding at all levels. This means ensuring every mother and child has consistent access to healthcare, information, and support from families, communities, and the nation at large. As advocates for breastfeeding, we must understand what closing the gap means in the context of Pakistan and how to bridge these gaps.

First and foremost, we need to ensure equitable access to information for all. This involves promoting awareness of the importance of breastfeeding in all local languages of Pakistan, tailoring content to urban and rural contexts, providing door-to-door counseling services in hard-to-reach areas, promoting this agenda through every media outlet, using public transport to advocate its significance, engaging youth to educate communities, and ensuring every expecting couple receives one session on breastfeeding. Additionally, social media influencers should promote this cause by developing culturally sensitive content to break stigmas and taboos around breastfeeding.

Strengthening healthcare systems to support breastfeeding is crucial. This means ensuring every midwife, nurse, obstetrician, and allied health staff working with mothers and children have the qualifications and skills for breastfeeding counseling, dedicating one antenatal visit to breastfeeding counseling, ensuring every healthcare facility has a licensed and well-trained lactation consultant, promoting patient education materials on breastfeeding, providing free breastfeeding counseling services where possible, and making breastfeeding education a mandatory part of discharge and postpartum visits. Where primary healthcare centers are not available, engaging youth to become breastfeeding community education champions to provide counseling services to parents.

The government should implement policies to support breastfeeding in workplaces and public places. This includes ensuring every office, educational institution, airport, mall, hospital, and public space has a breastfeeding booth, engaging civil society organizations, multinationals, and unions to form a task force to ensure flexible timings for mothers to support six months of exclusive breastfeeding, providing health and socioeconomic support to parents from resource-constrained areas, establishing and sustaining breast milk banks, promoting and destigmatizing breast milk donations, and setting targets for each province to raise their breastfeeding rates.

Breastfeeding is a unique and individual experience for each mother. Therefore, no single policy, plan, or set of standardized guidelines can fully address the diverse needs of all mothers. To effectively support breastfeeding, we need a flexible and inclusive approach that considers the varying circumstances and challenges mothers face in different geographical regions of Pakistan. We need to take a participatory approach in designing a national breastfeeding action plan by involving people from different sectors and engaging parents.

We can only close the gap by ensuring every mother and child receives breastfeeding support appropriate to their context and needs. It is a community effort; we need more voices, ideas, and efforts to ensure our children, our future, get the best they deserve.

Dr Shelina Bhamani is a faculty of ECD PREP Department of Obstetrics and Gynaecology at the Aga Khan University Views are personal.