Breastfeeding and Child Health

Letters

Breastfeeding and Child Health

e would like to applaud the author of ‘Child Malnutrition and Gender Discrimination in South Asia’ (March 11, 2006) for the completeness of the analysis, covering improvement in women’s health, education and caring capacity to ensure healthy development of the child.

However, we would like to contest the observations made on infant nutrition and the suggested policy implications, mainly that complementary foods must be provided within four months of birth.

(1) The author may have drawn his conclusions from a study, which has been found to be flawed internationally as well nationally. The study by Ravilla Anandaiah and Minja Kim Choe (‘Are the WHO/ UNICEF Guidelines on Breastfeeding Appropriate for India?’ NFHS Bulletin, No 16, September 2000) had several fundamental problems. For instance, Sultana Khanum of WHO and Patrice Engle of UNICEF, in a joint reaction have said, “The conclusion of the study diverges radically from most scientific research on the physiology of the developing infant and the benefits of exclusive brestfeeding for around the first six months of life”.

(2) WHO took several years of expert consultation into account before recommending a duration of exclusive breastfeeding during the first six months, which was adopted by the World Health Assembly (Resolution 54.2). The recommendation of exclusive breastfeeding for the first six months was only challenged by “market” forces and it took seven years of discussion at the WHA level before a consensus was reached.

(3) The scientific recommendation has been found to be feasible and the Infant Feeding Study group findings in Haryana proved that “Promotion of exclusive

breastfeeding until the age of six months in a developing country through existing primary healthcare services is feasible, reduces the risk of diarrhoea, and does not lead to growth faltering.” This is now public policy in a majority of countries.

(4) The role of exclusive breastfeeding for child survival has been amply demonstrated in Lancet’s child survival series of 2003. Exclusive breastfeeding for the first six months is viewed as the single-most effective intervention among other preventive interventions.

(5) Guidelines issued by the American Academy of Paediatrics in 2005 emphasise that children younger than six months require no other food or fluids beyond breast milk and recommend that breastfeeding continue after solid foods are introduced for at least the first year of life or longer, if the mother and child wish to continue. The WHO and UNICEF recommend breastfeeding for at least two years.

(6) Research suggests that milk production is relatively unaffected in quantity and quality except in extremely malnourished women (only 1 per cent of women). When women are malnourished it is the mother who suffers, not the infant. The solution to helping malnourished women and infants is to feed the mother, not the infant. By feeding her, you are helping both the mother and child and harming neither.

We expect the UN to promote these practices based on solid scientific facts. In light of these we feel that policy implications provided by the author do not stand the test of scrutiny.

ARUN GUPTA, DEEKSHA SHARMA

Breastfeeding Promotion Network of India, New Delhi

(Continued on p 1484)

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Economic and Political Weekly April 15, 2006

Letters

(Continued from p 1402)

Gokhale Institute

was shocked to read a letter (May 18, 2005) signed by renowned economists, which criticised recent developments at the renowned Gokhale Institute of Politics and Economics, Pune. The signatories should have realised that while they claim to be concerned about the institute, their letter may have damaged the reputation of GIPE.

The relationship between Gokhale institute and the Servants of India Society (SIS), the trustees of the institute, has been very cordial from the very inception of GIPE. The trustees have never interfered in the academic pursuits of the institute. Till now, the authority of the trustees, as per the memorandum of association and rules of the institute, was given due respect. It is for the first time, that the propriety of the SIS was put to an explicit challenge through a writ petition filed by the employees of GIPE. The petition was dismissed as baseless by the Bombay High Court.

I appeal to the renowned signatories that if they are really concerned about GIPE they should seriously think about their earlier letter and modify their stand if possible.

P R DUBHASHI

Pune

Article Title

n a very interesting editorial, ‘Central Banking: Changing Roles’ (March 25, 2006) you gave a quote in its last para from an article (August 27, 2005) without citing the title of the article (‘Towards an Independent Federal Reserve Bank of India’) nor the name of its erudite author (Anand Chandavarkar). How I wish that you had followed in this editorial an admirable precedent you set in your editorial comment on a book Development with Dignity in the March 11 issue of the EPW.

DEENA KHATKHATE

Maryland, US

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Economic and Political Weekly April 15, 2006

Breastfeeding and Child Health