World Breastfeeding Week, 2010 commemorates the 20 years for innocenti declaration that called for 10 simple steps to promote early initiation of breastfeeding to reduce the chances of neonatal morality to a great extent. Hence the theme for World Breastfeeding Week 2010 is “Just 10 Steps! Breastfeeding the Baby -Friendly Way.” Timely initiation of breast feeding is essential as it ensures that the child is immunized with a natural colostrums rich milk to sustain life. All the new born babies have a fundamental right to adequate nutrition, health care & survival.

Ten steps for the promotion of breastfeeding were presented jointly by WHO/ UNICEF in 1989. The declaration called for the world to fully implement all the 10 steps in all the maternities/ modern health facility by 1995. India has also joined the world breastfeeding campaign & every year India too celebrates ‘World Breastfeeding Weak’ between 1st-7th August of every year for promoting universalization of breast feeding practices. However, it is most excruciating fact that even now merely 24.5 percent of children are breast fed in India within an hour of birth.

Promotion of breast feeding is particularly vital in Indian context because India is home to the largest number of malnourished people in the world. India is long known to have some of the highest rates of child malnutrition and mortalities in under-fives in the world. India’s Global Hunger Index 2009 scores is 23.9 with ranking at 66th position out of 88 countries. While the 12 Indian states have alarming level, the condition of Madhya Pradesh, known as the heart state of India is ‘extremely alarming’ at GHI.

Early nutrition care is an important determinant of good health & it is imperative for cognitive development of the child. The first nutrition that the child gets through its mother milk. Exclusive breast feeding for initial six months period after birth provides all the essential nutrients to the children. Breastfeeding can save lives and plays a vital role in protecting infants. Breastfeeding also provides children with protection from infectious and respiratory illnesses, boosts their immune systems and helps protect them from chronic conditions later in life. If the child is not adequately & exclusively breastfed during this period, the child may develop weak, scrawny and developed severe malnutrition in the later stage.

Breastfeeding can save lives and plays a vital role in protecting infants. “Breast milk offers an excellent source of nutrition for infants and, especially where clean water is lacking, helps keep young children safe from dangerous water-borne illnesses like diarrhea.” Breastfeeding also provides children with protection from infectious and respiratory illnesses, boosts their immune systems and helps protect them from chronic conditions later in life. If the child is not adequately & exclusively breastfed during this period, the child may develop weak, scrawny and developed severe malnutrition in the later stage.

According to World Health Organization, 60% of all death under five years of age are related to malnutrition. Under-nutrition is an underlying cause of child death associated with infectious disease. Malnourished children are more prone to malaria, Pneumonia, Diarrhoea, & Measles. Inappropriate feeding practices related to 2/3rd of all under five child mortalities.

Lancet series on child survival, 2003 say that 13-16 percent of all child deaths can be avoided if the infant is exclusive breastfed during the initial six months. Exclusive breast feeding can help low birth weight children to revive their physical growth and development. Birth weight below 2500 grams is found to be closely associated with poor growth, not just in infancy but also through out childhood. India, where 21.5 percent are born with extremely low birth weight, it is crucial to promote universalization of breast feeding practices.

NFHS-3 shows that currently only 46.4 per cent of Indian children benefit from exclusive breastfeeding, an important child survival intervention. It is estimated that optimal breastfeeding and complementary feeding practices can avert almost 20 per cent of child deaths in India.

Keeping the pity scenario of health & nutrition among children in India, it is extremely imperative to endorse the universalization of breastfeeding practice through out the country. And for that India must follow the strict implementation of ten simple steps guided by WHO /UNICEF for encouraging the practices of early initiation and exclusive breastfeeding. But unfortunately, India hasn’t taken even the first step so far to have a written breastfeeding policy that is routinely communicated to all health care staff. The simple steps also embrace the component of informing all pregnant women about the benefits and management of breastfeeding. However, still merely 44% of rural women receive at least three ante-natal care by skilled attendant who could educate the pregnant women regarding breastfeeding management. It is also intended to show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants. However, it is considered extremely irrelevant in India to counsel mother with proper breastfeeding & child care practices even at health facilities. And for those mothers who delivered their baby outside the health facility, counseling is out of question?

In India one of the most important factors for low percentage of breastfeeding are the several cultural practices, traditional myths & superstitions associated with lactation and breastfeeding in India. Although breastfeeding is considered to be ideal but initiation of breastfeeding was delayed after birth for first three four days because yellowish colostrums is regarded impure and harmful to the child's health. Therefore, it is most substantial need to raise mass understanding on the nutritive values of breastfeeding. Expansion of institutional deliveries is definitely leading to encouragement of early initiation of breastfeeding. But still, more then 50 percent of the babies are delivered out of health institution; at road side or at best at home. Although ICDS workers, ASHa & ANM are trained for encouraging breastfeeding, however, it doesn’t seem working in its essence at the grassroots in rural India. Therefore, it is the need of the time that we must opt for community based management for appropriate counseling of pregnant women & lactating mothers for timely initiation, proper positioning while feeding & other important aspects of breast feeding practices.

Now, in Breastfeeding Week, 2010 India must have to take a pledge for universalization of breast feeding practices and encouraging breastfeeding on demand. For this we have to foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.