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Mother nutrition

In 1994, an honorary service was started for mothers. Dr Armida Fernadez, encouraged lactating mothers to donate their milk. On Fernadez’s intiative, for the first time in Asia, a human milk bank was set up at Lokmanya Tilak Municipal General Hospital in Mumbai. It’s been two decades since then but milk banking remains an ignored service, with India having only 14 milk banks till now.

Human milk bank is a service in which milk is collected from mothers, and stored. The milk is collected using breast pumps and then kept into sterilised containers. It is further pasteurised up to 65 degree centigrade for 30 minutes and then frozen at minus 20 degree Celsius. The sample stored can last for four - five months.

The recent guidelines issued by Infant and Young Child Feeding Chapter, Indian Academy of Paediatrics and Union Ministry of Health and Family Welfare states that only those women who are in good health and have enough milk after feeding their babies satisfactorily are allowed to donate milk. The donor should be willing to undergo blood testing for screening of infections. A woman who takes more than two ounces of alcohol regularly or three caffeinated drinks per day is disqualified as donor.

‘Screening is very essential. It is done so as to rule out infectious diseases such as HIV-1 and-2, hepatitis Band C and syphilis. After screening, the milk collected from mothers is pasteurised so that bacteria are killed and milk is fit for consumption,’ said Meeta Mathur, nutritionist, Save the children (NGO).

Breast milk is considered as life saver for infants. According to a joint statement by the World Health Organisation (WHO) and United Nations Children’s Fund (UNICEF), the best food for a baby who cannot be breastfed is milk expressed from the mother’s breast or from another healthy mother.

Where it is not possible for the biological mother to breast feed, the first alternative should be the use of human milk from other sources. Human milk banks should be made available in appropriate situations.

Naturally endowed with proteins and all the essential nutrients, breast milk is required for the healthy growth of a child. ‘Baby should be breast fed after the first hour of birth. Colostrum, the first yellowish milk that is expressed by mother is like a vaccination for baby. But there are so many myths around it that most people discard it, either under family pressure or religious beliefs. Even organisations such as WHO and UNICEF promote exclusive breast feeding in which baby is only breastfeed for first six months,’ said Vinod Kumar Paul, head of department of paediatrics, All India Institute of Medical Sciences (AIIMS).

Breast-fed babies have lower risk of asthma, childhood leukemia, low weight, ear infection, diarrhoea, pneumonia, sepsis eczema and such ailments. According to most recent estimates, in developing countries 35 per cent of newborn deaths are caused by complications from premature birth and 37 per cent of newborn deaths are due to infections and diseases such as diarrhoea (2 per cent), pneumonia (11 per cent), sepsis (13 per cent), tetanus (2 per cent). ‘I get four-five cases in a month where poor breastfeeding has led to diarrhoea, pneumonia, cold and such ailments,’ said Shekar Vashishth, consultant, institute of women’s and children heath, Moolchand Medcity.

The Infant Mortality Rate (IMR) of India which has not shown much improvement stands at 44 per 1,000 live births in 2012, according to data published by World Bank.

‘People are not aware about benefits of breastfeeding. They have lot of misconceptions and many people have started using powder milk for feeding their babies. Besides the awareness, the other problem is mothers often complain that enough milk is not been produced. Milk production depends upon lot of factors including social health and psychological. It is possible that a mother is producing enough milk but may not be able to express it. Changes in lifestyle, more women joining workforce and increase in stress levels have affected the production of milk. It can’t be denied that milk bank will be helpful in cases where mothers due to illness or other reasons are not able to feed their child.

In our hospital, we don’t have a milk bank but we store milk in containers for emergency requirements,’ said Shekar Vashishth. Delhi, despite having known hospitals like AIIMS, Safardjung, Sir Ganga Ram hospital has no human milk bank.
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