Other reasons help to explain why breastfeeding is declining in Nepal
More counselling for expectant and new mothers could definitely help boost breastfeeding
Listen to part of my chat with Hilary Wallace, at the end of this post.
World Breastfeeding Week was held earlier this month. As usual on such occasions local media was filled with articles about the topic. Many highlighted the falling rate of exclusive breastfeeding in the country — 56% of infants aged 0-5 months, according to the latest government figure, in the Nepal Demographic and Health Survey (NDHS) 2022. This compares to 66% in 2016. (See the graph below. All figures in this post are from the NDHS 2022.)
The articles also touched on some challenges to breastfeeding in Nepal today, such as the lack of support systems for working mothers, including breastfeeding spaces in workplaces. Others argued that many new mothers today are fearful of ‘losing their figures’ by breastfeeding and instead use bottle feeding.
One issue that we shouldn’t ignore is incessant marketing by formula makers, which happens much more than you probably realize. I wrote an article last year that noted how these companies have managed to imprint advertising in maternity wards of hospitals in Cambodia, and I wouldn’t be surprised to learn they’re doing it elsewhere also. Linked to that is growing online marketing by the companies.
I was surprised to learn that in Nepal counselling pregnant or new mothers about breastfeeding is not common. Just 52% of women who went for a pre-delivery checkup were counselled about breastfeeding, reported the NDHS, compared to 91% who were counselled about their diets and 65% who were counselled about weight gain.
I wanted to find out more so I contacted Hilary Wallace, co-author of a recent study about breastfeeding in Nepal. She first made it clear that she is not a breastfeeding expert but a health researcher and research trainer who helped medical students from Australia and Nepal to understand the data in the NDHS. One of her students later wrote a research paper based on the breastfeeding data in the 2016 NDHS.
One of the things Hilary stressed was the Implementation guidance of the WHO-UNICEF Baby Friendly Hospital Initiative. She thinks it provides solid advice that countries like Nepal can use to improve breastfeeding support and services.
In turn I mentioned the launch of a new app meant to provide health advice to mothers and families about issues such as nutrition, including breastfeeding. I’ll be interested to see what exactly it says about breastfeeding.
Listen to excerpts from our interview here, and let me know in the comments if you’d like me to upload our full conversation:
To clarify, where I said ‘continue to breastfeed for 6 months’, I meant ‘exclusively’ breastfeed for 6 months in that context 🙂 . Also, including breastfeeding counselling in antenatal care certainly requires resources, but there is huge potential ‘bang for buck’ for improving neonatal and infant health outcomes. The level of breastfeeding support available post-natally is also likely to be very important to promote exclusive breastfeeding to six months.