Kolkata, July 16 (IBNS): In the days of yore, many nursing mothers in India breastfed their babies for a longer period of time. But with changing times, women have begun weaning babies off breast milk much earlier.
Data from the National Family Health Survey 3 report indicates that many mothers stop exclusive breastfeeding prematurely, with only 69% infants less than two months of age being breastfed exclusively. By 2–3 months of age, the number falls to 51% and by 4–5 months, breastfeeding plummets to 28% only.
Declining rates in breastfeeding are mainly due to supplementation with plain water in the early months, followed by cow’s milk in subsequent months. Additionally, there exists the practice of introducing top feeds early in the form of diluted cow’s milk.
All this flies in the face of expert advice, which recommends avoiding cow’s milk for the first year of the baby’s life because it is inappropriate, unsafe and inadequate in terms of nutrient content.
Healthcare practitioners stress that the first two years are critical for the growth and development of babies, due to which they need to be nourished exclusively on breast milk.
This is why, the WHO and UNICEF, including national and international guidelines on Infant and Young Child Feeding, advise exclusive breastfeeding for the first six months and continued breastfeeding for up to two years and beyond.
In the first six months especially, exclusive breastfeeding is emphasized to curb the possibility of food contamination from impure water or malnutrition due to over-diluted bovine milk (cow or buffalo).
Mother’s milk is widely recommended because it is enriched with nutrients, vitamins and minerals, including antibodies that safeguard infants from life-threatening diseases. Besides minimizing risks of diarrhoea, breast milk protects babies from allergic reactions such as eczema.
Nutrition experts caution against the use of cow’s milk in the first two years of a child’s life because, unlike mother’s milk, it lacks adequate nutrients, contains no antibodies that protect against infections and is a poor source of iron.
Moreover, cow’s milk is usually processed and transported in environments that are simply not hygienic enough to prevent contamination from food-borne bacteria.
National surveys as well as published studies have repeatedly shown cow’s milk sold loose as well as in packets have high levels of adulteration with detergents and toxic substances such as urea, all of which could especially endanger the lives of babies who possess delicate immune systems.
To safeguard infants from such dangers, the Food Standards and Safety Association of India mandates an upper limit for certain microorganisms, such as E. coli, Staphylococcus aureus, Shigella and Salmonella, as well as yeast and moulds, among others, in pasteurized milk.
These norms are necessary because even milk from healthy cows and buffaloes that contains few bacteria can be liable to hundred-fold bacterial contamination once it is stored for some time at normal temperature.
Besides minor skin infections, some bacteria can cause life-endangering diseases such as pneumonia and diarrhoea.
In spite of milk being heated or pasteurized to protect it from bacterial contamination, it is still susceptible to recontamination, even under refrigeration.
Dr Geeta Dharmatti, Indian Dietetic Association (IDA) Pune Chapter President & Chief Dietitian, Aditya Birla Hospital, Pune, said: “Cow’s milk is susceptible to spoilage by yeasts and moulds and may even trigger allergic reactions in infants.
"At least two percent of infants across the world are said to be afflicted with cow’s milk allergy, which can cause rashes, eczema, colic, vomiting and diarrhoea, among other ailments. contamination of cow’s milk, including recontamination of pasteurized milk, is among the many reasons why Infant and Young Child Feeding recommendations state that infants should be exclusively breastfed during the first six months of life."
"Nutritionally, feeding with cows milk may lead to iron depletion in infants. Lactose in milk can diarrhea and gas. Infants could later be given appropriate complementary feeds with continued breastfeeding till two years of age or beyond,” Dharmatti said.
More worryingly, all practices connected with cow’s milk deprive babies of proper nutrition as the nutrient composition of cow’s milk is not suited for human infants, especially since it contains high levels of protein unsuitable for infants’ immature kidneys. While boiling and diluting with water destroys its nutritional content, the household practice of removing the fat layer in milk also deprives infants of essential nutrients.
Dr Jagmeet Madan, IDA Mumbai Chapter President, Mumbai, said: “Although feeding infants cow’s milk is more than a thousand-year-old tradition in India, it brings in additional concerns of contamination, adulterants and allergens thus making it unsafe.
"In the first six months, therefore, it is preferable to nurse the infant exclusively on mother’s milk since this boosts resistance to disease. Additionally breast milk is designed naturally to address the nutrient and assimilation ability of the infant for mothers unable to nurse because of health reasons, it’s best to consult the family physician about a safe alternative.”
