New Delhi: The image of a woman breastfeeding on the cover of a popular Malayalam magazine Grihalakshmi was too much for some to bear. A case was even filed in Kerala high court over it. However, the court recently came out in support of the publication, refusing to label the cover as ‘obscene’ and stating that “one man’s vulgarity is another man’s lyric.”
The court also refused to penalise the model-poet-actor Gilu Joseph who was pictured on the cover, the editor as well as others involved in the production of the magazine.
In March, the magazine had published the striking cover with the caption: Mothers tell Kerala, ‘please don’t stare, we need to breastfeed.’
The two-judge bench of the court, dismissing a writ petition filed by Felix M.A., stated in its order:
“Despite our best efforts, we do not see any obscenity in the picture nor do we find anything objectionable in the caption for men. We looked at the picture with the same eyes as we look at the paintings of artists like Raja Ravi Verma. As beauty lies in the beholder’s eye, so does obscenity perhaps.”
However, official government data says that if anything, more women need to be breastfeeding and there needs to be less social restriction on the practice.
What is the data on breastfeeding in India?
Between 2013-2014, the national average for infants who were breastfed within the vital one hour of their birth was 44.6%. That is only about 12 million out of 26 million babies. Breastfeeding in the first hour of life is important because infants need colostrum – yellowish breast milk produced in the initial days which is rich in antibodies.
In the same period, 64.9% infants under five months were exclusively breastfed. ‘Exclusive breastfeeding’ is a technical term for only feeding breast milk to infants for first six months, which is recommended by doctors everywhere including by the World Health Organization and UNICEF. The exclusivity is rigid – not even water is recommended during exclusive breastfeeding.
Data from the National Family Health Survey 2015-2016 (NFHS-4) shows that the percentage of infants being breastfed in different age groups hovers around 50%. This data is in the chapter on ‘Maternal and Child Health,’ and under ‘Child Feeding Practises.’
Data from 2013-2104 and 2015-2016 shows that these rates have fallen.
According to NFHS-4, the national average for infants under the age of three years who are breastfed within one hour of their birth is 41.6%. The states with the lowest percentages are Rajasthan (28.4%), Uttar Pradesh (25.2%), Delhi (29.1%) and Uttarakhand (27.8%). The states doing best in this area are Goa (73.3%), Mizoram (70.2%), Odisha (68.6%) and Sikkim (66.5%).
The national average of infants under six months who are exclusively breastfed has also dropped considerably, from 64.9% to 54.9%. Here, the worst states are surprising, as they are usually the ones who perform well on other health indicators – Meghalaya (35.8%), Uttar Pradesh (41.6%), Nagaland (44.5%), Puducherry (45.5%), Tamil Nadu (48.3%) and Delhi (49.8%). The highest percentages are found in Chhattisgarh (77.2%), Manipur (73.6%), Dadra and Nagar Haveli (72.7%) and Tripura (70.7%).
In higher age brackets, the overall picture of infants receiving ‘adequate diets,’ is dismal – the national average of infants in the age group of six to 23 months who receive an adequate diet is a shocking 9.6%. Those who are breastfed and also receive an adequate diet are 8.7% and those who are not breastfed but receive an adequate diet goes up to 14.4%.
What is happening instead of breastfeeding?
Long-time watchers and practitioners in this field say the practice has fallen prey to food companies who push their artificial food as good nutrition for babies.
“The majority are given formula milk, either powdered or liquid, or animal milk,” writes Dr Arun Gupta, paediatrician and founder of the Breastfeeding Promotion Network of India.
This situation has been acknowledged enough that India even passed legislation to control this: The Infant Milk Substitutes, Feeding Bottles and Infant Foods Act was passed in 1992 and is targeted at the regulation of production, supply and distribution of infant foods.
Yet, despite prohibitions in this Act, food companies like Nestle continue to sponsor events on nutrition. Infant foods are promoted online, sold with discounts. This month, Amitabh Bachchan was enlisted as a brand ambassador for Horlicks, to target malnutrition among children. He has backed out of the advertising campaign following criticism.
Breastfeeding is not just a matter of maternal and child health. It is also seen as a human rights issue. In 2016, the United Nations Human Rights Commission issued a statement on this which said, “Women who choose to breastfeed often lack the necessary support structures. Gaps in knowledge and skills among healthcare providers often leave women without access to accurate information or support”.