WomanBeat: First 1000 days vital for infant health

Why one of the world's largest manufacturers of infant formula is sponsoring a special Times of India feature on the health of babies is beyond me, considering that the series notes that 22 percent of newborns that fall victim to India's still disgraceful infant mortality rate could be saved by breastfeeding. Oh, wait, apparently the reason is in the feature.

"It's now official — the first 1,000 days of your life — conception to your second birthday — is what decides how healthy or brainy you will be the rest of your life," the paper writes. "This prompted the Times of India and Nestle to jointly launch an initiative to promote healthy nutrition in the first 1,000 days."

Mmmmhhhmmm.

I'll leave it expectant mothers to read all the health tips. But a couple interesting tidbits jumped out at me. Citing the WHO and others who advocate exclusive breastfeeding for the first six months of a child's life (that's 180 out 1,000 days, folks), the TOI says that 22 percent of the million babies who die in the first 28 days after they're born each year could be saved.

That's in line with what I learned a few years ago reporting on the work of an NGO program called Sure Start, which was helping to train India's barefoot nurses and midwives so they could communicate their knowledge to expectant mothers more effectively. 

“The project tries to strengthen the government workers, because if we do something directly it is going to give us faster results, but we're not going to be there forever,” Shilpa Nair, then PATH's state manager for Uttar Pradesh, told me at the time. “The minute we withdraw, it will collapse, because the women attending our meetings today are not going to be the ones pregnant tomorrow.”

For example, the government had created some great financial incentives to motivate locals trained in basic health care to convince women to give birth at the hospital, instead of at home. But nobody had given them any advice or teaching aids to allow them to capitalize on that motivation. Meanwhile, there were other, even simpler solutions where there was no financial incentive, and the cultural barriers to change were hard to overcome without some training in how to teach.

Most Indian cultures believe that the mother's milk is polluted after the delivery, and therefore most rural communities feed their babies honey or cow's milk for three days, I wrote at the time. Moreover, they extrude the mother's viscous, early breast milk—which contains vital antibodies—and throw it away. According to Save the Children, changing that practice alone reduces neonatal mortality by 22%. Similarly, in most rural Indian communities no one touches the baby until a low-caste cord cutter arrives who immediately bathes the infant, a practice that makes them susceptible to pneumonia—a leading cause of deaths. To fight these unhealthy cultural practices, Sure Start began involving all the women of the villages they serve—not just expectant mothers—in the mother's committee meetings. Mothers-in-law, who generally take charge of their son's wives, were a vital audience for conversion. A printed letter from the expected newborn to the father has also proved effective.

I'd like to check back with those guys to see how things are going. Or maybe somebody can comment on this post or link to me on twitter or facebook. (I'd like to get some use out of those $%@! things).

But the real reason that the TOI / Nestle feature caught my eye was a graph that shows the prevalence of breastfeeding in India. The top five states read like a listing of India's tribal belt — where the indigenous people's don't follow Hinduism, and where (in many cases) women have a more powerful role in the community. First on the list was Chhattisgarh (82 percent), followed by Assam (63 percent), Andhra Pradesh (63 percent, Manipur (62 percent) and Arunachal Pradesh (60 percent).

The worst states weren't the most Hindu, as they included Goa (18 percent) and Himachal Pradesh (27 percent), along with the "cow belt" states of Bihar (28 percent), Haryana (17 percent) and Madhya Pradesh (22 percent). But I was intrigued, nonetheless.