Case I. A baby weighing 1.1 Kg was admitted to a private nursing home, but the mother was sent back home. After 17 days, the baby was on ‘Infant Milk Substitute’ and his weight came down to 800 grams. The nursing home authority now declared that, they don’t have the facilities for further management of the case. Thus the infant, on non-human milk with diarrhea and oral thrush, was discharged. The mother, in the meantime, developed lactation failure inevitably. The baby and the mother were brought to us. We were able to manage this preventable tragedy, as we are fortunate to have a lactation management unit (LMU) with efficient and devoted staff. The mother was able to successfully breastfeed the baby exclusively within 15 days after admission and the baby along with the mother could be discharged after 6 weeks, with a body weight of 2.1 Kg. The mother was thoroughly confident of feeding and caring for the infant. The father was very happy and willing to support the mother physically and emotionally.

Case 2. A mother, who delivered at home, was admitted in a government health facility with portion of retained placenta, 3 days after delivery. The neonate was left at home, as there was no facility for the baby to be kept along with the mother in the health facility. When the mother was discharged after 7 days, the infant, who was on cow’s milk, had developed diarrhea at home and the mother, lactation failure at hospital. The infant along with the mother admitted to our LMU, could be easily managed, as the lactation gap was not long.

The damage done in both the cases could have been avoided, if it was ensured that the sick neonate was admitted to the health facility along with the mother and vice versa. Any unthoughtful action by the treating physician may deprive the newborn, his/her share of breast milk and certainly, that is not the lesson we are preaching for the ‘Baby Friendly Hospital’ or the ‘Baby Friendly Doctor’. This act of omission would not violate the ‘IMS Act’ directly, but certainly violate the code of conduct, which guides the spirit of ‘protection, promotion and support of ‘exclusive breastfeeding’.

What we need is a ‘Baby Friendly Community’ and not only a ‘Baby Friendly Hospital initiative’. A community movement with effective participation, implementation and monitoring is the key to success. It will be worthwhile to consider introducing ‘Infant Feeding and Caring Practices’ in the curriculum of primary school education as well as non-formal education for the adolescents. IAP, BPNI and IMA need to come out with specific suggestion to the government in this regard and work together.

N.C. De,
Consultant, Child Health,
CINI-Child In Need Institute,
Daulatpur, P.O. Pailan.
24, Pargana(S), (WB) 700 014, India.
E-mail: [email protected]