The gap between knowledge and practice in breastfeeding is widening. While breastfeeding is a natural process, it is not always easy to sustain breastfeeding specifically for working mothers. Earlier, lack of knowledge on correct breastfeeding practice was considered responsible for the gap but with the flourishing concept of empowerment, support from family and workplace turned out to be equally important determinants.
Nepal’s Labor Act, 2017, states that women have the right to maternity leave for 14 weeks i.e. 98 days but the provision of paid leave is only 60 days. This leave has to be taken two weeks before the expected date of delivery which allows only three months for breastfeeding while WHO recommends exclusive breastfeeding for the first six months.
Mother’s Milk Substitutes (Control of Sale and Distribution) Act, enacted in 1992, has a provision for the National Breastfeeding Promotion & Protection Committee (BPPC) to protect and promote breastfeeding and to control the sales and distribution of the substitutes. However, this committee is inactive at present and substitute milk is readily available in the market tempting working women to opt for infant formula instead of breastfeeding.
As per the National Demographic Health Survey (NDHS), exclusive breastfeeding among children aged below 6 months declined from 70% in 2011 to 66% in 2016. Only 41% of children age 4-5 months were exclusively breastfed compared to 80% in 0-1 months and 72% in 2-3 months indicating that working women might not be breastfeeding exclusively after 3 months of her delivery as her maternity leave gets over by then.
Similarly, maternity leave and breastfeeding break in the informal sector does not constitute a right but only a benefit for which permission has to be obtained from the employer or the authority who may or may not approve it at all. Efforts to promote breastfeeding are limited to the World Breastfeeding Week (August 1-7) are hence, are not sufficient.
Mothers need support – both to get started with breastfeeding and to sustain it. Here, support from workplace plays a vital role in sustaining breastfeeding. Maternity protection for working women needs to be extended to every sector and should be entitled as a right rather than a privilege.
In addition to making attempts to bridge the gap between knowledge and practice via informative activities on lactation management, endorsing policies and rights supporting breastfeeding and their appropriate implementation are equally important for the mother-infant relationship. Workplaces need to ensure breastfeeding breaks and breastfeeding corners in their premises so that women aren’t left with two harsh choices: either to keep the job and ignore her baby’s right to breast milk or quit the job and hold her baby’s hands.
Mero Tribune will cover breastfeeding related articles and cartoon stories this week. They are created by Ichchhya Rupakheti, Sabina KC, and Anjila Chhetri, who are studying Masters in Public Health in Chitwan Medical College.
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