Letters to the Editor
Indian Pediatrics 2004; 41:295
Exclusive, But Not Compulsory, Breastfeeding for Six Months
The Journal has done a commendable service to provide detailed
information about the Amended IMS Act, 2003 in the August issue. The
promotion and advertisement (in their various forms) of "infant foods"
and "infant milk substitutes" have been prohibited. However, the
manufacture of such articles and their consumption is NOT banned.
Pediatricians would largely share the sentiments expressed by Dr. Tiwari
and Dr. Chaturvedi(1). But surely they carry their zeal too far while
recommending that "exclusive breast feeding till 6 months is a must for
each and every child; in fact it is the right of every child". An
educated, well informed mother, fully knowing the advantages of breast
milk, may not be able to exclusively breast feed for 6 months (for
various reasons) and decide on an alternative. It is the pediatricianís
duty to advise and support her in whatever method of feeding she
selects. She must not be made to feel guilty of depriving her baby.
Practicality and convenience should also be considered and the motherís
decision respected. It is very obvious that artificial feeding cannot be
just "restricted to orphanages". There are rare situations where breast
feeding is contra-indicated. And talking of rights, there are other,
equally important "rights" (e.g., immunisations against
I appreciate Dr. Palmer and Dr. Costelloís concern about the health and development of Indian children(2). I wonder how important "commercial capital and marketing manipula-tion" are as compared to "poverty, pathogens and ignorance" in child health and survival in India. It would be of interest to know what proportion of the global sales of baby foods is in rich countries, and of those in poor countries (like India) what proportion is among the affluent sections. There can be very little doubt that breastfeeding may reduce diarrheal and other infectious diseases among infants in slums and unhygienic habitations. That benefit may not be very significant among the affluent and knowledgeable even in less developed countries.
The question that arises is how does the pediatrician obtain information about alter-native methods of feeding and the product to be recommendedí? I feel it is our right to receive information (not trinkets and other benefits, which most of us get from many other sources!) from those who manufacture the concerned products.