Breastfeeding rates are low in Pakistan – around 25% in the first hour following birth. Breastfeeding practice in Pakistan is declining. The fall in breastfeeding practice in Pakistan is undoubtedly because of many factors, increased urbanization, rapid supply of infant formula, desire to be ‘modern’, thinking to get milk tested before nursing it to the infant. In urban squatter areas of Pakistan human breast milk is regarded as a potential source of destruction.
- Milk is thought to become poisonous to the child or spoiled of a shadow cast over the mother. The source of the shadow is usually described as a dead or otherwise ritually impure person. Sometimes it is also attributed to the influence of an own infant who had died. Women also say that breast milk might become affected by a shadow if the mother had sexual intercourse and nurse without taking a ritual bath, in such a condition if shadow came over her, the infant would refuse to suck.
- An Evil eye is also thought of as a reason to turn the breast milk poisonous. Other thoughts about breast milk being poisonous were if
- infant refused to suck,
- it fails to thrive in days or weeks after birth,
- it cries a great deal, or
- it has the recurrent illness, particularly diarrhea.
Under any of these conditions the mother may consult an elder in her own family or they may suspect that her milk has turned sore and tell her to get her milk tested. If the nursing mother becomes pregnant it is also unanimously believed that either the nursing child or the fetus or both will be affected especially the nursing child will suffer.
- There is a striking discrepancy between the large amounts of money spent on teaching people in the developing world what Westerners want them to do and the scant funds spent on learning what they themselves think and how they live. Understanding what women really worry about in their squatter settlements and rural villages will enable us to design better health education programs to help dispel those worries, to combat wasteful expenditures on attractive but fraudulent procedures, and ultimately to enhance prospects for child survival.
Recommendation from World Health Organization
Breastfeeding and complementary feeding practices have long been demonstrated to have significant implications for maternal and child health. Healthy breastfeeding practices reduce child mortality and morbidity, and improve immunity in children, besides being essential for their optimal growth and development. In mothers, breastfeeding is associated with enhanced emotional attachment to the infant, reduced risk of breast and endometrial cancer, increased duration of postpartum amenorrhea, and consequent birth spacing, as well as several other health benefits. The World Health Organization recommends that infants be exclusively breastfed for the first six months, followed by breastfeeding along with complementary foods for up to two years of age or beyond.
Study from Aga Khan University School of Nursing and Midwifery
Yasmin Mithani and colleagues at Aga Khan University School of Nursing and Midwifery had interviewed 12 fathers in the urban and semi-urban area of Karachi Pakistan.
The fathers were living with the mother, were healthy, had healthy babies and had two to four children, at least one of which had been breastfed. All six fathers from the urban area were educated, only one from the semi-urban area was.
Ten fathers showed knowledge and awareness of the importance of breastfeeding. 10 fathers considered the mother’s milk to provide complete nutrition for the first 6 months of an infant’s life. The fathers in the urban area talked about the risks of breastmilk substitutes.
Nine fathers considered the role of the father to be important in supporting breastfeeding. All 12 fathers felt they could not do anything directly but could do other things, such as housework, looking after older children, supporting their wife’s diet and rest, and caring for the baby. Two fathers who admitted domestic violence said they were reluctant to hit their wives during the breastfeeding period.
All the fathers recognized the role of their religion in encouraging them to support their wives with breastfeeding.
11 fathers said that family support is a major factor, particularly the mother’s mother. Sometimes she was supportive of breastfeeding, sometimes she obstructed it.
Seven fathers said that health professionals supported breastfeeding but in no case did these professionals approach the father directly to speak about breastfeeding. 10 fathers said they had never received any professional support for maternal and child health and 9 felt left out as a result. The fathers regarded this as a barrier, alongside other social and cultural factors that exclude fathers from an active role.
Ten fathers received no paternity leave.
Most of the fathers felt that breastfeeding increases the bonding with their wives.