After 6 years in the emergency department as a nurse, graduate school, breastfeeding her 2 children, living in India, learning to speak Hindi, and working with breastfeeding women, Dana can look back and see how each step in her journey brought her to where she is today. She works one on one with moms and offers evidence-based recommendations to meet their breastfeeding goals. She builds a partnership among those working to promote and support breastfeeding in the medical community. She continues to dream of the day when every family’s reality is receiving antenatal education and postnatal support to breastfeed their new baby with success. Breastfeeding is not only a personal choice but a public health intervention to save babies’ lives and empower families to experience a blessed beginning. Below is her journey from being a trailing spouse to becoming a social entrepreneur.
In 2012 after giving birth to my 2nd child, my husband took a posting in India working in the IT sector. We boarded the plane, with a 2-year-old and a 3-month-old, to start a new season as a family in Dehradun, India. I have worked in healthcare for all of my professional careers, including 6 years as a trauma nurse in the emergency department. Working in healthcare is more than a job for me, it is a vocation and a passion. Every patient, every family has a story, and I feel privileged to walk with them for one conversation or a longer period of time. This led me on my own journey deciding how best to serve my new community in Dehradun. Informally in the beginning months, people were asking me questions because of my own newborn, but eventually, this led to becoming an IBCLC (Internationally Board Certified Lactation Consultant) and starting my own socially-focused business to provide lactation care and support. Blessed Beginnings International developed out of a dream and passion to help families in my local community in India but also to be a global initiative to help families and the professionals that care for them.
As a lactation consultant, I understand that evidenced-based research informs and guides practice every day. Although each family I see is its own independent unit, there is a bigger effect on the greater national and global society of early initiation of breastfeeding within the first hour and exclusive breastfeeding for the first 6 months. Breastfeeding is both a personal choice and a public health initiative. In 2016, the Lancet released a series about the impact of breastfeeding globally. One of the most shocking statistics states, “The scaling up of breastfeeding can prevent an estimated 823,000 child deaths every year” (Lancet BF Series, Jan 30, 2016). Recently UNICEF also shared this statistic, “The longer breastfeeding is delayed, the higher the risk of death in the first month of life. Delaying breastfeeding by 2-23 hours after birth increases the risk of dying in the first 28 days of life by 40 percent. Delaying it by 24 hours or more increases that risk to 80 percent” (http://www.unicef.org/media/media_92038.html). Breastfeeding, therefore, saves lives and gives babies the best start in life. This was the background m
otivation to launch both my own business in 2014, Blessed Beginnings International and ALPI (Association of Lactation Professionals India).
Globally we know best practices from research and other contexts, but this is not the current situation in my local practice and in many contexts throughout India. Each week, I visit maternity centers and complete home visits in my local community. Very few women are attempting to breastfeeding in the first hour, let alone the first days. Even if a mother’s wish is to exclusively breastfeed, her child will almost definitely be given top feed while in the hospital. After returning back home after 24 to 36 hours, she finds herself without confidence, unable to latch her own child, and believing that her milk is not enough. This is an epidemic problem throughout India. Women face multiple barriers when it comes to breastfeeding their own child in the first hour and first days of life. Whether she is lacking in knowledge and confidence herself or hearing voices from family members and medical staff that her milk is not enough, her nipples are too small too big or strange, or that she is too tired to eat, a mother must fight for the opportunity to give her baby the best start.
So with the knowledge that breastfeeding with mother’s own milk in the first hours and days is the best start for the baby, but the current problem of top feed being given in all levels of society, where do we go from here? The Lancet study concludes, “Not breastfeeding is associated with lower intelligence and economic losses of about $302 billion annually or 49% of world gross national income. Breastfeeding provides short-term and long-term health and economic and environmental advantages to children, women, and society. To realize these gains, political support and financial investment are needed to protect, promote and support breastfeeding” (Lancet BF Series, Jan 30, 2016). How do we protect, promote and support breastfeeding better here in India? Dr. Arun Gupta from BPNI shares, “Breastfeeding and its success depends on hormonal control particularly the flow of the mother’s milk which depends on her state of mind. If there is any doubt planted in her mind about her ability to lactate, it is unlikely that she will succeed. Therefore health workers or care providers have to play a vital role in building up the confidence of new mothers. However, such support is rarely forthcoming. If a woman complains of “not enough milk” she is usually asked to buy a formula feed rather than helped to gain confidence” (Gupta, “Manipulation by Assistance: Undermining Breastfeeding,” Sept 6, 2008).
From healthcare workers to family members to friends, we, as a community, need to help our families succeed. Confidence building is the best way to support a family in breastfeeding, from pregnancy through the postnatal period. In the majority of situations, the mother’s milk is more than enough. Also, there needs to be scaling up the lactation profession at all levels of care. With skilled lactation care, women will receive proper guidance and support in the beginning days and when challenges arrive. Changes are happening daily in India, but I hope we can look back in five and ten years and see a drastic transformation of the breastfeeding rates in India to ensure a better future for all children. Blessed Beginnings International, ALPI, BPNI, Birth India and other like-minded organizations are working together to collaborate for systems-based solutions for better support of families in India.