Breastfeeding: Taboo or must-do?

Published: August 10, 2013
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In Pakistan breast milk is an elixir of life that must be promoted. PHOTO: REUTERS

“Sorry, what?” I asked, absolutely shocked.

“Yes, madam, my doctor told me that my breast milk is poisonous and not suitable for the baby, and that is the reason she is sick all the time. I even got my milk tested as per my doctor’s instructions and it was indeed poisonous,” said the mother of a six-month-old, shrunken-eyed Maryam.

The child was diagnosed as a classic case of third degree malnutrition and marasmus.

I was taken by surprise. I had never ever heard of a healthy, physically fit woman like her producing poisonous milk; needless to say, I was extremely curious to see the test reports that stated such obscene information. Upon further probing, the mother revealed that she did not get her breast milk tested by any clinical laboratory but actually performed a ‘very simple and reliable procedure’ prescribed by the village doctor.

The procedure is as simple as pouring the milk in a bowl and then dipping an ant in the milk; if the ant survives, the milk is okay, but if it doesn’t, it is poisonous.

In this woman’s case, the ant didn’t live, and therefore, her milk was deemed toxic.

A medical practitioner asking his patients to perform such a test is ridiculous. This conversation left me speechless and horrified and I wondered how many other women were depriving their children of much-needed nutrition based on such lies.

Recently, a senior health official visited Children Hospital Complex (CHC) where I am currently working as a nutritionist. He delivered a lecture along with interviewing staff members and doctors regarding their awareness and knowledge about the “The World Breastfeeding Week.”

It was after this lecture that most of the hospital staff, including myself, came to know that the beautiful phenomenon of breastfeeding is celebrated all over the world. Though I am a part of the preventive paediatrics department and stabilisation, I am constantly tutored by my medical officer and head of department. Both of them have helped initiate breastfeeding awareness, promotion and re-establishment campaign.

After numerous sessions with different female patients, one thing that never ceases to amaze me is the amount and type of myths, taboos, distorted theories and a yard-long list of do’s and don’ts that surround the most natural and bonding practice between a mother and her child.

The reasons and causes affecting the decrease in breastfeeding are perhaps much more deeply latched on to the minds of the general public than we normally perceive. As a part of the team, trying to re-establish breastfeeding in the babies treated at CHC, I came across numerous stories (like the above mentioned one) where mothers are led to believe that their milk is unable to make their child ‘powerful and healthy’.

Such ideas are often proposed by village elders, elderly women of the family, and in some cases, by community midwives. This sad situation prevails across Pakistan where people like them are successfully promoting their half-baked ideas regarding the benefits of feeding an infant honey mixed with water, certain jari bootiyan (herbs) and diluted cow milk boiled with the very beneficial elaichi (cardamom) and saunf (aniseed).

The lack of knowledge and unawareness about breastfeeding was also apparent in 22-year-old Salma, who had serious concerns about her breasts being too small and her own dislike of drinking milk as being reason enough to not produce good quality milk for her newborn. In reality, breast size and intake of milk in the mother’s diet has no direct relation to the amount and nutritional value of breast milk.

All women regardless of breast size can produce enough milk for their neonates by consuming a balanced diet consisting of additional 500 calories, complex carbohydrates, high biological value proteins and essential vitamins and minerals with adequate fluid intake.

The benefits of breastfeeding go well beyond the hygienic value; it is also convenient. In Pakistan, where even the basic health facilities are a luxury, breastfeeding can offer as a sole protection against diseases like stomach viruses, respiratory illness, asthma, ear infections and certain childhood cancers. The immune factor Immunoglobin A (IgA) found in abundance in breast milk helps the newborn to fight germs and infections. Babies who are exclusively breastfed for at least six months are less likely to develop diabetes, high blood pressure, high cholesterol, obesity and inflammatory bowel disease.

The key to make a baby smart and intelligent with higher stress tolerance is also exclusive to breastfeeding (for at least the first six months). Additionally, studies prove breast milk to be a ‘mind friendly food’ too. In a developing country like ours, breast milk is an elixir of life for infants and must be promoted as a fundamental practice regardless of the socio-economic status.

So in spirit of World Breastfeeding Week 2013, we need to understand and accept the idea of breastfeeding as the basic survival requirement for our babies’ health and future. Let’s make sure the adults of the future are healthy, in their mind and body!

Reema Arshad

Reema Arshad

An inspiring nutritionist vowing to change perspectives about food and health. Currently working as a Nutritionist In Children Hospital Complex Multan and founder/consultant at Nutrilife. She tweets @reemaarshad (twitter.com/reemaarshad)

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Indian

    I’m startled with people being fooled with the ‘ant test’.That poor baby and her mislead mother. Such village ‘doctors’ must be fined.I feel,breastfeeding is a boon for poor mothers-no hassle with sterilization,a lot of Immunoglobulins and nutrients.
    Reema,I wish you’d stressed the importance of the colostrum too.Nice article.Recommend

  • sana

    Very good article. I live in the UK and as a mother of 2 I have been surprised time and again how much importance the midwives and doctors give to breastfeeding. The only case you are not allowed to feed your baby is if you have a chronic illness such as HIV, Cancer or Hepatitis. In all other cases, the mother should breastfeed the baby exclusively for the first six months and for a total of 2 years like mentioned in the Quran. The advantages of this are phenomenal. Also you are right about the elder women in the families preventing breastfeeding, my own in-laws created a lot of trouble for me and I literally had to fight to breastfeed specially in case of my first born. And the trend of starting to feed the baby solids once they turn 3 months is surely ridiculous and messes the breastfeeding up! Recommend

  • Parvez

    Great article
    Possibly the doctor got an all expense paid holiday from the powdered milk manufacturing giant…………and don’t think stuff like this does not happen all over the world.
    Recommend

  • MAD

    How can it possibly be taboo.Recommend

  • Hakim Nazimullah

    Astaghfirullah !!!!Recommend

  • fatima

    it shoudnt be taboo.

    however soon the liberal extremists in pakistan will be promoting the allowance of breast feeding in PUBLIC. this is what they do: coppy whatever their extremist ideals do in west.Recommend

  • Sara

    I think it has to do with male chauvinistic approach towards breasts. Although it is allowed for a woman to bare her breasts in front of her mahrams for breastfeeding, Pakistani people don’t understand the logic and importance of this. They are just scared of women’s bodies. I think we should become more understanding of what is acceptable and also not put unnecessary restrictions on women.Recommend

  • Prabhjyot Singh Madan

    Dear author,
    I cannot comment on a woman’s ability but I still believe it is the best for the child. I am scientifically ignorant becacuse I am an economist and and entrepreneur. But if the doctor says something is wrong, get it checked by all accounts. Go for a second opinion, if it still stands maam, believe in the docs. Mother’s milk is best but if a kid has to Live on skimmed milk, I agree. Rab rakha dear author, kid is more important.. sat Sri akalRecommend

  • J Maqsood

    @sanaa
    Agreed, but in UK they recommend one year breast feeding. (just info)

    @Concerned people
    What is really happening to the world, Post-Delivery Baby bumps are good, Breast feeding is good, having grand parents is a privilege, and then weight gain during 35+ is good and should be maintained. I am loving husband, proud father, doctor and tri-athlete, of pakistani origin, residing in UK.Recommend

  • http://blogs.tribune.com.pk/author/430/faraz-talat/ Faraz Talat

    Thanks. We needed this discussion.

    Matters like lactation, breast cancer, contraception and pregnancy termination are too huge to be left to mothers, daughters and sisters to whisper among themselves. Because health experts have no way to monitor this kind of exchange, this often leads to unchecked propagation of dangerous myths.

    These are matters of public importance with great social and political consequences. Therefore, the information on these issues must be shared publicly. The media and government need to do a far better job at this that they’re currently doing.Recommend

  • Taimoor

    @fatima:
    Madam, public breastfeeding is also frowned upon in the West. You don’t necessarily have to display your stupidity by mumbling stuff without any prior knowledge.Recommend

  • carol

    I think breastfeeding is important for a babies survival, too. The ant test is just insane. I think the ant would die in anyone’s milk.Recommend

  • Indian

    @ Taimoor

    It is frowned upon in the west,but Fatima is right-I have read a few reports pertaining to what she said.
    Sir,wouldn’t it have been nicer if you could have commented without the word ‘stupid’ aimed at the lady …Recommend

  • Ali Baba

    I am not a doctor. I am a senior member of my family so have seen and observed many breastfeed related issues.

    I totally agree with the writer that discussing health issues including breastfeed shouldn’t be taboos. Even sexual health issues can be discussed with parents, teachers and doctors without any embarrassment.

    Before that doctors needs be educated first. Conducting seminars and workshops is not enough until we see them working effectively on the grounds.I don’t know why they are always in hurry and don’t want to listen to the patients. Especially when they are dealing with the lower middle and poor class of our society which is the majority of our
    population.

    I slightly disagree with the point that breastfeeding is always the best. This disagreement is based on my own observation. Mother’s diet during breastfeeding plays a very important role. There are different results of mothers’ diet on different children. Different articles can be goggled on the internet on authentic websites. These issues should be listened by the doctors carefully and they should guide and educate the mothers comprehensively. It must not be like ” Bibi Jao bus apna doodh pilao, sub theek ho jae ga“.

    In certain cases mothers ( sometimes even healthy ones) aren’t producing enough breast milk to satisfy the child’s need. In this case bottle milk needs to be added with the breast milk. It is sometimes also observed that a child cannot take the both milk together and starts getting weak. Now what choice do you have? Certainly, you will go for bottle
    milk if it suits the child.

    In my family I have observed some weak children on breast milk and some healthy ones on bottle milk and Vice Versa. I agree, in the most cases breast milk is a better choice but we cannot make it a hard and fast rule.The healthiest and the most active child in my family was adopted by my cousin when the child was only 2 days old. Now he is Masha Allah 3 years old. Never had a single drop of breast milk. Never got ill. Raised on Meiji infant formula and Nestle water. Recommend

  • http://Lahore Fudge

    @fatima:
    Just so you, breastfeeding in public is a HUGE social taboo in the West. It is frowned upon. There are reported incidents of women been stopped from breastfeeding their children on flights in the West and many other similar incidents. Please look it up, know the facts before you begin your rant against the liberals. You guys know nothing yet make sure you pointless rant is acknowledged even if there is no need for it in the first place. Recommend

  • http://Lahore Fudge

    @fatima:
    ” this is what they do: coppy whatever their extremist ideals do in west.”

    You know anything about what goes on in the West?! Please look up “breastfeeding in public in Canada/US” on Google before you post another such comment. This will avoid further future embarrassment for you. Thanks. Recommend

  • Rhea

    @fatima:
    hey in what world do u live??!! breast feeding publically is very common in Pakistani households. I have seen women breast feeding their infants in buses, railway stations, u name any public place. And most of them do so as per necessity. they are travelling, but kids are hungry, so they must be fed wherever they are. And it is common esp in rural areas.Recommend

  • http://blogs.tribune.com.pk/author/430/faraz-talat/ Faraz Talat

    Ali Baba,

    Your personal observations are irrelevant. Everybody in my family is diabetic, so I say according to my personal observation, 100% of Pakistanis have diabetes. You see the fallacy, don’t you?

    Breast milk is never harmful, except for a few relatively rare exceptions (for instance, breast infection or AIDS). And while a good doctor should counsel his patients properly in these matters, our doctors are generally too busy because of the patient load.

    That’s why we need to make this information public. The benefits or contraindications of breast milk should be common knowledge because this is a natural matter concerning every single child-bearing woman.Recommend

  • dr naila talat

    In my practice I have found one common reason for mother in laws opposing breast feeding it is so because breast feeding promotes a strong bond between mother and baby and mother in laws dont want this so that they could easily separate baby from mother Recommend

  • Sarmad

    It should be understood that the requirement for covering in front of mahrams for girls and women is from the navel to knees and the rest can be uncovered. This notion should become common practice in our country. In this way breastfeeding at home can be encouraged at all times.Recommend

  • Insaan

    @dr naila talat: “one common reason for mother in laws opposing breast feeding it is so because breast feeding promotes a strong bond between mother and baby”

    Sounds so weird……..Recommend

  • Sonny Dexter

    @Sara:
    What Nonsense? Male Chauvanism has nothing to do breastfeeding in public. I live in Washington and whenmy son was born the hospital showed my wife and I nursery where only Women were allowed so they can breastfeed their kids easily.

    Point is you have to give some privacy for new born and once they are used to it still they need little room.
    Recommend

  • Unkown

    This incident happens in which village, please name it
    Second, what was the doctor name?Recommend

  • Amina

    @Unknown

    Dear Unkown,

    the inquiry about the name of the village and doctor is valid, but believe me the mentioned example in the article is not an uncommon one. These types of things are happening in almost all rural areas of Pakistan. The remoter the area the higher the chances of such practices. As per my experience as a dietitian in a public sector hospital, every second case of malnourished child admitted in the indoor department of the hospital was not breastfed and the reason mothers gave were the same,’ poisonous breast milk’, and the same, ‘ant test’, was performed. These types of so called tests are usually suggested by the midwives and the quacks, who, claims to be the doctor of the village. Recommend

  • observer

    A. Polio Drops lead to Impotence/ Infertility.

    B. Mother’s Milk is poisonous to a child.

    It seems medical practices applicable to the rest of the world are not applicable to Pakistan. Specially when it comes to children.Recommend

  • Nishant

    Show it on TV
    print ads in newspapers and play it on radios
    make the ads simple and catchy tunes that people in villages know about it
    if the “ant test” is specifically a problem then target that
    Indian government is running ads on all TV channels(including private entertainment channels) even during prime time shows against malnutrition
    4 points of it in a very catchy tune said by film actor Aamir Khan
    1- proper food for pregnant mother
    2- the milk of first few days is the best
    3- till 6 months only breastfeeding
    4- full attention to nutritionRecommend

  • Reema Arshad

    @Nishant:
    @nishat very nyc suggestions
    bt dese cannot b implemented by a single person as a massive national campaign requires huge funding,
    however on a small personal level the preventive paeds dept at CHC Multan hs initiaited a breastfeeding awareness, promotion and reestablishment campaign. Recommend

  • Reema Arshad

    @observer:

    de main culprit iz ignorance and lack ov awareness…..Recommend

  • Reema Arshad

    @Ali Baba:
    ur observations r genuine bt de article cnnt tackle awl de problems related to de issue,

    ur concern abt healthier mothers nt producing enuf milk and de ultimate practise ov switching to formula feed iz a very common concern.
    their r medicines, dietary regimes and lifestyle changes awl desigened to solve customized issues as per person.

    furthermore dese individual concerns n difficulties arising during breastfeeding cn b treated by a trained medical personnel or LHVsRecommend

  • Question

    What about the side-effects on the mother’s figure as a result of breastfeeding? Is there any precaution they can take in order to remain in shape and breastfeed simultaneously?Recommend

  • Insaan

    @Question: What about the side-effects on the mother’s figure as a result of breastfeeding? Is there any precaution they can take in order to remain in shape and breastfeed simultaneously?

    First pregnancy causes breasts to become bigger (glandular growth takes place) in many women. Primary function of breasts it to provide milk to kids.

    Breast Feeding Does Not Cause Sagging or Drooping BreastsRecommend

  • Ghazal Zaidee

    An ExceLLent Effort Indeed ..
    Very, Very Informative ..
    Quite HeLpfuL toWards the weLL-Being of the Mothers & their AngeLs because UnfortunateLy, it’s the mOst nEgLected Area & a topic with thousands of Myths & iLLusions, as in Aisa Karaingi to Waisa Hojaye ga, bLah, bLah, bLah !!

    Wish to Read Mch mOre from Your Area of Study & Experiences …

    Thumbs Up Mate !!!
    AnxiousLy Waiting for the Next One :)

    GOOD LUCK !Recommend

  • PRO PAK

    Howit cant be taboo..God gives the order to give milk the baby for years only…if its is not suitable for baby then dont give..Recommend

  • Dr. SAM Meesum

    The under and developed world is full of stupid ideas and acts and the above story is one of them. Nothing can be compared with breast milk for neonates. It is PYUSH means Amrit or Ab-e-hayat. Kindly support breastfeeding close to the mothers.Recommend

  • http://www.rabtt.org Aneeq Cheema

    Reema massive funding is available on maternal health etc. I’m sure you will be supported, please do not hesitate in going a few steps even further :)
    But a great start! Keep it up!

    Do contact Channan Development Association (http://cdapak.org/) for possible campaign possibilities.

    Here’s a nice photo from UNICEF to kick-start a Facebook page etc.

    https://www.facebook.com/photo.php?fbid=10151790442814002&set=pb.68793499001.-2207520000.1376416679.&type=3&src=https%3A%2F%2Ffbcdn-sphotos-b-a.akamaihd.net%2Fhphotos-ak-prn2%2F1079041101517904428140021693165550o.jpg&smallsrc=https%3A%2F%2Fsphotos-b.xx.fbcdn.net%2Fhphotos-prn1%2F524043101517904428140021693165550n.jpg&size=1000%2C1000Recommend

  • Aqsa Anwar

    Very excellent effort indeed , luking forward to your next article.
    keep it up :))Recommend