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In tea country, Indian mothers learn the importance of breastfeeding

© UNICEF India/2010/Purshotam
Young mother Monika Bedi feeds her one-and-a-half-month-old daughter, Mohima, in her home at the Nahortoli Tea Estate in India's Assam state.

By Angela Walker

DIBRUGARH, India, 24 June 2010 – Durowpadi Bedia, an ‘Angawadi’ community health worker at the Nahortoli Tea Estate in the north-eastern Indian state of Assam, takes her job very seriously.

Each month, Ms. Bedia conducts meetings to teach new and expectant mothers about the importance of exclusive breastfeeding for the first six months of their babies’ lives. Next, she visits them in their homes to reinforce the life-saving messages of proper health and nutrition for their newborn children.

Home visits

“Before the Angawadi workers, even though the doctor was advising them to breastfeed, the mothers were still following their traditions of feeding goat’s milk to the babies and putting goat dung on the [umbilical] cord as medicine,” said Ms. Bedia, who was herself born and raised on the tea estate, where her mother worked picking tea.

© UNICEF India/2010/Purshotam
Community health worker Durowpadi Bedia teaches new and expectant mothers the importance of exclusive breastfeeding in the Nahortoli Tea Estate in the north-eastern Indian state of Assam.

Ms. Bedia speaks the local dialect of Sadri. Through her work with mothers, she helps to reinforce health messages that are broadcast on television and radio.

Home visits help the whole family learn the importance of exclusive breastfeeding. Visiting mothers at home also means that Ms. Bedia can emphasize proper hygiene and the importance of handwashing with soap.

“Whenever we go on home visits, we talk to all members of the family – the parents, the grandparents, adolescent girls,” said Ms. Bedia. “They have faith in what I am saying.”

Promoting breastfeeding

Every year, almost two million Indian children die before their fifth birthday, most of them from preventable causes. UNICEF estimates that only about 46 per cent of infants in India are exclusively breastfed – a practice which builds immunity, protects against under-nutrition and gives babies the best start in life.

© UNICEF India/2010/Purshotam
Monika Bedia holds her baby daughter, Mohima, in her home at the Nahortoli Tea Estate in Assam state, India.

But in Assam, a coordinated strategy led by the state government in partnership with UNICEF and local non-governmental organizations has considerably increased the rate of exclusive breastfeeding in infants younger than six months of age.

"Unquestionable global evidence demonstrates that breastfeeding counselling and support is the most important child-survival intervention," said UNICEF India's Chief of Child Nutrition and Development, Dr. Victor Aguayo.

Traditional perceptions

Paul Taulfrank is the Dibrugargh District Programme Coordinator for Young Child Survival, working for the Assam Branch of the Indian Tea Association (ABITHA). The association promotes exclusive breastfeeding at the estate, working in particular to change traditional perceptions about colostrum, or ‘first milk,’ a type of nutrient-rich breast milk produced by mothers during the first 24 hours after delivery.

In Assam, colostrum was widely considered ‘dirty milk’ and was frequently expressed and discarded in the past.

© UNICEF India/2010/Purshotam
Health worker Durowpadi Bedia interacts with children after her meeting with new and expectant mothers on the Nahortoli Tea Estate in India's Assam state.

“We faced a lot of difficulties. They were not listening to us, and the infant mortality rate was very high,” said Mr. Taulfrank. “One team after another went to the community. It took time to convince them. Again and again, the same messages were delivered, and then they came to know and believe.”

In each village, health and nutrition workers meet monthly at the Anganwadi community health centre. They draw up a list of the women who are in their last trimester of pregnancy or are nursing an infant, and then they establish a schedule for home visits. Each mother is visited three to four times a month.

“Now mothers understand how vital breast milk is to the health of their babies,” said UNICEF Assam Chief of Field Office Jeroo Master. “Having health and nutrition workers actively promoting breastfeeding at the village level will ensure each child has the best start possible in life.”

Building trust

One young mother, Monika Bedi, named her one-and-a-half-month-old daughter Mohima, meaning ‘blessing.’ Her husband, Motilal, works in the tea factory.

The young mother is dressed traditionally in sherbet hues of pink, orange and blue, a streak of orange vermillion decorating the part of her hair, which is pulled back into a neat bun. Her house is tidy, and the baby is nestled in a blue blanket, her hair oiled and a streak of kohl on her forehead to ward against the evil eye.

From her mother, Ms. Bedi learned the tradition of throwing away the first milk. But the community health workers, who she calls ‘baideo’ or ‘elder sister,’ told her about the importance of colostrum and exclusive breastfeeding.

“When they come and talk in our own language, I understand better,” said Ms. Bedi. “I feel comfortable with them.”

Baby Mohima has grown much since birth and has suffered no bouts of diarrhoea. “I say mother’s milk is the best,” Ms. Bedi said. “If you feed mother’s milk, the baby is very healthy.”



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