When Sarita Khatri finally got to hold her newborn, nineteen long days had passed since her delivery. Her baby had arrived early and underweight, needing special care. Sarita, recovering from emergency surgery, could not hold or feed her daughter in those critical early days.
As she lay apart from her newborn, one thought haunted her: Is she going hungry?
But her daughter was not going hungry.
She was being fed the milk of another mother, someone Sarita would never meet, but whose generosity gave her baby a fighting chance. This life-saving milk came from Nepal’s first human milk bank, a UNICEF-supported initiative funded by the European Union.
This is what breastfeeding support for vulnerable newborns looks like. And this is what every mother deserves.
Why breastfeeding still isn’t as simple as it sounds
Breastfeeding is natural and it’s a baby’s first vaccine. But natural doesn’t mean easy.
For many mothers in South Asia, breastfeeding is shaped by family hierarchy, gender roles and cultural beliefs.[i]
Her environment heavily influences her ability to breastfeed, from hospital routines and workplace policies to advice of relatives and community norms.
When systems fail, breastfeeding falters, and mothers get blamed.
Many are overwhelmed with confusing and damaging messages: first milk is “too thick” or “not enough,” or that formula is more convenient. The baby food industry plays a role too, aggressively marketing breastmilk substitutes, foods, and drinks. These mixed messages create doubt, anxiety, and guilt.[ii]
And for mothers, like Sarita, with preterm, vulnerable babies, the barriers are even steeper, the stakes even higher. Without practical help, even from their own spouses, breastfeeding can fail before it’s truly begun.
[i] UNICEF South Asia (2024), Powering Counselling to Improve Nutrition
[ii] Khan et al. (2023), Alive & Thrive Bangladesh Qualitative Study
The gender gap no one talks about
The power in breastfeeding is profoundly skewed.
In South Asia, breastfeeding is often seen as the sole responsibility of the mother. But decisions about breastfeeding are frequently shaped by others, mothers-in-law, grandmothers, even neighbours. This is especially true for adolescent or first-time mothers[i].
All the while, many women are expected to juggle breastfeeding with housework, childcare, and, in some cases, return to work just days after giving birth. Most receive no paid leave, no workplace protections, and no space to breastfeed or express milk[ii].
Mothers are told to breastfeed, but rarely given the time, support, or conditions to succeed.
[i] Gittelsohn, J. et al. (1997). Cultural factors, and infant feeding practices in rural Nepal . Soc Sci Med.
[ii]Sen, G., Iyer, A., Chattopadhyay, S. (2018). A Framework to Understand Gender and Structural Determinants of Health and Illness. WHO Bulletin.
Transforming spouse's role in breastfeeding
A mother’s closest ally should be her spouse. Yet, many men are sidelined, told to stay away, undermining the success of breastfeeding from the very start.
We need to shift this mindset.
Spouses must be seen and supported as equal partners in parenting. That includes feeding. But beyond changing behaviour at home, it’s about transforming health systems and community beliefs to actively include men in the breastfeeding journey.
Raising a healthy child is a shared responsibility. When fathers are informed and engaged, breastfeeding improves.[i] Families thrive. Blame fades. And babies grow up healthier and stronger.
[i] Alive & Thrive. (2019). Fathers: Powerful Partners for Nutrition. https://www.aliveandthrive.org/en/resources/fathers-powerful-partners-for-nutrition
From promise to practice: what remains in closing the gaps
Sarita’s baby got the support she needed because she was born in one of the few hospitals in Nepal with a human milk bank - Amrit Kosh. Her daughter, too weak to suckle, survived and thrived thanks to donated milk.
UNICEF is working to ensure that more mothers get the support Sarita received.
Across Bangladesh, India, Nepal, and Pakistan, we are strengthening health systems adopt practices such as skin-to-skin contact and breastfeeding within the first hour after birth. We’re supporting networks of peer counsellors who walk alongside mothers in hospitals and communities, especially first-time and vulnerable mothers.
We’ve worked with governments to advocate for stronger maternity protection, improved labour ward protocols, and tighter enforcement of marketing of breastmilk substitutes.
And it’s working. South Asia has now surpassed the global target for exclusive breastfeeding. More babies are breastfed. More mothers are supported.
But we’re not done yet. Progress has been made, but in many countries, it is slow, uneven, and has plateaued. Particularly, early initiation of breastfeeding (EIBF), one of the simplest, most cost-effective interventions to reduce neonatal mortality, yet rates in South Asia have stagnated. In a region bearing the second highest rate of neonatal mortality, only 37 per cent of babies are breastfed within the first hour[i]. Scaling up EIBF could save thousands of newborns every year.
We can and must do better.
[i] UNICEF. (2024). Infant and Young Child Feeding Database. Retrieved from https://data.unicef.org/resources/dataset/infant-young-child-feeding/
Let’s build systems that support women, not blame them
We know what works. Now it’s time to act with urgency, scale, and compassion.
- At home: Involve spouses, grandmothers, and other household influencers. When families share the responsibility of care, everyone wins.
- In communities: Empower women’s groups, peer counsellors and local leaders to promote and protect breastfeeding as a community priority.
- In health systems: Invest in skilled lactation providers, integrate lactation education into medical education, and train all health workers to provide compassionate, evidence-based, gender-sensitive breastfeeding care.
- In laws and policies: Enforce strong legislation to stop the unethical promotion of breastmilk substitutes, and support environments that favour breastfeeding from birth.
- At work: Guarantee paid parental leave for all mothers and fathers. Prioritise longer leave for preterm or low birthweight babies. Provide safe spaces for breastfeeding and protect women from workplace discrimination.[i]
[i] Alive & Thrive Bangladesh. (2023). Support for breastfeeding in Bangladesh’s garment industry: Findings from a mixed-methods study. Dhaka: A&T and BRAC JPGSPH.
Breastfeeding isn’t just a mother’s job; it’s a collective act of care, sustained by networks of women who support and stand by each other. Just ask Sushila Nagarkoti, who donated milk to the same human milk bank that helped her daughter survive.
In a region where too many small, vulnerable newborns don’t survive their first month, breastmilk isn’t just food, it’s life-saving medicine.
Breastfeeding is powerful, but mothers need a system that stands with them.
Learn more about UNICEF’s work to protect, promote and support breastfeeding.
