Breastfeeding

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Breastfeeding a common practice in Bangladesh, particularly in rural areas. Almost every new-born is breastfed for quite a long period. The practice of using wet nurse for breastfeeding the new-born among the middle class and upper class families is very rare in the country. The breastfeeding patterns in Bangladesh is largely governed by the cultural and religious beliefs on the one hand and socio-economic status on the other. Despite widespread campaigns at government and NGO levels to promote early initiation of breastfeeding (i.e., feeding colostrum) to new-born, more than fifty percent are still given breastmilk after the first six hours of their birth and the rest are put to breastmilk after two days. This pattern of breastfeeding is mainly the outcome of the traditional belief that colostrum is not good for the new-born. In Bangladesh more than 90 percent of births are delivered at home and there is a general custom of feeding the baby a few drops of honey diluted with water shortly after birth. Even if the birth occurs in hospital and the initiation is not immediate (due to inability of the child to suckle or due to weakness or inability of mother), plain water or sugarcube diluted with water is given to the new-born until the mother is physically fit to feed the baby or it is strong enough to suckle the nipple. According to a recent study based on demographic and health survey data, Bangladeshi children are given supplemental food fairly early and cow's milk and infant formula are the most common supplemental food.

Breastfeeding a new-born baby is considered a sacred duty of every mother. She is advised to offer breastmilk to her baby for at least 30 months. A woman is forbidden to offer breastmilk to her baby beyond the age of 30 months. The poor economic condition of the people however often forces mothers to continue breastfeeding for a longer period. As a large proportion of the people are poor, they cannot afford to buy supplementary food for the young. As a result, the child has to remain dependent on mother';s milk for a long time and the frequency of suckling is also high. This perhaps leads to a long duration of post-partum amenorrhea. The 1975 Bangladesh Fertility Survey reported a mean length of postpartum amenorrhea of 14.6 months. The 1989 Survey found the overall median length of post-partum amenorrhea to be 12 months. More recent research, however, has reported shorter lengths of PPA, with significant differentials evident by socio-economic status indicating that although the duration of breastfeeding has not changed much over the last two decades, the length of amenorrhea is showing a declining trend. A study in Matlab in early 1990s observed that the median duration of post-partum amenorrhea fluctuated around 13 months for the cohorts of births during the 1978-1983 period. The study also showed that the increased use of contraception might be one of the important contributing factors to the declining trend in postpartum amenorrhea in Bangladesh. According to the demographic and health survey of 1996-97, the mean length of post-partum amenorrhea is 11 months. [M Mazharul Islam]