In Kerala, breastfeeding figures show a marked improvement

Kerala has achieved an impressive 88.53 percent coverage during its recent Pulse Polio drive, marking a significant milestone in the state's efforts to eradicate poliomyelitis. This achievement reflects the concerted efforts of healthcare workers, volunteers, and local authorities working together to ensure widespread immunization among children. The Pulse Polio campaign, typically conducted once every few years, aims to boost vaccination rates and prevent the resurgence of the disease.

The success of the Pulse Polio drive in Kerala comes amid broader improvements in maternal and child health indicators. According to the National Family Health Survey (NFHS-6), the state has seen notable progress in breastfeeding practices. The percentage of infants under six months who are exclusively breastfed has risen from 55.5% in NFHS-5 to 72.7%, indicating a positive trend in infant nutrition and health outcomes. Additionally, the rate of early breastfeeding initiation—within one hour of birth—has climbed to 82.3%, reflecting enhanced awareness and support for breastfeeding among new mothers.

These improvements are attributed, in part, to the implementation of the Mother and Baby-Friendly Hospital Initiative (MBFHI). Launched by the Indian Academy of Pediatrics (IAP) and the State National Health Mission, the MBFHI focuses on promoting breastfeeding and optimizing newborn care in maternity facilities. The program incorporates the World Health Organization (WHO) and UNICEF's "Ten Steps to Successful Breastfeeding" guidelines, ensuring that hospitals adhere to best practices in supporting mothers and their infants.

As part of the MBFHI, Kerala has established a comprehensive set of 130 checkpoints for certifying hospitals as mother- and baby-friendly. These standards include lactation counseling starting during the antenatal period, the appointment of lactation consultants, and the introduction of a lactation counseling certification course. Such measures aim to empower mothers with knowledge and resources necessary for successful breastfeeding.

However, challenges persist. High cesarean section (C-section) rates in Kerala—ranging from 44% in public hospitals to 45% in private institutions—have contributed to delayed breastfeeding initiation. Post-operative discomfort and the common practice of keeping newborns in neonatal intensive care units (NICUs) immediately after birth further hinder early bonding and feeding. To counteract these issues, the MBFHI emphasizes immediate post-delivery feeding and encourages kangaroo nursing, where mothers hold their infants skin-to-skin to facilitate bonding and breastfeeding.

In addition to improving breastfeeding rates, the establishment of breast milk banks has played a crucial role in providing essential nutrients to preterm and orphaned infants. Over 50 hospitals across the state have been certified under the MBFHI, demonstrating the initiative's reach and effectiveness. Nevertheless, experts caution that sustaining these gains requires ongoing vigilance and continuous improvement.

Despite these achievements, concerns remain regarding overall infant nutrition. NFHS-6 reveals that only 26% of children aged 6 to 23 months receive adequate diets in Kerala. Dr. K.E. Elizabeth, a pediatrician and nutrition expert, expresses bewilderment at this discrepancy, highlighting the need for further investigation and targeted interventions to address nutritional gaps in young children.

Looking ahead, the focus will likely shift towards maintaining the momentum gained through initiatives like the MBFHI and addressing lingering challenges in infant nutrition. Continued collaboration between healthcare providers, policymakers, and communities will be essential in ensuring long-term improvements in maternal and child health outcomes.