Neera (name changed) walked into my clinic. She had delivered a baby girl recently. She was a very chirpy and bubbly young mother who was always excited about holding her new born and nursing. I knew that she was struggling with breastfeeding and was trying very hard to ensure that her child is on breastfeeding exclusively. She and her husband along with all the others in the family were very concerned about the fact that baby was irritable and Neera was not able to provide sufficient breast milk. She had met a lactation consultant, taken medicines and left no stone unturned to find a solution to her problem.  Today she looked dull, sad and dejected.  The new born baby girl looked happy and had gained some weight too. I asked her what the matter is and she burst into tears.

“Doctor uncle”, she said as many of my young patients whose families and mothers have been my patients call me lovingly, even though the current trend is to call  as  “Doc”, “I am not able to fully breastfeed my child. My baby is unsatisfied and becomes very cranky. I have no alternative but to feed her formula milk. I know I am depriving the child of breast milk that is supposed to be the “elixir of life”.  Soon I realised that everybody around her had been bombarding her with the benefits of breast feeding and pushing her towards breastfeeding the child exclusively. This phrase “elixir of life” was from my own lecture taken during prenatal class. The mother, mother in law, friends and doctors had been so persuasive that she had almost started believing that she was doing injustice to her child. “I feel like I am nalayak  (not worthy) to be a mother. I feel worthless, useless as I can’t give exclusive breastfeed. What kind of a mother am I?”- she sobbed. She had no alternative but to supplement formula milk to the baby as she was not producing enough. This whole campaign around breast feeding almost made her believe that feeding formula was almost like giving poison to the baby. She was so inconsolable that she was almost on the verge of depression.

This situation infrequent but not rare in my practice. One mother who had twins said “The post delivery period was hell. Everyone was concerned about breastfeeding and the baby’s health. I had had no sleep for days together and no one ever seemed to care about my happiness”.

So this article is dedicated to bring some important perspectives. First of all let me clarify that I strongly believe that breastfeeding is the best feeding. The global movement around promoting breastfeeding has saved so many lives. There are many parts of the world where people do not know the importance of breast milk. Some feel that breast milk is inferior in nutritional value, some feel that it may disfigure the breasts. Some don’t have safe water and some don’t understand the importance of hygiene. Lack of breastfeeding and improper use of alternatives have caused diarrhoeas and other infections in the infants and led to mortalities. Thus there is no doubt that breastfeeding is the cheapest and best feed for the baby. But what if the mother is not able to produce adequate milk? What choices does she have?

I don’t think that there is even need to discuss about animal milk such as cow, buffalo and goat as a substitute for human milk. The animal milk is for the off springs of the animal and animal milk should not be given at any cost as a substitute. It may be worth considering the possibility of using another mother’s milk to feed the baby.  Today one hardly finds another lactating mother in the family who can do the job. So there are human milk banks which can help. But they are really far and few. Many people may have reservations around using a third person’s milk. Honestly I would say that another mother’s milk can be the next best option. Finally we come to formula milk. Is there any difference between formula and human milk? If one compares the ingredients that is proteins, carbohydrates, vitamins etc., there are almost the same. However the mother’s milk also transfers immunity to the baby but  formula can’t do that.  Yes, formula needs to be constituted.  Bottles are difficult to sterilise. In short hygiene issues are very critical here. Lack of hygenic care can be detrimental to the health of the child. It is obvious that formula milk is expensive and breast milk is free. Formula needs an elaborate mechanism to constitute it and needs some utensil to feed. That does not apply to breast milk. In all these aspects  breastfeeding scores above the formula milk indeed. But does it mean that not being able to breastfeed exclusively is “criminal”?

While I was explaining Neera all this she looked little at peace. I said “Look. Will you not tell your child to be the best in the field that he/ she goes into? So can everybody be the best? If someone is not the best does it mean that he/ she is a failure? Yet will you stop telling your child to strive hard to be the best?” Neera was listening to me intently. So the conclusion? “Breast feeding is the best feeding. But not breastfeeding does not mean that you are doing some thing seriously wrong to the child. You must strive hard to breastfeed but inability to do so does not mean that you are a bad or incompetent mother.”

And Neera finally smiled and confidentially took her baby in her arms.

On this breast feeding week I want to give this message to all the young mothers: Do breastfeed and try your best to but if you can’t, don’t get disheartened.”

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