The first week of August saw various campaigns and contests promoting the significance of mother’s milk as the baby’s best friend. But it is not merely the preference of breast milk over infant formula food that healthcare professionals are anxious about, but the method of consumption through bottles and receptacles with bacteria harbouring teats. Paediatricians are only too happy if new parents ‘ban the bottle’.
Going back to tradition
The feeding bottle, the tiny plastic container that has been seen as many a modern mother’s readymade solution to soothe a wailing baby is seen increasingly as the enemy. So what are paediatricians telling young mothers? Simply, to go back in time to the option favoured by their mothers and grandmothers – the humble spoon, the little cup and our home-grown Indian feeding device the ‘paladai’. Recently, a contest to pick the healthiest baby at the Annal Gandhi Memorial Government Hospital had all participants carry home a ‘paladai’ each.
The Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act, 1992 amended as the IMS Act, 2003 prohibits promotion of feeding bottles. Medical articles by the IAP have linked inappropriate methods of feeding infants to mortality and morbidity of infants.
Main cause of diarrhoea
Bottle feeds are one of the major causes of diarrhoea in infants, says paediatrician D.Saminathan, head, department of Paediatrics, K.A.P.Viswanatham Government Medical College.
The risk of infection is high as microorganisms may stick on the neck and teat of the bottle and transmit to the infant with reuse of the bottle. Diarrhoea in HIV infected, malnourished and underweight infants can prove life-threatening and is a reason why bottle feeds should be discouraged in such cases. Even if substitutes are given to adopted children and HIV kids, it should be through a cup or paladai.
In poor families, dilution is another possibility when bottles are used. To make formula feed last for more days, mothers may resort to adding excess water than necessary.
Feeding bottles require intensive sterilisation and regular cleaning, something which is not feasible in India, where access to potable water and sanitation are question marks.
In developing countries where disposable bottles are the norm, bottle feeds may not pose a problem, but most Indian households reuse and rewash the bottle several times.
Any closed container with narrow neck like a flask or a sipper is not an appropriate storage device. While some parents may prefer the bottle during long hours of travel, doctors frown upon it as there may be inadequate water to clean during bus or train travel, unless the bottle is used only once. If you must use feeding bottles, then use them for temporary storage, but do not use them directly on the infant, suggests U.S-certified breastfeeding counsellor, Rekha Sudarsan. The WHO has a free downloadable manual on sterilisation of bottles.