RAMEESA was Covid-positive when she gave birth prematurely to her son at 28 weeks. Both mother and child were critical. Formula was poison for the baby’s tiny, sensitive, underdeveloped and struggling body. Human milk donations were crowdsourced to fulfil his daily needs until he grew to term while his mother recovered.

Fatima, mother of two, contracted Covid immediately after giving birth to her third child yet was adamant she would breastfeed him. She would continue to latch him frequently until one day he slept for 18 hours straight and wouldn’t wake up. She rushed for support only to find out that the baby was extremely dehydrated. He had not urinated for over a day and had low blood sugar levels.

Covid-positive Muqaddisa had triplets and despite wanting desperately to breastfeed them, she kept haemorrhaging and was not even near attaining sound health many months after delivery.

Alongside these cases, which represent merely the tip of the iceberg, are hundreds, if not thousands, of mothers who went through Covid during pregnancy, postpartum or at any stage in their breastfeeding journey. Their babies were successfully breastfed and developed immunity through the antibodies the mothers transferred to them via the nutrition their bodies produced.

Do we actually step up for breastfeeding mothers?

Somewhere lost in this crowd were Rameesa, Fatima and Muqaddisa. Where studies say breastfeeding is safe while being infected with Covid, there is little discussion about the impact of the novel coronavirus on general maternal health that directly impacts a mother’s ability to produce enough milk for a while. It is the quantity of milk that is the first to take a hit.

In a world where we already struggle to safely and sufficiently feed our babies, these past few years threw a spanner in the form of the coronavirus — a virus we are still learning about every single day.

World Breastfeeding Week (Aug 1 to Aug 7) this year upholds the theme ‘Step Up for Breastfeeding: Educate and Support’; but what do we do for the rest of the year? Do we actually step up for the breastfeeding mother when she faces the reality of losing supply or suffers because of the consistent lack of skilled support at a national level? Or do we use this week to paste posters, saying how it is a ‘mother’s duty’ and the highest honour she can achieve, turning a blind eye to the plight of the one who was not able to, especially in the thick of the pandemic?

In a post-pandemic world, when our collective immunity has taken a direct hit, it is even more important for us to actually support (aspiring) breastfeeding mothers so that we can rebuild that lost immunity for the community at large.

It is important to educate mothers during their pregnancy about the skill of breastfeeding, for it may be natural but the skill is a learned one; to stop normalising pain or formula supplementation without involving a lactation professional in that conversation about how much, when and for how long.

It is important for her to be aware of a red flag when she sees one; for competent and skilled help to be available when a new mother raises those red flags.

It is important to promote lactation education and support the growth of this profession across the nation until it reaches every nook and cranny; to train our birth workers, NICU (newborn intensive care unit) staff and nursing staff on the techniques and protocols to be observed while truly supporting breastfeeding; and for the government to implement policies supporting lactation education as part of the medical care provider’s licensing.

We all need to step up in our own capacity as a partner, caregiver or parent to a breastfeeding mother, as medical professionals to serve our breastfeeding patients with informed and evidence-based practice, and as a health ministry that places emphasis on supporting breastfeeding via policies that call for action to improve breastfeeding support for the public at large.

Breastfeeding is not a means for a new mother to attain spiritual heights where she is isolated and left at the mercy of ‘nature’ to toil through it all. It is an essential piece of the jigsaw to ensure lifelong health for the newborn and a process where a mother needs constant care, support and clinical management if needed. Being a natural bodily function, access to breastfeeding support is a basic human right. It is teamwork and we cannot succeed unless we have the support of everyone who forms the community — from a child in the household right up to those who run the government’s machinery.

The writer is a certified lactation counsellor (ALPP), certified advanced lactation specialist, certified lactation educator counsellor (UC San Diego), a student (IBCLC) and member of LCGB and ILCA. She runs a lactation clinic at Dr Sajid Maqbool’s Clinic (Lahore) and Lactnation, the breastfeeding support Facebook group.

Published in Dawn, August 3rd, 2022