๐ผ BREASTFEEDING IN THE GOLDEN HOUR: A PUBLIC HEALTH PRIORITY, NOT A PERSONAL CHOICE
๐ World Breastfeeding Week (August 1–7) | By Suryavanshi IAS
๐งญ Context You Must Know
Despite 89.4% of births in India now taking place in institutional settings, only 41.8% of babies are breastfed within the first hour – known as the golden hour. This early breastfeeding, if done correctly, can reduce neonatal mortality by 33%, according to UNICEF.
Why this gap? And what can be done through policy, health governance, and awareness?
๐ What Is the “Breast Crawl”?
A newborn, when placed skin-to-skin on the mother’s chest or abdomen, naturally “crawls” to the breast guided by the smell of colostrum and instinctive reflexes. This movement is known as the breast crawl.
⏱️ It typically takes 30–60 minutes, and is recommended by:
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WHO and UNICEF through the Baby Friendly Hospital Initiative (BFHI)
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BPNI (Breastfeeding Promotion Network of India)
๐งฌ The breast crawl is not magic. It’s biology + right conditions.
๐ Why It Matters (And Why It’s Failing)
๐ฏ Golden Hour Breastfeeding Saves Lives:
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Reduces neonatal infections (pneumonia, diarrhoea)
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Provides colostrum: baby’s first vaccine
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Stabilizes newborn temperature & heart rate
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Boosts maternal bonding and milk production
๐งฉ Systemic Barriers
| Issue | Impact |
|---|---|
| ๐ด Not in medical curriculum | Most doctors & nurses unaware of the breast crawl |
| ๐ด C-section dominance | 21.5% national average; 49.7% in private hospitals |
| ๐ด Lack of training | Staff often separate baby for routine tests |
| ๐ด No standard protocol | Golden hour not enforced in hospitals |
| ๐ด Inadequate antenatal counselling | Parents unaware, can’t demand informed choices |
๐ง “Skin-to-skin and breastfeeding should be inseparable.” – Dr. Prashant Gangal
๐ Where India Stands (NFHS-5 & UNICEF Reports)
| Indicator | Data |
|---|---|
| Skin-to-skin contact | 76% |
| Breastfeeding in golden hour | 41.8% |
| C-section births (private) | 49.7% |
| Global Breastfeeding Scorecard (2018) | India ranked 46 out of 76 |
๐ UPSC Relevance
๐ GS Paper 2 – Health Governance & Welfare
Q. Discuss the importance of the “golden hour” in maternal and child health. What systemic failures prevent its effective implementation in India?
๐ GS Paper 4 – Ethics in Public Health
Q. As a district health officer, how would you promote breast crawl and early breastfeeding in government and private hospitals under your jurisdiction?
๐งญ Way Forward – The Suryavanshi IAS Framework
๐ฅ 1. Hospital Protocol Reform
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Mandate skin-to-skin + golden hour feeding in labour room SOPs
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Defer non-essential assessments to post-breastfeeding period
๐ 2. Training & Curriculum Inclusion
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Add breast crawl to MBBS/Nursing training
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BFHI & BPNI must expand state-level healthcare worker workshops
๐ฌ 3. Antenatal Group Counselling
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Use ASHAs, ANMs, and Anganwadi centres for counselling pregnant women
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Encourage male partner involvement
๐ 4. Audit & Monitoring
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Add “Golden Hour Breastfeeding” as a tracked KPI under NHM
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Public-private hospitals must submit monthly compliance reports
๐ข 5. Public Health Campaigns
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Leverage National Breastfeeding Week (Aug 1–7)
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Counter myths, promote breast crawl with local language awareness films
๐ง For UPSC Aspirants: 3 Takeaway Themes
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Health as Preventive Governance
➤ Breastfeeding is low-cost, high-impact. A governance failure, not individual error. -
Women-Centric Public Health
➤ Respecting maternal instincts must be built into health protocols, not optional. -
Science + Behaviour Change
➤ Just like Swachh Bharat, breastfeeding success depends on both doctors and citizens.
๐งฉ Did You Know?
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Babies not breastfed in the first hour face a 33% higher risk of neonatal death.
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Colostrum is packed with IgA antibodies, protecting against early infections.
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Breastfeeding reduces a mother’s future risk of breast and ovarian cancers.
✅ Conclusion: From Optional to Essential
๐ The idea that early breastfeeding or breast crawl is a “special request” reflects a broken system. In a country with high C-section rates, malnutrition, and unsafe alternatives, it’s not a luxury – it’s a lifeline.
๐ข Let World Breastfeeding Week remind us:
When a baby is born, it should first be placed on the mother’s chest – not the weighing scale.
๐ Suggested Sources for UPSC Prep:
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National Family Health Survey (NFHS-5)
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Global Breastfeeding Scorecard (UNICEF)
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WHO Guidelines on Early Initiation of Breastfeeding
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BPNI India Reports and Films
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Suryavanshi IAS – Not Just Preparation. Transformation.
Stay ahead. Stay aware.
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