July 10, 2023

By Maryam Missal


Under the chairmanship of Chief Minister of Sindh Syed Murad Ali Shah, the Sindh Cabinet on July 6 approved amendments to a law to promote breastfeeding of children of up to three years of age.

The Sindh Protection and Promotion of Breastfeeding and Child Nutrition Act of 2013 serves to ensure safe and adequate nutrition for infants and young children by promoting and protecting breastfeeding, as well as by regulating the marketing and promotion of designated products for breastfeeding.

Under this act, manufacturers of infant food are subject to specific, explicit restrictions, with violations attracting penalties of up to two years in prison and a fine of Rs. 500,000.

The breastfeeding law states that, unless otherwise permitted, no individual shall promote any identified products in any way.

Similarly, it is prohibited for anybody to imply that any designated product is a substitute for mother’s milk or that it is superior to, equal to, or comparable to mother’s milk in any way.

Per recent amendments to the act, pharmacists can only sell formula milk to children under three on a prescription from licenced medical professionals. Furthermore, representatives of infant food manufacturers are forbidden from touring hospitals and medical offices to advertise breast milk alternatives. Other than a health worker, no person employed by a manufacturer or distributor may instruct any individual on the necessity, preparation and use of any designated product.

Despite the law, however, the rate of breastfeeding in the first six months of birth in Sindh remained at 37% in 2017, whereas the World Health Organisation (WHO) advises breastfeeding exclusively until the child is six months old, at which point complementary (solid) foods should be introduced. Breastfeeding should be continued until the child is at least two years old.

According to research, inadequate milk supply, extended workdays in the field, and other demands on mothers’ time surfaced as causes of this discrepancy. Mothers in rural Sindh have complained about a lack of information and lactation counselling.

Dr. Shamsa Ilyas, Lahore-based gynaecologist, while talking to Voicepk.net said that it is extremely important for women to breastfeed in the early stages of the infant’s development, emphasizing that it is beneficial for both mother and child.

“Breastfeeding can also lower the risk of breast cancer in women,”

she said.

However, Dr. Ilyas also said that in some cases women are physically unable to lactate due to malnourishment.

“Women who have poor nutrition and diet are unable to lactate in some cases. In those cases, it becomes difficult for them to breastfeed and they have to rely on artificial feed,” she said.

In light of the approved breastfeeding law, Voicepk.net posed a question about the availability of milk donors or milk banks that women can turn to when they are unable to lactate.

Ilyas said there was no availability of milk banks or milk donors in Pakistan for women to fall upon in times of need.

Another Lahore based nutritionist, Dr. Shama Muneer, explained that healthcare professionals only recommend formula milk when a mother has any serious medical condition that can affect the child or when the mother is unable to produce milk.

“In case of contagious diseases like HIV, Aids or hepatitis etc., breastfeeding is strictly avoided. Other than that, we recommend breastfeeding for the first six months,”

she said.

Representatives of the baby food industry from multinational and local companies met Sindh Health Minister Dr. Azra Pechuho on Friday, to convince the committee to revise the amendments, however Dr. Pechuho declined.


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