Sri Lanka ranks first in the world for breastfeeding

In January this year, just two weeks after Chinese authorities identified a novel coronavirus from a cluster of pneumonia cases of unknown cause in Wuhan City in China, there was a report from the World Breastfeeding Trends Initiative (WBTi). It stated that according to a new survey conducted by the WBTi, Sri Lanka ranked first among 97 countries globally on breastfeeding rate. The country achieved the first ever "Green" nation status in supporting breastfeeding mothers. This landmark event was eclipsed and snowed over by the hype and hullabaloo about the coronavirus. It had gone practically unrecognised, unsung and even unacknowledged.

Sri Lanka’s rank is based on its performance on ten indicators of policies and programmes the WBTi uses to colour-code and rank countries. Sri Lanka has scored 91 out of 100 points and earned a green colour-code, which implies the very best level of performance. In an ascending order of performance WBTi colour codes are Red, Yellow, Blue and Green. Experts at the Breastfeeding Promotion Network of India in Delhi developed the World Breastfeeding Trends Initiative (WBTi) and launched it worldwide. So far 120 countries have been involved in WBTi and 97 have completed assessments and reported.

Dr. Arun Gupta, the global coordinator of WBTi has said "Sri Lanka has demonstrated high level commitment towards health and nutrition of mothers and babies. Not surprisingly, Sri Lanka ranks number one on the health and survival sub-index having taken effective steps in this direction." The WBTi while congratulating Sri Lanka, has categorically stated that the current status reached by the country is the result of persistent efforts over many decades to pursue improvements.

As indicated by the WBTi, this is not something that was achieved overnight. It involved sustained and dedicated efforts on the part of many individuals and institutions. In attaining this pivotal status, one needs to acknowledge the seminal roles played by many such personages and organisations that were responsible for this ground-breaking triumph. It is, indeed, a collective effort of very many people and institutions.

Foremost amongst them are the mothers and even the fathers of this resplendent isle. The mothers especially, have been the cornerstone of this pinnacle of accomplishment. With the very high literacy rate of the populace of our motherland, the mothers have responded magnificently to the advice tendered by the health authorities, especially the Family Health Bureau of the Ministry of Health of Sri Lanka. The grass-root level preventive healthcare professionals of the said ministry and the bureau have worked tirelessly to facilitate breastfeeding for our babies. The response has been absolutely marvellous. Even the working mothers have gone that extra mile to provide their offspring with all the undoubted benefits by providing them the milk that is the very best.

Lest they be forgotten, there is another group of people who contributed most significantly to this fantastic achievement. They are the members of the Sri Lanka Paediatric Association, which later on in 1996 became the Sri Lanka College of Paediatricians. All the Specialist Consultant Paediatricians are members of these organisations. There were, and still are, and there will always be, a dedicated lot of people in these institutions who have played and will continue to play, a crucial role in promoting breastfeeding for all babies. Their campaign started in the 1960s and 1970s. I hope my colleagues in these organisations would not grudge me the indulgence in mentioning just one person among all these dedicated people, a persona grata, who stands straight and tall, practically head and shoulders above the others. She is Professor Priyani Elizabeth Soysa, the Emeritus Professor of Paediatrics of the University of Colombo. In those early years she fought a lone and virtually a fearless battle to advocate breastfeeding, while taking head-on the infant milk food industry. She was also responsible for taking on a valiant fight to secure maternity leave for mothers, virtually almost entirely to enable them to exclusively breastfeed their babies. Take a bow Madam; you did such a great and unforgettable job, by initially paving the way for us to reach this exalted status now. One must also acknowledge all the paediatric academics of all the universities of Sri Lanka, who are entrusted with the important task of training all future doctors, for their dedication to this magnificent obsession with breastfeeding.

The former Sri Lanka Paediatric Association (SLPA) and its successor the Sri Lanka College of Paediatricians (SLCP) have played a major role in promoting and advocating breastfeeding. Over many decades, they have taken over the baton to organise awareness programmes and propagate advocacy initiatives to facilitate and promote universal breastfeeding for all newborn babies as well as to encourage mothers to be a part of the World Health Organisation policy of the first six months of life being a period of exclusive breastfeeding for all newborn babies. Specialist Consultant Paediatricians who are members of the SLCP see a very large number of babies in their hospital wards, their clinics and in the private sector. Mothers and fathers trust them with the lives of their babies. All the efforts of these Consultant Paediatricians have contributed, in no small measure, towards our achieving this illustrious status of literally and metaphorically being on top of the world, in the year 2020. In addition, very high rates of breastfeeding of our babies have even played a pivotal role in Sri Lanka enjoying some of the very best Child Health Indices in our Asian region. Indeed, some of the indices such as Neonatal Mortality, Infant Mortality and Under 5 Year Mortality are the envy of even the developed world.

In a world that is not perfect by any stretch of anyone’s imagination, there is no place for conceit and complacency. We can quite easily fall from our pedestal. This initiative to propagate and promote breastfeeding will always be an on-going skirmish against certain powerful industries. There are quite a few organisations which for very many economically related reasons would continue to be a thorn in the side of all who are committed to promoting breastfeeding. Unprincipled marketing practices and advertising of Infant Formulae are perhaps gradually rising again. Formula industry is innovating strategies to promote their products in a furtively tactical manner. Some lapses on the part of the regulatory mechanisms have also left the door open for the formula industry to capitalize on the situation for their benefit. Thus, it calls for cat-like vigilance on the part of regulatory authorities to ensure that some of these would not be able to scuttle the gains that we have achieved so far in the realm of breastfeeding of our babies.

As the headline of this article suggests, this year has been a gloomy, unforgiving, worrying and treacherous time for our beautiful island, the Pearl of the Indian Ocean. History may record the year 2020 as the Coronavirus Year for our beloved Motherland.

Yet for all that there is a silver lining to this melancholy cloud. Let it also be announced, from even the roof-tops, that 2020 is the year that Sri Lanka reached the pinnacle of excellence in promulgating and accomplishing the concept that breast milk is indeed the golden elixir of life for the young. On that score at least, we are on top of the world.