From Dr. Arun Gupta's Desk
BPNI over the years………
To start with……….
In 1979 our daughter was born. My wife and I, being doctors and strong supporters of breastfeeding, decided that she should be breastfed exclusively for the first months but we failed in a few days, there being no support available from the family or the health care system. The prevailing bottle-feeding culture was too strong. The little girl had to give up breastfeeding by 5-6 months. The story was repeated in 1981 when our son was born.
At that point of time we started looking for information on how one could succeed in breastfeeding but failed to find anything. We found ourselves in a position where women were only exhorted to follow optimal guidelines for breastfeeding but not supported to do so; so they often failed in their efforts to provide their babies with the best food. Years passed by, more and more women adopted bottle-feeding culture as a modern practice.
According to a simple research conducted by us in 1983-84, in Jalandhar town where we lived and practised, bottle-feeding was an accepted norm of feeding newborn babies and young infants in all the 17 maternity hospitals. We attempted to bring changes in the existing hospital practices through a campaign that included personal advocacy with the doctors and putting up posters in the maternity facilities; however, nothing seemed to work.
Commercial influence of infant formula industry on health care professionals was more than visible. The companies continued to benefit the health care system with 'free supplies' of infant formula as well as ‘sponsorships’ of their academic meetings. This had a visible impact on the attitude of doctors who were generally un-supportive to breastfeeding or would tend to ignore it because of their own lack of proper information. Bottle- feeding was not considered a health hazard. Their knowledge about 'breastfeeding or lactation management' (a term that came to the scene later) was as limited as ours. They strongly believed that exclusive breastfeeding was impossible to practice and the need of supplementary milk feeds during early days of child's life was justified and so infant formula came handy. Doctors believed they knew enough on breastfeeding, posed as a barrier.
At this point I got in touch with other like minded people, particularly Dr. Raj Anand from Mumbai, who had been spearheading consumer and breastfeeding issues. I invited him to Jalandhar during height of terrorist violence in Punjab to speak on how the baby food industry interfered with the feeding of babies. He came and spoke fearlessly to the surprise of audience. In the same year we also got involved in the advocacy work of the Voluntary Health Association of India (VHAI) for the enactment of a law to regulate marketing practices of baby foods companies.
Exploring how to intervene to bring about change in hospital practices and how to counsel mothers effectively became our objective in 1986. Fortunately, in 1989, I got linked to the International Baby Food Action Network (IBFAN) and took part in its 10th year Forum in Manila where I met the stalwarts working on infant feeding issues. I got an opportunity to be being trained in ‘breastfeeding and human lactation management’. I decided to take up the 5-day training and learn the skill. This was in spite of being ridiculed by friends and seniors. Next year, in 1990, my wife went for this training. The training gave us the light of hope, the knowledge and the skill we were missing. In the same year we decided to move to Delhi in a bid to take on the issue of breastfeeding along with other like minded friends. Little did we know
what was in store for us, but we took the risk of giving up our 30-bed hospital in Jalandhar and start afresh in Delhi.
In 1991 ACASH, IAP, and FOGSI organized the “Super- Trainer Workshop on Recent Advances in Human Lactation and Breastfeeding Management” at Wardha and I got invited. On the last day of training, December 3rd 1991, one of the crucial recommendation that emerged was to have an organized front for advocacy on breastfeeding. The participants even gave it a name. Thus Breastfeeding Promotion Network of India (BPNI) was born.
On 27 March 1992, Dr. R.K. Anand, Dr. N.B. Kumta, Dr. Tarsem Jindal and myself, met over an informal dinner at my place in Delhi. We decided to pool in some money and gave BPNI a go. Dr. Anand asked me a question, “Would you be able to manage?”. I could only answer “Yes”, though I had not yet fully understood what challenges were ahead of me at that time.
Thereafter, BPNI started functioning in full strength as a volunteer force of zonal coordinators who were trained together and sat together to set up BPNI. We began imparting training to our fellow colleagues and students of institutions we worked in. Formal activities started happening in the very next year like organizing World Breastfeeding Week (WBW) in India. It was here that BPNI got linked to a new global organization, the World Alliance for Breastfeeding Action (WABA) and they asked us to act as focal point of South Asia. Lobbying for a legislation to regulate marketing practices of baby food companies was a major work as a continuum of what we had been doing before. In 1992, first victory came when a battle in a bigger war was won as the Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992 (IMS Act) was enacted. Over the years BPNI started playing an increasing role in policy analysis and development as well as monitoring the IMS Act and strengthening its position with the government. Many other areas of action evolved as we worked on broadening our agenda. BPNI was notified in the Gazette of India and was assigned a role to monitor the compliance of the Act along with ACASH and two more semi government organizations. While ACASH filed complaints against violations in Mumbai, BPNI filed one in Delhi on behalf of ACASH in 1994.
The major role of BPNI was being defined as a special advocate for sound infant feeding policies. We went to government offices to do advocacy, only to be shown the door. However, even as BPNI added new issues to its agenda, and the focus broadened to include issues like child health, survival, nutrition and development, our advocacy was having its impact. In 1993 the first National Family Health Survey included an indicator on exclusive breastfeeding. Apart from having the IMS Act, over these years several milestones were achieved. In the year 2000 an additional legislative protection was granted to breastfeeding through the Cable TV Networks Amendment Act that banned any advertisement of the infant milk substitutes, infant foods and feeding bottles in the Cable TV network services.
BPNI entered the international arena as a member of the IBFAN movement; it had a role to stimulate action in the South Asian region. In 1996 BPNI was awarded to be - “Strong Regional Advocate” at the WABA Global Forum in Bangkok. In 1997, I was elected to represent South Asia in the International Baby Food Action Network (IBFAN). In 1998, the IBFAN network received the Right Livelihood Award, popularly known as the Alternative Nobel Prize. This was very encouraging for all of us to keep our energies high.