Issues and Challenges

Protecting Our Infants for a Better Tomorrow

“The true character of a society is revealed in how it treats its children.”
– Nelson Mendela

The physical and mental stability of an individual and, collectively, of a generation, can lift up the index of prosperity and growth of any country. November 7th is celebrated as Infant Protection Day globally. The day aims at spreading awareness about safety of infants and protecting their lives by taking proper care. It should be realized that due to the lack of protection and care, newborns face a lot of problems across the globe. World over, more than 5 million infants and children under the age of five succumb to lack of care, unhealthy environment and malnutrition. Unfortunately, Pakistan ranks 25th on Infant Mortality Rate index (IMR) in the world with approximately 60.76 deaths per thousand live births. The menace poses a dire threat to the socio-economic structure of a developing country like ours, unless these threats are addressed on priority basis and so we must strive to challenge the prevailing dynamics by working hard to improve the situation. This can be achieved by updating and improving national as well as domestic health practices and inculcating and adopting promising means to counter the ever increasing infant mortality rate and hence, making sure of our infants’ protection, on whom our future rests.
Pakistan’s rural population is 63.09%. The infant mortality rate in the rural belt is more prevalent than in urban areas. Centuries old cultural practices still overshadow the new researched medical practices. Lack of access to well-equipped healthcare facilities is one reason. But lack of education is the most pressing hurdle, which further fuels insufficient awareness, inadequately equipped healthcare facilities, and under-trained medical staff making it more difficult to bring people to rely on improvised and safe neonatal care practices.
According to the Journal of Pakistan Medical Association (JPMA), one of the causes of high infant and maternal mortality rates in Pakistan is unsafe delivery practices. Non-hospital deliveries on their own are not a bad practice, but in rural areas where they are combined with inexperienced midwives (dais) and unhygienic practices can be hazardous to both mothers and babies. Harmful delivery and homecare practices, especially in rural areas, include sepsis (while cutting umbilical cord with unsterilized equipment) and asphyxia (choking on the birth cord), inadequate neonatal care, discarding colostrum, failure to initiate breastfeeding and failure to keep the baby warm enough.
However, it is the duty of the state departments and healthcare units to educate and spread awareness about pregnancy and neonatal care. Maiden parents specifically have little idea about feeding routines and schedule, hygiene and general health. Parents must be educated thoroughly about neonatal care and safe practices. We should collectively work on achieving infants’ protection by following some basics guidelines.
Breastfeeding: Natural Immunization
Breast milk is the healthiest food for a newborn. The first secretion, a thick fluid called colostrum, is regarded as ‘super food’ for newborns. It contains antibodies that protect against environmental antigens and internal inflammation by creating a tough coating on the baby’s stomach and intestines to keep germs from causing illness. Babies who are breastfed exclusively for the first six months without any formula suffer from fewer ear infections, respiratory illnesses and bouts of diarrhea. Parents must be educated on prioritizing breastfeeding over formula feeding to help strengthen the immunity of babies. 
Dietary and Supplementary Needs
Nutritionists at healthcare facilities should thoroughly brief parents about age appropriate nutrition of infants and babies. The cultural and outdated myths often overshadow minds and parents do not take dietary guidelines into consideration. For instance, it is a common practice of giving honey to newborn as an anti-inflammatory but honey is linked with botulism and if given to babies less than a year old, can cause death. Vitamin D deficiency is another issue surfacing in babies, which is due to insufficient filtered sunlight and outdoor time. Parents need to be aware of healthy outdoor hours, which accelerates growth and boosts immunity.
Handling Infants and Co-sleeping
There is a need to educate parents about handling and carrying infants. Proper holding and feeding postures, sleeping positions, feeding schedules and extent of wrapping and clothing must be elaborated to avoid mishaps such as dehydration or suffocation. Sudden Infant Death Syndrome (SIDS), is a common cause of infant death where a baby sleeping face down or on soft bedding may suffocate or rebreathe exhaled carbon dioxide leading to life threatening circumstances and even death. Similarly, co-sleeping is a common practice that may cause accidental strangulation of infants. Parents may keep babies in the same room to monitor them but in their own soft bordered and separate bedding or crib.
Touch Empathy
Emotional care and physical love has immense effect on psychological well-being, which in turn lifts up the quality index of life. A research has shown that infants who are not held, nuzzled or hugged enough can stop growing and in some cases if the situation lasts long enough, they may even die of ignorance. Parents must be enlightened with the importance of showing love, empathy and care to promote mental health of infants and toddlers. Researchers explain that infants who do not receive enough stimulation or care do not develop to their full capacity.
Safety While Travelling
Travelling etiquettes and SOPs must be adhered to while taking babies onboard vehicles. In cars, infants should always be put in the car seat facing the rear of the vehicle to ensure safety and minimize damage in case of a mishap. Moreover, they should never be left alone in the car especially with windows rolled up as in extreme temperatures it may dehydrate, knock them unconscious or even suffocate them.
Emergency First Aid
Parents must be aware about potentially hazardous items and spaces. They should know about emergency first aid such as Heimlich’s maneuver and CPR in case of an emergency.
Maternity Leave
A period of at least six months should be dedicated as maternity leave and one month as paternal leave for the father to help foster the parent-child bond. Such an arrangement is beneficial as it helps with postpartum and consequently postnatal care, as both parents actively and devotedly get involved in looking after the baby. This paves way for a healthy upbringing of the baby, which has lasting impact on the emotional wellbeing of a child.
Trusted and Reliable Caretakers
The importance of a trustworthy, responsible and reliable caretaker cannot be emphasized enough. Parental devotion has no parallel but if a baby is to be entrusted to a caretaker, it needs to be made sure they are responsible and reliable. Considering the surfacing of child abuse cases, it is best to keep kids under one’s own supervision or check in on them often.
Hygienic and Comfortable Environment
Hygiene and environment of maternity and infant care at home and healthcare units is the basic way to cater for infant protection. A hygienic environment paves way for efficient growth and health by minimizing the risks of diseases and infections. Most infant mortalities are caused by low birth weights, infections such as pneumonia, diarrhea and malnutrition. In developing countries, infants often suffer from rabies and scabies due to poor hygienic environments. Rats and bed bugs can cause serious internal and skin infections, which pose danger to their health. 
Security and Protection against Infant Kidnapping
In developing countries, infants are often kidnapped from maternity clinics and are sold off. Parents are made to believe that the baby was stillborn or died after birth. There is no system in place to monitor nurseries. Government and public must work in tandem on taking down such criminals and ensure better security of nurseries.
Trained and Licensed Daycare System
Parents should make sure that they put their children in daycare systems that are licensed on merit. These must be equipped with trained, qualified and mentally stable staff to ensure positive care for infants and toddlers.
Most infant deaths are preventable provided the parents, government and healthcare officials responsibly cater for healthcare facilities. Lack of funds and trained personnel aggravate the problems. The healthcare governing units need to invest on training the healthcare staff as well as creating awareness and educating expectant mothers about neonatal care. Interventions like proper immunization and childcare in early stages can help save thousands of children.
The vision of a shining future is incomplete without ensuring health and safety of our children. Hence, it is pertinent to ensure the safety of our infants to achieve their proper growth and development. Pakistan has embarked on its way to prosperity; we must work hard to overcome any hurdles that may hinder the very essence of a well-functioning society, and for that the health of our children and their safety and security is vital.
“Each child represents either a potential addition to the protective capacity and enlightened citizenship of the nation or, if allowed to suffer from neglect, a potential addition to the destructive forces of a community … The interests of the nation are involved in the welfare of this array of children no less than in our great material affairs.” HH

—  Theodore Roosevelt

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