On the one hand, she knew she had no choice but to resume work. Based in Mumbai, Sengupta’s income was critical for the kind of life she dreamed of giving her sons. Neither could she bring herself to abandon her successful career. But guilt still nagged. She thought constantly of her doctor’s advice on the need to breastfeed her babies for at least six months. Yet, her long hours at General Electric (where she worked at the time) made this difficult. Struggling to balance work and motherhood, Sengupta gradually weaned her sons and began supplementing their diet with infant formula. “I constantly felt this psychological pressure that what I was doing wasn’t right, that I was somehow denying my children the most basic nutrition,” says Sengupta, whose sons are now almost three years old. “The most traumatizing part is that you know all the benefits of breast milk, and yet you can’t do anything about it because of work pressures.” With 1-7 August marking annual World Breastfeeding Week, health professionals around the globe have spent the last few days emphasizing the importance of initiating breastfeeding within the first hour of life and continuing solely with this until an infant is at least six months old. While that seems possible in theory, the reality is very different. As more and more young women join the workforce, they struggle to follow doctors’ orders. In the relative absence of government or corporate support, many are finding themselves in the same situation as Sengupta—caught between their infants’ needs and the demands of hectic careers. Health impact Researchers have amassed reams of data over the years on the health impacts of inadequate breastfeeding on mother and child, as well as on the hefty economic costs indirectly borne by employers as a result. Several companies in the West have developed an array of support systems, including longer maternity leave, on-site crèches and nursing stations, flexible work hours and the option to work from home. The good news is that a small but growing number of Indian organizations have followed suit. Others are yet to appreciate that a well-fed baby means a happy mother and a happy mother means a productive employee. The World Health Organization released revised guidelines last year recommending that new mothers exclusively breastfeed for the first six months of an infant’s life, followed by the introduction of complementary baby foods alongside breastfeeding over the next two years. Mother’s milk boosts development and immunity. Scientists also believe that proper breastfeeding could curb infant mortality by up to 15%. At present, malnutrition is responsible for more than half the deaths among Indian children under the age of five. Over two-thirds of these are associated with inappropriate feeding in the first year of life, according to the United Nations Children’s Fund (Unicef). Results from the latest National Family Health Survey—a door-to-door health poll conducted by the ministry of health and family welfare—suggest that only 46% of newborns in India are exclusively breastfed for the first six months. One reason for the low number is that more women are keeping their jobs after childbirth. The registrar general of India estimates that the proportion of women in the workforce increased from 19.7% in 1981 to 25.7% in 2001. But, in the newer industry of information technology (IT), women account for close to 30% of the workforce, with the number expected to rise to 45% by 2010, according to the National Association of Software and Service Companies. In keeping with the Maternity Benefit Act (1961), most Indian employers offer 12 weeks of maternity leave, with an extra month allowed in case of miscarriages, Caesarian sections and terminations. For public sector employees, that can stretch a little longer, up to 18 weeks. Workplace support While some working mothers continue to breastfeed exclusively, by expressing milk and leaving it at home, the vast majority “succumb to the easier option” and mix their infants’ diets with supplementary foods much sooner than they should, says Subhanu Mitra, a paediatrician at Kolkata’s Balananda Brahmachari Hospital. Mixing the diet too early, Mitra says, can make babies prone to respiratory and diarrhoeal infections, and disturb the natural bonding process between mother and child. To avoid this, doctors, health advocates and many working women say Indian employers could do more to help new mothers on the job. “Maternity leave is three months by law. But it should actually be six months. Companies should realize that it is beneficial if mothers and their babies are healthy,” says paediatrician Arun Gupta, co-founder and national coordinator of the Breastfeeding Promotion Network of India (BPNI). On-site crèches and breastfeeding stations, flexible work hours and early training on how to express milk safely are also crucial, Gupta says. “Breastfeeding should not be incompatible with women’s work,” agrees Augustine Veliath, a spokesperson for Unicef India. “Employers should support breastfeeding women who work, beginning with providing nursing stations in both government and private offices.” “New working mothers would hugely benefit from practical tips on how to plan the nursing intervals, their own health and nutrition, and exercise regimes they can follow,” says Sunita Bhuyan, head of training at Syntel BPO in Mumbai. “Employee assistance programmes in offices can run these short courses.” But, for many new mothers back on the job, that level of workplace support seems like a distant and unrealistic fantasy. “I don’t think anyone cares at most workplaces, because the work still needs to get done. If you want to be home and feed your baby, you’d better leave the job. In this work culture, people do think twice about coming back,” says Anamika Chatterjee, a new mother who has recently returned to work as head of credit and loan sanctions at Centurion Bank, Mumbai. Jaya Bhattacharya, another new mother who teaches political science at Delhi University’s Gargi College, agrees. “Even if your colleagues are empathetic and understanding, there is still a lack of awareness and practical understanding about this.” Some Indian companies,however, have for been accommodating the special needs of breastfeeding employees for many years. New Delhi’s ITC Maurya, for instance, has had a facility known as the Welcom Crèche inside its premises since it opened more than 25 years ago, says hotel spokeswoman Pratima Vasan. Hotel employees can entrust their children to trained attendants and breastfeed anytime they need. “I can’t explain in words how helpful (the crèche) has been to me. It is a great pleasure. If I could not bring my baby here, I would have to leave my job,” says Pooja Tyagi, a staffer at ITC Maurya, who brings her 10-month-old son to work every day. “The attendants are well-trained and the creche is neat and clean. This is a great facility. NDTV maintains a similar crèche at its headquarters in New Delhi and has also implemented the unusual policy of granting six months maternity leave to its employees. “We have a beautiful crèche with about nine beds, two or three maids and two supervisors,” says Mohuya Chaudhuri, senior editor at NDTV. “I used to take my daughter there when she was younger and she always had a great time.” “This kind of facility is critical for your child, especially in the media, which is terrible for women in terms of long hours and different shifts,” Chaudhuri continues. “I think corporates have largely been very irresponsible in this regard. Even now, it affects a woman’s career prospects if she is seen balancing her career around her child.” Showing the way Capital-rich multinationals and technology companies are also ahead when it comes to accommodating employees who are new mothers. IBM and General Electric, for instance, have provisions for allowing new or expecting mothers to work from home, while the New Delhi headquarters of appliance major LG India and the Pune branch of outsourcing technology firm Xansa India have crèches with trained staff and supervised activities for children. “At our crèche, mothers can see their child whenever they want. This provides psychological satisfaction as well as an increased commitment to the company,” says Yasho Verma, director of human resources at LG India, New Delhi. “I think such provisions are critical as they help to manage factors such as retention and diversity, which are very important to the company.” Unfortunately, only a small fraction of working women have the good fortune so far of securing supportive employers. “When women receive support from the workplace, it is the ideal situation. But I would say only one in 500 patients that I attend to have that opportunity,” says Dinesh Sahai, a paediatrician in Mayur Vihar, New Delhi, who estimates that more than two-thirds of his patients are working women. Still, Dipankar Banerjee, a Kolkata-based management consultant and human resources specialist, says there is reason to hope. “Traditional brick and mortar companies have not given as much attention to these areas as sunrise industries such as IT and media. But they are becoming more aware of these issues and I am sure things will definitely change in a few years.” Gupta believes that widespread changes will only emerge once the government makes a firm financial commitment to the breastfeeding cause. To that end, he and his colleagues at the BPNI have proposed an action plan to the ministry of women and child development. Recently, the advocates also met the Prime Minister to present their case. “We are asking that the government spend only Rs2 a day on breastfeeding promotion efforts such as training, the early counselling of pregnant mothers and the creation of crèche facilities,” says Gupta. “A separate budget would help.” Gupta and others hope their recommendations will find a solid berth in the 11th Five Year Plan (2007-2012). Shashi Prabha Gupta, technical adviser to the Food and Nutrition Bureau of the ministry of women and child development, says the chances of that happening are very high. “Gupta and the others have prepared an action plan which amounts to about Rs1,000 crore over the next five years,” she says. “It’s a practical proposal. I am 99% sure it will be included.” That’s good news, but many say it’s ultimately up to the women themselves to stand up for the right to properly nourish their newborns. “Breastfeeding is a right the mother herself should exercise,” says paediatrician Mitra. “Whatever the government, companies and doctors say, nothing will happen unless working mothers themselves lead the fight.” Write to us at businessoflife@livemint.com