Foundation for Mother & Child Health (FMCH) India tackles maternal child malnutrition by empowering women

Tomorrow is Diwali, a five-day festival that celebrates the victory of light over darkness. 

The Foundation for Mother & Child Health (FMCH) India reported that almost eight lakh (hundred thousand) children in India are not able to celebrate their first Diwali due to poor nutrition and health outcomes. 

FMCH works to empower families from vulnerable communities with actionable information and services, resulting in health seeking behavior and nutritious food choices in order to tackle maternal child malnutrition, ultimately breaking the cycle of poverty. 

“FMCH India’s work empowers women – it gives confidence and encouragement to an FMCH field officer, adds to the skills and knowledge of a government frontline worker, and builds agency and support for mothers in the community,” Shruthi Iyer, CEO and Co-founder, FMCH India tells Our Milky Way

When Our Milky Way first interviewed FMCH in 2018, the organization had reached 10,000 women and children in Mumbai and Thane districts of Maharashtra. To date, FMCH has now worked with 60,000 families across low income neighborhoods of Mumbai.  

Still, in 2020, more than 40 percent of children in India were undernourished and 50 percent of women were anemic. 

Community engagement event
Photo credit: FMCH

Within the first 1,000 Days, FMCH strives to implement education sessions in the community, home based counseling, and the strengthening of systems, each strategy with a strong emphasis on monitoring and maintenance of  quality. Sustainability has been built into the program through community engagement and government systems. 

Because malnutrition and maternal health are complex forces, FMCH engages in a variety of programs. Read in detail about them here

For instance, as part of Project Poshan, the organization identified that in Mumbai, “only 53 percent of newborns are breastfed within one hour of birth, displaying a serious lack of early initiation of breastfeeding. On the other hand, the percentage of breastfed children aged 6 to 23 months receiving an adequate diet is as low as 6.4 percent in the city.” [ Retrieved from https://www.fmch-india.org/wp-content/uploads/2021/10/FMCH-Annual-Report-2021-Interactive.pdf

Most recently, in the last year, FMCH “worked with close to 25,000 families, and recorded an increase in early initiation of breastfeeding – 74% from 59%… The national average is 57%,” documented in the latest Annual Report. What’s more, 70 percent of mothers started complementary feeding at the appropriate age of six months.

Photo by Ganta Srinivas

Their work supporting healthy infant feeding recognizes that breastfeeding is not only the responsibility of the mother though and aims to educate the network of people around the breastfeeding dyad

FMCH’s most recent annual report describes the success stories of health care providers and the families they serve. Explore them here

Iyer says the way forward is to establish more direct interventions, build out indicators for their theory of change and to conduct more trainings for Anganwadi workers. (Anganwadis are rural child care centers started by the Indian government as part of the Integrated Child Development Services program.)

Photo by Gene Brutty

In the earliest Indian literature, the Vedas (a large body of religious texts originating in ancient India) recognize the life-giving powers of breastmilk. 

As documented in The Religious and Cultural Bases for Breastfeeding Practices Among the Hindus “…Milk and breast are symbolic of longevity and nectarine sweetness” and “‘Drinking of the milk, whose sap is the sap of immortal life divine, may your baby gain long life, as do the gods by feeding on the beverage of immortality!’ (Susruta, III, 10).” 

Extolling breastmilk in modern India and globally, through programs like FMCH, is like the light over darkness during Diwali, the FMCH vision achieved: “Healthy mothers and thriving children for a world of unlimited possibilities.” 

No single solution nor single source of the problem

There’s a recent TED Talk soundbite that goes like this:

“…In a world as complex and interconnected as the one we live in, the idea that one person has the answer is ludicrous. It’s not only ineffective, it’s dangerous because it leads us to believe that it’s been solved by that hero, and we have no role. We don’t need heroes. We need radical interdependence, which is just another way of saying we need each other.” 

Photo by NASA on Unsplash

It’s a similar lesson Kimberly Seals Allers spoke to during a Milkshake Mondays Facebook Live session where she comments on the New York Times piece Climate Change Tied to Pregnancy Risks, Affecting Black Mothers Most and a laboratory creation intended to replicate human milk which just raised $3.5 million from Bill Gates’ investment firm.

In reference to the despicable maternal child health outcomes for birthing and lactating Black Indigenous People of Color (BIPOC), Seals Allers implores us to stop having “this very individualized conversation about what is happening to Black women.”

“There is so much involved,” she says. “There is no single solution, and there never was a single source of the problem.” 

The ideas of interconnectedness and multi-dimensional challenges apply perfectly to this year’s World Breastfeeding Week’s (WBW) theme Support Breastfeeding for a Healthier Planet. Environmental and human health are intricately intertwined.  

It’s a tangle that calls for more than reduction, reusing and recycling.

Through an equity lens, Seals Allers uses Bruce Bekkar’s, MD, et al research to ask questions like “Why are there factories mostly in Black and Brown neighborhoods? Why were Black and Brown people driven to heavily populated urban areas?”

Photo by Clay Banks on Unsplash

The association between air pollution and heat exposure with preterm birth, low birth weight, and stillbirth in the U.S., demonstrated in Bekkar’s research, is heavily influenced by systemic racism.

“Compounding the added risks from warming and pollution, Dr. Basu said, research has shown that minority communities tend to have less access to medical help and that minority patients tend not to receive equal levels of treatment,” Christopher Flavelle writes in the NYT piece. 

Flavelle goes on, “Adrienne Hollis, senior climate justice and health scientist for the Union of Concerned Scientists, said the problems could not be tackled in isolation.  ‘We need to look at policies that provide equitable opportunities for communities of color,’ Dr. Hollis said. ‘If you address structural racism, I think you’re going to start getting at some of these issues.’”

Seals Allers echoes: “Stop problematizing Black women; look at the systemic solutions.” 

Unsurprisingly, the “solutions” we tend to generate include pouring millions of dollars into synthetic milk instead of investing in breastfeeding and lactating people themselves. 

“It’s very disturbing,” Seals Allers comments in her Facebook stream. “The solution is not around empowering women, it’s not about getting women breastfeeding, it’s about finding synthetic solutions. [There’s ] such a disconnect.” 

Equally concerning in this case, is that the investment into a proposed solution for poor health outcomes related to not breastfeeding, comes from a climate change investment fund. Human milk is arguably the most sustainable food on our planet; why are sub-optimal, artificial substitutes getting so much funding instead of promoting policies and programs that support direct breastfeeding or pasteurized donor human milk

 Source: United States Breastfeeding Committee.

The conundrum goes beyond the years of milk feeding onto complementary foods which offer corporations new opportunities to target families with Ultraprocessed Foods (UPF). Like artificial milk substitutes,  UPFs pose environmental threats: processing takes natural resources and generates waste. Moreover, UPFs are often heavily marketed in underserved communities, so poor health outcomes continue to be compounded.   

Healthy Children Project’s Cindy Turner Maffei recently attended a webinar sponsored by the Breastfeeding Promotion Network of India  (BPNI) and the Nutrition Advocacy in Public Interest (NAPI) on UPFs and their relation to obesity, diabetes, and other health dangers. 

“Presenters from India, Brazil, and Australia shared insights on the health impacts of UPFs, about the market and social forces at play, and also what we can do to advocate reduction in use of these engineered foods,” Turner-Maffei reports. “Brazil in specific has incorporated decreasing UPFs into their dietary guidelines and restricted use of government funds to purchase these foods for school food programs.” 

BPNI and NAPI offer their document on UPFs here

BPNI has also created a WBW action folder.  The document contains information on the carbon footprint of breastmilk substitutes and offers interventions required to support breastfeeding at four levels: policy makers, civil society and breastfeeding advocates, hospitals and doctors and parents. 

Nothing is relevant if we don’t have a hospitable planet. Breastfeeding and appropriate, unprocessed complementary feeding are the roots of a healthy ecosystem that all humans benefit from. 

For more on interconnectedness read Breastfeeding and parallel advocacy. Explore more on infant feeding and our environment here and here.