There will always be a demand for breast milk, with breastfeeding lasting at least two years as a norm

Nepal's first-ever human milk bank, Amrit Kosh, has been established at the Paropakar Maternity and Women's Hospital in Kathmandu, an initiative worthy of emulation in other parts of the country as well. Donor human milk is recommended for premature, low and very-low birth weight infants as well as sick newborns who are unable to feed on their own mother's milk for some reason, and the newly established bank is expected to provide access to the vast benefits of breast milk when infants need it the most. Milk from the bank can be fed to infants with no breastfeeding mothers or be used for neonates who can't get milk from their mothers for medical reasons. Amrit Kosh, set up in partnership with the Nepal government, the European Union and UNICEF, has facilities to collect, pasteurise, test and store safe donor human milk from lactating mothers, which is then given to the infants in need. Human milk banks have been established in all our neighbouring countries, including India, Bangladesh and Sri Lanka, and there is plenty of opportunity to learn from their experiences.

Countries such as Brazil, which is said to have more than 215 human milk banks, or India with more than 90 such banks operating in 2021, have seen infant deaths and child malnutrition come down drastically. With a high burden of neonatal mortality of 16 in Nepal – that is the number of deaths per 1,000 live births during the first 28 days of life – access to human milk could be a key strategy to reducing it. It is estimated that more than 81,000 preterm babies are born in Nepal each year, who face a high risk of dying in their first month of life. Nepal also has a high infant mortality rate of 25, that is the number of deaths per 1,000 live births below 1 year of age, and under-five mortality rate of 28 per 1,000 live births, although the figures have come down drastically over the decades.

The concept of a human milk bank is new to the Nepalis, and there is a need to create awareness about how this works and who can donate. Normally, a lactating mother, who has lost her infant or has excess milk after feeding her baby, can store the breast milk at the bank. There will always be a demand for breast milk, with new mothers breastfeeding their infants for at least two years as a norm. While most mothers would donate milk voluntarily or as an act of humanity, there is still that question if donors should be reimbursed for providing breast milk regularly for a period of time, which could last more than two years at times. When there is a financial incentive, it could prompt poorer mothers to sell their milk, placing both their health as well as that of the child in peril. Also guidelines are needed to ensure the safety of the breast milk to be fed to an infant. Mothers could be concealing their medical history while donating milk to the bank in good faith. If Nepal is to improve on its infant health indicators, many more human milk banks need to be established outside the capital. This calls for increased government support at both the provincial and local levels as well as the multitude of non-governmental organisations working in the child and health sectors.

Two-wheelers' fatality

Motorcyclists are prone to road accidents in the Kathmandu Valley because of reckless driving, according to the Metropolitan Traffic Police Division. The valley had recorded as many as 10,733 road accidents in fiscal 2021/22. Of the 191 deaths related to road accidents, 117 were motorcyclists, who constitute 78 per cent of the total road accidents. The traffic police revealed that the motorcyclists, who were killed in the accidents, belonged to the 17-35 age group. The traffic police have launched a special drive to curb the alarming rate of accidents involving two-wheelers, but to no avail.

The main causes of road accidents involving two-wheelers were reckless driving and violation of traffic rules. The youngsters always tend to violate the rules thinking that they can easily navigate the congested lanes and evade the traffic police. Ultimately, they become the victim of their own wrong-doing. If they were to strictly follow the traffic rules and avoid over-speeding, deaths related to road accidents could be minimised to a great extent. The death of youngsters is not only a great tragedy to the family members, but also a huge economic loss to the nation. Everybody should be careful while driving a two-wheeler.

A version of this article appears in the print on August 22, 2022 of The Himalayan Times.