Latest / Health Wealth / Formula Milk vs Breastfeeding: What Hospitals Won't Tell You ft. Dr Arun Gupta | Sonal Mehrotra Kapoor | Doctor vs Internet

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Formula Milk vs Breastfeeding: What Hospitals Won't Tell You ft. Dr Arun Gupta | Sonal Mehrotra Kapoor | Doctor vs Internet · Health Wealth

0:00
Speaker 1: This is India Today Podcasts.
0:07
Speaker 2: Hello, I'm Raj Chengap of India Today and your host
0:10
for Nothing But The Truth. Every week, I'll bring you
0:16
insights and clarity on a major topical issue that matters
0:19
to you without holding back on the truth.
0:27
Speaker 3: The Himalayan catastrophe in Nepal last week has already left
0:33
over 1,200 people dead and close to 5,000 people still missing.
0:42
We all watched the horrific clips of nature's fury as
0:47
the high-speed torrent of rock, ice, mud and water, that
0:52
black monstrous looking thing, flew at tremendous speeds and destroyed
0:59
border checkposts, roads, bridges and power projects as if they
1:05
were mere toys. Even while rescue and relief work continues
1:10
in Nepal, let's be clear, the warning to India is unmistakable.
1:18
What happened across our border can happen in India and
1:23
unfortunately very soon. In fact, versions of that tragedy have
1:29
happened here already, and we need to be absolutely.
1:33
Speaker 4: Cautious and also heed the warnings.
1:37
Speaker 3: So in this episode of Nothing But The Truth, we
1:40
will look at just how high the risk of such
1:43
catastrophic glacial and bedrock floods are for India, where are
1:49
the danger zones, and what we all need to do
1:54
to minimize the impact.
1:57
Speaker 4: But first, let me talk about.
1:59
Speaker 3: The scale of India's vulnerability. Now, the Indian-Himalayan region stretches
2:04
roughly 2,500 kilometers across 13 states and union territories. And
2:10
this is from Ladakh in the west, of course, Jammu
2:13
and Kashmir you can add, to Arunachal Pradesh in the east,
2:17
and a global study published in Nature recently estimated that
2:22
about 3 million people in India live in areas directly
2:26
exposed to glacial lake outburst floods, which apparently is the
2:32
highest national total anywhere in the world. That is how
2:36
vulnerable that population is. It's one of the largest in
2:40
the world. But let's not forget that apart from that,
2:44
the hills themselves support.
2:45
Speaker 4: Close to 50 million people.
2:47
Speaker 3: And if you look, There is another estimated 500 million
2:51
people of us depended upon the Indus, the Ganga, and
2:55
the Brahmaputra systems that rise in the Himalayas, and we
2:58
depend on it for water, power, and farming, apart from
3:02
other things. So now let's talk a bit, and by
3:05
the way, that 500 million is about a third of
3:07
India's population. And let's look, therefore, at this vast Himalayan region,
3:15
and why it falls to such a Why does it
3:20
fall victim to such massive tragedies?
3:24
Speaker 4: Now, when we hear about a glacial.
3:26
Speaker 3: Disaster, we usually imagine a lake on top of a
3:30
mountain swelling until its natural dam burst. That is known
3:35
by the technical term GLOF, or G-L-O-F, or Glacial Lake
3:42
Outburst Flood. Now, these happen as the glaciers shrink largely
3:48
because of global warming, leaving behind a depression at its front,
3:53
which is filled normally with meltwater. Now, these invariably form
3:58
a lake because a dam made of rock and debris
4:02
called moraine blocks.
4:05
Speaker 4: The water from flowing down.
4:08
Speaker 3: Then, as water fills up in the lake, the dam
4:11
could breach because of various reasons, a landslide maybe, falling glaciers,
4:17
which will throw huge amounts of chunks of ice on
4:20
that and make the lake overflow or hit the dam
4:23
and break it, or even an earthquake. Then you would
4:27
see tons of ice and water come crashing down at
4:30
the valleys below. But the danger is wider as climate
4:36
change is taking its toll on the snow-picked mountains of
4:39
the Himalayas. And let me talk about that also. Because
4:43
retreating glaciers not only cause large lakes, But as the
4:47
ice withdraws, it removes support from adjoining slopes, which is
4:51
a process called de-buttracing. Now, there's a thing called permafrost
4:57
that experts say acted like cement inside a fractured rock.
5:02
And this begins to thaw because of the change in temperatures.
5:07
Melt water and freeze thaw cycles widen the cracks. And
5:12
a mountain face that looked permanent can suddenly become extremely
5:17
mobile or weak. Now, global warming, in fact, has started
5:23
warming permafrost on the bedrock of many of these mountains,
5:26
and these can cause entire mountain sites to collapse, as
5:30
we saw in Nepal recently. Apparently, a ledge, a mountain ledge,
5:37
the bedrock, the size of 10 cricket stadiums, broke off
5:43
And with it, the glacial ice and water came tumbling
5:46
down a gorge of over, no one knows the estimate,
5:49
they say close to 2,000 to 3,000 feet, causing even
5:55
a mini earthquake. Now, the speed at which water and
5:58
debris moved down the valleys of Nepal was over 180
6:02
kilometers per hour. Now normally 180 kilometers per hour is
6:07
the speed a.
6:08
Speaker 4: Jet aircraft, a civilian jet aircraft needs to take off.
6:12
Speaker 3: That's the kind of speed the water was rushing at
6:16
down the valleys of Nepal. It washed away towns and
6:21
villages right down up to 40 kilometers downstream. Now just
6:27
look at how many vulnerable glaciers and glacial lakes that
6:32
India has. Let's just estimate that. The Central Water Commission
6:36
is monitoring close to 2,485 glacial lakes, which are larger
6:42
than 10 hectares across the Himalayan River basins connected to India.
6:48
In 2025, last year, after Indian agencies assessed 189 high-risk lakes,
6:55
they classified 56 of them as very high-risk because of
7:00
both the chance of an outburst or gulf And of course,
7:04
what lies downstream and the damage that it could cause. Apparently,
7:11
the lakes are also changing in size. The Indian Space
7:14
Research Organization using satellites examined 2,431 large Himalayan glacial lakes
7:22
and found that 676 had expanded significantly. between 1984 and 2023.
7:31
Of these, 130 of them are inside India, 130 are
7:36
inside India. And most strikingly, 601 of those expanding lakes
7:41
of that 676 that I talked about had more than
7:45
doubled in area. And just to give an example, the
7:48
Gepang Ghat Lake in Himachal Pradesh grew by as much
7:52
as 178% between 1989 and 2022. If you just do
7:58
a Google search, you will see the pictures and you
8:00
will see how big that particular glacial lake is and
8:04
the danger it could cause if it broke and tumbled down. Now,
8:10
these lakes actually, if you look, they might look like
8:14
abstract blue dots on a satellite image, but many contain
8:19
millions of cubic meters of water. Some estimates are that
8:23
the amount of water that fell down from Nepal on
8:25
that particular day, just that day, could be one month's
8:31
supply of Delhi's water for its citizens here. So that's
8:35
the amount of water that flew down one hour, two
8:38
hours that it caused.
8:39
Speaker 4: The havoc that was there.
8:40
Speaker 3: And below, as these waters rushed, are villages, pilgrimage towns,
8:45
army posts, highways, bridges, tunnels, and hydropower projects. This is
8:50
what comes in the way, even in India, as we
8:52
saw in Nepal. Now, let's also not forget that the
8:55
Himalayas provide close to 80% of India's hydropower, and they
9:00
are an estimated over 450 projects or so, power projects
9:04
that have come up in their valleys, which have, and
9:08
it's difficult to confirm these figures, but an installed capacity
9:11
of over 50,000 megawatt. Now, this is India's special vulnerability.
9:18
In these narrow Himalayan valleys, almost everything we build is
9:23
forced onto this river corridor. As we saw in Nepal
9:27
as well, all the houses and the power projects and
9:30
the border posts, all were there.
9:32
Speaker 4: The same thing in India.
9:33
Speaker 3: So whether it is the dam, The powerhouse, the tunnel portal,
9:38
the workers' colony, all these occupy that strip because otherwise
9:42
there are steep slopes on either side. This road also
9:48
hugs the river as we saw, and these towns sit
9:52
beside the road. Now, so when a surge of water arrives,
9:56
one failure feeds the next, as we saw in Nepal recently.
10:00
A bridge becomes the debris that then goes across, including
10:06
construction muck, which thickens the flow and then breaks through
10:11
bridges and others, because that's the kind of, almost like
10:14
a hammer strike that happens And if a dam is
10:18
formed or a landslide blocks the river, it then releases
10:22
another huge tidal wave of water. So you can see
10:26
how a natural hazard becomes a cascading infrastructure disaster. The
10:32
blunt warning, therefore, is political boundaries do not exist from
10:37
a mountain stability perspective.
10:40
Speaker 4: It doesn't respect sovereignty. It respects geography. This is a
10:46
clear and present danger.
10:49
Speaker 3: India has already experienced massive Himalayan disasters in the past
10:55
12 years.
10:56
Speaker 4: We had them earlier as well.
10:57
Speaker 3: But I will only talk of five of them that
11:00
show the entire range of the threat that is posed
11:04
to this country. First, let us not forget Kedarnath. In fact,
11:10
a movie was made of it, which happened in 2013.
11:13
There was exceptional monsoon rain that year. It saturated slopes,
11:18
and the release of water and debris from the Chorabari Tal,
11:22
the lake above, combined into a compound catastrophe. Close to 6,000
11:27
people were reported dead or presumed dead across Uttarakhand, and
11:32
Kedarnath showed how pilgrimage crowds, hotels, roads, and settlements concentrated
11:38
in a very confined valley can turn extreme weather into
11:43
a mass tragedy as we saw. Second is Gya in
11:48
Ladakh in 2014. Many of you all would remember that.
11:51
A moraine-dammed glacial lake failed high above the village. The
11:56
flood traveled about 14 kilometers, damaging agricultural terraces, houses, and
12:03
a concrete bridge. The human toll was limited, but the
12:07
lesson was not. that even the cold, apparently dry Trans-Himalaya
12:13
has unstable lakes and exposed.
12:15
Speaker 4: Communities to these problems.
12:19
Speaker 3: Third, Chamoli in 2021. There was no large lake waiting
12:25
to burst, but about 27 million cubic meters of rock
12:29
and glacier ice detached from the Ronti Peak and fell
12:34
roughly 1,800 meters and transformed into an extraordinarily mobile debris flow.
12:42
And the pictures of that look so similar to what
12:45
happened in Nepal recently. More than 200 people were killed
12:48
or remain missing. The Rishiganga hydropower project was destroyed and
12:54
the Thappavan Vishnugaad project severely damaged. Now, Chamoli proved that
13:01
monitoring lakes alone is not enough. And let's go then
13:04
to the fourth example, which is the South Lonak in
13:08
Sikkim in 2023. There, a rock avalanche entered an already
13:13
enlarged glacial lake and helped trigger a catastrophic outburst of water.
13:19
Roughly 50 million cubic meters of water rushed into the
13:22
T-Star system. The flood killed 55 people, left 74 missing,
13:27
and destroyed the 1,200 megawatt T-Star III dam. It was,
13:33
in many respects, experts say, a textbook cascade. There was
13:37
a glacier, there was lakes, There was flood, a dam,
13:41
and downstream communities all linked in one tragic corridor. The
13:47
fifth example, and that is the most recent, it happened
13:49
last year in Dharali in Uttarakhand, and the scientific analysis
13:55
now points to the collapse of an exposed high-altitude ice patch,
14:01
which mobilized water, soil, and rock into a debris-laden flood
14:06
down the Kheergaad channel Dharali was initially described as a cloudburst.
14:12
Its deeper lesson is more unsettling. And experts say warming
14:18
is a revealing, unfamiliar, what they call cryospheric hazards that
14:23
conventional warning systems may not even be designed to detect.
14:28
So these five had different triggers and different landscapes, but
14:33
the same recurring pattern. Unstabilized and rock above, people and
14:38
critical infrastructure below, and very little time in between for escape.
14:44
And therefore, the damage to lives is quite enormous.
14:48
Speaker 4: In these incidents.
14:50
Speaker 3: So where, then, is the risk most acute in the
14:54
Indian Himalayas? There are six danger zones India must watch.
15:00
And let me talk a little bit about each of them.
15:02
Number one is Sikkim, which I mentioned earlier, and the
15:05
Dista Corridor. right into northern West Bengal. The South Lonok
15:11
has already shown the scale of the danger. Other growing
15:15
lakes in the region, steep slopes, and a chain of
15:18
hydropower assets remain above densely occupied valleys. A surge that
15:24
begins in North Sikkim does not stop at the state line.
15:28
It travels towards the Darjeeling Hills and the Bengal Plains.
15:32
So there is a whole vulnerable population a corridor that
15:36
could cause damage if we don't watch out.
15:39
Speaker 4: Number two is Uttarakhand.
15:41
Speaker 3: This may be India's most dangerous combination of unstable high
15:44
mountains and heavy human exposure. Now the Alaknanda, Dauliganga, Bhagirathi, Mandakini,
15:52
and Kali Sharda systems carry pilgrimage routes, towns, we've all
15:58
stayed there, hotels, highways, tunnels, and power projects.
16:03
Speaker 4: We've seen all of that. And in 2026, a study showed.
16:07
Speaker 3: That there were as many, it actually mapped 219 hanging
16:12
glaciers in the Alaknanda basin alone. The threat here is
16:16
not only a bursting lake, it is suspended ice, falling rock,
16:20
and a valley floor already crowded with people. Just try
16:24
going up during Charadam and you'll have a traffic jam
16:28
that rivals Mumbai or any other major city. I got
16:31
stuck once for three hours when I was just going
16:33
from the Rishikesh, I mean, from the Dehradun.
16:37
Speaker 4: Airport to Rishikesh.
16:39
Speaker 3: Number three in this danger zone, as we're calling it,
16:43
is Himachal Pradesh, especially the upper Sutlej and its Baspas, Pithi,
16:48
and Parvati tributaries. The gorges are steep, the lakes are changing,
16:54
and hydropower and road infrastructure sits directly below. Now, the
16:59
Sutlej also enters India from Tibet. That means the first
17:03
warning of an upstream collapse may have to come, have
17:06
to cross an international border before the flood does. That
17:10
is something I'll talk to you a little later about,
17:12
but let's look at number four, which is Ladakh and
17:15
Jammu and Kashmir. Here, population density is lower, but exposure
17:20
is concentrated. You have villages, you have tourism facilities, strategic roads,
17:25
and military installations that occupy the Indus Sanskar area.
17:29
Speaker 4: Siok, Nubra, and the Chenab valleys.
17:33
Speaker 3: Now, communication is thin and alternate escape routes are few
17:38
in that place. In fact, Ladakh showed that a remote
17:43
lake can release a damaging flood. A raucous avalanche or
17:47
temporary river blockage could be much.
17:50
Speaker 4: Much harder to anticipate.
17:52
Speaker 3: And finally, number five is Arunachal Pradesh and the upper
17:56
Brahmaputra system. This is among the least studied and potentially
18:02
the most consequential regions. Now, the hazards lie within Arunachal,
18:07
while enormous headwater catchments lie across the border in Tibet.
18:12
Hydropower development on the Siang, Subansiri, and the other rivers
18:18
raises the stakes. A major surge can reach Assam, carrying
18:22
boulders and sediment capable of damaging bridges, barrages, and settlements.
18:28
Speaker 4: Far from the glacier.
18:30
Speaker 3: And I'll put number six, though it's not technically in India.
18:34
Number six is the border blind spot itself. The headwaters
18:39
of the Indus, the settlement in the Brahmaputra, and several
18:42
tributaries of the Ganga lie in China, Nepal, or Bhutan.
18:47
India cannot place, let's put it that way, a sensor
18:50
everywhere beyond its frontier. Yet Bihar, as we've seen, Assam,
18:55
Northern Bengal, and other downstream regions, can feel the consequences
18:59
of a high mountain event combined with monsoon rain, landslides,
19:03
or embankment failures. Now, let us then look at the
19:09
big question, and these are the solutions. What must India
19:14
do to minimize the impact? The answer, of course, is
19:19
not in one grand engineering project. There's no way you
19:22
can do it in the Himalayas. It's such a massive project.
19:26
stretch of mountains and with its difficulties of access and
19:31
the height, the enormous height that it rises to and
19:36
the difficulties it poses for any sort of work. But
19:41
I will then, let's go down the points as to
19:44
how we can build several layers of defense if we
19:49
really plan it properly.
19:50
Speaker 4: Starting immediately.
19:51
Speaker 3: A lot of these things have happened, but let me
19:54
get into the details. First, we need to map the
19:58
whole hazard chain of mountains, replace a static list of lakes,
20:04
which we normally try and do and say, okay, these
20:06
are the many lakes. What we need is a living
20:09
catchment-level atlas. We need to track expanding lakes, hanging glaciers,
20:15
unstable rock surfaces, permafrost thaws, avalanche paths, possible river blockage sites,
20:23
and everything exposed downstream. That's the range we should have.
20:27
And satellite radar can see movement even through cloud. But
20:31
there's also optical imagery, drones, and field teams that can
20:35
add to the detail. The risk maps, as we call them,
20:38
must guide public planning, not remain buried in technical reports.
20:43
Speaker 4: That are there. So that's very important.
20:45
Speaker 3: We must have this major risk atlas updated constantly. It
20:49
is not we build it every year and say, okay,
20:51
now we'll see what next year. It has to be
20:52
done in real time, and there should be checks to
20:56
ensure that happens. Second, we need to build a genuine
21:01
end-to-end early warning system. you know, not just a gauge
21:06
beside a lake. That is not a warning system. India
21:09
needs water level and river flow sensors, cameras and seismic
21:13
instruments from the source down to the valley. For if
21:17
an avalanche begins on, or a river suddenly changes, alert
21:21
should move automatically through redundant links to control rooms, dam operators,
21:26
police and communities. So there must be this automatic system
21:30
that you have where instantly, as soon as there is
21:34
danger of a collapse or collapses happen, these sirens go around,
21:39
it's automatic, it's not switched on by any operator, and
21:42
goes right through all the regions that could have, be
21:47
vulnerable to the kind of impact such outbursts of floods
21:53
and other things could happen. And so that comes to
21:55
the third point. Turn every warning into a rehearsed evacuation.
22:02
You can't just say that the siren goes and people
22:05
don't know where to go. They will be running helter-skelter,
22:08
as we saw in those very sad visuals that were
22:11
coming out from Nepal. What you need to do is
22:14
mark routes to high ground, run day and night drills. Remember,
22:18
even in offices, we have these fire drills. We must
22:21
take them seriously. And therefore, residents, schools, pilgrims, tourists, the police,
22:27
And the power project workers should know where are these
22:31
areas that they could escape to. And you should decide
22:34
in advance who sounds the siren in that village, who
22:38
closes the road, who shuts the project, and who helps children,
22:42
older people, and persons with disabilities.
22:44
Speaker 4: So a community is then....
22:48
Speaker 3: Equipped in many senses to react in real time, because
22:51
as you've seen, you may get only 10 minutes, 15 minutes,
22:54
but the good thing about these mountains is that if
22:58
you go a little higher, you're more likely to escape
23:00
the flood, as you have seen. As you saw in
23:03
many of them, where people moved to the high ground
23:05
very rapidly, they were not impacted by the onrushing water
23:12
that was there. Now let's look at the fourth aspect
23:16
of what we can do to minimize the impact. And
23:20
this is the most important, stop adding vulnerable infrastructure. We
23:24
think the hills can take anything and we put houses,
23:29
power projects, whatever it is, without too much thought. We
23:35
must have what is called multi-hazard maps which are legally
23:38
binding for land use. So new homes, hotels, hospitals, fuels, fuel,
23:45
petrol pumps and others should be mapped and ensured that
23:51
it is clear from inundation and debris flow corridors.
23:55
Speaker 4: That's very important.
23:56
Speaker 3: And you must, which you never do, and we've seen
23:59
a lot of tragedies, enforce river setbacks because you can
24:02
see these houses virtually abut the river and any overflow
24:06
just sees them collapse. Now, where an existing settlement cannot
24:10
be protected, Safer access, retrofitting should be done. And in
24:15
exceptional cases, the government could actually recommend relocation. Because I
24:23
know it's a big thing, but needs to be considered
24:26
because lives are involved.
24:28
Speaker 4: The fifth aspect of it is build. or ensure climate-proof infrastructure.
24:35
Speaker 3: Now, every Himalayan dam, tunnel, highway, and bridge must be
24:38
tested against future conditions. We've seen how these dams just
24:43
crash and are broken right down without too much of resistance.
24:50
So not only historical floods should be taken into account,
24:54
but designs must include these glacial lake outbursts that we see,
25:02
rock ice avalanches, sediment, river blockages, and cascading dam failures.
25:07
Speaker 4: This is what all these dams and.
25:11
Speaker 3: Other infrastructure projects should look at before they put up.
25:14
And the existing projects also need independent reassessment. Make sure
25:19
that there are automatic shutdown rules, there are safe refuges.
25:25
systems and alternative evacuation routes for the workers who are there.
25:29
We saw how even today a lot of the workers
25:31
were trapped in the tunnel that was being constructed for
25:34
a hydropower project in Nepal.
25:36
Speaker 4: We've seen other problems in India as well.
25:38
Speaker 3: Now let's move to the sixth, which is, there is
25:41
a very interesting way of lowering the water levels in
25:45
a limited number of accessible dangerous glacial lakes. And this
25:51
can be done by very common engineering techniques like using siphons, pumps,
25:56
or controlled outlet channels that can reduce the volume available
26:00
for an outburst.
26:01
Speaker 4: This, of course, is a specialized work, not a universal cure,
26:05
and is expensive.
26:06
Speaker 3: But wherever we see a lake building, you can create
26:10
those channels of water so you get a regular flow
26:12
and it diffuses and doesn't become like a large dam
26:16
collapsing and coming. The seventh solution is create automatic cross-border
26:21
data sharing with Nepal.
26:23
Speaker 4: Bhutan, and China. I had mentioned this earlier.
26:26
Speaker 3: It's very, very important because many of these, as we
26:30
saw in Nepal, the incident happened in Tibet. The mountain
26:34
slope collapsed in Tibet, but Nepal faced the brunt of it.
26:37
So we need information about lake levels, rainfall, river discharge,
26:41
seismic signals, and barrier lake alerts. And these should be
26:45
directly passed between control rooms under protocols that even when
26:51
there are political relations that are strained, as we've seen
26:53
between India and China many times, or India and Nepal,
26:56
these continue to function without interruption.
27:00
Speaker 4: That is the key.
27:02
Speaker 3: And finally, and this is something that we all need
27:06
to do across the country, is slow the warming that
27:11
is intensifying the dangers. And that we've seen temperatures rise,
27:16
and the recent reports are showing that we are crossing
27:19
that tipping point. It's important that we cut greenhouse gas emissions.
27:23
And this is a long-term task, but India fortunately has
27:27
moved down that line. And we could also reduce near-term
27:31
regional heating by controlling black carbon from diesel, brick, kilns,
27:37
biomass burning, and poorly managed construction. A lot of these
27:41
black carbon go and sit in the rocks and the
27:44
snow of the Himalayas and they absorb heat. In fact,
27:47
snow temperatures in Himalayas, many parts of the Himalayas have
27:51
actually shown a dangerous increase apart from the overall rise
27:55
in temperature. So all this will not remove today's risk,
27:59
particularly these greenhouse gas reduction, but it can slow the
28:06
growth of tomorrow's tragedy in terms of the way Himalayas
28:10
has been going. The good news is that India has
28:13
made a start. It has satellite inventories, field expeditions. It
28:18
has a national GLAWF risk mitigation program and a new generation.
28:25
Speaker 4: Of early warning technology under test.
28:29
Speaker 3: But there remains a dangerous gap between seeing a changing
28:34
lake from space and mapping it and moving a family
28:39
uphill in time, we must have very strict monitoring of
28:46
mountain systems, regulate entire valleys, and prepare communities to evacuate
28:52
rapidly in an emergency. Nepal's catastrophe was a warning from
28:59
the roof of the world, as we call it. India
29:02
must treat it as a deadline. That is nothing but
29:06
the truth. Thank you for being with me in this
29:08
episode of Nothing But The Truth. I look forward to
29:11
having you with me next week.
29:30
Speaker 5: Thank you.
38:16
Speaker 1: This is India Today Podcasts. Hello and welcome.
38:21
Speaker 4: This is Dr.
38:21
Speaker 1: Boss's Internet.
38:23
Speaker 5: I am particularly very, very humbled with the guest we
38:28
have for you on the podcast today.
38:31
Speaker 1: He is a pediatrician.
38:33
Speaker 5: He's a pediatrician who left his very flourishing practice. He
38:38
had a 30-bed hospital. He left that practice to fight
38:43
for the children of the country. He fought, I won't
38:48
take his name because that case is still going on,
38:51
but he fought the biggest food company, not in India,
38:55
but in the world, to protect the health of kids
38:59
and children of India. It's because of him that companies
39:05
cannot advertise formula milk in India.
39:09
Speaker 1: That law is now in place.
39:12
Speaker 3: It is.
39:13
Speaker 5: because of doctors like him, that my trust in doctors
39:17
has risen. So I'm very, very delighted to have Dr.
39:22
Arun Gupta here with us on the podcast.
39:24
Speaker 6: Thank you so much.
39:25
Speaker 1: Thank you so much.
39:26
Speaker 6: This is a pleasure meeting you as well as being
39:30
on this podcast. I love this work.
39:34
Speaker 5: I am sure you do because nobody can work like you.
39:38
If I go out and talk to a doctor and
39:40
tell him that you will leave your flourishing practice and
39:43
run an NGO of six people and fight for it
39:48
for 20-30 years, I don't think I will get anyone else.
39:51
Speaker 7: It's difficult, but there are people. The world is full
39:55
of people who have.
39:58
Speaker 6: To do something or the other. So I am one
40:00
of them.
40:01
Speaker 7: So we decided To do this way because medicine doesn't
40:06
mean that you have to be clinical.
40:08
Speaker 6: Yeah. Medicine and especially pediatrics.
40:12
Speaker 7: If you look into the history of pediatrics, 90% and
40:15
above pediatrics is actually preventable pediatrics.
40:17
Speaker 1: Yeah.
40:18
Speaker 7: So that teaches you a lot when you are a student.
40:21
So probably that thing stayed with me.
40:25
Speaker 4: Hmm.
40:26
Speaker 6: And I had to jump into this work.
40:28
Speaker 5: We will talk about your life journey today.
40:31
Speaker 1: How did you decide to.
40:32
Speaker 5: Start an initiative against infant formula milk? How did you
40:37
take these big companies to the Supreme Court? How did
40:42
you enforce new laws? But first of all, for our
40:46
audience who is very aware, health aware, wants to do good,
40:49
just doesn't know how.
40:50
Speaker 1: Tell them first that... What is the problem in formula milk?
40:57
Speaker 7: I think the formula milk per se, if it is
41:01
powder milk, the problem is that the powder milk is
41:06
not sterile. WHO did this analysis in 2005-2006 and found
41:13
that it is not a sterile product by the processing itself.
41:17
Its processing is such that whatever animal's intestines travel some bacteria,
41:22
they remain dormant.
41:25
Speaker 6: When we mix it in water, it starts to flourish.
41:29
Speaker 7: Then after that, WHO issued a guidance that in an
41:33
hour or two, once you have dissolved the powder, after that,
41:40
it is good if you do not use it. But
41:43
if you are doing it, like it happens sometimes with
41:45
the family, with the mother, if you are in work,
41:48
you go from here to there, then you keep the
41:51
bottle here.
41:52
Speaker 6: So after an hour, they gave him the same. So
41:54
there is an amount of.
41:56
Speaker 7: Risk which increases for getting an infection. And that too
42:00
very deadly infections, particularly in the newborn babies. So that
42:05
was the alert WHO issued in 2006-2007 to alert that
42:10
this is not a sterile product. And throughout the world,
42:13
the advisories went out to the pediatricians, neonatologists, that if
42:17
you use it in nurseries, if you dissolve.
42:18
Speaker 6: It once, then... So per se, the problem.
42:23
Speaker 7: Is not mostly with the formula itself, but it's bad marketing.
42:27
Speaker 6: So what we.
42:28
Speaker 1: Thought was the bad marketing part. This is an awareness issue.
42:52
Speaker 7: That the formula is bad or not, because the bottle
42:55
comes in the middle, then hygiene issues come.
42:57
Speaker 6: Those things are necessary.
42:59
Speaker 7: I mean, nowadays we believe that people are aware of that,
43:04
that safety... I think that safety issues are very important,
43:09
but no one knows the inherent contamination. We will clean
43:11
the bottle, but it is not ensured that we remember
43:17
that someone told us.
43:17
Speaker 6: I don't think that... There has been an advisory issue
43:20
here as well.
43:21
Speaker 1: Sir, even doctors don't tell.
43:22
Speaker 7: No, even they don't know. If they are given an
43:25
advisory issue, then they will know. So the industry is
43:30
so powerful, it doesn't let any work happen. This is
43:33
a worldwide known fact. So they don't want to know.
43:37
Just now, you see how many news are coming from
43:39
the USA. When the formula had to be recalled, the
43:43
children got sick.
43:44
Speaker 3: Yes.
43:48
Speaker 7: But now there are two more companies. Now it has
43:50
been fined, it has been severely fined in America. But
43:53
they didn't tell us that children can get sick. There
43:58
are very serious diseases, like necrotizing and pterocolitis, which is
44:04
a very technical term. But it's a very deadly disease.
44:07
So because of that, the case that the mother did,
44:11
whose child died, she said, she didn't tell us. If
44:13
she had told us, we wouldn't have given it to her.
44:17
Whether the risk is 1% or not, whether it is 0.1%,
44:22
you should tell them.
44:24
Speaker 6: That comes under bad marketing. So in marketing, you tell that.
44:27
Speaker 7: The child's brain will grow, his eyes will become sharp,
44:33
his body will become good, he will become smart.
44:36
Speaker 6: You add some claims. Because selling is more than necessary
44:39
for them.
44:43
Speaker 4: So, there.
44:43
Speaker 5: They don't tell you what not to do with it.
44:46
Speaker 6: What not to do. Transparency. Transparency is not there. Then you.
44:51
Speaker 7: As much as the need is, that is fine. But
44:54
you should not create an extra need. That is not
44:58
logical and ethical.
45:01
Speaker 1: But Dr.
45:02
Speaker 5: Arun, if we talk about today, then today's Friday, and
45:05
this is not just Delhi, Bombay's problem, it happens in
45:09
places like Kanpur, Lucknow too, that.
45:12
Before you have even held your baby, before you have
45:17
even understood what is happening, somebody else is taking a
45:21
call that your child, the first thing that they have
45:25
when they enter this world will be formula. Without asking you,
45:29
if there is a cesarean mother, her C-section has taken place,
45:32
she is tired, she is sitting, in some cases she
45:35
is still not back to her senses and all of
45:38
that etc., without asking the mother... without informing them... without
45:44
telling them... what are the drawbacks or not... hospitals are
45:48
giving the formula directly to the children.
45:50
Speaker 6: Yes, without asking, they give.
45:51
Speaker 1: Is this legal?
45:52
Speaker 6: There is no illegality in this. Because... if it is
45:57
given over medical advice... it is not illegal. But.
46:03
Speaker 7: there is a lot of ethical concern in this. That
46:07
without that... knowledge of a parent, without giving the full
46:12
knowledge of the risks involved, then you cannot call it
46:15
informed consent. So once we ran a campaign. A friend
46:20
in Mumbai, she's an engineer, she started a... The change.org
46:28
petition is still going on. One lakh people have signed it.
46:31
that at least the family, the mother, the father, anyone
46:35
should be consented to sign the formula. So I and
46:40
he have jointly run it. But the point is that
46:45
there are few people who listen. We don't have a
46:48
government to listen to. Until they do, they won't be
46:50
able to realise. So the doctors who introduce the formula
46:54
to private hospitals, there is no pressure on them.
47:01
Speaker 6: This thing.
47:03
Speaker 7: That it should be told. Probably, in hindsight, they believe
47:07
that it is fine.
47:08
Speaker 6: It is the same thing.
47:10
Speaker 5: I want to know why this is so. Doctors don't
47:13
tell about it. Nurses don't tell about it. In the ecosystem,
47:16
our mothers don't tell about it.
47:17
Speaker 7: Look, the basic fundamental flaw is that the medical doctor,
47:22
in his making, doesn't know these things. After making the doctors, Like,
47:31
it's left in the hands of the pharma industry. So,
47:34
the medicines they tell us, the whole thing is treatment-oriented. So,
47:40
in treatment orientation, the preventive part, any doctor who wants
47:45
to learn on his own, he learns. In practice, there
47:48
is no skill transfer. No, it must be written in
47:52
the study, but the thing is that so many good
47:56
skills are not being transferred in the study. Which is
48:00
better in nurses. We checked the syllabus once.
48:04
Speaker 6: Of skills. After that, the books of doctors.
48:07
Speaker 7: Whether they are gynecologists or pediatricians. They lack skill. They
48:13
are giving knowledge that breast milk is good.
48:16
Speaker 6: Even the child knows that. That breast milk is good.
48:19
If you ask anyone. No, not everyone knows. Everyone still knows.
48:22
Speaker 1: Everyone thinks that.
48:28
Speaker 5: Breast milk does not fill the stomach. The baby does
48:30
not sleep properly. Top feed will have to be given.
48:32
Speaker 6: That is another thing.
48:34
Speaker 7: What I mean to say is that when I say
48:36
good means in terms of healthy, in terms of natural,
48:40
in terms of as compared to the artificial feeding.
48:44
Speaker 6: Comparing artificial feeding. You call it artificial feeding. Yes, it is.
48:49
We have been saying it for ages. Artificial feeding is
48:51
artificial feeding. It is not non-technical. It is technically artificial.
48:57
So all the research.
48:59
Speaker 7: That has been done in the world in the 80s,
49:01
scientists were challenged to prove that breast milk is better. Right?
49:08
Speaker 6: Because, as I said, you don't have evidence.
49:09
Speaker 7: When the formula was introduced in the 60s and 70s,
49:12
no one asked what evidence do you have to introduce this.
49:16
Speaker 6: That story is repeated over.
49:17
Speaker 7: And over again on everything. When something is introduced from
49:22
the corporate world, whether it is food or pharma, no
49:27
one asks. When something is against it, then the alternative
49:34
that should come, you have to give evidence. So this
49:40
is a very big irony, because of which all these
49:44
things are not mainstream. Take medical education or higher education,
49:50
which is of pediatrics, neonatology, day by day they are
49:53
getting more technical, like gadgetry based, you know, how many
50:00
incubators are there in your hospital, how many ventilator hai,
50:04
kitne ye hai, aap uss taraf jyada high end hai.
50:08
Not that, I'm not saying they are not necessary. But
50:11
I think the medical doctor has to put his mind
50:17
into this area also in terms of preventive, which is
50:22
a very, very important thing to do.
50:24
Speaker 5: A lot of mothers gravitate towards formula milk because they
50:29
think ki, I'm not able to make enough milk.
50:32
Speaker 4: Jee.
50:32
Speaker 1: My child is hungry.
50:34
Speaker 5: My stomach is not filling up with milk. Is it
50:37
a myth that mothers can't make enough milk?
50:41
Speaker 6: This is a perception. It's a perceived risk, actually. It's
50:46
not a disease. So, what happens is, when a mother
50:51
says this.
50:52
Speaker 7: To a doctor or a health worker, then she gets
50:56
a quick answer, that take this box.
50:57
Speaker 6: He treats a disease. Right?
51:03
Speaker 7: It is a perceived risk, which is based on the
51:06
hormonal control of production and flow of human breast milk.
51:08
Speaker 6: There are two hormones in the body. One is called prolactin.
51:13
Speaker 4: Hmm.
51:32
Speaker 7: As the name suggests, it produces milk. In the breast,
51:35
there are cells. Those cells secrete, like our tears. Similarly,
51:40
in those cells, milk is made. It comes out of
51:45
small pipes and comes down. Then the cells where the
51:48
milk is being made, there are micro-muscles around them. So
51:53
they have to be pushed. Doodh ko neechay. Aap push
52:01
karne ke liye oxytocin chahiye. Oxytocin jo hai, wo jab
52:08
bachcha shuru karta hai, feed. Prolactin toh pehle se kaam
52:12
kar chuka hota hai, pregnancy se hi.
52:14
Speaker 1: Correct.
52:15
Speaker 6: Jab oxytocin.
52:15
Speaker 1: Kyunki aapke breasts enlarge hotay hain, when you are prepping up.
52:18
Speaker 7: Haan, toh wo tiari ho rahi hota hai.
52:20
Speaker 1: Third trimester se shuru ho jata hai.
52:22
Speaker 7: Ab oxytocin kaam us din shuru karta hai, jab bachcha
52:25
suckling shuru karta hai. Toh oxytocin reflex upar se chalu
52:28
hota hai, brain se release hota hai. It goes and
52:31
increases the milk. The two major differences in these two hormones.
52:37
Prolactin depends upon how much a baby suckles.
52:40
Speaker 4: Okay.
52:41
Speaker 6: Like, more suckling, more milk.
52:43
Speaker 1: Okay.
52:44
Speaker 6: So, oxytocin depends upon mother's state of mind. Ah. If
52:52
it is doubt, pain, anxiety, then oxytocin starts to depress.
52:59
Speaker 7: So if the oxytocin is less, the flow will be less.
53:02
Speaker 6: Milk is there.
53:04
Speaker 4: But it's not flowing.
53:05
Speaker 6: It's just doesn't flow well. So what is its treatment?
53:10
Building confidence.
53:11
Speaker 7: That is where the role of a lactation person comes
53:15
or a doctor or a nurse, whosoever wants to help
53:17
a mother.
53:19
Speaker 6: Building confidence during pregnancy.
53:21
Speaker 7: That milk will never be below the need of a baby,
53:26
even if they are two.
53:27
Speaker 6: That's crazy.
53:28
Speaker 7: It's a It's hard work, no doubt, even feeding one
53:33
baby exclusively.
53:35
Speaker 6: But it is possible. It is possible.
53:38
Speaker 7: And when I always say, if you don't support a mother,
53:43
if you means the whole health system, if a health
53:48
system doesn't support a mother, she is likely to fail.
53:52
Then comes the role of the family.
53:55
Speaker 6: Because this failure occurs in the hospitals. First failure.
53:58
Speaker 7: Its data is also very important. In India, 90% women
54:05
deliver in the hospitals now. But only 41% start breastfeeding
54:10
within an hour of birth.
54:11
Speaker 1: Only 41%.
54:12
Speaker 7: This is the NFHS 5 data. There is no improvement
54:14
of 6. But there is no difference between.
54:18
Speaker 6: NFHS 4 and 5 in 10 years.
54:20
Speaker 7: Till now, look, till then, If one in two women
54:27
you are not able to support, whether they are normal
54:29
or caesarean, that doesn't matter.
54:32
Speaker 6: Breastfeeding has to succeed.
54:35
Speaker 7: Caesarean doesn't mean that you have to give formula because
54:38
it was a caesarean.
54:39
Speaker 1: No, but this is the myth. People think because it's
54:41
a caesarean, you have to give formula.
54:43
Speaker 6: The health system makes them believe.
54:44
Speaker 7: From there, the family feels that the mother may be tired,
54:50
she needs rest.
54:51
Speaker 6: We are not saying that. But the... So there are possibilities.
54:56
Speaker 7: So the condition is that she should be well supported.
55:02
Speaker 6: Automatic.
55:02
Speaker 7: That's also fine. Just giving a message is also fine.
55:27
But that is not enough.
55:29
Speaker 1: So what should be done?
55:29
Speaker 6: To make it successful.
55:31
Speaker 1: Tell me a scenario.
55:32
Speaker 5: If mothers are watching this, who are expecting, who are
55:36
trying to deliver, they feel that if a C-section is done,
55:39
then they will get the formula.
55:40
Speaker 1: You are saying that this is not the case.
55:41
Speaker 4: No, it is not.
55:42
Speaker 1: So what is the method?
55:44
Speaker 7: The method is that, let's say during pregnancy, I think
55:48
either the mother or the family, mother, father, any family member, they.
55:53
Speaker 6: Should learn these things. that what is this.
55:59
Speaker 7: Now our site, Breastfeeding Promotion Network of India, we have
56:02
made two, three minutes, six video modules for this.
56:08
Speaker 6: These types of things.
56:09
Speaker 1: How to breastfeed?
56:10
Speaker 7: Yes, there are six videos. There are all the elements
56:14
that should come for success. Which includes cesarean section, which
56:18
includes how to express breast milk, which includes why should
56:21
you breastfeed, which includes if the baby... So I decide
56:26
for feeding my baby. Nobody else. So you get the power.
56:43
You get the knowledge and you get the power. So
56:46
this is a message for the mothers.
56:47
Speaker 5: So the doctor will not decide. The nurse will not decide.
56:49
The hospital will not decide.
56:51
Speaker 1: I will decide.
56:52
Speaker 6: I will decide.
56:52
Speaker 1: If I want to feed my child.
56:54
Speaker 6: Yes.
56:55
Speaker 7: And for that, if a mother, I bet if a
56:57
mother sees those six videos and in addition, if she
57:02
wants to read, half an hour, we have a small
57:05
booklet on our website.
57:08
Speaker 6: Guide for parents.
57:10
Speaker 1: I'll put those links for everybody to read.
57:11
Speaker 6: It's available in nine languages.
57:13
Speaker 1: Yeah.
57:14
Speaker 3: Right?
57:14
Speaker 6: So any mother can read that.
57:16
Speaker 1: But I don't understand.
57:17
Speaker 5: If you have come out of C-section, you haven't regained
57:22
consciousness in post-op, then how will you breastfeed?
57:25
Speaker 6: I'm coming to that.
57:27
Speaker 7: This is a preparation during pregnancy. Preparation is done. So
57:31
you prepare your questions.
57:34
Speaker 6: Support.
57:35
Speaker 7: So you tell your health system, That I want to breastfeed.
57:39
Speaker 4: Right?
57:40
Speaker 6: So, this is your next step as a mother. So,
57:43
you need to tell the doctor attending on you. There
57:46
are gynecologists.
57:48
Speaker 7: And if there is a cesarean, then the rest are anesthetists.
57:53
Speaker 6: You have to declare your intent.
57:55
Speaker 4: Okay.
57:56
Speaker 7: That I want to breastfeed. Kindly arrange whatever support system
57:59
you have. Somebody by the side who.
58:02
Speaker 6: Can help me. They will do this as soon as
58:04
the baby is born. Hmm.
58:07
Speaker 7: After birth, there is a very important step. Not just breastfeeding.
58:11
It is said that in an hour, you should initiate.
58:13
It is not necessary that the baby starts drinking quickly.
58:17
You have to bring the baby here. When the baby
58:21
is born, you have to give him skin-to-skin contact. Sweden
58:27
had demonstrated many years ago. If you put the baby
58:30
naked on the naked mother's chest, the baby crawls to
58:34
go to the breast. You know, nature tells them where
58:43
to go. Maybe they were thinking there is a smell there,
58:46
the baby gets that.
58:47
Speaker 1: Yeah, yeah, they can smell it.
58:49
Speaker 6: So the baby reaches, catches the nipple.
58:51
Speaker 7: What I mean is that somebody should assist bringing this baby.
59:05
Helping the mother to start initiating that process. She can
59:10
lie down after the caesarean.
59:13
Speaker 1: Even if she's unconscious?
59:15
Speaker 6: No, unconscious is very rare.
59:17
Speaker 7: In the caesarean section, the mother is not unconscious.
59:22
Speaker 6: Even if she is, let's say....
59:27
Speaker 7: When the effect of general anesthesia ends, we say, start
59:30
at the same time.
59:31
Speaker 6: So in an hour or two, it also ends.
59:35
Speaker 7: We are saying that keep the mother lying down. Keep
59:39
her lying down like this, straight. The child can drink
59:43
from above. If she wants to turn, she can turn
59:45
and drink. It is not necessary to sit at that time.
59:48
That you have to sit and drink, you have to
59:51
take a particular posture. It does not happen like that.
59:53
The child can drink from above. So we have seen
59:57
it many times. In our hospital where I used to work,
1:00:01
we used to do it. It was possible. We have
1:00:04
just started a program. I will give you the data.
1:00:09
We started making breastfeeding friendly hospitals 2-3 years ago. We
1:00:15
said you need accreditation from us. So these are 18 points.
1:00:21
We will assist you.
1:00:22
Speaker 1: How many hospitals are there in India?
1:00:24
Speaker 5: 85.
1:00:24
Speaker 6: Wow. Do you have a list? Yes, our website. Will
1:00:28
you give.
1:00:29
Speaker 1: It to us?
1:00:29
Speaker 6: Yes, I will.
1:00:30
Speaker 1: All breastfeeding mothers should know.
1:00:32
Speaker 6: Friendly hospitals.
1:00:33
Speaker 1: Yes, breastfeeding friendly hospitals.
1:00:35
Speaker 7: We are telling other patients to come. It's a voluntary thing.
1:00:39
But we help you technically. We help you what you
1:00:42
need to change. Small little changes. And things take turn.
1:00:48
And they take turn for a permanence.
1:00:50
Speaker 6: Permanence.
1:00:51
Speaker 7: The changes come in such a way that they don't change.
1:00:54
They say, put in a tradition. It's very difficult to break.
1:00:57
So now the tradition is of formula feeding.
1:01:01
Speaker 6: We want to break it and put in a tradition
1:01:04
of breastfeeding.
1:01:04
Speaker 5: How did this formula feeding tradition come about?
1:01:08
Speaker 7: This came from bad marketing. This is from the olden days.
1:01:15
I remember this. In the 70s, in the USA, Marketing
1:01:22
in the 60s, 70s, there was a lot of marketing.
1:01:25
So there were a lot of protests. That this should
1:01:28
be stopped. In those days, there is an incident documented
1:01:33
in a book called Breastfeeding Politics.
1:01:37
Speaker 6: Politics of Breastfeeding. It's an English author. She wrote that.
1:01:42
Speaker 7: She has documented that Abbott offered architectural assistance to hospitals.
1:01:49
Speaker 6: And separated mothers and babies.
1:01:52
Speaker 4: Wow.
1:01:53
Speaker 6: Crazy. It's only now the U.S.
1:01:55
Speaker 7: Has started changing that they are doing the delivery in
1:01:58
the same room where you are doing. You are not
1:02:01
even taken to a labor room. There are many hospitals
1:02:04
in the U.S.
1:02:05
Speaker 3: Now.
1:02:05
Speaker 6: The call is on. LRDP, labor delivery resuscitation.
1:02:24
Speaker 5: Hmm.
1:02:24
Speaker 7: Hmm. Hmm.
1:02:25
Speaker 5: Hmm.
1:02:25
Speaker 4: Hmm.
1:02:26
Speaker 6: Hmm.
1:02:26
Speaker 3: Hmm.
1:02:48
Speaker 7: So, these things about marketing, they have a very old
1:02:53
history of marketing. Because of which, Kennedy once, in the U.S. Senate,
1:03:00
Senator Kennedy, in 1978, he did a Senate hearing on
1:03:07
formula marketing. Is that available? What did he say? He
1:03:13
called all the scientists, he also called Nestle and others.
1:03:19
When I asked Nestle, tell me.
1:03:23
Speaker 6: Is it right? Do you take responsibility?
1:03:26
Speaker 7: If there is a poor community, they are feeding you
1:03:32
milk and getting sick.
1:03:34
Speaker 6: Do you have any responsibility or not?
1:03:36
Speaker 7: When you do marketing, they say, no, we have no responsibility.
1:03:41
They don't know how to make it. They don't give
1:03:43
water properly. The government doesn't give water properly. So he said,
1:03:49
we don't have any responsibility, we are fine. So this
1:03:53
marketing was so strong in those days. We are aware
1:03:59
that he called up the director general of WHO at
1:04:01
that time and asked him, find an international solution to
1:04:05
this problem. And that's how in 1981, WHO, World Health Assembly,
1:04:12
a code of marketing was passed. International code of marketing
1:04:16
of breast milk substitutes Based on which the whole world
1:04:19
is now struggling to construct laws, which India did in 92. So,
1:04:23
the history of marketing is very long. There is so
1:04:29
much documentation. It is a global organization.
1:04:32
Speaker 5: Because it will be more than 10 years old.
1:04:36
Speaker 1: In fact, I think... 90s when I was growing up.
1:04:42
Speaker 5: I think at that time also this had already started
1:04:44
that mothers had started feeling that at night give a
1:04:48
top feed to the child so that he sleeps well.
1:04:51
Then came the era when they said oh if you
1:04:53
want a healthy baby then this is great for you.
1:04:56
Then there came a phase where they said okay let's
1:04:59
start expressing let's start pumping milk and let's start you
1:05:03
know giving that to the child as well.
1:05:05
Speaker 1: So how is this phase going on? Like what is
1:05:08
happening behind the scenes?
1:05:10
Speaker 7: When I was practicing in Jalandhar, I used to see
1:05:16
60-70 patients from morning to evening. I used to start
1:05:22
at 9 in the morning. I used to see 60-70
1:05:24
patients till 5 in the evening. There used to be
1:05:27
a lot of small children of 2-3 months. So I thought,
1:05:31
there are so many diseases coming. I mean, doctors get diseases.
1:05:36
But I was finding that preventable illness, like diarrhea or
1:05:40
This kind of diseases were increasing.
1:05:43
Speaker 6: So I started taking their history. So gradually I came
1:05:46
to know.
1:05:47
Speaker 7: Almost everybody had a powder milk in their hands. Then
1:05:54
I thought, let's document it. I conducted an interview of
1:06:00
100 mothers. I found that they were all 2 to
1:06:03
3 months old. Those who were 2 to 3 months old,
1:06:07
I interviewed 100 mothers. There were 10 to 15 questions.
1:06:11
When I asked, ultimately I got to know. There were
1:06:14
17 hospitals in Jalandhar in those days, which catered for
1:06:17
maternity services.
1:06:18
Speaker 6: They were born somewhere in 2017.
1:06:20
Speaker 7: And everyone was given a box, as you were saying
1:06:22
a little while ago, why it is given in hospitals.
1:06:27
So that box was given to them in hospitals.
1:06:36
Speaker 6: As a medical advice.
1:06:37
Speaker 7: That you have to give this.
1:06:41
Speaker 6: Doctors also felt that their milk does not come completely.
1:06:44
Mother's card. So they were giving. Now hygiene is not
1:06:47
explained by anyone. Nor did anyone have time. Then I
1:06:50
went and did investigation.
1:06:52
Speaker 7: If you used to buy 5 boxes, you used to
1:06:57
get 5 free.
1:06:58
Speaker 6: One was also getting.
1:06:59
Speaker 4: In hospital?
1:06:59
Speaker 7: Yes.
1:06:59
Speaker 6: If you have.
1:07:03
Speaker 7: From anywhere, if you consider my hospital, as a doctor,
1:07:07
if I used to buy five boxes of lactogen, this
1:07:09
was the story of lactogen, so I used to get
1:07:13
five free.
1:07:14
Speaker 1: From the company, from Nestle?
1:07:16
Speaker 6: Yes.
1:07:16
Speaker 7: I bought it and created evidence in those days. So
1:07:21
then I told all my Indian Academy of Pediatricians, Muthira,
1:07:24
now see what is happening. So ultimately, I am telling
1:07:30
you about the 80s, this is from 1983. So, Till 1996,
1:07:37
free supplies were going on globally. In 1996, the international
1:07:42
pressure increased. Then it went to the UN. Then it
1:07:46
went to the free supplies. All the marketing was not stopped.
1:07:52
It's still going on. It's not a new thing. Companies
1:07:55
don't leave marketing and advertisement. Wherever there is a chance
1:07:59
to increase sales, they do it.
1:08:01
Speaker 6: It's their job. Because their job is not to give
1:08:05
you health. Their job is to increase.
1:08:07
Speaker 7: The sales of dip bags, which is a written down
1:08:10
objective of every corporation. So they are doing it. Their
1:08:14
job is to let them do it. The government's job
1:08:17
is to stop the bad marketing. So the issues of
1:08:20
marketing are not even limited to free supply. After that
1:08:25
comes the meeting of doctors to sponsor, which we started
1:08:29
opposing at that time. to give an advertisement in the
1:08:34
doctor's journal. That's when we wrote these letters to the
1:08:39
paediatric journal, to stop this. So then there was a
1:08:43
lot of fight going on. There was a group here, V.I.
1:08:47
Bombay's Dr. Anand, Kanpur's Dr.
1:08:51
Speaker 6: Mathur.
1:08:52
Speaker 7: So I was in Jalandhar, I was the youngest. So
1:08:55
we all started putting up a show, that there should
1:08:58
be a law on this. So we got the success
1:09:02
that India made a law in 1992. In which advertisement etc.
1:09:07
Speaker 6: This law. This law was made. Then it took 10-11
1:09:11
years more. That.
1:09:16
Speaker 5: It's the Infant Milk Substitutes Feeding Bottles and Infant Food
1:09:21
Regulation of Production and Supply Distribution Act of 1992.
1:09:24
Speaker 7: It doesn't ban the sale of the product.
1:09:29
Speaker 6: So, whoever wants it, can get the product.
1:09:33
Speaker 7: It only bans the advertising, free supplies, gifts, incentives, direct
1:09:42
contact with mothers. There should be no photo of mother
1:09:45
and child on the label. Doctors should not have sponsorship.
1:09:49
Researchers cannot grant to doctors. Association of doctors cannot grant
1:09:54
any grant. Commission cannot give to its employees to increase sales.
1:09:59
So these are all provisions of it. It is a
1:10:03
very good law according to me. Any food of a
1:10:08
child of two years of age is covered in this law.
1:10:12
Speaker 6: Feeding bottle is covered.
1:10:14
Speaker 7: So under the age of two years, whatever consumption the
1:10:16
child has in food, that cannot be promoted. This is
1:10:20
the law. It majorly controls this. Suppose you are making biscuits.
1:10:28
Speaker 6: Making is allowed. Selling is also allowed.
1:10:31
Speaker 7: But you cannot promote biscuits on TV for a one-year-old child.
1:10:34
Suppose you are feeding the child milk. You cannot say
1:10:42
that you For a one-year-old child, this is good milk.
1:10:46
Speaker 6: We made it fat-free or whatever. They can't do that.
1:10:48
They can't do that. So, that was its intent.
1:10:52
Speaker 7: Parliament noted in the Statement of Objects that it.
1:10:58
Speaker 6: Is dismantling breastfeeding. It is declining. Due to which disease
1:11:02
and deaths are increasing.
1:11:03
Speaker 1: But did this law help?
1:11:04
Speaker 5: I still see so many Instagram reels in which they
1:11:06
are telling that I agree with you. One is that
1:11:09
why the government is not putting a lot of pressure
1:11:13
on the companies despite a wonderful law it.
1:11:15
Speaker 1: Gave to us.
1:11:34
Speaker 7: Parliament has done a good job. The government has given
1:11:39
this law. Now, the government has monitored it well. Or
1:11:43
the violators, to punish them, that work is not going well.
1:11:48
That's why those companies have left it open. Whatever they
1:11:54
want to do. So, these are some examples that I
1:11:57
will show you. What you are talking about now. See,
1:11:59
this is it. Like, to give options. These are the options.
1:12:06
These are some doctors. These are some doctors who promote.
1:12:15
This is considered indirectly promotion. No matter what they say inside.
1:12:18
They talk about it.
1:12:20
Speaker 6: They show the brand. Similarly, there is a company. They
1:12:26
have made a mothers club. Aptaclub.
1:12:30
Speaker 7: They call the doctor there. We don't know if they
1:12:34
pose or if they are real doctors. But it's an endorsement.
1:12:39
Speaker 1: This video is called C-section breastfeeding struggle.
1:12:41
Speaker 6: Yes.
1:12:42
Speaker 7: So whatever you were talking about C-section, they want to
1:12:46
make the perception stronger. Because C-section takes a lot of time.
1:12:51
This is also a factor. If C-section is around 40%,
1:12:56
then they will get a formula. So you see how
1:12:58
much the sale increases. So they address such things.
1:13:02
Speaker 6: Right. This company is also supporting doctors. Nestle.
1:13:06
Speaker 7: They make them relays. To make them influencers. They are
1:13:12
trying to pose them. These things are found on digital
1:13:18
social media.
1:13:18
Speaker 6: We record them.
1:13:22
Speaker 5: Doctors who are endorsing this. They don't know what happens
1:13:26
with this formula milk.
1:13:27
Speaker 1: I think they know.
1:13:28
Speaker 6: That now.
1:13:32
Speaker 7: I'm sure they must be part of the system being
1:13:36
given some incentives or something which we can't document. Like
1:13:42
this conference right now.
1:13:59
Speaker 5: Abbott Confluence 2.0 International Speaker Program.
1:14:03
Speaker 6: Now this.
1:14:03
Speaker 1: So under the law, all of this is illegal.
1:14:05
Speaker 6: Under the law, it is illegal. As many examples I
1:14:08
am showing you, it is illegal.
1:14:09
Speaker 1: So, responsibility is of the doctor at the end of
1:14:12
the day then.
1:14:13
Speaker 6: Yes.
1:14:14
Speaker 1: The responsibility, the buck stops with the doctor.
1:14:17
Speaker 6: Yes.
1:14:17
Speaker 1: To say that it is available, but I will suggest
1:14:20
that you breastfeed.
1:14:21
Speaker 5: Yes.
1:14:21
Speaker 1: It is important to give this information.
1:14:23
Speaker 7: It is very important and how to breastfeed. How to
1:14:27
be successful.
1:14:28
Speaker 5: Yes.
1:14:30
Speaker 6: Between success and to breastfeed, there are two things.
1:14:34
Speaker 7: Yeah, yeah.
1:14:35
Speaker 6: To be successful in breastfeeding, one is breastfeeding.
1:14:38
Speaker 3: Yeah.
1:14:39
Speaker 7: So breastfeeding is very easy. To be successful, a doctor
1:14:43
or a health worker will have to work hard.
1:14:45
Speaker 6: And a mother will have to work hard. But she
1:14:48
needs skills that she didn't get.
1:14:52
Speaker 1: So I will give you my example.
1:14:54
Speaker 4: Okay.
1:14:55
Speaker 5: I got very lucky, Tacho, to find a very good pediatrician.
1:15:00
And also a very good gynaec. The gynaec said that
1:15:02
we will do a normal delivery. Unless otherwise required. And
1:15:07
the pediatrician told me that if you give bottle to
1:15:10
your child, I cannot take you on as a patient. Right.
1:15:15
Speaker 1: The minute he said that, I was like, I want
1:15:16
this doctor. I will be my kid's doctor. But there
1:15:20
are so few.
1:15:27
Speaker 5: There are so few like this who are talking about
1:15:31
why breastfeeding is so important. Can you tell us in
1:15:33
simple terms what is in breast milk which beats everything
1:15:40
that is advertised about formula milk?
1:15:42
Speaker 7: I think there's a major, if I have to say
1:15:44
one thing, that it's a live fluid. It's a live fluid,
1:15:49
transfers live immunity, live cells from.
1:15:53
Speaker 6: Mother to the baby, which is so protective.
1:15:57
Speaker 7: Right. Say, for example, the mother is having a respiratory
1:16:00
infection at the time of breastfeeding. And her antibodies will
1:16:06
reach the baby to protect the baby from the same
1:16:09
infection which the mother is.
1:16:11
Speaker 1: But it's the other way around. If the mother is sick,
1:16:13
she says, don't give milk, give formula.
1:16:14
Speaker 6: That's what I'm saying. It's important to give importance to
1:16:17
these things.
1:16:18
Speaker 7: So it's not necessary that you have to become a
1:16:21
breastfeeding specialist. This knowledge should be with the common man.
1:16:26
This knowledge should also be with the doctor. So, success
1:16:30
starts there only when you get accurate knowledge. Now, where
1:16:33
will the knowledge come from? Either you study yourself or
1:16:37
you go to the government.
1:16:41
Speaker 1: No one tells about it, sir.
1:16:43
Speaker 4: No one tells.
1:16:43
Speaker 7: People don't give time. I am saying that the system
1:16:47
is geared up towards treatment. If there is a disease,
1:16:50
then the treatment of the medicine is done very quickly.
1:16:53
So it's not just breast milk. It's a process. It's
1:16:57
an activity between the mother.
1:16:58
Speaker 1: And the child which gives eye-to-eye contact.
1:17:21
Speaker 7: Which gives a skin-to-skin contact, which gives a talking to
1:17:25
the baby.
1:17:26
Speaker 6: All that helps the brain development also. Of the child.
1:17:30
Of the child.
1:17:31
Speaker 7: So, there are factors in the breast milk also, which
1:17:34
help better growth of the brain. But I think these
1:17:38
interactions improve that IQ part. So, there were studies in
1:17:44
Brazil in the early 80s, which I.
1:17:45
Speaker 6: Was telling you. So, it was proven.
1:17:49
Speaker 7: For me, the pivot of why I breastfed was I
1:17:50
read it in a book that breastfeeding is like creating
1:17:53
formula for your kid or creating.
1:18:17
Speaker 1: Milk for your kid, which is unique to the child.
1:18:19
Speaker 6: Yeah, that is another.
1:18:21
Speaker 1: Right?
1:18:21
Speaker 5: Because your child has sensors in his tongue and they
1:18:26
tell through the mother's nipple and everything to your brain
1:18:30
on what's lacking. And what's made is like bespoke, curated
1:18:35
milk only for the needs of that child.
1:18:38
Speaker 6: This is also proven. So many things actually.
1:18:41
Speaker 1: That research just blew my mind.
1:18:43
Speaker 6: I agree.
1:18:43
Speaker 1: I was like, wow, that's just God's best creation, right?
1:18:47
Speaker 7: If you breastfeed... Yeah. preterm baby, the protein level increases
1:18:53
in breast milk. He needs more protein for faster growth.
1:19:00
The first breast milk, sorry, not the first, the early
1:19:03
part of the breast milk.
1:19:05
Speaker 6: Contains enzymes and other stuff. Yeah.
1:19:09
Speaker 7: And the later part, which is called hind milk, contains
1:19:13
all the fats.
1:19:14
Speaker 6: Yeah.
1:19:15
Speaker 7: So, this is also an important element. Then, I gave
1:19:20
an example of preterm, which is tailored to your baby,
1:19:23
what you are saying, is one of the very big things,
1:19:27
which probably we take it for granted, you know. So,
1:19:31
the advantages are even bigger. Just protection from the disease
1:19:34
is a very big advantage. Forget about IQ.
1:19:38
Speaker 3: Yes.
1:19:39
Speaker 7: After that, the long-term health advantage that was proved later,
1:19:42
over those years, the research that was done in the 80s,
1:19:46
it was all about the benefits. Now, mother who breastfeeds,
1:19:51
she has a lesser chance of diabetes, she has a
1:19:53
lesser chance of breast and ovarian cancer, she has a
1:19:57
lesser chance of osteoporosis and the bone health problems. And
1:20:03
in the long term, children also have a lesser chance
1:20:07
problem of non-communicable diseases. So, all these things are being added. So,
1:20:12
it's something which I think is going on. You can't
1:20:16
compare it, actually.
1:20:18
Speaker 1: There's no comparison.
1:20:19
Speaker 6: There's no comparison.
1:20:20
Speaker 1: But, Doctor, you're saying that breast milk is great.
1:20:23
Speaker 4: It's an alternative. Okay.
1:20:25
Speaker 1: It's an alternative.
1:20:26
Speaker 5: But I'm coming to this point that breast milk is
1:20:28
great for the kid, great for the mother, great for
1:20:31
the mind space, great on the pocket also, by the way.
1:20:34
Speaker 1: So it wins on all fronts.
1:20:36
Speaker 6: That's right.
1:20:36
Speaker 5: But there are so many mothers today who I meet
1:20:38
who say, I gave formula milk to my child.
1:20:41
Speaker 1: What's wrong with that?
1:20:42
Speaker 6: What's wrong with that?
1:20:43
Speaker 5: He's a good player. Why is it so much said
1:20:46
to do breast milk? It's all done because they want
1:20:49
women to stay behind the wheel. They want women to
1:20:51
stay indoors. And when they say that, I'm thinking.
1:20:58
Speaker 6: See, I agree with the point. I also faced that
1:21:02
in my life. I'll tell you a story.
1:21:07
Speaker 7: When we moved to Delhi in 1990, we met a
1:21:09
doctor couple here. They got a baby and then we
1:21:14
went home and advised them how to do it and
1:21:18
all that. So, you know, after two months, the comment
1:21:22
he gave through another doctor, he had given his child
1:21:25
a bottle of water.
1:21:27
Speaker 6: Hume breast feed ki taraf laga diya.
1:21:29
Speaker 1: Yeh hua tha?
1:21:30
Speaker 6: Yeh maare saath hua tha. Right? I told him the story.
1:21:33
Speaker 1: Hume dena pada.
1:21:36
Speaker 7: We failed with our children. In 79 and 81. Because
1:21:42
nobody was supporting. Hume bhi utne hi knowledge thi ki
1:21:46
breast feeding is good. Jo success wali knowledge hume bhi
1:21:50
nahi thi. Hormonal wali knowledge hume nahi thi. 89 mein
1:21:54
mujhe yeh samajhaya ki This is the role of the hormone.
1:21:59
Whoever sorts this out, this is the key to success.
1:22:03
Speaker 1: Oxytocin.
1:22:04
Speaker 6: Yes. Whoever sorts this out, there is no problem. Right?
1:22:09
Speaker 7: I give you, then I found that our children, they
1:22:14
gave up in six months. So I don't shy of
1:22:17
that story. That they couldn't give us.
1:22:20
Speaker 5: Hmm.
1:22:21
Speaker 6: So what do we do now?
1:22:22
Speaker 7: Our mother is also saying, our doctors are also saying,
1:22:24
our gynecologists are also saying, give it to her, she
1:22:27
is crying.
1:22:27
Speaker 6: What do we do now?
1:22:29
Speaker 7: If the child is crying, give it to her. What
1:22:32
I am saying is not that, it's not an issue
1:22:35
of individual also. That it's not like you gave another milk,
1:22:41
so her IQ is decreasing.
1:22:42
Speaker 6: We are not saying that. This is a public health issue.
1:22:46
Speaker 7: If you are talking about the population, that there is
1:22:49
a breastfeeding population in a population and there is another population,
1:22:53
then the IQ level can increase. So, as a society,
1:22:57
it has an advantage. So, it happens to individuals too.
1:23:00
You don't know. You are breastfeeding a child. You think,
1:23:08
I can tell you about my own grandchildren.
1:23:12
Speaker 3: Yeah.
1:23:13
Speaker 7: My daughter, she got, there is no maternity leave in America.
1:23:18
Speaker 4: Okay.
1:23:19
Speaker 7: So she took leave for three months without pay. She
1:23:21
did breastfeeding for three months. After three months, she had
1:23:24
to leave the baby in a crèche. But all these
1:23:28
three months, she was expressing breast milk every day. And
1:23:31
his freezer was full. She had so much milk that
1:23:35
after a year or two, she had to throw it away.
1:23:39
Speaker 6: It was so much. What was it? It was just confidence.
1:23:43
Speaker 7: She didn't have any problem with how much milk she had.
1:23:49
Second time she decided actually to get off the job
1:23:54
for a year and a half. Both the boys, they
1:23:58
went on breastfeeding for two and a half years. So
1:24:05
the point is that this whole thing which I find
1:24:09
when people start thinking there's not enough milk is actually
1:24:15
this click of confidence.
1:24:19
Speaker 6: That I can breastfeed. It's my body, I can.
1:24:23
Speaker 7: I was looking at the data that the percentage of
1:24:28
deliveries in which the mother is medically unable to breastfeed.
1:24:48
Speaker 1: Is lower than 3%.
1:24:50
Speaker 7: It may be lower than that also. Which I don't
1:24:54
remember exactly. In my beginning of the breastfeeding career, I
1:24:59
remember I could inference that if there is a surgical
1:25:08
removal of the breast because of the reasons. So those
1:25:12
are the only mothers whose physiology cannot breastfeed.
1:25:16
Speaker 6: So these 3% can has that number.
1:25:20
Speaker 7: So there's no documented study at the population level.
1:25:27
Speaker 6: How will you do this? No, I don't understand.
1:25:30
Speaker 1: Why is this happening?
1:25:31
Speaker 5: If it's such a natural process, if it's going to happen,
1:25:34
you're saying all mothers can breastfeed if they are given
1:25:38
the right environment. How have we come to this position
1:25:41
that barely 10 or 20% of mothers breastfeed?
1:25:47
Speaker 4: Why?
1:25:48
Speaker 1: Like, why has that confidence lost?
1:25:51
Speaker 7: No, I don't think so. First, breastfeeding as such. One
1:25:56
question is whether you breastfeed or not. So, the number
1:25:59
is quite high.
1:26:02
Speaker 6: I think it can be 70, 80 or 90.
1:26:04
Speaker 4: Okay.
1:26:05
Speaker 7: That means, if you're doing it once or twice or thrice,
1:26:09
are you breastfeeding or not? The question is, for the
1:26:12
first six months, when it comes to whether you started
1:26:15
in the first hour or not, there the data starts
1:26:19
to disappear.
1:26:20
Speaker 4: Okay.
1:26:21
Speaker 6: Right? If you assume, as I am telling you, this
1:26:23
is national data.
1:26:24
Speaker 7: Now, even here, if you ask mothers, whether you started
1:26:27
it in the first hour or not, then.
1:26:29
Speaker 6: You will find that 50% of mothers are not doing it.
1:26:32
What is the reason for that?
1:26:34
Speaker 7: When the doctor gave you a debate, then why will
1:26:38
you start it? You are understanding it equally, right? You
1:26:42
are just considering it equal to breast milk. Because the
1:26:45
doctor is saying, Doctor ki value hai. Doctor jab aapko
1:26:49
prescribe karta hai ki dibba de do. Usko bura lagta
1:26:52
hi nahi kuch. Kyunki wo khud bhi believe karta hai
1:26:54
ya karta hi hai ki isko doodh nahi pura ata.
1:26:57
Ab 6 meene mein pehle wo kaita exclusive breastfeeding. Jab
1:27:00
tak aap second sawal nahi puchoge. Are you giving anything else?
1:27:06
To aap batate ho ki haan mein doodh bhi de
1:27:07
rahi ho, paani bhi de rahi ho, juice bhi de
1:27:10
rahi ho. Jab kuch ista ki cheeze aati hai to
1:27:12
pata chalta hai ki this child is not exclusively breastfed. So,
1:27:17
from there data is generated. So, this situation is not
1:27:22
so bad. But I think the majorly exclusive breastfeeding in
1:27:28
the last 10 years, after 30 years of this law,
1:27:33
in the last 10 years, 5-10% has increased. Earlier it
1:27:36
was static. Earlier it was falling. In the 70s, 80s
1:27:39
it was falling. Breastfeeding overall.
1:27:44
Speaker 6: It was falling. There is a documentation.
1:27:47
Speaker 7: After the law, which I give full credit to, this
1:27:51
is the only big ticket reform which is called, this
1:27:53
is the law. After this law, first the fall of
1:27:58
breastfeeding happened. I am talking about the whole country.
1:28:02
Speaker 6: Yes. Now the fall happened, then gradually it became flat.
1:28:06
Speaker 7: It remained flat for 5-10 years. Then it started to increase.
1:28:12
So it takes ages, decades. To bring a change in
1:28:16
such a dynamic. After that, there was a percentage of 45-50.
1:28:22
Speaker 6: Exclusive.
1:28:23
Speaker 7: So, in the last NFHS, it went above 60 for
1:28:27
the first time.
1:28:29
Speaker 1: Okay.
1:28:30
Speaker 6: First, it went 55.
1:28:30
Speaker 1: And its time frame is 6 months or 1 year?
1:28:32
Speaker 7: 6 months. Exclusive is 6 months. And after 6 months,
1:28:36
baby needs something else for the growth.
1:28:38
Speaker 6: Yeah.
1:28:40
Speaker 7: Are many children who stay. Production is this much.
1:28:44
Speaker 6: I've seen.
1:28:45
Speaker 1: But that's not enough. You have to complement it.
1:28:47
Speaker 4: It's not enough.
1:28:47
Speaker 7: It must be complemented after six months with some solid foods.
1:28:51
Speaker 6: So that slowly, slowly, slowly. One, two, three, four.
1:28:57
Speaker 7: Until he is 1 year old, he should get 4-5
1:28:59
times complimentary food.
1:29:02
Speaker 1: We talked a lot, sir.
1:29:04
Speaker 5: We understood the difference between formula milk and breast milk.
1:29:08
We understood what are the advantages of breastfeeding for mother
1:29:14
and child. We also understood why formula milk has spread
1:29:22
like a scam in our society and we don't even
1:29:24
know about it. And doctors are ready to take so
1:29:28
much responsibility behind it. We understood that too. I want
1:29:32
to know now that... I mean, I want to play
1:29:35
the devil's advocate here. I have met many mothers who
1:29:38
are living in this guilt that they are not able
1:29:41
to breastfeed. They want to, they are not being able to.
1:29:46
And now I understand, you are saying they are not
1:29:48
getting oxytocin from their environment, right? It's not kicking in.
1:29:50
So the milk is there, the supply is not happening, right?
1:29:54
It's not coming in.
1:29:56
Speaker 4: So.
1:29:56
Speaker 1: What advice do you.
1:29:58
Speaker 6: Have for them?
1:29:59
Speaker 7: For the recent mothers, who have already left, they may
1:30:05
not be affected much.
1:30:08
Speaker 6: But I think early, if the children.
1:30:10
Speaker 7: Are in their first few months, if the mother has
1:30:13
a feeling that there is not enough milk, my only
1:30:16
advice would be to study about the oxytocin reflex.
1:30:23
Speaker 6: It takes 10 minutes to read it. What it does.
1:30:27
So how it is produced and how it works.
1:30:31
Speaker 1: Can you tell us something?
1:30:33
Speaker 7: So in that, if you are feeling that my milk
1:30:37
is not complete. So I will tell you number one.
1:30:41
This does not mean that milk is not made. The
1:30:44
process of making milk, which is the process inside the breast.
1:30:49
Speaker 6: Is different. The process of bringing.
1:30:53
Speaker 7: Milk from there to the baby is different. The process
1:30:58
of bringing it depends on oxytocin. If you doubt yourself,
1:31:03
or if you have pain, or if you have anxiety
1:31:07
that the milk will not come full, then these things
1:31:10
reinforce that oxytocin depends on your mental makeup, on.
1:31:15
Speaker 1: Your state of mind.
1:31:15
Speaker 6: And all new mothers are stressed.
1:31:18
Speaker 1: If you want to learn about it and want to
1:31:20
increase your.
1:31:46
Speaker 7: Breast milk supply. This is the purpose. There are only
1:31:50
two ways. One is to feed the baby repeatedly. That
1:31:53
will keep the prolactin right. The production of milk will
1:31:59
be right. Now we have to make it flow. So
1:32:01
for that you have to keep confidence in yourself. When
1:32:05
you do this 2, 3, 4 times. Then when you
1:32:07
will start thinking that the flow has also improved.
1:32:11
Speaker 6: Then the problem will be solved automatically. There are many
1:32:15
ways of it. We use it in training.
1:32:17
Speaker 7: For example, if you feel that there is a lack
1:32:21
of flow in oxytocin, then back massage helps. So back
1:32:26
massage can be done by a family member. The other stress.
1:32:32
Speaker 1: Back massage means on the shoulder?
1:32:34
Speaker 6: No, on the back.
1:32:36
Speaker 1: On the spine.
1:32:37
Speaker 6: If you massage.
1:32:38
Speaker 7: It helps to increase oxytocin.
1:32:41
Speaker 6: So now this.
1:32:46
Speaker 7: There is no medicine for it. There are many medicines
1:32:48
in the market that say that milk will be more
1:32:50
than this.
1:32:50
Speaker 1: There is some mixture that they give to mothers.
1:32:53
Speaker 6: Yes, there is some desi.
1:32:54
Speaker 1: There are granules.
1:32:56
Speaker 6: Yes, see, some things affect psychologically.
1:32:58
Speaker 7: If it is affecting psychologically, then you take it.
1:33:03
Speaker 6: Some say fenugreek, some say something. I don't know. Galactagogues
1:33:07
are also the names of medicines.
1:33:09
Speaker 7: People are promoting those medicines these days.
1:33:12
Speaker 6: Yeah.
1:33:13
Speaker 5: Yeah.
1:33:41
Speaker 1: So what should mothers eat to make the right milk?
1:33:44
There is a lot of debate on that too.
1:33:45
Speaker 5: All mothers feed them ghee, wheat, and I don't know
1:33:49
what else.
1:33:49
Speaker 1: Does that factor the milk that the mother is eating?
1:33:51
There is no difference in.
1:33:53
Speaker 6: The production of milk. There is no difference? No, there
1:33:56
is no difference.
1:33:58
Speaker 7: The production of milk is not linked to your food.
1:34:01
Speaker 6: How much milk will be made.
1:34:03
Speaker 4: Okay.
1:34:03
Speaker 6: Flavors cross. Because the process of milk, you understand, secretes
1:34:07
from the cell. Yes. Okay. Okay.
1:34:11
Speaker 7: Okay. So that flavor, whether the child likes it or not,
1:34:40
sometimes it happens. It's very difficult to diagnose. But I'm
1:34:44
just theoretically explaining. So I don't think that with any food,
1:34:52
you keep a fast. Milk will be made if the
1:34:57
child is drinking.
1:34:58
Speaker 6: Women do 24-hour fasting. Very common.
1:35:01
Speaker 7: Milk doesn't stop making. Fat will be extracted from your body.
1:35:07
You will use your body fat. Energy, which is there
1:35:10
to make milk, will be used by your body. Wow.
1:35:14
The calories, let's say, the calories you gave the child
1:35:18
in one day, let's say, I'm just theoretically saying, if
1:35:21
you gave him.
1:35:23
Speaker 6: 200 calories, 200 calories will be used by your body.
1:35:26
Speaker 7: You have kept it full. Your body has energy. So
1:35:31
the child will get milk. I'm not getting into those extremes.
1:35:37
There are extremes available historically. When women were kept in
1:35:48
Japan's jails, women got emaciated.
1:35:51
Speaker 6: The babies came out alive because they were breastfeeding.
1:35:57
Speaker 7: So their production didn't stop. Day by day, day by day,
1:36:01
they became so extremely malnourished. They didn't feed the baby.
1:36:06
This is documented in history. So, 20 children born, 20
1:36:12
children came out alive.
1:36:14
Speaker 4: Wow.
1:36:15
Speaker 7: So, this is a link of nature's production, supply and production.
1:36:19
If the baby drinks, then milk will be made. This
1:36:24
is dependent on that.
1:36:27
Speaker 6: Quantity-wise.
1:36:28
Speaker 7: As they say, if there are two children, then milk
1:36:30
can be made as much as two children. In one breast,
1:36:35
in 40 minutes, the next feed can be prepared.
1:36:39
Speaker 6: Within 40 minutes.
1:36:40
Speaker 1: Within 40 minutes.
1:36:41
Speaker 4: Yes.
1:36:41
Speaker 6: It depends. If there are.
1:36:46
Speaker 1: Triplets or twins of any mother, will your body adapt?
1:36:49
Speaker 6: It adapts.
1:36:50
Speaker 7: These are case studies. These are documented case studies. Only
1:36:58
then did we know how the production took place. There
1:37:01
are many mothers who have fed triplets. Twins have many examples. So,
1:37:06
there is a possibility. There is a distinct physiological possibility
1:37:12
of more production. Because it depends on suckling. If the
1:37:18
child is sucking 24 times, then the milk is being
1:37:20
made 24 times. If there are two children and they
1:37:22
are drinking 12 times, then if the child is sucking
1:37:25
24 times, then it's a huge work for the mother.
1:37:29
No doubt about that. But there is a distinct possibility.
1:37:33
So I'm just trying to explain that if you think
1:37:40
you can eat this, but there is no link in production.
1:37:45
Speaker 1: No, gas will happen, then the child will get gas.
1:37:49
Speaker 5: Don't eat spinach, then the milk will be green.
1:37:53
Speaker 7: No, that smell thing that I told you, that possibility
1:37:56
is there.
1:37:57
Speaker 6: Smell can come. That smell.
1:38:00
Speaker 7: The child can pass. But there is nothing else which
1:38:04
actually affects the.
1:38:06
Speaker 1: Fluids that you eat impact the production of milk.
1:38:09
Speaker 6: Production doesn't impact that either.
1:38:11
Speaker 7: But it's important for your.
1:38:15
Speaker 6: Body, right?
1:38:15
Speaker 7: To maintain your health, water balance, nutrition balance, it's important
1:38:21
to maintain all that. Because physically and mentally, she has
1:38:24
to be fit too. That is why it is very important.
1:38:28
That production is not linked.
1:38:32
Speaker 6: For example, the mother who is not feeding. When the
1:38:36
child stops drinking, the milk stops being made.
1:38:40
Speaker 7: Otherwise it keeps flowing. So this is a science.
1:38:46
Speaker 1: Demand supply.
1:38:47
Speaker 6: Demand supply. Scientifically linked. That hormone works like this.
1:38:52
Speaker 1: So, there are two interesting things in this.
1:38:56
Speaker 3: Yes.
1:38:56
Speaker 5: That all the stories that our grandmothers used to tell us,
1:39:01
they are all wrong. So, what she used to say
1:39:03
that give your milk, your milk is the best, that
1:39:06
is right.
1:39:06
Speaker 6: That is right.
1:39:07
Speaker 1: But eat this gum and eat all this, it doesn't
1:39:10
make any difference, you are saying.
1:39:11
Speaker 6: No, it doesn't make a difference.
1:39:13
Speaker 7: Psychologically, I believe that, like the thing about confidence building,
1:39:17
confidence building comes that, look, my mother gave me this medicine. So,
1:39:21
she is saying that my milk should increase. Your confidence increases.
1:39:25
Speaker 1: But, you know, I want to be sensitive.
1:39:28
Speaker 7: It is not scientific to say that if you eat wheat,
1:39:31
your milk will increase, or if you eat fenugreek, it won't.
1:39:33
Speaker 1: But, Dr.
1:39:34
Speaker 5: Arun, I must say that a lot of people watching
1:39:38
this podcast are going to feel that. I failed as
1:39:42
a mother because I could not breastfeed. A lot of
1:39:45
women are unable to breastfeed because India, you're right, compared
1:39:49
to the West, at least has six months maternity leave.
1:39:52
But even after that, going back home, doing full job,
1:39:57
feeding a child, taking care of yourself, and then going
1:40:00
back to a job where you are judged that now
1:40:02
she has become a mother, now what will she do?
1:40:08
So taking all those challenges, it's a little unfair to
1:40:13
expect the mother to be fully responsible and to breastfeed
1:40:17
and to do everything.
1:40:18
Speaker 7: I don't hold a mother even 1% responsible. I don't
1:40:23
think she should ever feel that she has failed. I
1:40:28
blame the environment. I don't think there is any way
1:40:34
that a mother should be blamed.
1:40:37
Speaker 6: Right?
1:40:37
Speaker 7: If she decided not to breastfeed, even then, There was
1:40:42
an environment which made her decide.
1:40:44
Speaker 4: Right?
1:40:46
Speaker 7: Secondly, this between the mixed feeding, there is an environment
1:40:50
which pushes you to give mixed feeding.
1:40:53
Speaker 6: How do you stop? So, I don't think any mother
1:40:59
should feel bad about it. That I failed. It's not
1:41:05
her failure.
1:41:06
Speaker 7: It's a failure of the system or the environment which
1:41:11
includes societal environment, family environment also. There's many negative things
1:41:18
happening at the family level also, which she has to bear.
1:41:22
So I can only say that I'm not here to
1:41:27
blame a mother. We're talking about breastfeeding versus artificial feeding,
1:41:32
advantages or disadvantages. It's the marketing. I want to bring it.
1:41:39
It's an environment where marketing is also coming. Now, if
1:41:43
your marketing is spoiling your environment, which is a health system,
1:41:51
and the health system forces you to give top feed,
1:41:56
and then you have to continue, because your baby has
1:42:02
learned to get, say, for example, it has a 600-700
1:42:06
ml requirement. It is not in addition to. It is
1:42:10
actually replacing breast milk. If we talk about the first
1:42:13
six months. So that's why I don't think mothers have
1:42:16
any fault in this. I don't agree with this.
1:42:20
Speaker 5: If that.
1:42:35
Speaker 7: A lot of people these days who want to breastfeed
1:42:37
have this way in which they are able to express
1:42:40
their milk.
1:42:59
Speaker 5: They pump the milk and then they give it through
1:43:01
a bottle. Is that also okay?
1:43:04
Speaker 6: Yeah, okay.
1:43:05
Speaker 7: I think whatever alternative systems have been made to continue
1:43:09
breastfeeding and then breast milk feeding, they are.
1:43:13
Speaker 6: Better than formula feeding. If the.
1:43:17
Speaker 7: Hygiene of the bottle is kept well, then there is
1:43:20
no such problem. Because I see a problem in this
1:43:24
that that there is a new marketing game going on
1:43:31
in the pump industry. They are trying to force that
1:43:35
every woman should have a pump. Every woman should have
1:43:38
an electric pump. Every doctor should prescribe one pump to
1:43:43
a mother.
1:43:44
Speaker 6: So I feel.
1:43:45
Speaker 7: That it is occasionally used for expression. So hand expression
1:43:51
is also a good idea. One can learn during the pregnancy.
1:43:56
What is its technique? And when the child is born,
1:43:59
then hand expression. If you have to do it once
1:44:01
or twice. Like if you have to do it regularly,
1:44:04
then these things are needed. But every family doesn't need
1:44:08
a pump. This is the point. All mothers are not
1:44:12
going out to work. But those who go out in
1:44:16
the informal sector, you look at them.
1:44:19
Speaker 6: They don't even use a pump. They take the child
1:44:22
with them.
1:44:25
Speaker 7: Or artificial feeding starts there.
1:44:29
Speaker 3: Yeah.
1:44:29
Speaker 6: In the village, if there is a female.
1:44:33
Speaker 7: So these things, in infant feeding, there is always a challenge.
1:44:39
Speaker 6: There is a lack of awareness.
1:44:41
Speaker 1: I am thinking this after talking to you.
1:44:43
Speaker 5: That how wrong we have been told, taught.
1:44:47
Speaker 1: In our environment. And information is not only wrong, it
1:44:52
is harmful.
1:44:53
Speaker 3: Yes, harmful.
1:44:53
Speaker 5: Harmful both for the child and for the mother. And
1:44:57
I so appreciate the fact that you're saying.
1:45:00
Speaker 1: That it's not the mother's fault.
1:45:02
Speaker 6: Yeah, it's not.
1:45:02
Speaker 5: If you're not able to do it, don't for a
1:45:04
minute think that you have failed at something. Please take
1:45:08
a step back to understand that perhaps your environment wasn't
1:45:11
conducive enough. But the power is with you. I like
1:45:16
what you said there. The power is with you. You
1:45:18
get to decide whether or not you'll be able to
1:45:21
pull it through. And I think having that power and
1:45:24
sometimes exercising that right is also a luxury.
1:45:27
Speaker 7: I agree, but if you get that power in pregnancy,
1:45:30
during pregnancy is the time when I think every woman
1:45:34
might have more time to learn and read than immediately
1:45:41
after birth. After that, it's very difficult. After that, the
1:45:45
sensitivity level increases a lot.
1:45:48
Speaker 6: 15 people tell you 15 things.
1:46:01
Speaker 7: So I will request every mother who is wanting a baby,
1:46:06
going into pregnancy, make a decision about feeding the baby
1:46:10
during pregnancy. Keep that decision with you. Tell everybody around
1:46:15
you that I want to breastfeed.
1:46:17
Speaker 6: Come what may. I think things will settle.
1:46:22
Speaker 1: I like that approach. I like that approach.
1:46:24
Speaker 5: Sir, there are a lot of mothers who watch this podcast.
1:46:27
They have sent some questions. I would like to ask
1:46:30
you that. Let's bust the myths.
1:46:32
Speaker 6: Sure.
1:46:33
Speaker 5: First, I want to ask you, are formula and breast
1:46:35
milk nutritionally equivalent today?
1:46:38
Speaker 6: No, they are not. They are not equivalent at all.
1:46:43
Speaker 7: Formulas contain artificial things. To claim that I am equivalent,
1:46:50
And near, some people used to say near mother's milk.
1:46:53
Speaker 6: Our law prohibits this too. You can't say humanized. They
1:46:59
can't be equal.
1:47:00
Speaker 7: The biggest difference is the life cells.
1:47:04
Speaker 6: Correct.
1:47:05
Speaker 5: If you are stressed and sleep deprived, you simply can't
1:47:09
make enough milk.
1:47:11
Speaker 7: This is wrong to say that you can't make it.
1:47:13
Your milk may not flow well. Sufficiently well. The child may...
1:47:20
feel hungry, and you start thinking that you're not making enough.
1:47:26
Speaker 6: It's the oxytocin issue here.
1:47:27
Speaker 5: But which mother gets more sleep than two hours?
1:47:31
Speaker 1: And if she doesn't get sleep, how will she get out?
1:47:34
Speaker 7: No, no, sleep is not more important than two hours
1:47:37
at that stage. Gradually, the child starts adjusting. But the
1:47:44
oxytocin is a relaxing hormone. She knew that mothers have
1:47:51
to give milk after 2-3 hours. She needs relaxation in between.
1:47:55
So she can sleep off and on, if not. And
1:47:59
slowly I have seen with my own children as well
1:48:03
as my grandchildren and then other families I have been
1:48:07
closer to, that children start learning about the day-night system.
1:48:14
And then they start sleeping longer during the night.
1:48:18
Speaker 6: Wherever they are.
1:48:20
Speaker 7: Are.
1:48:20
Speaker 6: That's a big factor.
1:48:21
Speaker 7: When they start sleeping for 6-7 hours, and sometimes it
1:48:26
happens in the second month, third month, then that.
1:48:29
Speaker 1: Thing gets better.
1:48:30
Speaker 5: I read that the mothers' feed at night has sleeping
1:48:35
hormones in it.
1:48:36
Speaker 7: If you feed them at night, prolactin secretes more to
1:48:44
maintain production. There are only two hormones. The sleeping one,
1:48:49
which is called relaxing, is oxytocin. If the child sucks it,
1:48:54
oxytocin will start. It will complete its cycle. The oxytocin
1:48:59
released in the body, So it's called love hormone, right?
1:49:03
Speaker 6: Oxytocin.
1:49:04
Speaker 7: So this is the hormone that is used at many places, times.
1:49:10
When delivery is done, oxytocin is used to push the
1:49:14
placenta out. Yeah.
1:49:17
Speaker 5: Breastfeeding in public is impractical for working urban women.
1:49:21
Speaker 1: Formula is the realistic choice.
1:49:24
Speaker 7: I don't think this is a narrative, I think, which
1:49:26
suits the industry more than anybody else. So, to my mind, this,
1:49:32
my colleague, junior colleague in BP and I, she did
1:49:36
a study on this perceptions of breastfeeding. Of course, there is,
1:49:41
there are issues of people staring at women. But I
1:49:44
think if you want to normalize breastfeeding, then breastfeeding at
1:49:47
any place is a good idea.
1:49:49
Speaker 4: Okay.
1:49:50
Speaker 5: Top feeding with formula helps babies sleep longer and gain
1:49:54
weight faster.
1:49:56
Speaker 7: Yeah, this is true, actually, in the sense because it
1:49:59
takes longer time to digest the formula. Breast milk is
1:50:03
digested very easily and quickly. So naturally, the child will
1:50:08
sleep longer. So that also creates a perception that my
1:50:13
milk is not sufficient.
1:50:15
Speaker 6: Because when I gave the formula... You get hungry quickly. Yes.
1:50:17
So that is a.
1:50:20
Speaker 7: But that adjustment has to be done by the child,
1:50:22
as I said earlier, that slowly the child adjusts the
1:50:25
timing on their own. What you need to watch is
1:50:28
not how much child has taken, what you need to
1:50:30
watch is the growth of the child. So the true
1:50:33
indicator of sufficiency of your milk is how the child
1:50:39
is growing. If the child is growing well, I think
1:50:43
just forget it. Whether you're thinking whether it's coming or not.
1:50:47
If his weight gain is getting better, then it means
1:50:48
that he's getting as much as he needs.
1:50:51
Speaker 6: Actually, the advantage of.
1:50:53
Speaker 5: The bottle is that you can see how much the
1:50:55
child has drunk. Yes, you can't see it in this.
1:50:57
Speaker 1: So, you can track it. And we are a tracking generation.
1:51:00
Speaker 5: We track our steps, we track our heart beat, we
1:51:02
track our VO2 max. So, you should track his growth
1:51:05
in the child.
1:51:06
Speaker 7: You shouldn't track his feed. Good point.
1:51:09
Speaker 1: Good point. Okay, I'll see the next one.
1:51:12
Speaker 5: When a hospital gives a new mother formula without asking,
1:51:15
is it illegal?
1:51:17
Speaker 6: It's not illegal.
1:51:18
Speaker 7: It's highly unethical, I would say. So that it's better
1:51:22
if they start asking, they create a consent form and
1:51:26
inform the mother about all the risks the formula carries
1:51:30
and what are the advantages if they have and then
1:51:33
ask her if she wants to sign.
1:51:35
Speaker 1: Not sign.
1:51:36
Speaker 6: Yeah. Okay. And it should be done during pregnancy.
1:51:39
Speaker 1: Correct.
1:51:40
Speaker 5: What should parents look for on formula packaging that indicates
1:51:44
a violation of the Indian law?
1:51:46
Speaker 7: On the packaging, there should not be a picture or
1:51:49
a graphic which increases sellability, attraction of a mother or
1:51:53
a baby. So, secondly, there is a guideline saying the
1:51:58
mother's milk is best. That is an important notice there.
1:52:03
And then, this is not the sole source of nourishment
1:52:06
for your baby. So, these are the requirements by law. So,
1:52:11
that is on the, on the tin itself.
1:52:15
Speaker 4: Okay.
1:52:16
Speaker 5: If a pediatrician recommends formula supplementation, what question should a
1:52:20
parent ask before agreeing?
1:52:22
Speaker 7: The reasons, they should ask why, if, for example, the
1:52:27
reason might be the child is not gaining weight enough. So,
1:52:31
if I was a pediatrician and concerned about breastfeeding at
1:52:35
the age of, say, for example, if the child is
1:52:37
three months or four months, And is not gaining weight enough.
1:52:41
So I will first go into the history. Whether breastfeeding
1:52:44
is sufficiently done or not. In that sense. You just
1:52:47
said night feeding is happening or not. What is heart feeding?
1:52:50
So if it is not happening. Then they should be
1:52:55
given a trial. With full confidence. For next 15 days.
1:52:58
And see the weight gain. Then every child is different also.
1:53:04
Speaker 6: That.
1:53:05
Speaker 7: Research has shown. That up to 6 months. Mother's milk
1:53:08
is enough. It is all that a baby needs, right?
1:53:12
Speaker 6: This is known.
1:53:13
Speaker 7: Now the child could be, so six months is not
1:53:17
that the date of six months.
1:53:19
Speaker 6: So one can be ahead or there depending upon the
1:53:22
need of the baby. Yeah. If the baby needs something,
1:53:25
then it should be given.
1:53:26
Speaker 5: Yeah.
1:53:27
Speaker 6: Yeah. Okay.
1:53:28
Speaker 5: Is there a safe way to use formula if a
1:53:30
mother genuinely needs it?
1:53:33
Speaker 7: Safety is a very big concern. I think that is
1:53:35
one of the major things once the formula is on
1:53:37
the table.
1:53:38
Speaker 3: Hmm.
1:53:39
Speaker 6: So, which people forget.
1:53:41
Speaker 7: So, how to keep the baby safe is the biggest thing,
1:53:47
in my opinion. Other than cleaning the bottle, its cleaning,
1:53:51
if you have expressed it, how to use it. If
1:53:55
you are using powder milk, then you have mixed powder
1:54:01
milk in water. The formula is made. After that, it
1:54:08
is better that It is fed. Jitna bache ne piya,
1:54:11
utna pi liya. Baaki jo bacha hai, usko aap rakhiye mat.
1:54:15
Usko better hai, usko discard kar dijiye. O safety level
1:54:18
badh jayega. So, keep the whole containers in the bottles,
1:54:24
jo sterile karna hi hai, wo to karna hi hai.
1:54:27
Par ye jo milk ke andar inherent contamination hai, powder
1:54:30
milk mein.
1:54:30
Speaker 6: Usko avoid karne ka yeh tarika hai.
1:54:33
Speaker 7: WHO ka pehle ghanta kehta da, do ghante bhi kehta da,
1:54:36
do ghante par ho gaya, phir toh bilkul nahi dena chahi.
1:54:38
Par mai toh personally advice karta hu, sometimes you don't
1:54:42
count the bacteria, you know. So it's better to avoid.
1:54:47
Speaker 1: Yeah, better to avoid. Okay. So that brings us to
1:54:51
the end of this podcast.
1:54:53
Speaker 5: Main jaane se pehle aap se aapki zubani, wo kahani
1:54:56
sunna chaati hoon.
1:54:58
Speaker 1: Jiski wajah se aapne aapti practice chhodi.
1:55:00
Speaker 5: And you became so compelled that now you leave your
1:55:03
flourishing practice and run an NGO which only works for
1:55:09
safety of infants, formula milk substitutes and processed food.
1:55:17
Speaker 1: Why did you do that?
1:55:18
Speaker 6: Yeah. It's a very long story, but I'll make it
1:55:22
short and tell you. So when I....
1:55:28
Speaker 7: I passed out of medical college and went to Punjab.
1:55:30
There's a small town in Kapurthala, a civil hospital. I
1:55:34
got a job there. After nine months, they transferred me.
1:55:39
Jalandhar was my town. My parents lived there. So I
1:55:43
also felt good that I was transferred here. So I
1:55:45
got a job in the X-ray department. I did pediatrics.
1:55:49
At that time, there was no priority of specialization. Nowadays,
1:55:53
everything is specialization. So they said, for us, you are
1:55:58
a medical officer. So they give you the X-ray department.
1:56:02
So you sit in the X-ray department. Do your doctorate.
1:56:08
So I got bored in six months. So I thought,
1:56:11
it's better to quit. I didn't have any mood to
1:56:13
do private practice. I was in the mood to become
1:56:17
a teacher. So medical college. So it wasn't working. So
1:56:22
I resigned. I started practicing in Jalandhar. So first year
1:56:27
and a half, I did consultation practice. And then I
1:56:29
got a place to work. So someone advised me that
1:56:32
if the kids are sick, I should start them indoors.
1:56:35
So I did it for 30 minutes. I started the hospital.
1:56:42
Then I had a couple of junior doctors with me.
1:56:45
And my wife also. She was working for the government.
1:56:49
So after 3-4 years, she also joined me. So, we
1:56:53
were four doctors. So, we managed 30 bedded hospitals. So,
1:56:57
when we saw the sickness there, it was very disturbing. So,
1:57:02
because of that disturbing, when I did the investigation, that
1:57:07
there are free supplies in the hospitals of Dubai. So,
1:57:12
I saw a circle of marketing. Same eyewitness in Kapurthala also.
1:57:17
That how the representatives are. they keep on luring you,
1:57:23
medical representatives. So I took a decision in Kapurthala that
1:57:27
I don't want to take any sample from any closed
1:57:30
company or pharma company or any gift.
1:57:32
Speaker 6: So I took this decision.
1:57:33
Speaker 7: I felt that this work is going very wrong. You
1:57:38
can meet me, I don't have any problem. But I
1:57:42
felt day by day, day by day, this marketing is so...
1:57:44
I mean, you used to come to meet, you knew
1:57:46
what they wanted to do. But I didn't take anything
1:57:50
from them. But I used to see that the pitch
1:57:52
of marketing is very high. So then I started writing
1:57:57
to the Indian Academy of Pediatrics.
1:57:59
Speaker 6: I used to see their journal.
1:58:00
Speaker 7: I used to know that behind it was an electrogenic baby,
1:58:03
a bubbly baby. So we used to ask them, why
1:58:05
are you studying so much? are they taking advertisement? They
1:58:12
used to argue. We became like-minded people. We used to
1:58:23
discuss till 1989. Bombay, Gorakhpur, Jalandhar, Delhi. So four or
1:58:29
five people were concerned, all the pediatricians. So we kept
1:58:34
doing it. So then we got in touch with International
1:58:38
Baby Food Action Network. It's a global organization since 79, 81,
1:58:41
when the International Code of Marketing was passed in the
1:58:47
World Health Assembly. So there was a meeting going on
1:58:50
in Manila. So I went there to attend it. It
1:58:54
had been 10 years since that network. So they were
1:58:57
kind of celebrating. I met with more than 350 people
1:59:01
from 70 countries who were fighting like this.
1:59:05
Speaker 6: So that helped me to create more energies inside me.
1:59:09
Speaker 4: So Dr.
1:59:10
Speaker 7: Anand, who was in Bombay, he organized a training course
1:59:15
in Develali in 1989. That training course was called Lactation Management.
1:59:20
It was a five-day course. I went from Jalandhar to
1:59:24
do it.
1:59:26
Speaker 1: You're a man doing lactation management.
1:59:28
Speaker 6: Hmm.
1:59:56
Speaker 7: So he started laughing at me. He also said this
1:59:59
while laughing. Okay, tell me what happened on the return.
2:00:03
So in those five days, we learned this.
2:00:04
Speaker 6: How to make mother successful.
2:00:06
Speaker 7: This oxytocin fight, we learned there for the first time.
2:00:11
I think this was again a turning point. Global network,
2:00:15
people fighting. And then these companies pushing. So by combining
2:00:21
all these things, I felt that this change, Kuch kaam
2:00:26
karna padega.
2:00:27
Speaker 6: Tabi baat banegi. Otherwise, nahi banegi.
2:00:29
Speaker 7: Toh ek aur trigger hua, ke un dhanon mein terrorism
2:00:33
bahut tha Punjab mein.
2:00:35
Speaker 6: Toh my kids were like.
2:00:36
Speaker 7: My daughter was, jabam Delhi aaye, toh she was 11,
2:00:45
and my son was 9. Toh usse pehle jo bachpan tha,
2:00:51
wo undhere mein gujra tha. Ke jahan sab kuch bandh
2:00:54
rehta tha, Now you are putting nails on the walls
2:00:58
so that no one comes. There was so much fear
2:01:00
of terrorism. No one used to come out at night.
2:01:04
So we thought, let's do this too. That was added.
2:01:08
So we decided to move to Delhi. We closed the hostel.
2:01:12
So we decided to come to Delhi. Meanwhile, in 1991,
2:01:16
there was a training of trainers. Then lactation management.
2:01:21
Speaker 6: We went there.
2:01:22
Speaker 7: We went there. That too was in Varda. In Mahatma
2:01:26
Gandhi Ashram. So there were 22 people. So in the
2:01:31
last session, there was a two-week training course for 14 days.
2:01:37
Speaker 6: How to train others. Okay.
2:01:39
Speaker 7: Lactation management, how to train others. So some people came
2:01:42
from outside, from Africa. So BPNI, Breastfeeding Promotion Network of India,
2:01:49
was recommended on its last day. That such an organization
2:01:53
should be there. Who only fights for this thing.
2:01:55
Speaker 6: Correct. I had shifted to Delhi.
2:02:00
Speaker 7: Dr.
2:02:01
Speaker 6: Anand, Dr. Kumta, Bombay. Dr. Kumta is no more now.
2:02:05
And Dr.
2:02:06
Speaker 7: Jindal, the same Jindal, a pediatrician from Delhi, he is
2:02:09
also no more.
2:02:10
Speaker 6: Dr.
2:02:10
Speaker 7: Anand is 18 years older than me. He lives in Bombay.
2:02:16
We met at lunch at my house in Delhi. He said,
2:02:19
put in Rs. 1,000 each and start. So they asked
2:02:25
me a question. Arun, will you manage it? Be able
2:02:29
to manage it? So I had no other answer except yes.
2:02:33
Speaker 6: So I said yes.
2:02:34
Speaker 7: So the work of breastfeeding promotion started formally. So that
2:02:39
organization was formed. Gradually it grew. When I came here,
2:02:44
I used to practice a little. Just to earn some
2:02:49
money and wealth. So I also joined a hospital, Jaipur
2:02:53
Golden Hospital in Rohini. After 4 years, I left that.
2:02:58
I dedicated myself to breastfeeding work. So after that, I
2:03:02
kept bringing myself live. There are so many policy things
2:03:08
like maternity protection. We fought for it from 12 to
2:03:12
26 weeks. Then the poor women get economic advantage. During
2:03:19
Congress government, Manmohan Singh got Rs. 1,000 per month compensation
2:03:26
to maternity women. We regularly monitor this law. BPNI is
2:03:35
notified in the gadget to monitor this law. We file
2:03:38
a complaint in it. During the case that we did
2:03:41
at Nestle.
2:03:47
Speaker 6: So, what happened in that case?
2:03:48
Speaker 7: In that case, the charges were framed on them by
2:03:53
the lower court. Because it's a criminal law.
2:03:57
Speaker 6: It's like treated as a criminal offense.
2:04:00
Speaker 7: After that, Nestle went to the high court. The high
2:04:06
court left him. There's a confusion. We went to the
2:04:09
Supreme Court. The Supreme Court.
2:04:11
Speaker 6: Said, you're an NGO. Where's the government? So, that's why....
2:04:20
Speaker 7: But we keep on monitoring. We keep on doing our work.
2:04:24
So that was one thing which I think also helped
2:04:29
in a way to bring on board the lesser violations.
2:04:35
Speaker 4: Yeah.
2:04:36
Speaker 7: More implementation. So coming back to that, how did I decide?
2:04:47
I think it was more like a passion to work
2:04:51
in this area, which was developed in late 80s and
2:04:55
being executed till now.
2:05:00
Speaker 5: But I have to say, Dr. Rangupta, that case may
2:05:03
not have happened.
2:05:05
Speaker 7: No, I am not complaining about it. I am writing
2:05:07
a book on it. Thank you so much for being
2:05:31
here and for doing everything that you do.
2:05:33
Speaker 1: Thank you. It's a pleasure.