Breastfeeding for up to first six months is a gateway to good health for the child: HCFI

Health Care, Heart Care Foundation of India, Medicine Comments Off

Colostrum or the first milk is akin to “liquid gold” and boosts immunity

New Delhi, 9th May 2019: Feeding breastmilk to premature babies during the first month of life appears to stimulate more robust brain growth, as per a recent study. It indicated that cerebral white matter showed significantly greater levels of a molecule similar to glucose for babies fed breast milk, compared with babies who were fed formula.[1] Research also suggests that babies who are exclusively breastfed for at least two months stand a lesser chance of Sudden Infant Death Syndrome (SIDS).

Only 54.9 % children under the age of six months have been exclusively breastfed, according to the latest National Health and Family Survey (NHFS-4). There are ongoing efforts worldwide to improve the rates of breastfeeding, and the WHO has the goal of having more than half of infants worldwide being breastfed exclusively for at least six months by 2025. The need of the hour is to create wide awareness on the importance of exclusive breastfeeding for up to six months after birth.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “Breastfeeding is an essential requirement for infants at least up to the first 6 months. Exclusive breastfeeding can reduce chances of infections and diseases by building their immunity. However, there could be several factors that discourage women from breastfeeding: lack of designated places for women to feed the child, minimal understanding of the concept and family pressure. In addition, there are many infant feed formulations available in the market. This is sometimes projected as a healthy alternative and can be a deterrent to breastfeeding.”

Breast milk is rich in antibodies and enzymes that offer a child protection against several diseases. Studies have found that children who are exclusively breastfed also gain weight better, have higher IQ, better immunity and are less prone to allergies and infection.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Colostrum is like ‘liquid gold’ for the baby. It is rich in fat and antibodies and coats the baby’s gastro-intestinal system. When the baby is out of the mother’s womb, it is attacked from outside by several factors. It is the colostrum that offers protection.”

The following points are a must to remember after childbirth.

  • Wash your hands with soap or use a hand sanitizer before handling the baby.
  • Be careful to support the baby’s head and neck.
  • Start breastfeeding within an hour of birth.
  • Ensure that the baby is exclusively breastfed for the first 6 months.
  • Child should be fed on demand or at least 8 times in 24 hours.
  • Avoid feeding honey, water or things other than breast milk in lieu of a ritual as it can be a source of infection to a baby.
  • Give the baby a sponge bath until the umbilical cord falls off and the navel heals completely (1-4 weeks).
  • Kangaroo Mother Care especially for low birth weight infants, wherein the baby is held in a special way stuck with the chest to provide skin to skin contact with the mother along with exclusive and frequent breastfeeding.

[1] Study presented at the Meeting Pediatric Academic Societies.

Safe disposal of expired and unused medicines

Health Care Comments Off

It is the usual tendency to throw the unused and expired medicines in the household trash, which is then collected by the waste collector or thrown into vacant plots in the neighborhood or on the streets. But this is approach to drug disposal is hazardous to the environment and thence to life.

Through the waste (in the open or landfills), these medicines may pollute water sources and also enter the soil. There are chances of accidental exposure to these medicines for waste pickers or children. Then, there is the hypothetical risk of these drugs being recycled back into the market.

Unused and expired medicines are considered as “domestic hazardous waste” in India as per the Solid Waste Management Rules 2016. These new rules mandate segregation of waste at source into biodegradable, non-biodegradable (recyclable and combustible), sanitary waste and domestic hazardous wastes.

“direct waste generators not to litter i.e throw or dispose of any waste such as paper, water bottles, liquor bottles, soft drink cans, tetra packs, fruit peel, wrappers, etc., or burn or burry waste on streets, open public spaces, drains, waste bodies and to segregate the waste at source as prescribed under these rules and hand over the segregated waste to authorised the waste pickers or waste collectors authorised by the local body”

The rules also require the local authorities to ensure door to door collection of segregated solid waste from all households and transport it in covered vehicles to the processing or disposal facilities.

Biomedical Waste Management Rules, 2016 categorize Discarded or Expired Medicine Pharmaceutical waste like antibiotics, cytotoxic drugs including all items contaminated with cytotoxic drugs along with glass or plastic ampoules, vials etc. in the yellow category, which are to be discarded in the yellow coloured non-chlorinated Plastic Bags

The US FDA has listed three disposal methods for unused or expired medicines:

Medicine take-back options
Disposal in the household trash and
Flushing certain potentially dangerous medicines in the toilet
Medicine take-back option is the preferred option to safely dispose of most types of unneeded medicines. This can be done via temporary collection sites or authorized permanent collection sites, which may be available in may be in retail pharmacies, hospital or clinic pharmacies, and law enforcement facilities.

The FDA has laid down simple steps when considering disposal in the household trash

Mix medicines (do not crush tablets or capsules) with an unpalatable substance such as dirt, cat litter, or used coffee grounds;
Place the mixture in a container such as a sealed plastic bag;
Throw the container in your household trash; and
Delete all personal information on the prescription label of empty pill bottles or medicine packaging, then dispose of the container.
Some medicines such as fentanyl patches, diazepam have specific instructions to immediately flush down the toilet when no longer needed and a take-back option is not readily available. The FDA has created a list of medicines recommended for disposal by flushing that are no longer needed and when take-back options are not readily available.

In an article published in 2017 in the journal Science of the Total Environment, the FDA examined the risks associated with the environmental release of 15 active pharmaceutical ingredients (APIs) currently on its “flush list”. The FDA concluded that most of these APIs present a negligible eco-toxicological risk, although some additional data would be helpful for confirming this finding for some of these medicines. And, all 15 APIs present negligible risk through ingestion of water and fish (Sci Total Environ. 2017 Dec 31;609:1023-1040).

It is important to be aware of the drug disposal methods to avoid potential harm to the community. Patients should be counselled about safe drug disposal.

India has the rules and regulations in place for safe drug disposal, but they need to be implemented strictly.


Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA