Islamabad: Pakistani households spend an estimated $888 million, or about Rs248 billion, annually on commercial breast-milk substitutes, while an estimated 33,700 child deaths each year are attributed to inadequate breastfeeding, according to figures presented by senior paediatricians at a national conference.
The figures were presented by Dr Muhammad Khalid Shafi of the Sindh Institute of Child Health and Neonatology (SICHN) at the 28th Biennial International Paediatric Conference, organised by the Pakistan Paediatric Association’s Federal Branch in Islamabad. The three-day meeting brought specialists together to discuss child health and policy.
Dr Shafi said Pakistan’s under-five mortality rate was 58 per 1,000 live births and neonatal mortality was 38 per 1,000, with newborns accounting for 62 per cent of under-five deaths. Exclusive breastfeeding among infants under six months stood at 48.4 per cent, while initiation in the first hour ranged from 20 to 48 per cent across regions.
His presentation said non-breastfed infants under six months faced about 15 times the mortality risk of exclusively breastfed infants, with diarrhoea and pneumonia among the main causes associated with inadequate breastfeeding.
Dr Shafi called for expanded Baby-Friendly Hospital Initiative training, public campaigns and enforcement of the Sindh 2023 law, alongside harmonised provincial rules. He criticised formula-industry marketing and inducements to health workers, urging professional bodies to enforce conflict-of-interest rules and regulators to act against violations.
Prof Masood Sadiq, vice chancellor of the University of Child Health Sciences, Lahore, said childhood heart failure often stemmed from congenital heart disease, rheumatic heart disease, myocarditis, sepsis, malnutrition and severe anaemia.
Citing the National Nutrition Survey, he said 57 per cent of Pakistani children under five had some degree of anaemia. He urged clinicians to recognise warning signs, including poor feeding, sweating during feeds, rapid breathing and poor weight gain, and refer children in time.
Prof Ejaz A. Khan of Shifa International Hospital said Pakistan faced persistent typhoid transmission and antimicrobial resistance but lacked reliable, up-to-date national surveillance. A five-laboratory dataset from 2017–19 found extensively drug-resistant typhoid in 57 per cent of isolates. He cautioned that the figure was not a current national incidence estimate. He called for better surveillance, susceptibility-guided treatment, vaccination, and improved water and sanitation.
Prof Aisha Mehnaz warned that air pollution was worsening respiratory risks for children. She cited fine particulate pollution at more than 13 times World Health Organisation guidelines and estimated that pneumonia kills about 70,000 children in Pakistan annually. She urged controls on vehicle and industrial emissions, crop and waste burning, year-round air-quality monitoring and stronger respiratory services.
Dr Muhammad Idrees of Lady Reading Hospital said estimated new HIV infections among children aged 0–14 rose from about 530 in 2010 to 1,800 in 2023. Only 38 per cent of children living with HIV were receiving treatment in 2024, he said. He cited unsafe healthcare and blood transfusions, as well as mother-to-child transmission, as preventable routes of infection.
A survey presented by Dr Mehek Naeem found gaps in adolescent care. Among 91 providers, 90 per cent reported no dedicated inpatient space for adolescents, while 78 per cent said their hospitals lacked a written policy for transition to adult care.
Prof Syed Jamal Raza, executive director of SICHN, highlighted paediatric endocrine concerns, including childhood obesity and diabetes, growth and thyroid disorders, and early or delayed puberty.
A Karachi study presented by Areeba Sultan of Aga Khan University examined 150 stillbirths and child deaths. Perinatal asphyxia accounted for 25 per cent, sepsis for 13 per cent and malnutrition for 9 per cent, pointing to preventable gaps in care.
In his vote of thanks, Prof Maqbool Hussain, chair of the organising committee and president of the PPA Federal Branch, said the programme brought specialists together for plenary and parallel sessions. The first day covered breastfeeding, life-course immunisation, vaccine hesitancy, meningococcal B disease and HPV vaccination, alongside community interventions to save newborn and child lives.
During the conference, Maj. Gen. (retd) Prof Salman Ali was elected PPA president, while Prof Waseem Jamalvi of Karachi was elected secretary general.
Ends