“Fitness consciousness” among mothers is being linked to measles death — what the reality shows

As measles outbreaks continue across the country, many parents are now fighting relentlessly in hospitals to save their children. Recently, I spoke with one such mother at the Infectious Diseases Hospital in Mohakhali, Dhaka. She had come from Gazipur. Even in the intense heat, she sat beside her son’s bed fully covered in a large hijab, with only her eyes visible. She could not have been older than 24, and she appeared extremely thin and frail. She said that because her husband did not want it, none of her four children—including the child infected with measles—had received any vaccines.

For more than a month, I have been speaking almost regularly with mothers of children with measles at Bangladesh Shishu Hospital and Dhaka Medical College Hospital as well. Most of these mothers have little decision-making power within their families. Nor did it seem that they had the luxury to worry about maintaining their figure or fitness. Given the price of infant formula or powdered milk, it also did not appear that the mothers present in these three hospitals could afford them.

The reason for writing this is a recent claim that has surfaced. On 13 May, amid successive child deaths from measles, Abdullah Al Jaber, member secretary of the organisation Inquilab Moncho, said at a press conference that “55 per cent of mothers are not breastfeeding their children out of fear of losing fitness.” The next day, however, he attempted to partially revise his statement in a Facebook post. He wrote that a “study” by Deutsche Welle had found that around 55 per cent of mothers were not breastfeeding their children, causing those children to develop weak immunity.

Abdullah Al Jaber also added that among that 55 per cent, many mothers were unable to breastfeed because of various difficulties. Since he had not initially mentioned this “many,” his statement was being misinterpreted, for which he apologised.

Although Abdullah Al Jaber referred to it as a “study,” it was actually a news report published by Deutsche Welle Bangla. The report quoted physician Lelin Chowdhury as saying, “Research shows that if a child is breastfed, the immunity developed during the first six months is so strong that vaccines are not necessary during that period. After that, immunity begins to decline. That is why the vaccination age was set at 9 months. Now research has found that 55 per cent of mothers are not breastfeeding, so these children are not developing immunity.”

However, he did not connect mothers’ failure to breastfeed with concerns about fitness.

Following the outbreak, as of 21 May, a total of 488 people have died in Bangladesh from measles and related symptoms. The number of confirmed and suspected cases has exceeded 59,000.

Not only in the three hospitals I visited in Dhaka, but also in the photos and videos sent by Prothom Alo photojournalists from hospitals in and outside the capital, the mothers of measles-infected children did not appear “fitness conscious.” Rather, the images clearly reflected malnourished mothers and children.

Experts have identified missed childhood vaccinations over recent years as the primary reason for this measles outbreak. Malnutrition has also been cited as a contributing factor, including the decline in breastfeeding rates. And this has now become an occasion for blaming women.

On 17 May, at the inauguration and scientific seminar of an awareness week titled “Public Awareness and Prevention Are the Best Ways to Control Measles and Dengue,” Health Minister Sardar Md Sakhawat Hossain also blamed mothers for child deaths and malnutrition linked to measles, although he did mention mothers’ own health crises.

The essence of the minister’s remarks was that children suffer from malnutrition because their mothers themselves are malnourished, unhealthy, hollow-eyed, with rough skin and visible bones. These mothers do not breastfeed. They do not feed proper milk. As a result, children fail to grow properly during the crucial developmental period.

Physicians have long emphasised that breastfeeding within the first hour after birth, followed by exclusive breastfeeding for six months (not even water), and continued breastfeeding for two years or more helps build a strong immune system in children. Still, it is true that breastfeeding rates in Bangladesh are declining.

The Bangladesh Demographic and Health Survey 2022, published in March 2023, found that the rate of exclusive breastfeeding among children aged 0–5 months fell from 65 per cent in 2017–18 to 55 per cent in 2022. Among babies born at home, breastfeeding within one hour of birth fell from 69 per cent in 2017–18 to 40 per cent in 2022.

The government report also stated that nearly 18 per cent of infants aged 4–5 months were consuming other milk in addition to breast milk, while 26 per cent were being given complementary foods. Bottle-feeding with nipples is also affecting breastfeeding rates.

In other words, the decline in exclusive breastfeeding is linked to practices such as giving water, formula milk, or complementary food before the appropriate age, delaying breastfeeding after birth, and bottle-feeding. The report did not mention mothers’ fitness or physical appearance as a direct factor.

A 2025 Multiple Indicator Cluster Survey jointly conducted by the Bangladesh Bureau of Statistics and UNICEF found that breastfeeding within one hour of birth was comparatively lower among urban and highly educated mothers. One major reason identified was the high rate of cesarean deliveries.

Now let us briefly look at another country.

Turkey, a transcontinental nation, conducted a study between November 2023 and July 2024 examining the relationship between body image, depression, and breastfeeding attitudes among mothers of children aged 0–24 months. Conducted by researchers from two Turkish universities, the study involved 282 mothers. Sixty-three per cent had higher education, 52 per cent were employed, and 50 per cent had delivered through cesarean section.

The research, conducted through various Turkish digital platforms, found that mothers with a more positive perception of their bodies tended to breastfeed more. Breastfeeding rates declined as levels of depression increased. Stretch marks, sagging skin, and changes in breast shape after childbirth could make mothers anxious. Weight gain was also linked to negative body image. However, 51 per cent of the women in the study said they stopped breastfeeding not because of fitness concerns, but because they felt they did not have enough milk.

This experience of “not producing enough milk” is also common among Bangladeshi women. Khurshid Jahan, director of the Bangladesh Breastfeeding Foundation, told Prothom Alo that many new mothers do not understand how to properly position and breastfeed a newborn.

During the first two or three days after birth, breast milk production is often low, causing many mothers to lose confidence. They begin to think they cannot breastfeed successfully. At the same time, they often do not receive adequate support from family members. For working mothers, the lack of paid maternity leave and childcare facilities at workplaces also has an impact. And then there is the aggressive marketing of formula milk, enabled through loopholes in the law.

Khurshid Jahan said that concerns about fitness may exist among upper-class mothers, but “it would not be more than 5 per cent.”

In 2022, the World Health Organization and UNICEF jointly published a study on the marketing of formula milk and its impact on infant feeding choices. Field data were collected between August 2019 and April 2021. The survey included 8,500 parents and pregnant women, along with 300 healthcare workers, from cities in Bangladesh, China, Mexico, Morocco, Nigeria, South Africa, the United Kingdom, and Vietnam.

Funded by the Bill & Melinda Gates Foundation, the study found that Bangladesh’s exclusive breastfeeding rate up to six months was 65 per cent. Comparable figures were 35 per cent in Morocco, 32 per cent in South Africa, 29 per cent in Nigeria and Mexico, 24 per cent in Vietnam, and 21 per cent in China.

The study also found that 98 per cent of pregnant women in Bangladesh intended to practice exclusive breastfeeding — higher than in the other countries surveyed. Only 27 per cent of Bangladeshi women had been influenced by formula milk advertising in the past year, again lower than in other countries. However, the perception that formula milk is “necessary” because of advertising was comparatively higher in Bangladesh.

After 11 years of marriage, Farzana Islam and Helal Bhuiyan had a child through IVF. Their son, Faiyaz Hasan Tazim, died from measles on 22 April at the age of 8 months and 18 days. The struggle for his life had begun in March. In just 17 days, hospital expenses exceeded 400,000 taka.

Farzana wrote on Facebook: “Innocent children are dying, but there is no discussion in parliament. No one is accountable. No one admits failure. Everything is the fault of mothers and children. Why were these children born in this country? Why did mothers give birth to them?”

Experts say that before blaming mothers, the real causes behind children contracting measles must be identified.

The biggest factor in Bangladesh losing its path toward measles elimination is disruption in vaccination coverage. Under the Expanded Programme on Immunization (EPI), children are routinely given the first dose of measles vaccine at 9 months and the second dose at 15 months.
On 2 April, the World Health Organization office in Dhaka told Prothom Alo that the current measles outbreak was primarily caused by the “immunity gap” created over the past two years due to disruptions in routine child vaccination.

On 5 May, UNICEF’s acting representative in Bangladesh, Stanley Gwavuya, told Prothom Alo in an interview that UNICEF had repeatedly met with senior leaders of the interim government and formally warned them after each meeting about possible vaccine shortages, outbreaks, rising complications, and death risks.

Reports have also revealed that hospitals across Bangladesh, including those in the capital, were unprepared to handle the outbreak. Parents have been seen moving from one hospital to another because of shortages of pediatric intensive care units and other facilities, while children die in their arms. Families are also becoming financially devastated by medical costs.

The issue of maternal malnutrition was highlighted in the 2025 Bangladesh Multiple Indicator Cluster Survey, which found that nearly 53 per cent of pregnant women in Bangladesh suffer from anemia.

Prenatal care plays a crucial role in protecting mothers’ nutrition and health. The report stated that only 43.3 per cent of mothers received at least four antenatal care visits, as recommended by WHO. Only 5.5 per cent received eight visits.

Fauzia Moslem, president of the Bangladesh Mahila Parishad and herself a physician, said she has noticed numerous statements blaming mothers for measles-related child deaths.

She told Prothom Alo, “Various people are blaming mothers for children dying from measles. These statements are obscuring the real issues. It reflects ignorance about mothers’ realities and is a strategy to attack women.”

Fauzia Moslem pointed out that most of the children dying from measles are from outside Dhaka. How many of these mothers, she asked, can even afford canned formula milk?

Questioning women’s decision-making power within Bangladesh’s patriarchal social structure, she added, “How much decision-making power does a mother who was a victim of child marriage really have? We also need to examine whether these mothers are physically capable of breastfeeding their children.”