Breastfeeding is a public health issue… Says Prof. Olivier De Schutter, UN Special Rapporteur on the Right to Food

By James Achanyi-Fontem, camlink99@gmail.com

Olivier de Schutter, United Nation special Rapporteur for right to food an made recommendations to governments as to how to improve food security & promote the vital food at all levels, during the World Breastfeeding Conference in Delhi, India from the 6th – 9th December, 2012. Though not present in Delhi, he sent a message from New York and lauded the work of the International Baby Food Action Network Asia that was instrumental in organizing the event. He called on governments to copy the Vietnam good example, where on the 18th June 2012, the National Assembly approved the extension of paid maternity leave from 4 months to 6 months. On 24th June, it voted to ban the advertising of Breast Milk Substitutes for infants from 6 to 24 months, aligning the country more closely with the 1981 International Code on Breastmilk Substitutes on the marketing of breastmilk substitute and subsequent World Health Assembly resolutions. Prof. Olivier De Schutter added that, exclusive breastfeeding for 6 months and continued breastfeeding until the second birthday of the child, is very important for governments to move beyond promotional campaigns and education. Promotional Campaigns and education are extremely important, that they are necessary and useful. Education about nutrition and the benefits of breastfeeding in schools should be supported, while the media should be sending the right messages to communities.

He regretted that there is relatively a low number of countries that are serious about the enforcing the International Code on the Marketing of Breastmilk Substitute. In his words, the count made by World Health Organization in December 2011, shows that out of a total of 165 states 103 states had some regulatory measure in place, 37 States relied only on the voluntary commitments of the infant formula manufacturers and 25 States had taken no action. More worrying is the fact that out of the 103 States which adopted legislative instruments in order to implement the International Code on the Marketing of Breastmilk Substitute, only a bit less than 50% of the countries have provisions on enforcement and only 37 States has the World Health Organization considered serious enforcement of these provisions. With this, the UN Special Rapporteur on the Right to Food said, governments should ensure that the mothers are given the right message and that the efforts of government to promote breastfeeding are not nullified and made fruitless by the selling of infant formula by the manufacturers.

The International Code of 1981 is absolutely vital but it is not enough and governments must also ensure that the employers facilitate breastfeeding, by having childcare facilities in the work place. Maternity leaves allow women not to have to choose between remaining in employment and providing adequate breastfeeding to the child, he emphasised. This should also be true for public work programmes because the important part of social protection measures is often forgotten in developing countries. Another phase for action for supporting breastfeeding is by strengthening women’s rights and women’s education. There was a very impressive study published in 2000 by Smith & Haddad showing that based on a cross country study, covering 25 years from 1970 to 1995 Smith & Haddad showed that 43% of the reduction of hunger in developing countries during those 25 years were attributable to improved women’s education. This is almost as much as the increase in food availability which stands at 26% and the improvements in health services at 19% together. Infact if we 12% of the improvements to the reduction of hunger and malnutrition during this period attributable to better life expectations for women, the conclusion is that 55% of the gains against hunger, malnutrition during this period were attributable to women’s education or a longer life expectancy for women.

This leads us to recognize the importance of adequate care of the children during the first few years of life in order to have adequate nutritional and health outcomes. UNICEF in particular has proven and demonstrated that food intake alone would not ensure adequate health & nutritional outcomes if not combined with adequate care, if not combined with adequate access to water, sanitation services and health services, All these together ensures that young children develop well physically and mentally and that the mortality of the children under five is reduced. Better education for girls and women is absolutely vital to achieve this. Today, better education for women and girls means more economic opportunities and more chances of employment outside the household. The income effects are such that the child ultimately benefits & women that are more economically active and more economically independent can make better use of their time and make the right choices, for example, to visit health facilities and to have the child adequately taken care of. To promote breastfeeding better and more effectively, we must build on breastfeeding as a human right both for the women and for the infant. This imposes certain obligations on governments particularly to adapt the world of employment to the need to support breastfeeding and to seriously implement the International Code of Marketing of Breastmilk Substitutes In support of the UN vision, the President of India, His Excellency, Shri Pranah Mukherjee send a congratulatory message to the organizers of the World Breastfeeding Conference. Considering that New delhi was honoured as host, he extended wishes of success during the deliberations. Mrs. Sheila Dikshit, the Chirf Minister of the National Capital Territory of Delhi, on her part said, that the Global Breastfeeding Initiative for Child Survival, GBIGS, organizing the World Breastfeeding Conference, WBC, under the theme “Babies need mom-made, Not man-made” was very relevant, especially as over 1.000 delegates from all regions of the world were in Delhi to contribute and exchange their experiences. Chief Minister of Gujrat, Narendra Modi. On his part said, while India is fighting malnutrition, the age=old tradition of breastfeeding is a blessing in disguise. Breastfeeding the very natural source of nutrition for nw born provides anti-bodies which help to establish the baby’s immune system. It also provides digestive nutrients essential for healthy growth.

Some 800 experts from 84 countries arrived India to support the initiative of the International Baby Food Action Network, IBFAN and the World Alliance for Breastfeeding Action, WABA. It was an opportunity to pledge support for every breastfeeding mother in the world. Minister Omar Abdullah, Minister of Jammu and Kashmir said, the nature of the theme is welcome and timely. He observed that the nature of the family is changing and the change is impacting the relationship between the mother and the child with breastfeeding as an important structural element. He aaded that feeding the baby through any other method different from the breast is artificial. Artificial feeding impacts on the baby negatively health-wise, physically and psychologically. Minister Oomen Chandy of Kerala, added his voice by saying that the dawn of modern day health care remedies and life style has influenced artificial feeding to suppress breastfeeding. With this situation, we have to highlight the nutritious and healthy nature of mother’s milk. Breastmilk substitutes trigger impairment in children and we should fight against it. The world breastfeeding conference aimed at popularizing the significance of infant feeding globally. H.E. Manohar Parrikar of Goa called on participants to take up issues related to policy gaps if change has to be achieved in the struggle for child survival and especially to support women to improve on child health and nutrition. India has a ministry for health and family welfare and another ministry for women and child development. For more information, click on the following web pages – http://uk.youtube.com/camlink99/ - http://camlinknews.blogspot.com/2012/12/breastfeeding-gets-into-worldwide_5124.html

Breastfeeding Gets Into Worldwide Development Agenda

By James Achanyi-Fontem, Email: camlink99@gmail.com

The World Breastfeeding Conference 2012 theme, “ Babies Need Mom Made Not Man Made” was echoed in over 100 presentations in three busy working days by facilitators and over 800 participants from 84 countries. This articles points out some of the strong statements by presenters. Dr. Arun Gupta highlighted the advantages of breastmilk in a paper, saying that junk food cause girls to hit puberty at the age of 6 years, bananas may soon become a critical food sources for millions of people and replace potatoes as a staple diet due to climate change according to recent research. Healthy diet can prevent second heart attack because this has been seen as powerful as pills and healthy life is what mothers and their babies deserve. Breastfeeding can save 22% of new born babies, especially as the first 1.000 days shape the health life of the baby.

Prof. Anwar Fazal had presented the past icons of breastfeeding promotion and what they all left behind as a memorial legacy. Dr. Nicholas Alipui, the UNICEF Director of Programmes in New York presented a paper which revealed that breastfeeding is on the development agenda worldwide, as he highlighted the successes, challenges and way forward. Dr. Alipui said, what is hampering progress is the lack of a common agenda with a shared vision of change and the orphan issue is not grounded in a cohesive advocacy with the communities. The industries act as counter forces. The bottle neck at programme level is the under-estimation and inadequate recognition of impact, the absence of effective, comprehensive approaches at scale, interventions are not optimally implemented, slow and not tangible behaviour change, while HIV and infant feeding makes issues more complex and confusing.

Some of the opportunities are the Scaling Up Nutrition (SUN) action with focus on a promise renewed, quality of education/learning link to Nutrition, early Childhood Development, greater focus on gender equality and support to national movements for the expansion of health campaigns to involve community workers. UNICEF has produced a good number of IYCF tool and reviews to facilitate achievement of goals within communities and health facilities. Another strong intervention was made on how to enhance breastfeeding rates globally by Dr F. Branca, Director of Nutrition for health development department at the World Health Organisation head quarters.

It was made known that on the 26th May 2012 at the WHA, Member States committed to tackle global nutrition challenges. The six nutrition targets agreed on include reduction of childhood stunting by 40%, reduction of anemia in women of reproductive age by 50%, reduction of Low Birth Weight by 30%, 0% increase in childhood overweight, increase exclusive breastfeeding rates in the first 6 months up to 50% and reduction and maintaining childhood wasting to less than 5% The actions recommended include: ACTION 1: To create a supportive environment for the implementation of comprehensive food and nutrition policies ACTION 2: To include all required effective health interventions with an impact on nutrition in plans for scaling up ACTION 3: To stimulate the implementation of non health interventions with an impact on nutrition ACTION 4: To provide adequate human and financial resources for the implementation of health interventions with an impact on nutrition ACTION 5: To monitor and evaluate the implementation of policies and programmes The factors for successful breastfeeding promotion include: 1. implementation of the International Code of Marketing of Breast-milk Substitutes 2. Baby Friendly Hospital Initiative (BFHI) 3. Advocacy, training and education of health professionals 4. Community-based promotion and support 5. Maternity legislation and workplace support Participants at the World Breastfeeding Conference in New Delhi, India were reminded of the Innocenti Declaration and countries that have not already accomplished the following, should plan to: 1. a national BF coordinator and establish a multisectoral national BF committee. 2. Ensure that every facility providing maternity services fully practice all the “Ten steps to successful BF”. 3. Give effect to the principles and aim of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant World Health Assembly resolutions (Code). 4. Enact imaginative legislation to protect the BF rights of working women. 5. Develop, implement, monitor and evaluate a comprehensive policy on infant and young child feeding. 6. Ensure that the health and other relevant sectors protect, promote and support EBF for six months and continued BF up to two years of age or beyond. 7. Promote timely, adequate, safe and appropriate complementary feeding with continued BF. 8. Provide guidance on feeding infants and young children in exceptionally difficult circumstances. 9. Consider new legislation or other measures to give effect to the principles and aim of the Code.