Key strategies for promotion of Breastfeeding
Facts and figures
- Each year over 10.8 million children under 5 die in the world, 3.9 million occur in the first 28 days of life.
- Undernutrition is an important underlying cause of deaths associated with infectious diseases
- About 2 million children die from diarrhoea each year.
- Two thirds of these deaths could have been prevented if effective child survival intervention had reached all children and mothers who needed them.
- Data from the East Asia and the Pacific region show that approximately 1.02 million children under 5 years died from 2000-2003.
- The World Summit for Children in 1990 called for a worldwide reduction in child mortality to below 70 deaths per 1000 livebirths by the year 2000 - this was not achieved.
- 13 percent of under-5 deaths at global level could be prevented if infants were exclusively breastfed for 6 months.
- 6 percent of under-5 deaths could be prevented with adequate and safe complementary feeding.
- Infants aged 0-5 months who are not breastfed have seven-fold and five-fold increased risks of death from diarrhoea and pneumonia, respectively, compared with infants who are exclusively breastfed.
- The exclusive breastfeeding rate 0-6 months in East Asia and the Pacific is 35.5 percent, ranging form 5.4 percent (Thailand) to 65.1 percent (Democratic People's Republic of Korea).
Baby-friendly hospital initiative
- In 2005, 10 441 hospitals and maternities were designated as Baby-friendly Hospitals in the Region.
- Countries leading are Thailand, Philippines, Myanmar, China and Mongolia.
- Current status - slippage occurring: WHO revising and streamlining all BFHI documents, tools and courses to revitalize the initiative.
- In most countries (42 countries) fewer than 10 percent of all health workers providing child care had been trained. (Bryce J. et al. Reducing child mortality: can public health deliver. Lancet 2003; 362: 159-164).
- Globally in 2006 alone, an estimated 530,000 (410,000-660,000) and 380,000 (290,000-500,000) children less than 15 years of age acquired HIV and died of AIDS.
- HIV/AIDS is an emerging problem in East Asia and the Pacific and is related to about 1 percent of mortality among children under 5 years of age.
- Without interventions and depending on duration, about 5-20 percent of HIV-infected women will transmit HIV through breastfeeding.
- The risk of transmission through exclusive breastfeeding up to 6 months of age (measured from 6 weeks) is about 4 percent.
- These women face dilemma of choosing the right infant feeding option for them and their babies while balancing the risks of trying to prevent HIV transmission to their infants while not exposing them to the risk of malnutrition and other illnesses due to not breastfeeding.
Global strategy for infant and young child feeding
The Global Strategy aims to revitalize efforts to promote, protect and support appropriate infant and young child feeding.
It builds upon past initiatives, in particular the Innocenti Declaration and the Baby-friendly Hospital initiative and addresses the needs of all children including those living in difficult circumstances, such as infants of mothers living with HIV, low-birth-weight infants and infants in emergency situations.
The strategy calls for action in the following areas:
- All governments should develop and implement a comprehensive policy on infant and young child feeding, in the context of national policies for nutrition, child and reproductive health, and poverty reduction.
- All mothers should have access to skilled support to initiate and sustain exclusive breastfeeding for 6 months and ensure the timely introduction of adequate and safe complementary foods with continued breastfeeding up to two years or beyond.
- Health workers should be empowered to provide effective feeding counselling, and their services be extended in the community by trained lay or peer counsellors.
- Governments should review progress in national implementation of the International Code of Marketing of Breast milk Substitutes, and consider new legislation or additional measures as needed to protect families from adverse commercial influences.
- Governments should enact imaginative legislation protecting the breastfeeding rights of working women and establishing means for its enforcement in accordance with international labour standards.
The WHO/UNICEF Regional Child Survival Strategy focuses on the implementation of an Essential package for child survival. The package is composed of:
- Care of the newborn
- Breastfeeding and complementary feeding
- Micronutrient supplementation
- Immunization of children and mothers
- Integrated management of sick children
- Use of insecticide-treated bednets (in malarious areas)
WHO Child Growth Standard - a growth chart for the 21st century
- Allow growth measurements of infants and children against a standard optimum value
- There are charts for boys and for girls, for infants to one year, for children up to 5 years
- Include windows of achievement on development milestones
- Describe "how children should grow"
- Establish breastfeeding as the biological "norm"
Policy statements on infant feeding
- "The breastfed infant is the normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short- and long-term outcomes", American Academy of Pediatrics, 1997"The promotion and practice of breastfeeding is essential to the achievement of optimal infant and child health, growth, and development", American Academy of Pediatrics, 2005
- "The promotion and practice of breastfeeding is essential to the achievement of optimal infant and child health, growth, and development", American Academy of Pediatrics, 2005
- National infant feeding policies of many countries recommend exclusive breastfeeding as the optimal source of nutrition for the first six months of age