WHO/UNICEF Consultation on Breastfeeding Protection, Promotion and Support
In spite of what is known about the great benefits of breastfeeding that accrue to children, mothers, families and society—and the risks of disease and morbidity associated with bottle-feeding—the practice of breastfeeding continues to decline in many parts of the Asia and Pacific region. Breastfeeding competes for mother’s time, especially time she needs to earn income for the family, and breast milk is being made to compete against breast-milk substitutes. The clear inferiority of the substitutes is being masked by very aggressive marketing efforts of companies selling them. These campaigns often provide inaccurate information as well as incentives to health workers and professionals in clear violation of the national and international codes and agreements for marketing breast-milk substitutes. These tactics have undermined the efforts of governments, nongovernmental organizations (NGOs), individuals, and international organizations to provide mothers and families with accurate information to help them make the right choices for their children and themselves. The aggressive marketing of substitutes has also made it very difficult for concerned individuals and organizations to create environments that protect, promote and support breastfeeding.
To address these and related issues, a consultation on breastfeeding protection, promotion and support was organized by the WHO Regional Office for the Western Pacific and the United Nations Children’s Fund (UNICEF) Regional Office for East Asia and Pacific. Participants from Australia, Cambodia, the People’s Republic of China, Fiji, Indonesia, Japan, the Lao People’s Democratic Republic, Malaysia, Mongolia, New Zealand, Papua New Guinea, the Philippines, Samoa, Singapore, Solomon Islands, Thailand, Timor-Leste, Vanuatu, and Viet Nam met in Manila, Philippines, from 20 to 22 June 2007. The consultation was designed to strengthen the regional network with new and better tools and human and knowledge resources for expanding and sustaining the region’s breastfeeding culture.
The consultation objectives were to: share successful experiences and lessons learnt, and to analyse constraints to improving breastfeeding; discuss the status of the Baby-Friendly Hospital Initiative (BFHI) and future steps needed to strengthen and sustain the initiative; review the status of the adoption and implementation of the international and national codes for marketing breast-milk substitutes, and identify actions that will improve their effective implementation; and identify innovative ways to promote a breastfeeding culture and discourage a bottle-feeding culture.
The three-day workshop was divided into two main parts which were prefaced by presentations and discussions on breastfeeding in the context of the Regional Child Survival Strategy, the economics of breastfeeding, and country situation analyses (and available data tools). The first part aimed at creating an enabling environment (personal, societal and political) for breastfeeding by sharing experiences, looking for ways to strengthen BFHI, improving health worker skills, and effectively using communication tools to transform behaviour. The Cambodia case study was presented. The second part of the consultation focused on preventing a bottle-feeding culture from proliferating. The Philippine story was presented as an example which led to extensive discussions on how to better monitor and implement codes of marketing of breast-milk substitutes. Technical updates on breastfeeding in emergencies, breastfeeding and HIV, breastfeeding the low-birth-weight baby, the long-term effects of breastfeeding and breastfeeding beyond six months concluded the presentations.
Throughout the consultation, emphasis was placed on the need to identify actions that participants would commit to taking after the consultation. Therefore, to conclude the workshop, lists of recommendations and suggested actions were compiled (based on discussions over the three days) and organized under the following areas: breastfeeding economics; use of data, communication and advocacy; strengthening the BFHI; creating an enabling environment; increasing health worker skills; and implementation of the Code of Marketing of Breastmilk Substitutes.
The participants were expected to return to their respective countries and to use these lists—as well as personal lists that they were asked to prepare—to guide them through a course of action that would strengthen and expand the breastfeeding culture in their countries. With knowledge gained from the consultation and the connections made with fellow participants, resource persons and representatives of national and international organizations, participants were expected to become effective drivers in their present and future spheres of influence.