Breastfeeding: Global and National Commitment

Dr. Abhishek IngoleP.G. Community Medicine

7days

28 days

1 year

Birth

5 years

10 years

19 years

Pregnancy

Adulthood

Ageing

Death

Nutrition interventions around the life course

Micronutrient supplementation

as necessaryEnergy & nutrient

adequate dietSchool meals

Pre-pregnancy dietary advise for adolescent

girls and women

Adolescent dietary advise

Diet and micronutrients

during pregnancy

GLOBAL STRATEGIES

IYCF Adequate complementary

feeding 6-24 months

Continued breastfeeding

Early initiation of

breastfeeding Exclusive

breastfeeding for 6 months

Global and National Commitment: Key Initiatives

The Innocenti Declaration on Protection, Promotion and Support of Breastfeeding ;1990 and the Innocenti Declaration on Infant and Young Child Feeding; 2005.

Global Strategy for Infant and Young Child Feeding; 2004.

World Breastfeeding Week campaign since1992.

The Infant Milk Substitutes Act 1992 and The IMS Amendment Act; 2003

National Guidelines for Infant And Young Child Nutrition; 2004

The Joint Statement on Infant and Young Child Feeding; 2006

The Innocenti Declaration

In 1990, 30 countries together with their partner organizations decided to create a global action plan to reverse the declining breastfeeding rates.

A collaboration of technical staff, known as Integracy Group for Action on Breastfeeding (IGAB) with WHO, UNICEF, USAID and SIDA at the Florence meeting on 30 July- 1 Aug 1990 adopted the Innocenti Declaration on Protection, Promotion and Support of Breastfeeding.

• To appoint a national coordinator and a breastfeeding committee composed of representatives from relevant government departments, NGOs and associations of health professionals;

• Ensure that every facility providing maternity services fully practices all the “Ten steps to successful breastfeeding”

• Give effect to the principles and aim of the International Code of Marketing of Breast-milk substitutes

• Enact legislation protecting breastfeeding rights of working women and establish means for its enforcement.

Operational targets of the Innocenti Declaration

The Innocenti Declaration: Achievements

The Declaration inspired the establishment of the Baby-Friendly Hospital Initiative (BFHI)

It called on all countries to follow the Ten Steps of successful Breast-feeding to improve maternity practices

It ensured full support for mothers intending to breastfeed.

The Innocenti Declaration

On 22nd November 2005, at the 15th anniversary of Innocenti declaration, another declaration was passed on Infant and Young Child Feeding.

• Develop a comprehensive policy on IYCF, in context of national policies and programmes for nutrition, RCH and poverty reduction.

• Protect, promote and support exclusive breastfeeding for six months and continued breastfeeding up to two years of age or beyond.

• Provide guidance on feeding infants and young children in exceptionally difficult circumstances, and on support required by mothers, families and other caregivers.

Operational targets of the Innocenti Declaration

Global Strategy for Infant and Young Child Feeding

• Jointly Developed by WHO and UNICEF in 2004

• Aims to improve - through optimal feeding - the nutritional status, growth and development, health, and thus the very survival of infants and young children.

Objectives -• Improve the feeding of infants and

young children • Increase the commitment of

governments, civil society and international organizations.

Com

preh

ensiv

e ac

tion

Steps for implementing the Strategy for IYCF in countries

1. Identify and orient key stakeholders and prepare for developing a comprehensive strategy

2. Assess and analyse local situation3. Define preliminary national objectives4. Identify and prioritize actions5. Develop a national strategy and plan of action6. Implement and monitor

To develop, implement, monitor and evaluate a policy on infant and young child feeding in the context of national policies and programmes for nutrition, child and reproductive health, and poverty reduction.

World Breastfeeding Week

• World Alliance for Breastfeeding Action (WABA) organized the WBW campaign in 1992 as their first social mobilization effort to raise awareness and stimulate action globally in support of breastfeeding.

• WBW is celebrated in more than 100 countries every year from 1–7 August to mark the Innocenti’ anniversary on 1 August.

• WBW has mobilized governments, ministries, civil society

organizations to conduct activities in support of breastfeeding.

The Infant Milk Substitutes Act 1992

An Act to amend the Infant Milk Substitutes, Feeding Bottles and Infants Foods

• It provides for the regulation of production, supply and distribution of infant milk substitutes, feeding bottles and infant foods

• To protect and promote breastfeeding and ensure the proper use of infant foods.

‘The IMS Amendment Act 2003’ was enacted on 2nd June 2003• It prohibits promotion of breast-milk substitute products on the

pretext of distribution of educational or informational material.

The IMS Amendment Act 2003

• No person shall donate or distribute infant milk substitutes or feeding bottles or infant foods to anyone except to an orphanage.

• All products should mention in a clean, conspicuous and easily understandable manner, the words “IMPORTANT NOTICE ” and -a) A statement - “MOTHER’s MILK IS BEST FOR YOUNG BABY

”.b) A statement that “ The product should be used only

on the advice of health worker or medical personnel.”c) A warning – “ Infant milk substitutes are not the sole

source of nourishment of an infant.”

National Guidelines for Infant And Young Child Nutrition; 2004

Objective to achieve the nutritional goals set by planning commission of the Tenth Five Year Plan -

• Initiation of Breastfeeding 15.8 % to 50% • Exclusive breastfeeding 55.2% to 80% • Complementary feeding 33.5% to 75%

To intensify nutrition and health education.

To bring down the prevalence of underweight children and malnutrition.

December 20, 2006

It appealed the chairperson of the planning Commission to recognize ‘Breastfeeding’ as food security for infants and

include it in National Food Security Plans and make it a part of annual reporting of Government of India.

Breastfeeding Promotion Network of India (BPNI)

• National network of organizations and individuals dedicated to protection, promotion and support of breastfeeding and optimal infant and young child feeding practices.

• It was founded on 3rd Dec., 1991 at MGIMS, and is working under the National coordination of Dr. Arun Gupta, 3500 members allover India and multiple partner organizations.

MDG: A Commitment

Breastfeeding improves short and long term maternal and child health; and thus contribute to the

attainment of the Millennium Development Goals (MDGs) 4 and 5 REDUCE CHILD MORTALITY and IMPROVE MATERNAL HEALTH to achieve by 2015.

Prevalence of exclusive breastfeeding among children<6

months of age

Glaring gaps in policy and programmes of IYCF

That’s the reasons why NFHS 3 did not show very encouraging results.

India’s 6th position in South Asia puts us to shame.

Three areas of action need to be acted upon.

Essential Actions to promote, protect and support appropriate IYCF practices

Legislation and policy

Implementation

Improving family and community practices

Improving Health system

and health worker skills

What works? Breastfeeding education

• Good Information and skilful counselling (pregnancy, birth

and later)• Assistance at birth and later• ‘Counsel’ and help to prevent sore nipples,

engorgement, and solve these if they arise • ‘Counselling’ on complementary feeding• Counselling on feeding options for

emergencies and special situations.Breastfeeding [IYCF]

SupportCentres at cluster and

blocklevel in NRHM

Newborn deserves the best Nutrition, Improved survival, Optimum

development and a Healthy LifeBreast-feeding can do this miracle!!!...

Thank You!