Wednesday, July 31, 2013

World Breastfeeding Week – bringing support closer to mothers

A doctor shows a new mother the correct position for breastfeeding
© UNICEF Viet Nam/2013/Truong Viet Hung
Breastfeeding made it again! Yes, it made the top key interventions that can save lives featured in the 2013 nutrition series in The Lancet. As a nutritionist, I was delighted to see this given that breastfeeding is not a magic bullet but simply a natural thing to do by every mother in the world. More than 800,000 child deaths every year are linked to poor breastfeeding practices. Starting breastfeeding right after birth, doing it exclusively for the first six months and continuing for two years or more can make a significant difference in the life and development of a child.

The Lancet Series showed that counseling or education increased exclusive breastfeeding by 90 per cent between 1-5 months. So efforts to promote, protect, and support breastfeeding should be a no brainer, shouldn’t they?  And if some people think that breastfeeding is related to child survival in developing countries only, findings from a study done in the United States will prove them wrong. It showed that if 90 per cent of US families followed medical recommendations to breastfeed exclusively for 6 months, the US would save $13 billion per year and prevent more than 900 deaths, nearly all infants.

World Breastfeeding Week is an annual celebration marked from 1-7 August. This year, the theme is breastfeeding support for mothers. More mothers breastfeed when they receive support, counselling and education in health centres and in their communities.  UNICEF supports mothers by advocating for stronger national policies and laws on infant and young child feeding, and by assisting countries to expand programmes that promote healthy breastfeeding practices.
Nguyen Anh Dao, 24, breastfeeds her four-month-old daughter Minh Anh. © UNICEF Viet Nam/2013/Truong Viet Hung
Sharing learning with the region

This is what we did earlier this year when UNICEF joined forces with Alive and Thrive, Viet Nam Institute of Legislative Studies, World Health Organisation and others to hold a regional advocacy workshop for ASEAN countries. We wanted to share the Viet Nam Government’s recent experience in extending paid maternity leave to six months and expanding the ban on advertising of breast milk substitutes for infants up to 24 months. Both policies were passed by the Viet Nam National Assembly with more than 90 per cent of the vote. 

The workshop provided an excellent opportunity to learn about how policy was changed in Viet Nam and to spur action from the delegates towards more effective policy change in their countries. Viet Nam’s experience showed that it requires sustained efforts to build up evidence, develop the right messages tailored to various audiences, advocate relentlessly, build consensus and more. All this doesn’t happen overnight so patience and perseverance are required. 

However, I think the most important factor of all is political will.  When there is a will, there is a way and I think the Government of Viet Nam clearly showed such will. They are did it in the interests of children and mothers, and in the end for their country’s future. 

A month after the workshop, I was asked to go to Laos as the government there is also considering ways to protect and support breastfeeding, including through extended maternity leave. In preparing for this meeting, I was shocked to find out that several countries in our region do not even meet the minimum 14 weeks of paid maternity leave recommended by the International Labour Organisation (ILO), as shown on the map below. 
Source: Developing Stronger Policies and Laws on IYCF in the ASEAN Region and Beyond Workshop Report, Hanoi 2013. 
A mother’s story

Not all countries can extend paid maternity leave to 6 months like Viet Nam did. They need to have the room in their budget to do it or it may take time to make that change. But there are other ways to support mothers to breastfeed once they get back to work. Before I get to this, let me briefly share my own experience.

I breastfed all three of my children. I was working in Guatemala when my second child was born. I had to go back to work when she was not even three months old.  I was fully motivated to breastfeed her exclusively (and I did!) but it was not easy. My challenges included trying to find a place to express milk, sometimes having to rush back from project visits to do it in the office where I was working, bringing ice packs to work to keep the milk cold until I get home, and so on. So I strongly empathise with women who work in government offices, factories, or elsewhere who would like to continue breastfeeding their child but don’t have support from their employers.

In our region, many countries do not provide for nursing breaks, let alone a space or room to do it at work. Fortunately, we have some examples that are starting to emerge of employers who are ready to support mothers to breastfeed when they go back to work, either by establishing day-care centres, lactation rooms or breastfeed breaks.

For example in China, in an effort to boost declining breastfeeding rates, UNICEF and the National Centre for Women and Children’s Health  jointly launched the ’10m2 of Love‘ campaign. This innovative campaign aims to locate, register, certify and publicize breastfeeding rooms, both for employees and for customers in public buildings and stores.  In the Philippines, UNICEF and the ILO are working to develop practical guidelines and a communication toolkit in support of the government’s regulations to establish lactation stations in formal and informal workplaces.

It is my heartfelt hope that the landmark decision by Viet Nam to expand the ban on advertising of breast milk substitutes for children up to 24 months, and to extend maternity leave to six months, will have a domino effect in the region, and that other countries will follow their example.

Let us remember during World Breastfeeding Week that breastfeeding ensures the best and most sustainable start in life. As such, it is a basic right of every child.

The author
France Begin is UNICEF Regional Advisor on Nutrition

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