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Taking Action to Ensure Breastfeeding Breastfeeding through through Projects, Studies, and Surveys

La Leche League 18th International Conference
Strength through Diversity - Creating One Breastfeeding World
San Francisco, California, USA
July 3-6, 2003

Friday, July 4 - Session #125
Global Issues - Taking Action to Ensure Breastfeeding through Projects, Studies, and Surveys

During this session, selected presenters talked about the work displayed on their posters. Following the presentations, time was provided for participants to ask questions and for presenters to supply more information, if needed. Below are their abstracts:


The Influence of Birthing Practices on Breastfeeding: Protecting the Mother-Baby Continuum
Author and presenter: Mary Kroeger

The miraculous partnership between a mother and her newborn, from conception, throughout pregnancy, labor, birth and breastfeeding, has been the foundation of the survival of our species. This mother-baby continuum is in danger from many directions. The move from birth in the home to the hospital in developed countries has seen a rapid change in how care is provided. The establishment of two professional and academic specialties: obstetrics and pediatrics have split the mother from her newborn. Global policy and programs have consistently failed to preserve this mother-infant partnership in child survival and safe motherhood programs and breastfeeding promotion has often fallen through the cracks. The WHO/ UNICEF Baby Friendly Hospital Initiative pioneered the protection and promotion of breastfeeding in maternity facilities, but it does not bring significant attention to care of the mother during childbirth, even while targeting "maternity services."

This poster session, based on a soon to be published book, highlights some of the research evidence that shows impact of certain childbirth interventions on breastfeeding outcomes. Among the childbirth interventions examined are: labor support with a doula, position at birth, withholding of fluids and IV therapy, episiotomy, instrumental delivery, cesarean section, and labor pain medications. Broad recommendations for how to integrate holistic, non-medicalized care in pregnancy, birth, and breastfeeding in such a way that supports the mother-infant partnership, reinforces keeping childbirth normal, supporting optimal breastfeeding and thus supporting nature's master plan.


Regional Variation in Public Opinion about Breastfeeding in the United States
Authors: Abeda Hussain, Ruowei Li, MD, PhD, Sandra Benton-Davis, RD, Laurence Grummer-Strawn, PhD
Presenter: Katherine Shealy

Background: Although many studies have been done about nursing women's knowledge, attitudes and barriers to breastfeeding, few have been done to understand attitudes toward breastfeeding. None have examined geographic variation in public opinions about breastfeeding. This examines public knowledge, attitudes, and support of breastfeeding.

Methods: The Healthstyles survey is a national mail survey to adults aged 18 years and older, conducted annually by Porter Novelli. Since 1999, breastfeeding items have been added to Healthstyles, focusing on different themes of public opinions on breastfeeding each year. Using 1999-2001 data, we mapped regional differences in public opinion of four breastfeeding themes: public knowledge about health benefits of breastfeeding, public attitude toward breastfeeding privacy, public support of breastfeeding policies at work, and public perception about breastfeeding duration.

Results: Maps show that the Pacific, West South Central, West North Central, and Mountain regions had the best knowledge about breastfeeding health benefits. The Mountain, New England and Pacific regions had the most positive attitudes about breastfeeding privacy. The Mountain, Pacific, and East South Central regions had the strongest support for breastfeeding policies at work. The Mountain and East North Central regions had the most positive perceptions about breastfeeding duration.

Conclusion: When linking geographic patterns of public opinion to breastfeeding rates from the Ross Laboratory Mothers Survey, we found the Pacific and Mountain regions to have consistently high breastfeeding rates and positive public opinion about breastfeeding. Further studies are needed to learn why these regions are so positive and apply these observations to those regions with lower breastfeeding rates and negative


Attitudes and Knowledge of Medical Students at the Federal University of Alagoas, Brazil Regarding Breastfeeding
Authors: Pajuçara Marroquim, Maria de Salete Medeiros, Kênia Araújo.
Presenter: Pajuçara Marroquim

Various studies have shown that a negative comment from a health professional is considered one of the reasons why women wean early. Although many health professionals are convinced of the value of human milk, few have the necessary skills to be able to offer solutions and support to mothers who experience problems breastfeeding. Following up on this theory, the study objective was to evaluate the attitudes and knowledge base on breastfeeding of medical school students at the Federal University of Alagoas. In 2000, data was collected through a questionnaire that was given to students in their fifth year of medical school, covering a total of 77 students. The percentage results showed that 42% responded incorrectly to an open question (situation/problem), another 42% made reference to only one correct solution, 11% responded correctly to two solutions and only 4% made reference to stress as a possible cause of milk reduction. Not one student offered more than two correct responses.

The conclusion is that the theoretical knowledge demonstrated by the students through correct responses (86%) to the closed questions was not helpful enough when a practical resolution to a situation/problem was needed. Therefore, the current medical school's breastfeeding curriculum can not be considered sufficient for a health professional to obtain the needed skills in order to work with mothers who are experiencing a breastfeeding problem.


Training Traditional Mother Support in Mumbai, India
Author and presenter: Dr. Prashant S. Gangal

A large number of families in India employ a Traditional Massage Woman (TMW) to give oil massage and bath to the mother and young one. TMWs provide one hour of daily service for about six months and exert a tremendous influence on mother and family. They can be considered as 'traditional mother support'. TMWs answer many questions about feeding and child-care asked by mothers and their relatives. However their knowledge and attitudes in these subjects is scientifically incorrect. They are directly or indirectly responsible for propagating many traditionally incorrect customs and practices. With this background, a project was initiated by BPNI (Breastfeeding Promotion Network of India) Maharashtra in North-West Mumbai (Population 1.5 million) to formally train and utilize the potential of TMW to educate mothers and community (Project Support: UNICEF).

Mother Support Group (MSG) Leaders train TMWs through 12 one-hour sessions (over 12 weeks). The training methodology consists of a pre-test followed by class room training, role plays and practical demonstrations. Literature on infant feeding and child care is provided in local language. Post-test and viva are conducted to evaluate effectiveness of training. Certificate and Identity Cards have been given to about 500 TMWs who have successfully completed training. An equal number still remain untrained.

Certified TMWs are expected to pass accurate information, messages and literature to mothers and community. The project is practical, feasible and has improved outreach to mothers after discharge from maternity homes. The project can be easily replicated all over Maharashtra (Population: 80 million).


Helping Mothers Breastfeed at a Baby-Friendly Hospital in Asunción, Paraguay
Author and presenter: Pushpa V. Panadam

As a La Leche League leader I wanted to help more mothers in my community breastfeed. The Hospital Barrio Obrero, which has been baby friendly since September 1995, is only two blocks from my house. Once I was introduced to the hospital staff, I decided to talk to mothers every Monday morning. That was in August 2001, right after the LLL International Conference in Chicago. In these past 1 ½ years, the question I had asked myself at the Global Initiative for Mother Support Session "How can a lay breastfeeding counsellor influence health professionals?" is being answered. In the beginning, I only spoke to mothers using the Breastfeeding Manual. Soon I was using cloth posters, the Kathy comic series and talking to family and friends visiting the mother. During World Breastfeeding Week in 2002, LLL Paraguay gave a session at the hospital. The doctor in charge of the NICU became interested in Kangaroo Care. This led to exchanging information, sharing and learning possibilities. Whilst suggesting breastfeeding sessions for his staff, mothers learn how to express milk for their babies, and about exclusive breastfeeding. Sometimes I help babies latch on, to find out that some were fed the bottle at night. Some nurses begin to show an interest in breastfeeding. My vision is for a maternity ward that is truly baby friendly. The Director of Public Health and the Head nurse working separately with me plan for regular talks for the mums and the health staff. The photos and data show the activities at the hospital but the key to it all seems to be trust, confidence and learning to build a friendly, family atmosphere.


Priority for Survival - Food Security for Nursing Mothers
Authors: Solveig Francis, Selma James, Phoebe Jones Schellenberg, and Nina Lopez-Jones
Presenter: Selma James

Breastfeeding is integral to the caring work women do ensuring the survival of new life. Since in Third World countries especially, our survival and our children's is not an economic priority, this survival work of women is ignored and undermined. Besides, nobody makes a profit on breastfeeding. To reverse this undermining of life itself, women's caring work must be counted and economically valued.

The basic support for breastfeeding is food security. Few resources are put into providing enough food anywhere, though money is never short for arms or profitable technologies. As well as breastfeeding their children, women are the global farmers, growing 80% of food eaten in Africa (with children's help). But in times of war or climate change, even women who are nursing are often neglected for food aid.

Every year in the South 1,500,000 infants die from formula-feeding, and 60% of under-fives die from malnutrition. Compare this with the 4% expected to die from HIV/AIDS. Yet a so-called HIV/AIDS epidemic is lavishly funded and used to attack breastfeeding.

Pharmaceutical companies, backed by the US, block the sale of generic drugs - proof they don't care about our survival, but not proof that such toxic drugs can end AIDS. For this, malnutrition, starvation and pollution must be ended.

Breastfeeding NGOs partner the UNICEF of McDonald's and Coca Cola, which now prefers "informed choice" - often telling mothers that formula is better - over breast is best. The breastfeeding champion and the NGOs it helps fund have become part of the problem.

Determined advocates for breastfeeding as a human right to life and health, cannot avoid confronting governments, multinationals, and their NGO apologists. The alternative is silence, condoning genocide.


Thursday, September 4, 2003 2:20 PM by ljw.
Page last edited .


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