Taking Action to Ensure Breastfeeding Breastfeeding through Legislation/Public Health Policy, and International Documents

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

Sunday, July 6 - Session #318
Global Issues - Taking Action to Ensure Breastfeeding through Legislation/Public Health Policy, and International Documents

Presenters: Randa Saadeh, Linda Sanei and Miriam Labbok
Facilitators: Gisèle Laviolle, Audrey Naylor and Rachel O'Leary

Miriam Labbok gave an overview of the UN Millenium Development Goals. This is an initiative endorsed in September 2000 by all 191 UN member states which protects breastfeeding in one of its key targets: to reduce by half the proportion of people who suffer from malnutrition through the promotion of exclusive breastfeeding. Labbok then formally acknowledged Dr. Audrey Naylor's LLLI Special Lifetime Achievement Award, presented during this conference, by bestowing upon her the last Golden Bow pin from the initial launch of the Golden Bow Initiative (Linda Sanei talked about this Initiative).

Linda Sanei talked about international documents and initiatives that directly or indirectly affect breastfeeding. Following are some examples. Save the Children brought out a new Initiative, the Saving Newborn Lives Initiative, in 2000 as a strategy to focus on promoting early initiation and exclusive breastfeeding for the first six months. In May 2002, UNICEF issued a call to people throughout the world to support the Global Movement for Children, stipulating ten steps that need to be present in every child's life. Included in these steps are caring for every child, and reducing infant mortality rates and child malnutrition by a third. In 2002, another initiative was launched by UNICEF and WABA called the Golden Bow Initiative. The Golden Bow is a lesson in the protection, promotion and support of breastfeeding. The gold color symbolizes that breastfeeding is the gold standard and each part of the bow (loops, knot, ribbons) carries a special message. For an electronic copy of this presentation, please email Rmagalhaes at llli.org.

Randa Saadeh gave a presentation on the Global Strategy on Infant and Young Child Feeding. Given that inappropriate feeding is responsible for at least one-third of malnutrition, the strategy aims to improve the feeding of infants and young children, and to increase the commitment of governments, society groups and international organizations to promote the health and nutrition of children. WHO plans to achieve these aims through five operational targets:

• Comprehensive policy and programming supported by a multisectoral national commitment, through a coordinator and national committee, and policy and standards
  
• Enacted legislation on international code and maternity protection
  
• Health services and training updated for BFHI, implementation of step 10, and development of pre-service training
  
• Community support for the mother, including breastfeeding, child care and birth spacing; national communications and social marketing activities; and monitoring and evaluating all sectors and civil society levels
  
• Care for infants and young children in exceptionally difficult circumstances, such as HIV, for which a framework for action is needed, and guidelines for emergency situations.

In order to achieve the goals of the Strategy it is necessary to have the involvement and coordination from many sectors and stakeholders of society: national authorities, international agencies, obstetricians, lactation consultants, pre-service educators, etc. All of society needs to work together to achieve the goals of the Global Strategy.

Following are the actions presented during the session:

A. UNtold Story Campaign
Facilitated by Miriam Labbok

This group composed a letter that recommends changes to the language of the UNtold Story Campaign: Working for Children's Health.

Paragraph 1:
Change the last sentence to say the following: Access to this information enables women to make informed decisions concerning pregnancy and infant feeding. Counseling will focus on ensuring optimal infant feeding practices and reducing the stigma and fear related to HIV.

Paragraph 2:
Guidelines for ARV should be made consistent with the latest UN AIDS recommendations. It should be pointed out that there are many alternate sources of donations and funding. Broadening the base of support will eliminate reliance on a single industry and avoid conflicts of interest.

Paragraph 3:
The heading should be changed to "Infant Feeding." This section does not reflect the current UN guidelines for optimizing infant feeding in the presence of HIV. It does not address the issue of balancing risks (morbidity and mortality due to HIV vs. morbidity and mortality due to lack of breastfeeding).

Combine the last two bullets:
Counseling and supporting HIV-positive women about infant feeding choices which are based on full information and lack of commercial bias.

Closing paragraph of letter:

We strongly urge you to make, at the very least, these essential changes which are necessary to bring your MTCT overview statement into compliance with international policy and research.

We look forward to seeing a revised draft of the Overview Statement at your earliest convenience.

Sincerely,

LLLI

Cc: Miriam Labbok, UNICEF
Randa Saadeh, WHO

B. Pre-service education
Facilitated by Gisèle Laviolle

1) Write a draft letter addressed to WHO/UNICEF with reference to the need for pre-service education to be among the top priorities in the organization, in the context of the "Global Strategy"
2) Circulate the draft to other organizations and encourage them to do the same (IBFAN/WABA)

C. Follow-up to Martigney meeting on Health Interventions in Emergencies
Facilitated by Audrey Naylor

The action is to compose draft talking points to encourage individuals in key organizations to write to the Martigney committee working on a document that will state the key interventions during emergency situations.

Once all the facts are gathered about the agencies/people involved in making the decision, members of this group will send out talking points to the following groups via a e-news:
- CORE
- Interaction
- La Leche League International
- ENN Online- organizations that endorsed IFE guidelines
- Countries

D. Follow-up to Martigney meeting on Health Interventions in Emergencies
Facilitated by Rachel O'Leary

Designed a letter, signed by the members of this group, to call attention to the omission of breastfeeding as a key intervention in emergency situations during the Martigney meeting.

Letter:

Dear …

It has come to our attention that breastfeeding was not included in the top priorities of the CORE Interventions Group (Martigney) responding to emergency situations, when breastfeeding is a comprehensive solution for the most vulnerable segment of the population at risk. No single solution is more life-sustaining to the infant or toddler. It significantly lowers the risk and severity of diarrhea, pneumonia and other killer diseases. It is often regarded as the baby's first immunization. Deprivation of breastfeeding can compound the effects of any emergency. It is a complete food providing excellent nutrition and safe water for infants and toddlers at minimal cost. It encourages families to value women.

We are a group of parents, health professionals and volunteers who have come from many countries to meet in San Francisco. This setting reminds us that emergencies occur in all communities and that breastfeeding prevents diseases in developed and developing countries.

Sincerely,

Will be signed by the individuals who were at this table.