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LLLI Goes to Penang, Malaysia

Rebecca Magalhães
LLLI Director of External Relations and Advocacy
From: Leaven, Vol. 44, No. 4, 2008, pp. 20-21

On October 7-10, 2008, I had the wonderful opportunity to represent La Leche League International at two World Alliance for Breastfeeding Action (WABA) events in Penang, Malaysia: a workshop on "Protecting, Promoting and Supporting Optimal Breastfeeding from Six to 24+ Months" and the seventh Global Breastfeeding Partners Meeting (GBPM).

La Leche League International is a Core Partner of WABA along with the following organizations:

The Academy of Breastfeeding Medicine

International Baby Food Action Network

International Lactation Consultant Association

Wellstart International

As the LLLI contact for our role as a WABA Core Partner (see box), I received the invitation in June 2008 to attend these events with the offer to cover plane fare, lodging, and onsite expenses. I attended these events as the Core Partner liaison, a co-coordinator of the WABA Mother Support Task Force, and for LLLI as the WABA North America Focal Point (NAFP).

The GBPM is an annual event. The impetus for the workshop that preceded the GBPM came because of concerns about the increased use of ready-to-use therapeutic foods (RUTF) and ready-to-use foods (RUF) as a preventive measure in general populations. RUTFs and RUFs are normally intended for children in emergency situations and/or with acute malnutrition. Although recognizing the value and importance of these nutrient dense foods, the concern is that their distribution will become widespread, with the risk of undermining breastfeeding in the six- to 24-month period. My role in these events was to:

  • Represent and present LLLI as a WABA Core Partner
  • Participate actively
  • Provide input and contribute to the WABA Strategic Plan
  • Network with attendees at both events
  • Touch base with those attendees who live in the North America region

Workshop: Activities and Outcomes

Activities: The workshop opened on October 6 with a presentation by Dr. Michael Latham, Graduate School Professor of International Nutrition and Development, Cornell University, USA. Dr. Latham said that more attention should be given to increasing breastfeeding duration and to the volume of human milk that is produced during the six- to 24+ month period. He also advised mothers to breastfeed first when adding other foods and liquids and cautioned that RUTFs should do no harm to breastfeeding, family feeding, and local agriculture.

The workshop continued the next two days with presentations, work groups, and discussion on the development of breastfeeding indicators for the six to 24+ month period. Participants confirmed the importance of breastfeeding during this time period, noting that undue pressure to add complementary foods can undermine breastfeeding. There were presentations on protecting breastfeeding after six months and on addressing RUFs and RUTFs that are being promoted without any guidelines or regulations. It was noted by one presenter that national development is increasingly being decided by who is giving the money; multinational companies are influencing health policies. There was also concern about the increasing emergence of public/private partnerships, with one participant noting that we must live in the world without compromising ourselves.

I participated in the work group that looked at supporting a breastfeeding mother during this time period, with mother support groups being emphasized as a valid and important approach. The workshop concluded with participants agreeing on two letters to address a WHO/UNICEF meeting taking place at that time on this topic. One letter advised WHO/UNICEF to be cautious in carrying out programs with company involvement, and the other letter presented the group's recommendations for definitions and breastfeeding indicators during the six to 24+ month period.

Outcomes:

  • Development of draft breastfeeding definitions and indicators for six to 24+ month period
  • Awareness on challenges of the use of ready-to-use foods and ready-to-use therapeutic foods in relation to breastfeeding
  • Draft workshop statement to be reviewed and approved by Core Partners and the WABA General Assembly
  • Letter written and sent to WHO/UNICEF re: breastfeeding from six to 24+ months

Global Breastfeeding Partners Meeting:
Activities and Outcomes

Activities: Participants were welcomed by Felicity Savage, Chairperson, WABA Steering Committee, who presented the meeting objectives, followed by presentations from each of the five Core Partners. Susan Siew and Sarah Amin, WABA Co-directors, presented the annual WABA Update, the WABA Strategic Plan (SP), and potential areas of Core Partner involvement: World Breastfeeding Week (WBW) 2009; Youth activities, Global Forum III; Breastfeeding Gateway Project; Rapid Response System; and the Global Breastfeeding Initiative for Child Survival (GBICS).

Over the two-day meeting, working groups, task forces and regional focal points presented their activities, future plans, and how these fit into the WABA Strategic Plan. During these discussions, the Mother Support Task Force proposed working with the Women and Work Task Force on the implementation of the Hirkani's Room Concept, which describes the guidelines for implementing breastfeeding mother/baby workplace environments as an extension of the LLLI book Hirkani's Daughters: Women Who Scale Modern Mountains to Combine Breastfeeding and Working. The Hirkani's Room Concept was developed by Dr. Prashant Gangal (India), pediatrician and co-coordinator of the Mother Support Task Force. There was also discussion on possible international accreditation/certification of breastfeeding counselors.

Before closing, GBPM VII attendees discussed the draft of the WABA position statements (Public/Private Partnerships; Breastfeeding and Complementary Feeding; Infant Feeding and Globalization; and Breastmilk Pump Promotion). These were to be emailed after the meeting to the Core Partners for review and possible approval and finalization.

Outcomes:

  • WABA Strategic Plan discussed and finalized
  • Breastfeeding and Emergencies presented as the possible 2009 World Breastfeeding Week (WBW) theme
  • Confirmation of the WABA Global Forum III in Québec City, Canada, June 7-12, 2010
  • Presentation of North America Region as template for WABA regional collaboration
  • Presentation of WABA/IBFAN (International Baby Food Action Network) Global Breastfeeding Initiative for Child Survival Project
  • Presentation of the Breastfeeding Gateway Project

Recommendations to LLLI

As a result of the WABA meetings, the following recommendations were made to the LLLI Executive Director and the LLLI Board of Directors:

  • Explore the implementation of an LLLI event either before or after WABA Global Forum III
  • Implement guidelines for an LLLI/WABA scholarship, as currently implemented by ILCA (International Lactation Consultant Association)
  • Propose to WABA, WHO, UNICEF the pilot testing by LLL Leaders and LLL Group members of the draft Workshop breastfeeding indicators for 6-24+ month period
  • Post the International Code Documentation Centre Monitoring Form on the LLLI Web site
  • Staff and LLL Leaders brainstorm ideas for LLLI contribution(s) to 2009 WBW

Editor's Note: An electronic copy of the Workshop and GBPM VII Report is available by emailing Rebecca Magalhães at RMagalhaes@llli.org.

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