WHO and UNICEF issues new global guidance to promote breastfeeding in health facilities

Context:

• A 10-step guidance to increase support for breastfeeding in health facilities has been recently released.

Background:

12^th, April, 2018:

• The World Health Organization (WHO) and UNICEF issued new ten-step guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services.

1991:

• The Ten Steps to Successful Breastfeeding strengthens the Baby-friendly Hospital Initiative (1991).

Know more about Baby-friendly Hospital Initiative

Importance of breastfeeding is as follows:

• Vital to a child’s lifelong health,
• Protects newborn babies from infections,
• Reduces costs for health facilities, families, and governments,
• Improves IQ, school readiness and attendance,
• Associated with higher income in adult life,
• Reduces the risk of breast cancer in the mother,
• Partial breastfed or not breastfed at all leads to the risk of death due to diarrhoea and other infections, and
• Exclusive breastfeeding for six months protects infant and mother against gastrointestinal infections and malnutrition, which are observed not only in developing but also industrialized countries.

Importance of policy for breastfeeding is as follows:

• Requires a course of action and provides guidance,
• Helps establish consistent care for mothers and babies and
• Provides a standard that can be evaluated.

The policy should primarily include:

• 10 steps to successful breastfeeding,
• Institutional ban on acceptance of free or low cost supplies of breast-milk substitutes, bottles, and teats and its distribution to mothers, and
• Framework for assisting HIV positive mothers to make informed infant feeding decisions that meet their individual circumstances and then support for this decision.

Ten Steps to Successful Breastfeeding are as follows:

1. Comply fully with the International Code of Marketing of Breast-milk Substitutesand relevant World Health Assembly resolutions.
2. Have a written infant feeding policy that is routinely communicated to staff and parents.
3. 1c. Establish the present monitoring and data-management systems.
4. Ensure that staff has sufficient knowledge, competence and skills to support breastfeeding.
5. Discuss the importance and management of breastfeeding with pregnant women and their families.
6. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
7. Support mothers to initiate and maintain breastfeeding and manage common difficulties.
8. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.
9. Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day.
10. Support mothers to recognize and respond to their infants’ cues for feeding.
11. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.
12. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.

India’s programme to promote breastfeeding: MAA (Mothers Absolute Affection):

• “MAA-Mother’s Absolute Affection’’ is a nationwide programme.
• It is launched in an attempt to bring undiluted focus on promotion of breastfeeding and provision of counselling services for supporting breastfeeding through health systems.
• The programme has been named ‘MAA’ to signify the support a lactating mother requires from family members and at health facilities to breastfeed successfully.
• The chief components of the MAA Programme are:
  • Community awareness generation,
  • Strengthening inter personal communication through ASHA,
  • Skilled support for breastfeeding at Delivery points in Public health facilities, and
  • Monitoring and Award/recognition.
• Under this programme, ASHA has been incentivized for reaching out to pregnant and lactating mothers.
• They provide information on benefits and techniques of successful breastfeeding during interpersonal communication.
• ANMs at all sub-centres and health personnel at all delivery points are being trained for providing skilled support to mothers referred with issues related to breastfeeding.

Conclusion:

Thus, religious implementation of the ten step guidance will significantly improve the much needed breastfeeding rates and its related aspects.