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11 APRIL 2018 | GENEVA – WHO and UNICEF today issued new ten-step guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services. Breastfeeding all babies for the first 2 years would save the lives of more than 820 000 children under age 5 annually.
The Ten Steps to Successful Breastfeeding underpin the Baby-friendly Hospital Initiative, which both organizations launched in 1991. The practical guidance encourages new mothers to breastfeed and informs health workers how best to support breastfeeding.
Breastfeeding is vital to a child’s lifelong health, and reduces costs for health facilities, families, and governments. Breastfeeding within the first hour of birth protects newborn babies from infections and saves lives. Infants are at greater risk of death due to diarrhoea and other infections when they are only partially breastfed or not breastfed at all. Breastfeeding also improves IQ, school readiness and attendance, and is associated with higher income in adult life. It also reduces the risk of breast cancer in the mother.
“Breastfeeding saves lives. Its benefits help keep babies healthy in their first days and last will into adulthood,” says UNICEF Executive Director Henrietta H. Fore. “But breastfeeding requires support, encouragement and guidance. With these basic steps, implemented properly, we can significantly improve breastfeeding rates around the world and give children the best possible start in life.”
WHO Director-General Dr Tedros Adhanom Ghebreyesus says that in many hospitals and communities around the world, whether a child can be breastfed or not can make the difference between life and death, and whether a child will develop to reach his or her full potential.
“Hospitals are not there just to cure the ill. They are there to promote life and ensure people can thrive and live their lives to their full potential,” says Dr Tedros. “As part of every country’s drive to achieve universal health coverage, there is no better or more crucial place to start than by ensuring the Ten Steps to Successful Breastfeeding are the standard for care of mothers and their babies.”
The new guidance describes practical steps countries should take to protect, promote and support breastfeeding in facilities providing maternity and newborn services. They provide the immediate health system platform to help mothers initiate breastfeeding within the first hour and breastfeed exclusively for six months.
It describes how hospitals should have a written breastfeeding policy in place, staff competencies, and antenatal and post-birth care, including breastfeeding support for mothers. It also recommends limited use of breastmilk substitutes, rooming-in, responsive feeding, educating parents on the use of bottles and pacifiers, and support when mothers and babies are discharged from hospital.
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Breastfeeding is one of the most effective ways to ensure child health and survival.
If every child was breastfed within an hour of birth, given only breast milk for their first six months of life, and continued breastfeeding up to the age of two years, about 800 000 child lives would be saved every year 1. Globally, less than 40% of infants under six months of age are exclusively breastfed. Adequate breastfeeding counselling and support are essential for mothers and families to initiate and maintain optimal breastfeeding practices.
WHO actively promotes breastfeeding as the best source of nourishment for infants and young children. This fact file explores the many benefits of the practice, and how strong support to mothers can increase breastfeeding worldwide.
WHO recommends exclusive breastfeeding for the first six months of life. At six months, solid foods, such as mashed fruits and vegetables, should be introduced to complement breastfeeding for up to two years or more. In addition:
Breast milk is the ideal food for newborns and infants. It gives infants all the nutrients they need for healthy development. It is safe and contains antibodies that help protect infants from common childhood illnesses such as diarrhoea and pneumonia, the two primary causes of child mortality worldwide. Breast milk is readily available and affordable, which helps to ensure that infants get adequate nutrition.
Breastfeeding also benefits mothers. Exclusive breastfeeding is associated with a natural (though not fail-safe) method of birth control (98% protection in the first six months after birth). It reduces risks of breast and ovarian cancer, type II diabetes, and postpartum depression.
Beyond the immediate benefits for children, breastfeeding contributes to a lifetime of good health. Adolescents and adults who were breastfed as babies are less likely to be overweight or obese. They are less likely to have type-II diabetes and perform better in intelligence tests.
Infant formula does not contain the antibodies found in breast milk. The long-term benefits of breastfeeding for mothers and children cannot be replicated with infant formula. When infant formula is not properly prepared, there are risks arising from the use of unsafe water and unsterilized equipment or the potential presence of bacteria in powdered formula. Malnutrition can result from over-diluting formula to “stretch” supplies. While frequent feeding maintains breast milk supply, if formula is used but becomes unavailable, a return to breastfeeding may not be an option due to diminished breast milk production.
An HIV-infected mother can pass the infection to her infant during pregnancy, delivery and through breastfeeding. However, antiretroviral (ARV) drugs given to either the mother or HIV-exposed infant reduces the risk of transmission. Together, breastfeeding and ARVs have the potential to significantly improve infants’ chances of surviving while remaining HIV uninfected. WHO recommends that when HIV-infected mothers breastfeed, they should receive ARVs and follow WHO guidance for infant feeding.
An international code to regulate the marketing of breast-milk substitutes was adopted in 1981. It calls for:
Breastfeeding has to be learned and many women encounter difficulties at the beginning. Many routine practices, such as separation of mother and baby, use of newborn nurseries, and supplementation with infant formula, actually make it harder for mothers and babies to breastfeed. Health facilities that support breastfeeding by avoiding these practices and making trained breastfeeding counsellors available to new mothers encourage higher rates of the practice. To provide this support and improve care for mothers and newborns, there are “baby-friendly” facilities in about 152 countries thanks to the WHO-UNICEF Baby-friendly Hospital Initiative.
Many mothers who return to work abandon breastfeeding partially or completely because they do not have sufficient time, or a place to breastfeed, express and store their milk. Mothers need a safe, clean and private place in or near their workplace to continue breastfeeding. Enabling conditions at work, such as paid maternity leave, part-time work arrangements, on-site crèches, facilities for expressing and storing breast milk, and breastfeeding breaks, can help.
To meet the growing needs of babies at six months of age, mashed solid foods should be introduced as a complement to continued breastfeeding. Foods for the baby can be specially prepared or modified from family meals. WHO notes that:
WHO and UNICEF launched the Baby-friendly Hospital Initiative (BFHI) to help motivate facilities providing maternity and newborn services worldwide to implement the Ten Steps to Successful Breastfeeding. The Ten Steps summarize a package of policies and procedures that facilities providing maternity and newborn services should implement to support breastfeeding. WHO has called upon all facilities providing maternity and newborn services worldwide to implement the Ten Steps.
The implementation guidance for BFHI emphasizes strategies to scale up to universal coverage and ensure sustainability over time. The guidance focuses on integrating the programme more fully in the health-care system, to ensure that all facilities in a country implement the Ten Steps. Countries are called upon to fulfill nine key responsibilities through a national BFHI programme:
1a. Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions.
1b. Have a written infant feeding policy that is routinely communicated to staff and parents.
1c. Establish ongoing monitoring and data-management systems.
2. Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.
3. Discuss the importance and management of breastfeeding with pregnant women and their families.
4. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
5. Support mothers to initiate and maintain breastfeeding and manage common difficulties.
6. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.
7. Enable mothers and their infants to remain together and to practise rooming-in 24 hours a day.
8. Support mothers to recognize and respond to their infants’ cues for feeding.
9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.
10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.
There is substantial evidence that implementing the Ten Steps significantly improves breastfeeding rates. A systematic review of 58 studies on maternity and newborn care published in 2016 demonstrated clearly that adherence to the Ten Steps impacts early initiation of breastfeeding immediately after birth, exclusive breastfeeding and total duration of breastfeeding.
WHO and UNICEF issue new guidance to promote breastfeeding in health facilities globally
3 in 5 babies not breastfed in the first hour of life
Breastfeeding within an hour after birth is critical for saving newborn lives
Earlier studies, cited in the report, show that newborns who began breastfeeding between two and 23 hours after birth had a 33% greater risk of dying compared with those who began breastfeeding within one hour of birth. Among newborns who started breastfeeding a day or more after birth, the risk was more than twice as high.
The report urges governments, donors and other decision-makers to adopt strong legal measures to restrict the marketing of infant formula and other breastmilk substitutes.
The WHO and UNICEF-led Global Breastfeeding Collective also released the 2018 Global Breastfeeding Scorecard, which tracks progress for breastfeeding policies and programmes. In it, they encourage countries to advance policies and programmes that help all mothers to start breastfeeding in the first hour of their child’s life and to continue as long as they want.
Breastfeeding provides the strongest foundation for lifelong health and optimal nutrition
WHO SEARO MEDIA CENTRE
By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
Exclusive breastfeeding for the first six months of life and continued breastfeeding up to the age of two years and beyond provides the strongest foundation for lifelong health. Breast milk contains all the nutrients infants need to grow healthy and strong and, when combined with appropriate complementary foods after six months of age, is a powerful means to set up a lifetime of optimal nutrition, including the prevention of undernutrition and obesity.
Notably, breastfeeding has been promoted as critical to infant development in the WHO South-East Asia Region for many years, with broad cultural acceptance and some of the world’s strongest legislation to encourage the practice. These and other factors mean that on average around half of the Region’s infants are exclusively breastfed for the first six months of life, compared to 38% globally and 18% in industrialized countries.
To build on the Region’s impressive record and provide each of its infants the strongest foundation for lifelong health and optimal nutrition, a series of key initiatives should be implemented.
First, breastfeeding should be promoted across sectors and its many virtues highlighted wherever possible. That means developing campaigns that educate new mothers and support them to breastfeed, including by highlighting the benefits to mothers themselves, at the same time as enhancing public buy-in. It also means ensuring policymakers across sectors, including in the workplace, are aware that breastfeeding is a proven means to prevent undernutrition (around 60 million children in the Region aged 0-5 years’ experience stunting), as well as to combat obesity and the premature deaths noncommunicable diseases can cause – one of the Region’s Flagship Priorities.
Second, the Region’s Member States should harness the backing provided by the recently adopted World Health Assembly Resolution on infant and young child feeding, which urges all WHO Member States “to implement and/or strengthen national mechanisms for effective implementation of measures aimed at giving effect to the International Code of Marketing of Breast-milk Substitutes”. In other words, each WHO Member State should take the steps necessary to ensure the health and wellbeing of infants is put ahead of all other concerns.
And third, Member States and health facilities across the Region should fully embrace the WHO- and UNICEF-developed Baby-friendly Hospital Initiative. Since 1991 the Initiative has sought to create maternal and child care institutions that protect and promote breastfeeding – especially important outcomes as institutional births increase Region-wide. To this end, in December 2017 WHO South-East Asia held a regional consultation on enhancing the Initiative’s uptake and implementation, with Member State follow-up a key takeaway.
That is especially encouraging as WHO South-East Asia marks World Breastfeeding Week. If every child was breastfed within an hour of birth, was exclusively breastfed for the first six months of life, and continued to be breastfed up to the age of two years, the lives of more than 800 000 children would be saved worldwide each year, many of them in the South-East Asia Region. Importantly, each of those children would be given the strongest foundation for lifelong health and optimal nutrition, and the best chance possible of achieving the highest attainable standard of health.
World breastfeeding week is celebrated every year in August first week globally. The aim of world breastfeeding week is to encourage breastfeeding and improve the health of babies.
It commemorates the Innocenti Declaration signed in August 1990 by government policymakers, WHO, UNICEF and other organizations to protect, promote and support breastfeeding. (WHO)
Objective Word breast feeding Week 2018
World Breastfeeding Week 2018 focuses on:
Breastfeeding helps to prevent malnutrition in all its forms, ensures food security for infants and young children, and thus helps to bring people and nations out of the hunger and poverty cycle. It is therefore a [ Foundation of life. Protecting, promoting and supporting breastfeeding is vital to a more sustainable world. ]
Source of Info: World Alliance for Breastfeeding Action (WABA
Support World Breastfeeding week with Facebook Profile Frame
In 1989, WHO and UNICEF described the Ten Steps to Successful Breastfeeding as a global standard of quality maternity care. The Ten Steps address facility policies, training, community outreach, and caring procedures for new mothers and babies. The Baby-friendly Hospital Initiative (BFHI) was launched to encourage maternity facilities worldwide to adopt the Ten Steps. Maternity facilities that adhere to the Ten Steps and comply with the International Code of Marketing of Breast-milk Substitutes are awarded the prestigious title of being ”Baby-friendly”. The Baby-friendly Hospital Initiative (BFHI) was launched in 1991 as a global programme to incentivize maternity facilities throughout the world to adhere to the Ten Steps to Successful Breastfeeding and comply with the International Code of Marketing of Breast-milk Substitutes.
The Ten Steps to Successful Breastfeeding;
1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
2. Train all health care staff in skills necessary to implement this policy.
3. Inform all pregnant women about the benefits and management of breastfeeding.
4. Help mothers initiate breastfeeding within one half-hour of birth.
5. Show mothers how to breastfeed and maintain lactation, even if they should be separated from
their infants.
6. Give newborn infants no food or drink other than breastmilk, unless medically indicated.
7. Practice rooming in – that is, allow mothers and infants to remain together 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on
discharge from the hospital or clinic.
ORIGINAL SOURCE OF INFO : National implementation of the Baby-friendly Hospital Initiative 2017
World Hepatitis Day (WHD) takes places every year on 28 July bringing the world together under a single theme to raise awareness of the global burden of viral hepatitis and to influence real change. One of just four disease-specific global awareness days officially endorsed by the World Health Organization (WHO), WHD unites patient organizations, governments, medical professionals, civil society, industry and the general public to boost the global profile of viral hepatitis. Patient advocates across the world joined together for the first WHD on 19 May 2008.
Following the adoption of a World Health Assembly resolution in 2010, WHD was given global endorsement as the primary focus for national and international awareness-raising efforts. The date was chosen to honour Nobel Laureate Baruch Samuel Blumberg who discovered the hepatitis B virus and was born on 28 July. The resolution resolves that “28 July shall be designated as WHD in order to provide an opportunity for education and greater understanding of viral hepatitis as a global public health problem, and to stimulate the strengthening of preventive and control measures of this disease in Member States.”
World Hepatitis Day presents an ideal opportunity: an opportunity to join together and raise the profile of viral hepatitis among the public, the world’s media and on the global health agenda, driving action towards achieving the elimination of viral hepatitis by 2030.
In 2016, 194 governments adopted WHO’s Global Strategy on Viral Hepatitis, which includes a goal of eliminating hepatitis B and C by 2030.
WHD 2018,The World Hepatitis Alliance calls on all individuals and organizations to unite under the theme of “Eliminate Hepatitis” to drive action, build momentum and hold governments accountable.
Out of the 325 million people living with viral hepatitis globally, upward of 290 million (that’s 9 in 10!) are living with the hepatitis B or hepatitis C and don’t know it.
On WHD, the World Hepatitis Alliance is launching Find the Missing Millions, a three year awareness-raising and advocacy campaign to educate, influence national testing policies and encourage people to get screened and/or become advocates in the quest to find the undiagnosed.
In South-East Asia, 97% of men and women living with viral hepatitis don’t know it. Unless detected and treated it can cause liver disease, cirrhosis and liver cancer.
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