Unicef's stand on breastfeeding

Breastfeeding

Impact on child survival and global situation
Optimal breastfeeding of infants under two years of age has the greatest potential impact on child survival of all preventive interventions, with the potential to prevent 1.4 million deaths in children under five in the developing world (Lancet 2008). The results of a study conducted in Ghana show that breastfeeding babies within the first hour of birth can prevent 22 per cent of neonatal deaths.
Breastfed children have at least six times greater chance of survival in the early months than non-breastfed children. Breastfeeding drastically reduces deaths from acute respiratory infection and diarrhoea, two major child killers, as well as from other infectious diseases (WHO-Lancet 2000). The potential impact of optimal breastfeeding practices is especially important in developing country situations with a high burden of disease and low access to clean water and sanitation. But non-breastfed children in industrialized countries are also at greater risk of dying - a recent study of post-neonatal mortality in the United States found a 25% increase in mortality among non-breastfed infants. In the UK Millennium Cohort Survey, six months of exclusive breast feeding was associated with a 53% decrease in hospital admissions for diarrhoea and a 27% decrease in respiratory tract infections.
While breastfeeding rates are no longer declining at the global level, with many countries experiencing significant increases in the last decade, only 38 per cent of children less than six months of age in the developing world are exclusively breastfed and just 39 per cent of 20-23 month olds benefit from the practice of continued breastfeeding.
Map: Percentage of children <six months old exclusively breastfed (2000-2006)


Recommendations for optimal breastfeeding
The World Health Organization and UNICEF recommendations on breastfeeding are as follows: initiation of breastfeeding within the first hour after the birth; exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, nutritionally adequate, age appropriate, responsive complementary feeding starting in the sixth month.
Benefits of breastfeeding
Breastfeeding has an extraordinary range of benefits. It has profound impact on a child’s survival, health, nutrition and development. Breast milk provides all of the nutrients, vitamins and minerals an infant needs for growth for the first six months, and no other liquids or food are needed. In addition, breast milk carries antibodies from the mother that help combat disease. The act of breastfeeding itself stimulates proper growth of the mouth and jaw, and secretion of hormones for digestion and satiety. Breastfeeding creates a special bond between mother and baby and the interaction between the mother and child during breastfeeding has positive repercussions for life, in terms of stimulation, behaviour, speech, sense of wellbeing and security and how the child relates to other people. Breastfeeding also lowers the risk of chronic conditions later in life, such as obesity, high cholesterol, high blood pressure, diabetes, childhood asthma and childhood leukaemias. Studies have shown that breastfed infants do better on intelligence and behaviour tests into adulthood than formula-fed babies.
Virtually every mother can breastfeed, if given appropriate support, advice and encouragement, as well as practical assistance to resolve any problems. Studies have shown that early skin to skin contact between mothers and babies, frequent and unrestricted breast feeding to ensure continued production of milk and help with positioning and attaching the baby increase the chances of breast feeding being successful.
Breastfeeding also contributes to maternal health immediately after the delivery because it helps reduce the risk of post-partum haemorrhage. In the short term, breastfeeding delays the return to fertility and in the long term, it reduces type 2 diabetes and breast, uterine and ovarian cancer. Studies have also found an association between early cessation of breastfeeding and post natal depression in mothers.
Risks of mixed feeding
Mixed feeding, or giving other liquids and/or foods together with breast milk to infants under 6 months of age, is widespread in many countries. This practice poses risks to an infant’s health because it can increase the chance of their getting diarrhea and other infectious diseases. Mixed feeding, especially giving water or other liquids, can also causes the supply of breast milk to decrease as the baby sucks less at the breast. Babies do not need liquids other than breastmilk, not even water, in the first 6 months as breastmilk contains all the water a baby needs, even in very hot climates.
Mixed feeding increases the risk of mother to child transmission of HIV. Exclusive breastfeeding for up to six months was associated with a three to four fold decreased risk of transmission of HIV compared to mixed feeding breastfeeding in several African studies.
Risks of artificial feedingIn many countries, the reinforcement of a "breastfeeding culture" and its vigorous defense against incursions of a “formula-feeding culture” is imperative. Many mothers neither exclusively breastfeed for the first six months of the baby’s life nor continue breastfeeding for the recommended two years or more, and instead replace breast milk with commercial breastmilk substitutes or other milks. Artificial feeding is expensive and carries risks of additional illness and death, particularly where the levels of infectious disease are high and access to safe water is poor. Formula-feeding poses many practical challenges for mothers in developing countries, including ensuring the formula is mixed with clean water, that dilution is correct, that sufficient quantities of formula can continually be acquired and that the feeding utensils, especially if bottles are used, can be adequately cleaned.
Formula is not an acceptable substitute for breastmilk because formula, at its best, only replaces most of the nutritional components of breast milk: it is just a food, whereas breast milk is a complex living nutritional fluid containing anti-bodies, enzymes, long chain fatty acids and hormones, many of which simply cannot be included in formula. Furthermore, in the first few months, it is hard for the baby’s gut to absorb anything other than breastmilk. Even one feeding of formula or other foods can cause injuries to the gut, taking weeks for the baby to recover.
The major problems are the societal and commercial pressure to stop breastfeeding, including aggressive marketing and promotion by formula producers. These pressures are too often worsened by inaccurate medical advice from health workers who lack proper skills and training in breastfeeding support. In addition, many women have to return to work soon after delivery, and they face a number of challenges and pressures which often lead them to stop exclusive breastfeeding early. Working mothers need support, including legislative measures, to enable them to continue breastfeeding.
UNICEF action
UNICEF supports countries to implement the priority actions outlined in the Global Strategy for Infant and Young Child Feeding. The focus in countries is on five major areas:
1. At national level: ensuring that not only is appropriate policies and legislation in place but that these are implemented and enforced. This includes support for:

• development and implementation of national infant and young child feeding policies and strategy frameworks,
• development and implementation of programme plans to operationalize the strategy,
• development and enforcement of appropriate legislation (such as the International Code of Marketing of Breast milk Substitutes and maternity protection legislation).
• Encouraging and facilitating strategic public and private partnerships with other international and country-level actors for improvement of infant and young child nutrition

2. Health system level: support is provided to implement interventions in the health system, such as the Ten Steps to Successful Breastfeeding and the Baby-Friendly Hospital Initiative (BFHI), curricula, training and support of health workers and health information systems. Resources, jointly produced with the World Health Organization, include the BFHI training course and an Integrated Course on IYCF Counseling.
3. Community level: support is provided for community-based nutrition and mother support activities involving for example community health workers, lay counselors and mother to mother support groups.
4. Communication and advocacy activities on breastfeeding are also a key component of UNICEF support. World Breastfeeding Week is an annual advocacy event celebrated around the world with support from UNICEF, WHO and other partners.
5. IYCF in especially difficult circumstances: UNICEF supports interventions to address infant feeding in emergencies and infant feeding in the context of HIV/AIDS.

Breastfeeding Saves More Lives Than Any Other Preventive Intervention!

The Florida Breastfeeding Law & You

You have the right to breastfeed in public - it is the law.
Florida Legislation February 1993
Section 1. The breastfeeding of a baby is an important and basic act of nurture which must be encouraged in the interests of maternal and child health and family values. A mother may breastfeed her baby in any location, public or private, where the mother is otherwise authorized to be, irrespective of whether or not the nipple of the mother's breast is covered during or incidental to the breastfeeding.
House Bill  #HB 231 Fl. ALS 4; 1993 Fl. Laws ch. 4; 1993 Fl. HB 231 Fl. Stat. 383.015 /
800.02 - 800.04 / 847.001(later 827.071)
 For further info please contact The Florida Lactation Consultant Association
www.flca.info
or www.babyfirstlactation.com

Crying Babies

American Academy of Pediatrics

All babies cry, and some babies cry a lot. In a short video, Dr. Bob Block, president of the American Academy of Pediatrics, offers some advice to parents in this frustrating situation.

My Breastfeeding Unsuccess Story

For many years I wanted to become a mother. I dreamt about staying home on a maternity leave and taking care of my newborn. I pictured myself sitting in the perfectly decorated nursery, with a celestial theme, and rocking my baby gently while I nursed him.

For years before this scenario could become a reality; I was working as a nurse. First, as a neonatal transport nurse, and then as a neonatal nurse practitioner. Many years were spent taking care of others' babies; both preemies and seriously ill term newborns. I felt that I had a calling to be a nurse; yet I was personally left feeling void without my own child.

After a first timester miscarriage two years prior; I became pregnant. Even though I was labeled advanced maternal age; I had a great pregnancy and thoroughly enjoyed impending motherhood. I took a several week long childbirth education class and learned all about being in labor. I feared the probable pain associated with delivery but still was very excited.  I neglected to take a breastfeeding class, in part because I had worked with many mothers of preemies, and had assisted many to provide the skin to skin technique. After all; breastfeeding is natural. There can't be that much to it that would make you need a class?  Oh, was I wrong and misinformed to say the least.

My son was born at very close to term. Brad came into this world via a stat-emergency cesarean section. His heartrate had dropped during my labor. My OB later discovered that Brad had an umbilical cord around his neck; known as a nuccal cord. Because of my age I was considered high-risk. So I had all the prenatal diagnostic tests while pregnant. Not that any results would alter my pregnancy, however, I am the type of personality that does better with prior information.  After Brad was born, the neonatologist discovered that Brad had an undiagnosed cleft palate. Funny; no family history so I never considered that one. I still attempted to breastfeed my newborn in the hospital; but he would never latch. So by the time I took him home from the hospital he was partially dehydrated with impending hyperbilirubinemia (jaundice). As we were being discharged a nurse handed me an unopened package that contained the Haberman Special Needs Nurser.
When we got home I proceeded to re-hydrate Brad, even going so far as to calculate out how many mL's per kilogram per day of fluid he was receiving. The neonatal nurse practitioner part of me was taking over. And, yes, I started a "chart" on Brad. I even counted his respirations. Signs of a nervous mom, or just a bad combination of mom/nurse? Thankfully Brad did well, although I needed to use formula because my milk never came in. Because my son wouldn't or couldn't latch; I knew to rent a hospital grade double electric breastpump. Because I didn't get support at that time from a Lactation Consultant; I didn't know how often to pump. Also, because I negelected to take a breastfeeding class; I was unaware of the need to pump frequently. That situation prompted me to go into a post partum depression, I had been a failure at having a vaginal birth and also a failure with breastfeeding.

Several great things have happened since that period in my life. I recovered from my PPD, my son Brad has thrived and grown into a fine, young man. Yes, he is handsome. But because of my ordeal I have now become a Certfied Childbirth Educator, first a Certified Lactation Counselor, and now a IBCLC (International Board Certified Lactation Consultant).
Last year I ventured into a private business known as BabyFirst Lactation & Childbirth. I truly recommend that all pregnant mothers take prenatal educational classes. I also recommend that breastfeeding is the absolute best way to nourish your baby. Breastfeeding is my passion and I desire to help you reach your personal breastfeeding goals.  ~Amy www.babyfirstlactation.com

Breastmilk vs. Formula

Supporting Studies on Infant Formula Marketing

Reference these studies when you talk to the media, healthcare providers, or hospital administrators.

Studies on the prevalence of formula sample distribution in the U.S.

1. Sadacharan, R., Grossman, X., Sanchez, E., & Merewood, A. (2011). Trends in US Hospital Distribution of Industry-Sponsored Infant Formula Sample Packs. Pediatrics, 128(4), 702-705.

Study of 1239 hospitals in 20 states found that most US hospitals continue to distribute industry-sponsored formula sample packs, but trends indicate a significant change in practice; increasing proportions of hospitals eliminate these packs. Change was more significant in states where higher proportions of hospitals had already eliminated packs in 2007. Based on the CDC’s breastfeeding report care for 2010, average breastfeeding initiation rates were significantly higher in the states with the best-record of banning samples when compare to those with the worst records (81.5 percent vs. 67 percent). Similarly, the rate of breastfeeding at six months was higher in states with the best record of banning sample bags (52.7 percent to 37 percent).

2. Merewood, A., Grossman, X., Cook, J., Sadacharan, R., Singleton, M., Peters, K., et al. (2010). US hospitals violate WHO policy on the distribution of formula sample packs: results of a national survey. Journal of Human Lactation, 26(4), 363.

Cross-sectional telephone survey of 3209 US maternity sites, conducted from 2006 to 2007. Found that 91% of hospitals distributed formula sample packs, and a trend toward discontinuation of the practice was statistically significant. Most US hospitals distribute infant formula samples, in violation of the WHO Code and the recommendations of public health and healthcare provider organizations.

3. Merewood, A., Fonrose, R., Singleton, M., Grossman, X., Navidi, T., Cook, J. T., et al. (2008). From Maine to Mississippi: hospital distribution of formula sample packs along the Eastern Seaboard. Archives of Pediatrics and Adolescent Medicine, 162(9), 823.

Studied 21 eastern states and the District of Columbia. Rates varied by region. Found that 94 percent of hospitals distributed formula sample packs. Regional trends were evident. The proportion of distributing hospitals ranged from 70.4 percent (New Hampshire) to 100.0 percent (4 states-New Jersey, Maryland, Mississippi, and West Virginia-and Washington, DC). The proportion of hospitals that do not distribute sample packs has risen significantly between 1979 and 2006.

Studies on the effects of industry-sponsored formula samples on breastfeeding

1. Rosenberg, K. D., Eastham, C. A., Kasehagen, L. J., & Sandoval, A. P. (2008). Marketing Infant Formula Through Hospitals: the Impact of Commercial Hospital Discharge Packs on Breastfeeding. Am J Public Health, 98(2), 290-295.

Among women who had initiated breastfeeding, 66.8 percent reported having received commercial hospital discharge packs. Women who received these packs were more likely to exclusively breastfeed for fewer than 10 weeks than were women who had not received the packs

2. Donnelly A, Snowden HM, Renfrew MJ, Woolridge MW. Commercial hospital discharge packs for breastfeeding women. Cochrane Database Syst Rev. 2000

Nine randomized controlled trials involving a total of 3730 women from North America were analyzed. Commercial discharge packs reduced exclusive breastfeeding.

3. Wright, A., Rice, S., & Wells, S. (1996). Changing Hospital Practices to Increase the Duration of Breastfeeding. Pediatrics, 97(5), 669-675.

Duration of breastfeeding was longer in women who did not receive commercial discharge packs with formula samples or coupons for formula samples.

4. Perez-Escamilla, R., Pollitt, E., Lonnerdal, B., & Dewey, K. (1994). Infant feeding policies in maternity wards and their effect on breast-feeding success: an analytical overview. American journal of public health, 84(1), 89.

A meta-analysis of 18 studies showed that commercial discharge packs have a detrimental effect on exclusive breastfeeding at one month and any breastfeeding at four months.

5. Dungy, C. I., Christensen-Szalanski, J., Losch, M., & Russell, D. (1992). Effect of discharge samples on duration of breast-feeding. Pediatrics, 90(2), 233.

Women who received a manual breast pump in their discharge bags instead of formula samples were more likely to exclusively breastfeed their babies for a longer number of weeks (4.18 weeks compared to 2.78 weeks).

6. Snell, B., Krantz, M., Keeton, R., Delgado, K., & Peckham, C. (1992). The association of formula samples given at hospital discharge with the early duration of breastfeeding. Journal of Human Lactation, 8(2), 67.

At 21 days, there was a significant relationship between receipt of a gift pack and the decline of exclusive breastfeeding among a group of low-income Hispanic women. A larger proportion of breastfeeding women who received a gift pack either began by supplementing with formula or changed to bottle-feeding by three weeks.

7. Bergevin, C., Dougherty, Y., & Kramer, M. S. (1983). Do infant formula samples shorten the duration of breast-feeding? The Lancet, 321(8334), 1148-1151.

New mothers receiving formula giveaways were less likely to still be breastfeeding at one month and more likely to have introduced solid foods by 2 months These trends became more significant in three vulnerable subgroups: less educated mothers, primiparas, and mothers who had been ill post-partum. Results suggest that infant formula samples may shorten the duration of breast-feeding and hasten the age at which solids are introduced.

Selected studies on health benefits of breastfeeding

1. Ip, S., Chung, M., Raman, G., Chew, P., Magula, N., DeVine, D., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Agency for Healthcare Research and Quality Publication, U.S. Department of Healthcare and Human Services. Retrieved 2 November, 2011, from http://www.ahrq.gov/downloads/pub/evidence/pdf/brfout/brfout.pdf

Found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. For maternal outcomes, a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer. Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression.

2. Harder, T., Bergmann, R., Kallischnigg, G., & Plagemann, A. (2005). Duration of Breastfeeding and Risk of Overweight: A Meta-Analysis. American Journal of Epidemiology, 162(5), 397-403.

Meta-analysis of 17 studies shows that a longer duration of breastfeeding is associated with a larger decrease in risk of overweight.

3. Arenz S., Ruckerl R., Koletzko B., Von Kries R.(2004).Breast-feeding and childhood obesity: a systematic review. International Journal of Obesity and Related Metabolic Disorders, 28, 1247-

Children who are breastfed are 22 percent less likely to be obese.

4. Labbok, M. H. (2001). Effects of Breastfeeding on the Mother. Pediatric Clinics of North America, 48(1), 143-158.

Breastfeeding reduces the risk for postpartum blood loss by increasing the rate of uterine contraction, premenopausal breast cancer, and ovarian cancer. In addition to reducing the severity of anemia, breastfeeding may cause changes that help to protect mothers against bladder and other infections. Epidemiologic studies seem to indicate that women who breastfeed may be at reduced risk for spinal and hip fracture after menopause. In addition to the direct health effects, breastfeeding seems to provide a sense of bonding, a sense of well-being, and an improved sense of self-esteem for many women.

Studies on the economic benefits of breastfeeding

1. Bartick, M., & Reinhold, A. (2010). The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis. Pediatrics, 125(5), e1048-e1056.

Finding that if 90 percent of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80 percent compliance).

2. Oliveira, V., Prell, M., Smallwood, D., & Frazao, E. (2001). Infant Formula Prices and Availability: Final Report to Congress. Retrieved 2 November, 2011, from http://www.ers.usda.gov/publications/efan02001/efan02001.pdf

Finds that the average price of brand name infant formula is close to two thirds more than store brand formula. Parents who use brand name formula may spend $700 per year more than those who use store brand formula.

3. Weimer, J. (2001). The Economic Benefits of Breastfeeding: A Review and Analysis. Food and Rural Economics Division, Economic Research Service, U.S. Department of Agriculture. Food Assistance and Nutrition Research Report No. 13. Retrieved 2 November 2011, from http://www.ers.usda.gov/publications/fanrr13/fanrr13.pdf

A minimum of $3.6 billion would be saved if breastfeeding were increased from current levels (64 percent in-hospital, 29 percent at 6 months) to those recommended by the U.S. Surgeon General (75 and 50 percent). This figure is likely an underestimation of the total savings because it represents cost savings from the treatment of only three childhood illnesses: otitis media, gastroenteritis, and necrotizing enterocolitis.

4. Cohen, R., Mrtek, M. B., & Mrtek, R. G. (1995). Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. American Journal of Health Promotion, 10, 148-148.

Finds that one-day absences from work to care for sick infants occurred more than twice as often among formula-feeding mothers than breast-feeding mothers.

• Join Today
• Contact Us
• Contribute
• Careers/Internships
• Privacy Policy
• Site Map

Celebrate Breastfeeding

Jenna Elfman, Kelly Preston & Laila Ali Host Event to Celebrate Breastfeeding & Toxin-Free Living in Raising Healthy Children

On April 14, 2012, actresses Jenna Elfman, Kelly Preston & former boxer Laila Ali, in partnership with non-profits Best for Babes and Healthy Child Healthy World, will host the first celebrity-driven event to raise awareness of the pivotal role that both breastfeeding and toxin-free living play in raising healthy children. “Education and awareness are the first steps. No one can do everything, but everyone can do something, and every action counts,” said hostess Jenna Elfman.

Presented by Leading Lady & Ameda, two companies that have supported breastfeeding moms for 70 years, the event is the first to introduce the breastfeeding cause and Best for Babes to expecting and new celebrity moms and Hollywood influencers. Best for Babes is the only mainstream nonprofit dedicated to raising awareness of and removing the barriers (The Breastfeeding Booby Traps™) that keep millions of mothers in the U.S. from achieving their personal breastfeeding goals. Together with Healthy Child Healthy World, which has successfully partnered with high profile stars to teach parents around the globe how to protect children from environmental toxins, Best for Babes, Jenna, Kelly and Laila hope that this event will encourage Hollywood to lend its reach and influence to the breastfeeding and toxin-free causes. Hollywood has been instrumental in raising awareness and bringing about change for many pressing health issues, from AIDS to Parkinson’s to breast cancer.
“Best for Babes is exceptionally grateful to Jenna, Kelly and Laila, and their outstanding event planning team for this opportunity to inspire and educate the influential Hollywood community,” said Bettina Forbes and Danielle Rigg of Best for Babes. “We thankfully acknowledge the leadership and support provided by Healthy Child Healthy World in mentoring Best for Babes, and we applaud them for their mission of empowering parents to protect children from harmful chemicals. Special thanks to Presenting Sponsors Leading Lady & Ameda, as well as our Leading and Contributing Sponsors, for making this event possible and for funding a new Best for Babes initiative to help moms and babies. Three cheers to top party planner The Party Goddess! for bestowing her magic upon the event, and to all those who contributed to making it possible!”
The event, an afternoon tea, will be held on April 14th at the beautiful Hollywood home of actress and gracious hostess Jenna Elfman who is known for her impeccable style. Hostesses Jenna, Kelly and Laila and the event team have attended to every detail to deliver an experience that is as elegant as it is intimate, and as informative as it is inspiring. French Chef Ludo Lefebvre (Awarded Mobil 5-star, star of Top Chef Masters and Ludo Bites America) will demonstrate healthy snacks for moms and babies. Guests will have the opportunity to explore and learn about the best breastfeeding and non-toxic living practices, information and products through display stations located throughout the home. Topics include getting a good breastfeeding start, sustainable and toxin-free nursery furniture, managing milk supply, baby-wearing and gear for on-the-go, using natural cleaning products, natural and organic body care for babies and moms, natural diapering, and organic and healthy nutrition. Some of the host’s favorite breastfeeding & non-toxic products will be displayed.
Sponsors: All of the sponsors and additional products displayed at the event were personally selected by the hostesses and their event teams, Best for Babes, and Healthy Child Healthy World, who thank them for making this event possible!