LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Denise Arcoverde <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 18 Apr 1996 20:38:22 -0300
Content-Type:
text/plain
Parts/Attachments:
text/plain (543 lines)
Hi, all


This is the "oficial" World Breastfeeding Week's action folder 96. I hope
this could be very useful to you.

Denise Arcoverde, from WABA Brasil.



World Breastfeeding Week
1-7 August 1996

A  woman's choice about how best to feed her child is a  personal one.
However, as no woman lives in isolation, her  decision  is influenced by
many factors.  Family members, health workers,  the media, religious
institutions, social traditions, the work  place and  her own education can
all have a bearing on her decision  to breastfeed - as well as her ability
to continue breastfeeding for the optimal length of time.

Every  woman should be able to count on full support  from  those around
her to enable her to initiate and sustain  breastfeeding.  It is the
responsibility of the entire community to see that  the best  possible
nutrition and health is available to all  of  its members, beginning with
its youngest.
A community  is  the  people  nearby  -  in  the   family, neighbourhood, at
work, and in the town.'  People all around  join to  support the
breastfeeding mother. Women feel supported  when the  community  welcomes
them to breastfeed in  public,  provides help to overcome difficulties,
offers facilities to breastfeed at the  work  place; and when health
professionals take  an  ethical stand  against  the promotion of breastmilk
substitutes and  use their influential power to support women to breastfeed.

The  theme for World Breastfeeding Week 1996,  "Breastfeeding:  A Community
Responsibility" provides an opportunity for us all  to evaluate our own
communities and the attitudes expressed, to  see if we are indeed supportive
of breastfeeding.

In  this  action folder, designed to give you  some  solid  ideas about WBW
activities that you can organise in your own community, we will explore the
"Triple-A" model for advocacy.

Assessment
Analysis
Action


The Triple A Approach

The  "Triple A" model is very logical.  The approach of  "Assess, Analyse,
Act" is also known as "Look-Think-Do".

Assess - Look

First,  ASSESS,  or look at the situation around  you.   Talk  to people
about  how infant feeding decisions are made -  talk  not only  with
mothers, but with health workers and  family  members.  Find  out just how
far support for breastfeeding goes  in  health care facilities and in the
work place.  Try to establish how much people  really understand about the
importance of  breastfeeding,  not just  for  the  child and the mother,
but  for  the  entire community.

Analyse - Think

Once  you have gathered your impressions, ANALYSE or think  about what  you
have discovered.  Are there gaps?  Contradictions?   Is there
misinformation?   Prejudice?  Also look at  your  positive findings.   Are
there any areas that work very well?  What  makes them  so successful?
Which practices or people help  mothers  to breastfeed?
 Act - Do

Design   activities   based   on  what  you   have   found. If
misinformation  exists,  organise training programmes to  set  it right.  If
support groups for breastfeeding mothers do not exist, see  if  you or a
local organisation might start  one.   Talk  to decision-makers  in health
facilities, religious and  educational institutions  and government to point
out the gaps and work  with them to design ways to fill the gaps.

ASSESSMENT

Talk about breastfeeding and listen to what is said.

Look  around  your  community.   Everybody  from  shopkeepers  to religious
leaders, factory owners to policy makers can  help  to ensure  that
children  can  benefit  from breastfeeding. The following   sectors  of
your  community  can  play  a  role   in influencing attitudes and promoting
child health.  Talk to people to  learn  about how they see breastfeeding.
Use  the  questions on page 5  as  a  guideline,  though you may choose to
modify  the questions   to  suit  your  particular  situation.   The
sample questions are designed to help you gather information, perhaps by
making  up  a checklist or writing down your  observations.   The
"assessment  process" tells you what is going on.  In conducting this
exploration, refrain from judgment.  You will have time for this in the
analysis phase.

ASSESS YOUR COMMUNITY: Survey Questions

SCHOOL

How  do young people learn about breastfeeding?

How early do the influences begin?

Do dolls in children's pre-school play area come with bottles?

Do middle schools and high school cover breastfeeding in  biology classes?

Is there support for young mothers who continue to attend school?

RESTAURANTS/PUBLIC PLACES/BUSINESSES

Does a women feel comfortable breastfeeding her baby in public?

Do staff members at restaurants understand that babies, too, must have their
meals?

Do shops selling breastmilk substitutes have any understanding of the Code?

WORK PLACE

How baby-friendly is the work place?

Is there on-site crhche?

Are women allowed breaks for breastfeeding?

Are  clean and private facilities available for women who  choose to express
milk?

RELIGIOUS INSTITUTIONS

Is breastfeeding understood and supported by religious leaders?

Does the institution encourage breastfeeding support  groups  by lending its
space or
helping to organise meetings?

Are  breastfeeding  women  made  to  feel  welcome  at  religious services?

SOCIAL GROUPS/ CLUBS/ ORGANISATIONS

Do  any  clubs or social organisations in  your  community  offer
breastfeeding support groups?

How are breeastfeeding support organisations promoted?

FAMILY

Do family members understand the need to pitch in with  household chores
when a mother is breastfeeding?

Do they realise that a breastfeeding mother needs extra food  and extra rest?

Do  grandmothers  and mothers-in-law appreciate and  support  the decision
made by the mothers?

Do  fathers  understands that there are  many  opportunities  for bonding
in  addition  to feeding an  infant,  such  as  bathing, cuddling and burping?

MEDIA

How are breastfeeding issues presented in the press?

What about television programmes?

Have  any  daytime  or prime series raised the  issue  of  infant feeding?

Are any local celebrities known to breastfeed?

Do infant formula manufacturers advertise in publications, on the air or on
outdoor media (billboards, public transit, etc.) ?

GOVERNMENT

Is there a national breastfeeding committee?

Does  the  ministry  of  Health  have  any  policies   regarding breastfeeding?

Do welfare mothers receive support for breastfeeding in the  form of extra
food? 0

HEALTH FACILITIES/ HEALTH WORKERS

Are  the  hospitals  and  Maternity Clinics  in  your  community  baby-friendly?

Is breastfeeding discussed at pre-natal programmes?

How  informed are members of the staff? Is there  any  post-natal support
for breastfeeding, particularly once a women has returned to her home?

Does the hospital accept free supplies of breastmilk  substitutes or
distribute sample to mothers?

Can  a  woman  who is having trouble breastfeeding  turn  to  the health
facility for help?

Schools

Most  children  are not exposed to breastfeeding or any  form  of
breastfeeding instructions in school. A teenage mother will  receive little
support in breastfeeding from her school.   Medical curriculum  gives
little  or no attention  to  the  science  and practice of breastfeeding

Religious Institutions

Breastfeeding  is  approved as a family planning method  in  many  cultures
and  religions. In Buddhist tradition,  the  father  is responsible for
providing the best nutrition for the mother while she  is  breastfeeding.
The  Quran specifies  that  a  baby  be breastfed for two years with the
health of the mother a priority.

Media

Radio,  television and newspapers have powerful influences on  our opinions
and relationships with others.  We can work  with  the media   create
supportive environments for   breastfeeding. In Slovakia,  a  magazine
called Child has agreed  to  publish  one article  about  breastfeeding  in
each  issue  provided  by  the breastfeeding  NGO  Pro Vita. In South Africa
a  cartoon  booklet 'Maria's New Baby' designed to promote the benefits of
breastfeeding has been adapted into radio script. In Sweden, sports
celebrities are helping to promote breastfeeding with a famous hockey
player and his  family appearing  on  a  poster  with   the   caption
"Breastfeeding: the best goal!" Some parents and family magazines no longer
advertise  breastmilk substitutes, although images of bottles are slower to
disappear.

Restaurants/ Business/ Public places

Breastfeeding   in   public  is  often  met   with   disapproval.
Breastfeeding is a woman's right and a child's right.   Pioneering steps to
make it acceptable are vital.  In 1994, UNICEF commended a  US  restaurant
for encouraging women to  breastfeed.   At  the
Soekarno  International Airport in Indonesia, the feeding  bottle symbol has
been replaced with an image of a breastfeeding mother.

A  bank  in  Brazil produced a credit card  for  members  of  the National
Pediatric Society featuring a colour photograph  of  a breastfeeding infant.

Work Place

The International Labour Organisation's minimum standards require 12  weeks
of maternity leave with cash benefits amounting  to  at least  66% of
previous earnings, prohibition of dismissal  during maternity leave, and
once a woman has returned to work, two half-hour  breastfeeding  breaks
during each working  day.  The  1990 'Innocenti Declaration' and 1995 '
Platform for Action' from  the  UN World  Conference on Women, called on all
governments  to  protect the breastfeeding rights of working women.

Employees in countries such as Guatemala, Swaziland and Mauritius have  set
up crhches for breastfeeding babies setting an  example to other employers
to become for mother-friendly work places.

FAMILY

A survey of 115 UK mothers has shown that the partner's attitude to
breastfeeding is the biggest factor influencing feeding decisions. If the
father approved of breastfeeding, three quarters  of  infants were totally
breastfed; if the  father  was indifferent or disapproving, the proportion
fell to less than 10%. Other  members  of the family and friends, a  new
mother's   mother  may also  have  a  positive  influence  by   being
supportive.

Breastfeeding Improves Household Food Security
Breastfeeding is total food security for infants up to 6  months of age. The
per  cent  of an average annual  urban  wages  required  to purchase a
one-year supply of infant formula for one child:

Kenya: 45%
India: 50%
Nigeria: 260%

An important calculatioin which has often been ignored, is that of the
contribution to the World's food supply of human milk.  Millions of tonnes
of breastmilk would be added if infants were fed this in their first 4-6
months and were continued to be breastfed, right through their second year.

GOVERNMENT

The  International  Code of Marketing of  Breastmilk  Substitutes requires
that no words or pictures idealising artificial  feeding, including
pictures of infants on labels of products and  that unsuitable  products
such as sweetened condensed milk, should  not be promoted for babies.
The Innocenti Declaration called upon all government to appoint a national
breastfeeding coordinator  and to establish a "multisectoral  national
breastfeeding  committee composed  of representatives from relevant
government departments, on-government organisations and  health professional
associations.

In India, the law on Infant Milk Substitutes, Feeding Bottles and Infant
Foods Act came into effect in 1993 and aims  to  regulate production,
supply, distribution and promotion of these  products to ensure they do not
interfere with breastfeeding.

SOCIAL GROUPS/ CLUBS/ ORGANISATIONS

Step 10 of the "Ten Steps To Successful Breastfeeding" is "Help start
breastfeeding support groups and refer mothers to them".
La  Leche  League International started in 1959 when a  group  of seven
women  got together  to  discuss   their   breastfeeding experiences.
Today,  support groups like La Leche  League,  Susu Mamas,  IBFAN groups and
ILCA provide crucial support to mothers outside of the health system. La
Leche Leauge has more than 8,000 certified leaders who reach over 100,000
women each month in more than  60  countries. In Norway,  where close to
100%  of  mothers  initiate breastfeeding,  and  more  than 80%  of  babies
are exclusively breastfed at three months, mother support groups are an
important complement to the services of health are institutions.

HEALTH FACILITIES, HEALTH WORKERS

Initiation  of  breastfeeding  soon after birth  is  crucial  for successful
breastfeeding and requires the full support of  health personnel  attending
birth.  Possibly the single  most disabling factor  for  breastfeeding
mothers is the lack  of  support  from health professionals coupled with
the  lack  of  accurate  information  and sometimes just plain misinformation.
 Hospital   practices  and  routines  often  interfere  with   the
establishment  of breastfeeding. Health professionals  have  not been
taught  how lactation works, how to help women  "latch  on" their  babies
so  nipples  don't get damaged  or  how  to  solve brestfeeding problems.
Well-meaning hospital staff, doctors  and pharmacists  give  new mothers
gift packs with  formula  samples, bottles,  teats  and  formula-company
produced 'breastfeeding' information.   Along with samples comes a not-so
subtle  message that breastfeeding women also should use 'formula'.

ANALYSIS

Once  you  have surveyed members of the various  sectors  of  the community
listed on page 3 using the sample questions,  it is time to take a look at
the responses. Now is also the time  to begin asking the questions why? Or
why not?  Expand  the questions  you  have  posed  in  the  assessment
stage  to  more analytical questions.  For example: Why is infant feeding
largely ignored  in  high school biology classes? Or, why has  the  local
newspaper  relegated ? Breastfeeding to the family pages  instead of  the
science or health sections? Or, is there a way for  women to  breastfeed  at
the local factory? Or,  could the community centre provide space for a
weekly mother-support group meeting?

These  questions  will most likely inspire discussion,  and  this discussion
will begin to point you towards specific actions  that will address the
needs and gaps that you have uncovered.

ACTION

The  Actions you plan will link directly back to  the  Assessment phase,
and will propose solutions to problems uncovered  through the Analysis.
Actions will be different in every community, based on  the area of most
apparent need, and also based on  where  the best opportunities exist.
Success depends in large part  on  the involvement  of  the  entire
community.  If  teachers,  religious leaders,  health  workers,  employers,
government and business leaders and family members are brought into the
process early on, if  their insights and  opinions  are  thoughtfully
considered and worked into any plan of action, then their continued  support
is far more likely.

ACTION   =  Get  your  Community  to  restore  a  baby - friendly
Breastfeeding Culture

The  goal of a baby-friendly community will be reached through  a series  of
actions, education and public awareness,  changes  in the  work  place,
eliminating the damaging influence  of  infant formula promoters. These
larger goals can be helped by activities that you can undertake in your own
community.


Ask  the  Mayor  or  Health  minister  to  issue  a  proclamation declaring
World Breastfeeding Week.

Hold a press conference with local experts.

Ask  the  media  to  broadcast  or  print  free  public   service
announcements about WBW.

Visit  your local health center and make sure that there  are  no posters or
pamphlets on display promoting breastmilk substitutes.

Offer a free workshop or talk to introduce "baby-friendliness".

Activities  can  be as simple as congratulating  a  breastfeeding woman on
the choice that she has made or as complex as helping to set up training
programmes for hospital staff.

Ask local shops and restaurants to participate in WBW. A book shop could
have a window display with books  on  breastfeeding  and infant nutrition; a
restaurant could have a special luncheon  for breastfeeding  mothers or
offer discounts to families  who bring infants to share a meal.

Organise  an  exhibition at a shopping mall or  transit  station, hospital
or clinic

"What Family And Friends Can Do".

Promotions and correct information in the community can  increase family
and friends knowledge about breastfeeding.  Supporting  a breastfeeding
mother can include;

Cuddle, sing to, play with, change and bathe the baby. Look after other
siblings, take them to school or on activities.

Go shopping, prepare and cook meals, help with household chores.

Support the mother's decision to breastfeed.

Partners can attend ante-natal and/or breastfeeding classes with mothers.

Do not question her milk supply.  There is no surer way to make a new
mother  doubt her natural ability.  She will  have  enough milk if she feeds
frequently.

Be understanding - taking care of a baby is time consuming.   She may  not
be able to spend as much time with you as she  used  to, but your support
and friendship counts nonetheless.

The Train

Goals = Engine

To advocate a community approach to supporting breastfeeding.

To  work  with all sectors of the community to  develop  ways  to restore a
breastfeeding culture.

Recognising   the   multifaceted  influence  of  a   community   on
breastfeeding.  World Breastfeeding Week 1996  encourages  groups and
individuals,  government, public and private  institutions, employers   and
the  media  to  protect,  promote  and   support breastfeeding.

Hospital coach

Baby friendly Hospital.
We practice Ten steps to succesful breastfeeding.

Educated staff.
No formula samples.
No free supplies.

Public health coach

Pre-natal breastfeeding classes.
Support after hospital discharge.
24hr help line.
Drop in clinics.
No formula promotions.

Media Coach

Our programme include breastfeeding images.
Reporters are educated in breastfeeding matters.

Nursing, medical and nutrition coach.
Use us to get breastfeeding information to the public.

Travel Coach

Buses,  trains,  aeroplanes  and  boats  are  all   breastfeeding friendly
services.
Airports, terminals and stations are baby friendly.
Travel in comfort with your breastfeeding baby.

Restaurants, parks and other public coaches, babies are encouraged to feed here.
Shops encourage breastfeeding babies.
Comfort is provided.

Library Coach

Up to date breastfeeding resources.
Displays for WBW.
Posters.

Mother to mother support Coach.

Working together to support breastfeeding.
Call us - we want to help you.

Education Coach

Breastfeeding incorporated into the school programme.
On site nurseries for adolescent mothers.
Children's books and toys present, no bottles. Book  illustrations that show
mothers breastfeeding.

Religious Coach

Breastfeeding mothers and babies welcomed by the congregation.

Doctors office/ Clinic Coach

We're 1005 %? behind breastfeeding.
Good advice.
No formula samples.

Workplace Coach

This employment offers:
Flexible hours,
Job sharing
On site day care
Quiet nursing site
4 months maternity

Distributing Centres

Regional and acting coordinating centres for WBW 1996 are:

AFRICA
IBFAN Africa (English)
PO Box 781, Mbabane
Swaziland
Tel: (268) 45006; Fax: 44246

IBFAN Africa Francophone c/o APAIB
01 P.B.1776, Ouagadougou 01
Burkina Faso
Tel: (226) 303804; Fax: 300968

AUSTRALIA, NEW ZEALAND & THE PACIFIC
Nursing Mothers Association of Australia (NMAA)
PO Box 321, Nunawading, VIC 3131
Australia
Tel: (61-3) 9877 5011; Fax: 9894 3270

Secretary PINDA, C/o Continuing Education
USP (University of South Pacific), PO Box 1168
Suva
Fiji
Fax: (679) 300482

BRAZIL & LUSPHONE COUNTRIES
Grupo ORIGEM/WABA Brazil (Portuguese)
Av.  Beira Mar, 3661 Loja 19, Casa Caiada,
Olinda PE 53130-540
Brazil
Tel/Fax: (55-81) 432 1913
e-mail: [log in to unmask]

If  you want to do a more detailed investigation of the state  of
breastfeeding  in  your country or  community  join  the  Global
Participatory Action Research (GLOPAR) project. Contact the  WABA
Secretariat for more information.

WABA  does  not  accept sponsorship of any  kind  from  companies producing
breastmilk   substitutes,   related   equipment   and complementary  foods.
WABA encourages all participants of  World Breastfeeding Week to respect and
follow this ethical stance.

ATOM RSS1 RSS2