WABA's 10 Links in the Warm chain for Breastfeeding

Andrew Chetley (WABA Glopar Project Consultant)

Breastfeeding has been estimated as preventing 6 milion infant deaths a year
nearly 1 milion more that the combined preventive effect of oral rehydration
and immunisation programmes. If breastfeeding patterns were improved - more
exclusive breastfeeding for the first six months of age and more
breastfeeding generally a further 2 milion deaths could be prevented.

For these improvements to occur, as an editorial in The Lancet said in 1994:

"Breastfeeding...requires its own "warm chain" of support - that is, skilled
care for mothers to build their confidence and show them what to do, and
protection from harmful practices..Policy makers need to understand that
provision of a warm chain for breastfeeding is a valuable as provision of a
cold chain for vaccines and likewise requires adequate resources."

As part of its Global Participatory Action Researche (GLOPAR) Project, WABA
has been helping project partners in countries throughout the world to
identify existing obstacles to successful breastfeeding and to develop
national action plans, their own national "warm chain".

One result of this work is "WABA's Ten Links in the Warm Chain for
Breastfeeding", a set of strategies that provide the human touch that is so
essential to the protection, promotion and support of breastfeeding, and
that go beyond the Innocenti Declaration targets set out in 1990.

WABA's 10 LINKS in the Warm Chain for Breastfeeding

1. Promote exclusive breastfeeding

2. Develop innovative social support mechanisms for breastfeeding mothers
working in the informal sector, as weel as ensuring that adequate maternity
legislation is in place and respected for women working in the formal public
and private sector.

3. Encourage and support the development of community breastfeeding support
groups - icluding mother-to-mother support groups, women's groups and mother
and child groups.

4. Ensure that the practices recommended in the Ten Steps to Succesful
Breastfeeding are adopted by all health care facilities offering maternity
services.

5. Extend and adapt the Baby Friendly Hospital Initiative to encompass
antenatal clinics, primary care and community facilities (including
mother-friendly workplaces, baby-friendly communities).

6. Ensure that every health worker who has dealings with pregnant women and
mothers (including primary care staff, nurses, midwives, general
practioners, and consultant specialists) have adequate training in
breastfeeding to be supportive.

7. Eliminate sponsorship by manufacturers of infant feeding products of the
continuing medical education of health workers.

8. Enforce the International Code of Marketing of Breastmilk Substitutes (or
legislation based upon the Code) as a means of protecting mothers from
misleading commercial influences.

9. Develop and implement a National Breastfeeding Policy which includes a
section on the appropriate use of complementary foods.

10. Encourage and sopport the develop-ment of national collaborative
networks of groups and individuals working on breastfeeding, other infant
feeding questions and broader questions of the care of children, as part of
regional and international efforts in these fields.