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.
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