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Taking Action to Ensure Breastfeeding Breastfeeding through through Projects, Studies, and Surveys
La Leche League 18th
International Conference
Strength through Diversity - Creating One Breastfeeding World
San Francisco, California, USA
July 3-6, 2003
Friday, July 4 - Session
#125
Global Issues - Taking Action to Ensure Breastfeeding through Projects,
Studies, and Surveys
During this session, selected
presenters talked about the work displayed on their posters. Following
the presentations, time was provided for participants to ask questions
and for presenters to supply more information, if needed. Below are
their abstracts:
The Influence of Birthing Practices on Breastfeeding: Protecting the
Mother-Baby Continuum
Author and presenter: Mary Kroeger
The miraculous partnership
between a mother and her newborn, from conception, throughout pregnancy,
labor, birth and breastfeeding, has been the foundation of the survival
of our species. This mother-baby continuum is in danger from many directions.
The move from birth in the home to the hospital in developed countries
has seen a rapid change in how care is provided. The establishment of
two professional and academic specialties: obstetrics and pediatrics
have split the mother from her newborn. Global policy and programs have
consistently failed to preserve this mother-infant partnership in child
survival and safe motherhood programs and breastfeeding promotion has
often fallen through the cracks. The WHO/ UNICEF Baby Friendly Hospital
Initiative pioneered the protection and promotion of breastfeeding
in maternity facilities, but it does not bring significant attention
to care of the mother during childbirth, even while targeting "maternity
services."
This poster session, based
on a soon to be published book, highlights some of the research evidence
that shows impact of certain childbirth interventions on breastfeeding
outcomes. Among the childbirth interventions examined are: labor support
with a doula, position at birth, withholding of fluids and IV therapy,
episiotomy, instrumental delivery, cesarean section, and labor pain
medications. Broad recommendations for how to integrate holistic, non-medicalized
care in pregnancy, birth, and breastfeeding in such a way that supports
the mother-infant partnership, reinforces keeping childbirth normal,
supporting optimal breastfeeding and thus supporting nature's master
plan.
Regional Variation in Public Opinion about Breastfeeding in the United
States
Authors: Abeda Hussain, Ruowei Li, MD, PhD, Sandra Benton-Davis, RD,
Laurence Grummer-Strawn, PhD
Presenter: Katherine Shealy
Background: Although many
studies have been done about nursing women's knowledge, attitudes and
barriers to breastfeeding, few have been done to understand attitudes
toward breastfeeding. None have examined geographic variation in public
opinions about breastfeeding. This examines public knowledge, attitudes,
and support of breastfeeding.
Methods: The Healthstyles
survey is a national mail survey to adults aged 18 years and older,
conducted annually by Porter Novelli. Since 1999, breastfeeding items
have been added to Healthstyles, focusing on different themes of
public opinions on breastfeeding each year. Using 1999-2001 data, we mapped regional
differences in public opinion of four breastfeeding themes: public knowledge
about health benefits of breastfeeding, public attitude toward breastfeeding
privacy, public support of breastfeeding policies at work, and public
perception about breastfeeding duration.
Results: Maps show that the Pacific,
West South Central, West North Central, and Mountain regions had the
best knowledge about breastfeeding health benefits. The Mountain, New England
and Pacific regions had the most positive attitudes about breastfeeding
privacy. The Mountain, Pacific, and East South Central regions had the strongest
support for breastfeeding policies at work. The Mountain and East North
Central regions had the most positive perceptions about breastfeeding
duration.
Conclusion: When linking
geographic patterns of public opinion to breastfeeding rates from the
Ross Laboratory Mothers Survey, we found the Pacific and Mountain regions
to have consistently high breastfeeding rates and positive public opinion
about breastfeeding. Further studies are needed to learn why these regions
are so positive and apply these observations to those regions with lower
breastfeeding rates and negative
Attitudes and Knowledge of Medical Students at the Federal University
of Alagoas, Brazil Regarding Breastfeeding
Authors: Pajuçara Marroquim, Maria de Salete Medeiros, Kênia
Araújo.
Presenter: Pajuçara Marroquim
Various studies have shown
that a negative comment from a health professional is considered one
of the reasons why women wean early. Although many health professionals
are convinced of the value of human milk, few have the necessary skills
to be able to offer solutions and support to mothers who experience
problems breastfeeding. Following up on this theory, the study objective
was to evaluate the attitudes and knowledge base on breastfeeding of
medical school students at the Federal University of Alagoas. In 2000,
data was collected through a questionnaire that was given to students
in their fifth year of medical school, covering a total of 77 students.
The percentage results showed that 42% responded incorrectly to an open
question (situation/problem), another 42% made reference to only one
correct solution, 11% responded correctly to two solutions and only
4% made reference to stress as a possible cause of milk reduction. Not
one student offered more than two correct responses.
The conclusion is that the
theoretical knowledge demonstrated by the students through correct responses
(86%) to the closed questions was not helpful enough when a practical
resolution to a situation/problem was needed. Therefore, the current
medical school's breastfeeding curriculum can not be considered sufficient
for a health professional to obtain the needed skills in order to work
with mothers who are experiencing a breastfeeding problem.
Training Traditional Mother Support in Mumbai, India
Author and presenter: Dr. Prashant S. Gangal
A large number of families
in India employ a Traditional Massage Woman (TMW) to give oil massage
and bath to the mother and young one. TMWs provide one hour of daily
service for about six months and exert a tremendous influence on mother
and family. They can be considered as 'traditional mother support'.
TMWs answer many questions about feeding and child-care asked by mothers
and their relatives. However their knowledge and attitudes in these subjects
is scientifically incorrect. They are directly or indirectly responsible
for propagating many traditionally incorrect customs and practices.
With this background, a project was initiated by BPNI (Breastfeeding
Promotion Network of India) Maharashtra in North-West Mumbai (Population
1.5 million) to formally train and utilize the potential of TMW to educate
mothers and community (Project Support: UNICEF).
Mother Support Group (MSG)
Leaders train TMWs through 12 one-hour sessions (over 12 weeks). The
training methodology consists of a pre-test followed by class room training,
role plays and practical demonstrations. Literature on infant feeding
and child care is provided in local language. Post-test and viva are
conducted to evaluate effectiveness of training. Certificate and Identity
Cards have been given to about 500 TMWs who have successfully completed
training. An equal number still remain untrained.
Certified TMWs are expected
to pass accurate information, messages and literature to mothers and
community. The project is practical, feasible and has improved outreach
to mothers after discharge from maternity homes. The project can
be easily replicated all over Maharashtra (Population: 80 million).
Helping Mothers Breastfeed at a Baby-Friendly Hospital in Asunción,
Paraguay
Author and presenter: Pushpa V. Panadam
As a La Leche League leader
I wanted to help more mothers in my community breastfeed. The Hospital
Barrio Obrero, which has been baby friendly since September 1995, is
only two blocks from my house. Once I was introduced to the hospital
staff, I decided to talk to mothers every Monday morning. That was in
August 2001, right after the LLL International Conference in Chicago. In these past
1 ½ years, the question I had asked myself at the Global Initiative
for Mother Support Session "How can a lay breastfeeding counsellor
influence health professionals?" is being answered. In the beginning,
I only spoke to mothers using the Breastfeeding Manual. Soon I was using
cloth posters, the Kathy comic series and talking to family and friends
visiting the mother. During World Breastfeeding Week in 2002, LLL Paraguay gave a session
at the hospital. The doctor in charge of the NICU became interested
in Kangaroo Care. This led to exchanging information, sharing and learning
possibilities. Whilst suggesting breastfeeding sessions for his staff,
mothers learn how to express milk for their babies, and about exclusive
breastfeeding. Sometimes I help babies latch on, to find out that some
were fed the bottle at night. Some nurses begin to show an interest
in breastfeeding. My vision is for a maternity ward that is truly baby
friendly. The Director of Public Health and the Head nurse working separately
with me plan for regular talks for the mums and the health staff. The
photos and data show the activities at the hospital but the key to it
all seems to be trust, confidence and learning to build a friendly,
family atmosphere.
Priority for Survival - Food Security for Nursing Mothers
Authors: Solveig Francis, Selma James, Phoebe Jones Schellenberg, and
Nina Lopez-Jones
Presenter: Selma James
Breastfeeding is integral
to the caring work women do ensuring the survival of new life. Since
in Third World countries especially, our survival and our children's
is not an economic priority, this survival work of women is ignored
and undermined. Besides, nobody makes a profit on breastfeeding. To reverse
this undermining of life itself, women's caring work must be counted
and economically valued.
The basic support for breastfeeding
is food security. Few resources are put into providing enough food anywhere,
though money is never short for arms or profitable technologies. As
well as breastfeeding their children, women are the global farmers, growing 80% of
food eaten in Africa (with children's help). But in times of war or
climate change, even women who are nursing are often neglected for food
aid.
Every year in the South 1,500,000
infants die from formula-feeding, and 60% of under-fives die from malnutrition.
Compare this with the 4% expected to die from HIV/AIDS. Yet a so-called
HIV/AIDS epidemic is lavishly funded and used to attack breastfeeding.
Pharmaceutical companies,
backed by the US, block the sale of generic drugs - proof they don't
care about our survival, but not proof that such toxic drugs can end
AIDS. For this, malnutrition, starvation and pollution must be ended.
Breastfeeding NGOs partner
the UNICEF of McDonald's and Coca Cola, which now prefers "informed
choice" - often telling mothers that formula is better - over breast
is best. The breastfeeding champion and the NGOs it helps fund have
become part of the problem.
Determined advocates for
breastfeeding as a human right to life and health, cannot avoid confronting
governments, multinationals, and their NGO apologists. The alternative
is silence, condoning genocide.
Thursday, September 4, 2003 2:20 PM
by ljw.
Page last edited Sun Oct 14 09:34:03 UTC 2007.
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