Taking Action to Ensure Breastfeeding Breastfeeding in Populations Where Hunger is a Fact of Life
La Leche League 18th
Strength through Diversity - Creating One Breastfeeding World
San Francisco, California, USA
July 3-6, 2003
Saturday, July 5 - Session
Global Issues - Taking Action to Ensure Breastfeeding in Populations
where Hunger is a Fact of Life
Presenter: Robb Davis
Facilitators: Judy Canahuati, Jean Ridler, Ines Fernandez, Ros Escott
and Janine Schooley
Robb Davis gave a presentation on hunger, food security and how breastfeeding can play a role in alleviating malnutrition. When we talk about hunger we need to take into consideration factors such as utilization, access and availability. Although famines do happen, the vast majority of the world population is affected by food insecurity. In these situations there usually is food but it is not made available to all people, either because it is too expensive for people to buy or many times because of political problems preventing food reaching all people. It is also the case that even if people have access to food and it is available it is not always utilized appropriately. For example, chronic diarrhea prevents the body from absorbing the food. When looking at food security we need to address the issue of utilization.
Davis focused on four countries, Mali, Uganda, Benin and Haiti, all of which have extremely high infant mortality rates and a high percentage of stunting among children of 6 to 11 months of age. Stunting is considered a good indicator of malnutrition, a problem which most probably starts at birth and will affect children for the rest of their lives. The low rates of exclusive breastfeeding is one reason for the stunting, however when we look at poverty stricken areas it is important to look at other factors such as malaria, other infectious diseases, and food accessibility, availability, utilization and quality.
When we look at breastfeeding, the problem is not that women do not realize its value, the percentage of children ever breastfed is around 98% in all four countries, but the fact that the rates of exclusive breastfeeding among children from four to five months are alarmingly low.
Women in "resource poor"
environments face many constraints:
- Lack of control over essential
household resources making it difficult to make decisions that affect
their own/children's interests
- Lack of economic prospects
to develop their own resources and competencies resulting in long
hours of physically difficult work that keeps them away from the household
making breastfeeding difficult
- Lack of education and
limited access to information outside the community resulting in limited
support to know how to deal with breastfeeding problems/questions
- Untrained health staff in local clinics and hospitals with little encouragement to work though breastfeeding problems
At the same time, women do
have many resources which if accessed can help them alleviate malnutrition
in their communities:
- A deep well of "social
capital" which is a kind of insurance helping them to have the
willingness to support others and be supported in times of need
- Local resource people
who provide a model for how to breastfeed successfully despite constraints
(if these can be identified)
- The "demographic
opportunity" of migration and the evolution of civil society
allowing new information to flow into the communities from the outside
about the benefits of breastfeeding
- A desire to learn, grow,
expand horizons and share with other women
- An openness to new and old ideas, and the ability for education to draw on the power of the group
It is these resources which we all need to draw upon to help communities create an environment where a mother can confidently breastfeed and give the adequate food to her children, and through this experience be able to establish a loving bond in her family.
Following are the actions presented during the session:
The common thread in all these actions is the importance of involving men to support women who breastfeed and to take an active role in ensuring a successful breastfeeding experience.
A. Engaging men in breastfeeding
Facilitated by Janine Schooley and Ines Fernandez
Following is a poem composed by Chris Mulford, Janine Schooley, Ines Fernandez, Michael Latham, Beth Styer, and Susan Moore.
You can make
your family strong
You can make your family wise
Do what you know in your heart is true
'Cause men can breastfeed too.
strong and bright
Filled with flowing gold
You can help your baby thrive
Stand up! Be strong! Be bold!
gold - many fold
Found in Mama's mold
Yes! Men can be involved
Bring the message to the world.
woman night and day
Let nothing stand in your way
She needs time, food and you
Men can breastfeed too!
keeps your baby's health
Breastfeeding helps to build your wealth
Leaders want their nations strong
Fathers help their young along.
have breasts, but do have heart
And men can surely play their part.
What you invest comes back to you.
Yes - men can breastfeed too!
B. Engaging men in breastfeeding
Facilitated by Ros Escott
This group composed a letter to send to NGOs addressing the issue of men's involvement in supporting women during pregnancy and breastfeeding, including specific actions that can be taken to achieve a positive involvement from fathers.
We write to you with a concern for breastfeeding mothers in your country. Our concern has to do with the nutritional health of mothers and the future health of the babies they carry in pregnancy.
Our goal is women's health through the support of their partners and of their community. Men's and women's lives are interdependent and we would like to know what is being done to encourage men to take more responsibility for the nutritional health of their families, especially pregnant women and babies in the early months. We urge you to develop participatory learning programs for action.
It is important to acknowledge that men play an important role in the health of the next generation and we urge you to promote the following strategies for men:
- Support women
from early pregnancy, particularly with food resources
- Support women after
birth to enable exclusive breastfeeding for six months:
- no separation
- adequate food for
- facilitate education/knowledge
- no separation
- Once the mother
goes back to work:
- enable breastfeeding
to be maintained two years or more
- support breastfeeding
- enable breastfeeding to be maintained two years or more
- Understand women's
- Understand that
child spacing of three to five years is optimal for health
- Ensure child safety while mother is working
C. Engaging men in breastfeeding
Facilitated by Judy Canahuati
Below is a letter addressed to UNICEF urging the involvement of men to achieve optimal maternal and child health
Cc: Dr. Miriam Labbok
Dear Ms. Bellamy:
The Baby Friendly Hospital Initiative led by UNICEF has been an incredibly creative, energizing force worldwide for increasing support for breastfeeding. However, for the initiative to be made effective, we believe that men should be explicitly included in the guidelines for successful initiation and maintenance of breastfeeding and complementary feeding.
Experiences in many countries indicate that educating men about the benefits of breastfeeding and appropriate and adequate complementary feeding and care provides support for women that is critical for optimal child development and the health and nutrition of mothers . the second part of the above letter can be included here.
D. Joining forces with nurses
Facilitated by Jean Ridler
This group worked on a letter
to send to nurses working with Matercare. Once the letter is finalized
it will be added to the report.