Breastfeeding : Challenges and Opportunities

1
Breastfeeding Challenges and Opportunities

• Arun Gupta MD FIAP
• 2nd National Conference on Breastfeeding and
  Complementary Feeding (Infant and young Child
  feeding)
• DHAKA BANGLADESH
• 19 August 2006

2
Introduction

• List some challenges and opportunities
• Explain how do we convert challenges to
  opportunities,
• Growing HIV and prevention of infant HIV as a
  case for scaling exclusive breastfeeding

3
List

• MDG 4 achievement
• HIV
• High level attention for declaring breastfeeding
  education a public health priority
• Scaling to 90 early and exclusive breastfeeding
• Scaling up ORT and Newborn care to 100

4
MDG 4

• The targets of the 1990 Innocenti Declaration and
  the 2002 Global Strategy for Infant and Young
  Child Feeding remain the foundation for action.
  While remarkable progress has been made, much
  more needs to be done.

5
Challenges Remain !

• Shift emphasis from Curative to preventive
  services
• Support women employed outside the home,
  including in the non-formal sector.

6
Prevent infant HIV

• Look at your PMTCT programmes see how this is
  addressed Informed choice on infant feeding
• How many women get a test and how many who are
  positive choose Replacement feeding?
• Are they supported to avoid mixed feeding,
  challenge is to achieve exclusivity of both
  either breastfeeding or artificial feeding
• Aim at HIV free child survival
• Build populations and communities with high rates
  of exclusive breastfeeding

7
Exclusive breastfeeding Prevents HIV in infants
Most mothers are either negative or not tested,
better prevent transmission as well as ensure HIV
free child survival
Early Exclusive Breastfeeding reduces the risk of
postnatal HIV-1 transmission and increases
HIV-free survival. AIDS 2005 19699-708
8
High level attention for declaring breastfeeding
education a CORE public health priority

• Lack of adequate understanding with policy makers
  and programme managers, economists
• Need serious dialogue and education using
  breastfeeding education as a prevention ORT as
  treatment intervention for diarrhea, still the
  major cause of infant mortality
• Need to accelerate infant mortality reduction for
  reaching goals of U-5 child mortality
• Discuss to dissect 0-12 month period and 13-60
  month period of under five mortality and wise
  allocation of resources. Are we truly using 75
  of child health and nutrition resources during
  first year, analyse and present.

9
Contd

• Continuum of care 4th stage of labour
• Acceleration of reduction of infant and neonatal
  mortality

10
Growing numbers of underweight childrenand
obesity

• If we reduce infant mortality rate(IMR) by other
  means and dont prevent child malnutrition , we
  will end up having more underdeveloped children
  and later adults, thus the society as whole

11
Childhood Obesity

• Global epidemic, alarming increase of prevalence
  severity
• Severe psychosocial health burdens, huge costs,
  difficult to treat
• Primary prevention greatly needed, breastfeeding
  is the answer other than changing children's
  life style
• Koletzko B, Chen W, Dietz W, et al. Obesity in
  children and adolescents world-wide current
  views and future directions. JPGN 2002 (August)

12
U-5 child deaths () saved with preventive and
treatment interventions
UNIVERSAL COVERAGE IS THE ANSWER
13
Breastfeedingreduces laterrisk
foroverweightand obesityby 20-50
14
Scaling to 90 early and exclusive breastfeeding

• Serious Action is needed at ALL levels
• Call upon your governments to commit financial
  resources for implementing the Call for Action
• One to one counselling

15
Scaling up ORT and Newborn care to 100

• Link breastfeeding education to these two
  interventions effectively
• Given the current trend we ignore breastfeeding
  the most since it is not delivered like vaccines.
• Both have a good potential but we end up treating
  diarrhea that too does not have a wide reach
• Newborn care like warmth and exclusive
  breastfeeding need more emphasis.

16
Otherwise ?

• Whats that .exclusive breastfeeding ?
• Whats that.. ORS?
• Will remain as questions only !

17

• Thanks !