Anwar Fazal

A Grand Alliance For Breastfeeding Action

This document was originally prepared for and published in the ‘Christian Social Action’ 1991. It is the publication of the General Board of Church and Society of the United Methodist Church, USA.

When 17 nations and international organisations dedicated to the protection, promotion and support of breastfeeding met for three days from 13 to 15 February 1991 in New York under the auspices of UNICEF, they focused on two issues:

·      The body of international actions taken over the past decade.

·      New data and concerns on the tragic loss of life among infants from illness that could have been avoided by breastfeeding.

It was clear that ‘bottle baby scandal’ continued unabated and that global action of a new order was necessary to counter the subversive forces that had undermined the breastfeeding culture – a culture based on a gift of love, nature and God.  It was also clear that the issue was universal, the actins taken should be unequivocal and the promoters of baby milk should initiate unilaterally action to stop any activities that would undermine breastfeeding. It was clear that only with a massive global effort that can link and multiply the efforts of all good people can we see a return to a breastfeeding culture.

At the governmental level, the importance of breastfeeding had been highlighted by several global documents – the Convention on the Rights of the Child, the World Summit on Children and most recently, the Innocenti Declaration. The latter is the most comprehensive and goal-oriented official action framework and is the cornerstone for a resurgence of actions on breastfeeding.

A New Initiative is Born

There was now a new opportunity for working together, of cooperation through action. The February meeting in New York showed us how much each group was doing. More importantly, it showed how much more was needed to be done and that there was a real need for popular mobilisation on a scale we have never dared to dream before.

At a meeting on the evening of 15 February 1991, a working group met to decide on the coordination of follow up action. A new initiative aimed at galvanising the power of all kinds of citizens groups was born. It was given the acronym WABA (it never failed to bring a smile) which stands for the World Alliance for Breastfeeding Action.

This initiative is an open light participatory and action-oriented global mechanism of mass involvement of every sector which is demonstratively committed to protecting, promoting and supporting breastfeeding. Among the key groups involved in the initiative are the following:

·         American Public Health Association

·         International Baby Food Action Network (IBFAN)

·         International Lactation Consultant Association (ILCA)

·         International Organization of Consumers Unions (IOCU)

·         La Leche League International

·         World Council of Churches,

and such eminent scientists as Professors Derrick Jelliffe and Patrice Jelliffe of the University of California, Dr. Michael Latham of Cornell University, Dr Audrey Naylor of Wellstart, USA and Felicity Savage-King of the Institute of Child Health, London.

An exciting workable set of actions began to emerge that evening. Among them:

·               The idea of a World Breastfeeding Day

·               A ‘baby friendly’ hospital campaign.

A new partnership among mother support groups, researchers, trainers, health care professionals and development workers was born. As significant was the new cooperative working partnership between the collective of citizens groups and UNICEF.

Aims

At a subsequent meeting also held in New York on 20 and 21 April 1991, the working arrangements of WABA were determined and a programme of action agreed to. A secretariat was established in Penang, Malaysia.

The mission of WABA is defined as follows:

·            WABA, a global network of organisations and individuals, that believes breastfeeding to be the right of all children and mothers, dedicates itself to protect, promote and support this right, and acts on the Innocenti Declaration.

·            WABA believes that these goals can be achieved only if breastfeeding is seen in the context of social, health and nutritional needs of communities, and especially of women and children. WABA’s goal, therefore, is the mobilisation of all sectors of the community to restore and sustain a breastfeeding culture.

A mega alliance of such diverse groups should also define its working methods. WABA defines them as:

·            Respect the independence and autonomy of the participating groups and individuals.

·            Reinforce, not replace, existing formal and informal structures.

·            Foster the development of strong local, national and regional groups and networks.

·            Facilitate consultation and consensus on international campaigns, advocacy and fundraising, including training for these.

·            Ensure geographical and cultural diversity.

An Action Plan

WABA agreed to work on a participatory task force approach. Eight important areas were identified for multiplying the linking. A volunteer was elected to facilitate each task force. The eight task forces and their work areas are:

·            Social mobilisation: support social mobilisation towards a breastfeeding culture by disseminating information, facilitating public debate, and building bridges between communities and potential allies through joint actions for common efforts to promote, protect and support breastfeeding;

·            Information clearinghouses: expand the availability of information on breastfeeding at the local, national, regional and international levels; strengthen the capacity of breastfeeding resource centers to collect, disseminate, use and share information to support programmes and coordinate the dissemination of information produced by WABA task forces;

·            Research groups and briefing papers: disseminate research findings relevant to protection, support and promotion of breastfeeding; prepare briefing papers (for example, in relation to ecology, economics, and feminism); stimulate and support applied research important to the goals of WABA and as expressed in the Innocenti Declaration;

·            Healthcare practices: promote healthcare practices in hospitals, other health facilities and in the community to protect, promote and support breastfeeding according to the WHO/UNICEF Joint Statement on the Ten Steps to Successful Breastfeeding;

·            Education and training: coordinate and facilitate the education and training of personnel in the protection, promotion and support of breastfeeding;

·            Mother support groups: the linking of mother support groups worldwide to enable them to train counsellors and expand the number of groups worldwide to enable them to train counsellors and expand the number of groups, in order to create the appropriate environment of awareness and support for a mother to initiate and sustain breastfeeding;

·            Women and work: the development of strategies to address the special needs of working women, through imaginative new legislations and other actions that assist women to integrate breastfeeding into their working lives;

·            Code compliance: bring about the implementation of the international Code of Marketing of Breastmilk Substitutes through training sessions and development of materials at all levels, as well as the monitoring of Code Compliance and the development of legislation and other mechanisms.

Each of the task forces is now engaged in a variety of networking, information and other support activities.

World Breastfeeding Day

Perhaps the single most unifying activity launched by WABA has been a global monitoring exercise to check if hospitals are baby friendly, i.e. if they are following the “Ten Steps of Successful Breastfeeding” developed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). These steps involve every health facility providing maternity services and care for new born infants to:

·         Have a written breastfeeding policy that is routinely communicated to all healthcare staff.

·         Train all healthcare staff in skills necessary to implement this policy.

·         Inform all pregnant women about the benefits and management of breastfeeding.

·         Help mothers initiate breastfeeding within a half-hour of birth.

·         Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants.

·         Give newborn infants no food or drink other than breastmilk, unless medically indicated.

·         Practice rooming-in to allow mothers and infants to remain together – 24 hours a day. Encourage breastfeeding on demand.

·         Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

·         Foster the establishment of breastfeeding support groups are refer mothers to them on discharge from the hospital or clinic.

An important element of the global monitoring exercise is the launch for the first time this year of World Breastfeeding day – on 1 August, the day the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding was adopted by 32 governments and 10 United Nations and other International agencies.

WABA is an international campaign that seeks to involve all sectors of the community on the basis that the widespread adoption of breastfeeding will:

·            Save the lives of over one million infants each year.

·            Save many infants in each country from the suffering of preventable diseases.

·            Save our earth’s resources, including trees and other sources of energy.

·            Decrease the number of women who develop breast and ovarian cancers.

·            Decrease the pollution of air, water and land from the production and preparation of artificial baby milk and used milk tins.

·            Decrease government spending for artificial baby milk for subsidised infant feeding programmes.

·            Decrease medical costs by preventing illnesses and allergies caused by the use of artificial baby milks. Prevent the devaluing of women’s ability to breastfeed and affirm their important contribution to society when they breastfeed.

·            Provide food security for babies and an important source of nutrition for children for at least the first two years of life.

·            Provide a natural way to help space pregnancies which protects women’s health.

·            Provide positive role models enabling women to learn breastfeeding skills that will be passed from generation to generation.

·            Foster the optimal emotional, intellectual and cognitive development of the world’s children.

Action Ideas

WABA has developed an action folder* as a resource for action by individuals and groups. Some of its action ideas include:

At the community level:

·   Post the Ten Steps to Successful Breastfeeding poster in public places.

·   Visit or write the hospitals in your community to learn if they are baby-friendly and publish a list of all baby-friendly hospitals in your community newspaper. Tell other mothers what you have learned.

·   Contact one of the organisations working on the Baby-Friendly Hospital Initiative and World Breastfeeding Day to offer your help, financial support or both.

·   Ask your employer to support the establishment of policies which allow children in the work place, provide creches/on site child care, and assure adequate maternity leave.

·   Talk to children about breastfeeding.

·   Write an article about the Baby-Friendly Hospital initiative for a community newsletter.

·   Form or join a mother’s support group;

·      If you have given birth recently, fill out a Baby-Friendly Hospital Initiative Survey (obtainable from WABA) and send it to the hospital administrator and key personnel in charge of maternal and/or infant care.

·      Distribute copies of the Baby-Friendly Hospital Initiative Survey to pregnant women in your community.

·      Give a copy of the folder to a friend.

·      Breastfeed where other women will see you.

·      Organise a community fair for World Breastfeeding Day.

·      Iinvite some neighbours to visit and talk to them about the Initiative and World Breastfeeding Day.

·      Give positive reinforcement to breastfeeding mothers.

·      Ask five people you know to talk to five people they know about breastfeeding.

·      Bring this folder to your place of worship.

·      Communicate to companies and others who promote artificial baby drinks/milks to mothers, your disapproval of this practice.

·      Speak to health workers about the Baby-Friendly Hospital Initiative.

·      Encourage your organisation to support and distribute this folder.

·      Form or join a World Breastfeeding Day planning committee.

·      Include information about breastfeeding in school activities at all educational levels.

·      Teach facts about breastfeeding in your local girls’ and boys’ organisations.

·      Ask your place of worship to encourage breastfeeding and sponsor a special World Breastfeeding Day Celebration.

At the national level:

 

·      Form or join breastfeeding promotion groups and encourage networking with other organisations active in this area.

·      Create a World Breastfeeding Day Committee or contact and support the committee in your country.

·      Start a letter-writing campaign to your Head of State to request that 1 August be proclaimed National Breastfeeding Day.

·      Hold your country leaders accountable for the promises made in the Innocenti Declaration. Ask for a report on the progress of implementation in your country.

·      Urge your country’s legislators to introduce and support legislation which follow the International Code of Marketing of breastmilk Substitutes.

What We need to do

There are three things WABA considers most important to create a breastfeeding culture.

Firstly, breastfeeding must be protected by legislation, ensuring adequate provision of crèches/child care in or near the work place and prohibiting inappropriate marketing practices by artificial baby milk manufacturers and others.

Secondly, breastfeeding must be supported by hospital policies and health worker practices consistent with the WHO/UNICEF joint statement and by a national strategy for the establishment and support of breastfeeding women and breastfeeding support groups.

Thirdly, breastfeeding must be promoted by every member of society, with each national government playing a leading role as stated in the Innocenti Declaration.

Conclusion

Moving from a ‘bottle feeding culture’ back to a ‘breastfeeding culture’ will mean a transformation process that is going to require uncommon action. We have to use our power in the market not to buy products of companies that do not comply with universal norms accepted by the world community. We must use the power of the vote to ensure governments give the necessary protection and support for breastfeeding.

Most of all we have to do it by example, by our little actions in our communities. All revolutions begin and succeed with little people in little places take little actions. When this happens everywhere, things change.

We need that change. The lives of over one million babies depend on us.

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