Support of breastfeeding focuses on educating the breastfeeding family and community along with developing and implementing programs that provide access to expert care and ongoing support systems, according to Nurse Rhonda Kemp. She said education about breastfeeding along with qualified, skilled maternity care in the antenatal, intrapartum, and postpartum periods ensures optimal health and well-being of the mother and infant, and provides care that seeks to monitor and promote health, discover and treat illness early while also ensuring that women and their support systems are confident in establishing and maintaining their milk supply and are avoiding harmful practices, thereby, improving exclusive breastfeeding rates and duration of breastfeeding rates.
Kemp said healthcare facilities providing care for mothers and infants should be baby-friendly, implementing the 10 steps for successful breastfeeding and skin-to-skin contact in the immediate post-delivery period and initiation of breastfeeding within one hour of delivery.
“Training of staff and adequate lactation counselors ensures the availability of persons to support breastfeeding mothers,” said Kemp. “Implementing community support groups also helps to secure breastfeeding success by providing a means of peer support and encouragement for mothers. Companies can provide support by ensuring mothers have the allotted break time to breastfeed or pump in a secure, private setting. Breastfeeding rooms and areas in public spaces is another way to support breastfeeding. Community and personal gardens along with appropriate vitamin supplements ensure access to healthy food to support the nutritional needs of mothers and their infants. Establishing and maintaining a human milk bank, encouraging nurseries and preschools to be breastmilk-friendly, educating students, healthcare staff and the public about the importance and benefits of breastfeeding, all help to support breastfeeding success.”
The World Health Organization (WHO) and UNICEF launched the Baby-Friendly Hospital Initiative (BFHI) to help motivate facilities providing maternity and newborn services worldwide to implement the 10 Steps to Successful Breastfeeding. The 10 Steps summarize a package of policies and procedures that facilities providing maternity and newborn services should implement to support breastfeeding. The WHO has called upon all facilities providing maternity and newborn services worldwide to implement the 10 Steps.
“Promotion of breastfeeding must stand on a foundation of providing factual evidenced-based information to women and the communities in which they live,” said Kemp. “The focus should be on education that highlights the superiority and benefits of breastfeeding, empowering mothers to make informed decisions that includes their partners, families and friends and identifying barriers to the breastfeeding family and exploring solutions.
The WHO’s 10 Steps include critical management procedures: Comply fully with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions. Have a written infant feeding policy that is routinely communicated to staff and parents. Establish ongoing monitoring and data-management systems. And ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.
The key clinical practice on the 10 Steps includes discussing the importance and management of breastfeeding with pregnant women and their families. Facilitating immediate and uninterrupted skin-to-skin contact and supporting mothers to initiate breastfeeding as soon as possible after birth. Supporting mothers to initiate and maintain breastfeeding and manage common difficulties. Not providing breastfed newborns any food or fluids other than breast milk, unless medically indicated. Enabling mothers and their infants to remain together and to practice rooming-in 24 hours a day. Supporting mothers to recognize and respond to their infants’ cues for feeding. Counseling mothers on the use and risks of feeding bottles, tests and pacifiers. Coordinating discharge so that parents and their infants have timely access to ongoing support and care.
According to the WHO, there is substantial evidence that implementing the 10 Steps significantly improves breastfeeding rates. And that a systematic review of 58 studies on maternity and newborn care published in 2016, demonstrated clearly that adherence to the 10 Steps impacts early initiation of breastfeeding immediately after birth, exclusive breastfeeding and total duration of breastfeeding.
As the Bahamas National Breastfeeding Association (BNBA) recognizes World Breastfeeding Week, August 1-7, with the theme, “Step Up For Breastfeeding: Educate and Support,” Kemp said breast milk is the gold standard for newborn and infant feeding for the first six months of life and up to two years and beyond.
“It provides optimal nutrition for health, development, initial immunity, protection against illness and disease in infancy and chronic
non-communicable illnesses in childhood and adulthood. It also extends to the mother, protection against certain diseases such as ovarian and breast cancer.”
During the recognition week, the World Alliance for Breastfeeding Action’s (WABA) focus is on targeting audiences, including governments, health systems, workplaces and communities to be informed, educated and empowered to strengthen their capacity to provide and sustain breastfeeding-friendly environments for families.
WABA said breastfeeding is key as it improves nutrition, ensures food security and reduces inequalities. Their objectives for World Breastfeeding Week is to inform people about their role in strengthening the warm chain of support for breastfeeding; anchor breastfeeding as part of good nutrition, food security and reduction of inequalities; engage with individuals and organizations for support; and galvanize – action on strengthening systems for transformational change.
Kemp said astonishing ongoing scientific discoveries have revealed that the act of breastfeeding and breast milk creates a unique, intricate and multi-faceted biome that unleashes bountiful immediate and lifelong benefits that extend far beyond the mother-infant dyad.
“Successful breastfeeding is and historically always has been a community-centered effort,” said the nurse. “One that modern societies sadly have moved away from, but slowly is returning to. The 1990 Innocenti Declaration states that obstacles to breastfeeding within the health system, workplace and community must be eliminated and measures should be taken to ensure women are adequately nourished for their health and that of their families. To make communities baby-friendly again, there must be comprehensive and intensive promotion, protection and support of breastfeeding as the best choice of nutrition for infants and young children.
She said the protection of breastfeeding places emphasis on government, social and manufacturer responsibility to ensure that commercial interest does not diminish breastfeeding as the optimum feeding choice.
“Specific recommendations for all governments for developing national breastfeeding policies and ensuring the policies are integrated in their overall health and development schemes have been set forth in the Innocenti Declaration to protect breastfeeding families,” said Kemp. “The International Code of Marketing of Breastmilk Substitutes is a voluntary code of practice adopted by all countries that regulates the marketing of breast milk substitutes, feeding bottles and teats for infants and young children. It sets the standards for product labelling and quality of products that ensures feeding choices are made based on information that is factual and unbiased.”
Kemp said improper marketing practices of formula manufacturers such as declaring formula is better than breast milk and unchecked distribution of free formula to mothers is impeded. And that protection also includes legislation that bolsters exclusive breastfeeding efforts.
“Maternal and child health protective laws would provide for sufficient maternal and paternal leave allowing for adequate time for the establishment of successful breastfeeding. Laws protecting the right of infants to feed in public spaces also protect the breastfeeding dynamic by encouraging on-demand feeding to meet the needs of the infant. Laws protecting the pregnant and nursing mother against job loss also protect breastfeeding by ensuring income security.”
Kemp said support of breastfeeding focuses on educating the breastfeeding family and community along with developing and implementing programs that provide access to expert care and ongoing support systems.
“Promotion, protection and support of breastfeeding mothers and their infants is a community effort,” said the nurse. “Successful breastfeeding practices and its numerous benefits branch out and embed into the very fabric of society, extending its life-sustaining health, social and economic power that has great impact in securing thriving families, communities and nations. It’s time for all of us to step up and do our part to ensure crucial breastfeeding success.”