Re: The e-Consultation on Hunger, Food and Nutrition Security

11-01-2013

Key Lessons - Both over nutrition (obesity) and under nutrition (malnutrition) are set during infancy.  Early and exclusive breastfeeding during the first six months fo life followed by complementary (home) foods and continued breastfeeding up to two years and beyond mitigates both these extremes.  (1) 

 

Human milk is the most 'secure' food for an infant. Protection of breastfeeding by world wide adherence to both the International Code of Marketing of Breastmilk Substitutes (and subsequent relevant WHA Resolutions) ('the Code') and The Global Strategy for Infant and Young Child Feeding ( 2003) is critical to ensuring that each child can maximize their life potential.     

 

The attached summary table in the UN SCN Breastfeeding and Complementary Feeding Working Group 2004 summarises how intimately essential breastfeeding (human milk) is to achieving the eight MD goals.  Breastfeeding (human milk) protects the life of the child nutritionally and healthwise now and in the future, and protects and provides normal health for the mother. (2)  All of which is a cost saving to both the family and the community. (3) 

 

(1) Victora C. Nutrition in early life: a global priority. The Lancet 2009; 374(9696):1123-1125.)

(2) Ip S, Chung M, Raman G, et al. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007 Apr. (Evidence Reports/Technology Assessments, No. 153.) Available from: http://www.ncbi.nlm.nih.gov/books/NBK38337/

(3) Bartick M, Reinhold A. Pediatrics. The burden of suboptimal breastfeeding in the United States: A pediatric cost analysis.  2010 Apr 5. Pediatrics (online) DOI: 10.1542/peds.2009-1616

 

 
Challenges - The encrochment of industry and commercial self-interests into the governance and decision making around nutrition issues is a challenge.  Blurring of the distinction between the interests of the private sector in public policy making weakens and pushes aside public input.  As is stated by The Conflicts of Interest Coalition " a clear distinction to be made between business-interest not-for-profit organisations (BINGOs) and public interest non-governmental organisations (PINGOs)" in particular with the World Health Organization.  The pressure by industry to get involved in public health decisions must be resisted by governments and governing agencies in order to protect, in particular, breastfeeding.  This is why as above adherence to 'the Code' is crucial.  
 
 
What Works Best - An ethical, and  human rights based approach. 
 
 
First, the child's right to human milk (4) and second the mother's right to breastfeed.(5)   To quote IBFAN
"Breastfeeding is an integral part of women’s reproductive health and as such, represents a right for  women. However, women can only enjoy the full health benefits of breastfeeding when they receive  accurate information to make an informed choice about infant feeding, are able to exercise their  right to breastfeed without coercion and pressure, and when governments, communities, health  professionals and families protect this right." 
 
 
Second, basic principles of ethics.  
Veracity - truthfulness and lack of guilt in stating the RISKS of not breastfeeding to mothers and families preparing for childbirth.  Application of the strictest guidelines to truthfulness in marketing and advertising of foods which can interfere with breastfeeding. i.e 'the Code.'  
Beneficence and non maleficence -protection from harm, doing good and ensuring that in efforts to eradicate hunger and achieve food security the focus of doing good clearly benefits the public and NOT industry. ( i.e Nestle gift to PAWHO, contracts with US municipalities to eradicate obesity.)  
Justice - equality and no discrimination in the meting out of world resources for prevention of malnutrition and insuring as food security, the protection, promotion and support of breastfeeding in developing AND developed countries. 
 
 
(4) Convention on the Rights of the Child 24.2.ehttp://www2.ohchr.org/english/law/crc.htm  

(5) Ball O.  Breastmilk is a human right.  Breastfeeding Rev. 2010;18(3):9-19

 

Initiatives - The International Code of Marketing of Breastmilk Substitutes and subsequent relevant Resolutions, and The Global Strategy for Infant and Young Child Feeding, if applied worldwide with honest commitment of governments to their people, will ensure reaching the eight goals.