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

10-01-2013
Key lessons - Under nutrition (malnutrition) and over nutrition (obesity) are programmed mostly during infancy. Prevention of either means ensuring early and exclusive breastfeeding  during the first six months, followed by introduction of complementary foods along with continued  breastfeeding up to two years and beyond.  A growing body of evidence points to the key role of infant and young child feeding practices, especially early and exclusive breastfeeding, in mitigating over and under malnutrition.
 
Breastfeeding is one of the best preventions for disease later in life for both the child being fed human milk and the mother herself.  Breastfeeding also provides protection for the infant and child from communicable diseases.  In developing nations which lack clean water, access to public healthcare, human milk is not only healthful but can be lifesaving, and in developed countries is shown to provide normal health compared to use of artificial baby milks which results in sub-optimal health.  (1)
 
 In conclusion, both the WHO/UNICEF International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA Resolutions, and the Global Strategy on Infant and Young Child Feeding are key directives, that if applied broadly worldwide will accomplish the ideals set out in the health-related Millennium Development Goal (MDG) see attached table summary from this 2004 document.  (2)
 
(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/
 

Key challenges - the commercialization of food world wide, and the encrochment by commercial food industry interests into the decision making of non-governmental bodies around the world.  To quote Baby Milk Action " Several WHA Resolutions have highlighted these risks and have called for 'governance' in health policy and programme setting to be protected from the undue influence of those who stand to gain financially from decisions.  Insustry involvement at a core strategic level can favour market led response to infant and young child feeding that sidelines the critical role of breastfeeding and appropriate complementary feeding"... of 'home' foods.  See coicoalition.blogspot.com

 

What works best. A respect for the rights of the child! It is a child's right to have it's mother's milk. (3)  An approach that respects human rights, and one which incorporates the basic tenets of medical ethics ( after all, over and under nutrition end up being medical problems!); autonomy and veracity (parents getting the truth about the risks of NOT breastfeeding when a choice of feeding is available); beneficence and non-maleficence (acknowlegement without guilt, that NOT receiving human milk for the first six months is harmful), and justice (the same rules for all babies, children, familes and mothers no matter where in the world they live).   

 

(3) Convention on the Rights of the Child, 24.1.g   http://www.unicef.org/crc/ 

(4) Nygren-Krug, Helena.  A human rights based approach to non-communicable disease.  http://www.swisshumanrightsbook.com/SHRB/shrb_03_files/16_453_Nygren.pdf

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

See the attachment: UN SCN BF Comp Food 2004 Table