The document discusses the importance of optimal breastfeeding practices for infant and young child health and development. It notes that exclusive breastfeeding for the first six months, followed by continued breastfeeding for up to two years or beyond, provides crucial nutrition and protects against disease and death. However, breastfeeding rates have declined globally due to inappropriate promotion of breastmilk substitutes. The World Health Organization and various countries have since implemented policies and legislation like the International Code of Marketing of Breastmilk Substitutes to protect breastfeeding practices.
4. Optimal infant and young child feeding
is defined as initiation
of breast feeding
immediately after birth
within one hour, exclusive
breastfeeding, from birth to
six months of age, and
thereafter continued
breastfeeding for two years
or beyond, with adequate,
safe and proper additional
foods and liquid, to meet
the nutritional needs of a
young child.
5. Why optimal feeding
• and almost 90% of the
mothers switched to
mixed feeding as they
believed that they did not
have enough milk.
• Malnourished
• Prone for infections
• risk of death is increased.
• Stunted
• Brain development
affected
• Lower IQ
7. 1000 Days…Critical Window
• It is well recognized that the period from birth
to two years of age is the “critical window” for
the promotion of good growth, health, and
behavioral development. Therefore, optimal
infant and young child feeding is crucial during
this period.
• Poor nutrition during this period leads to
significant morbidity and mortality and delay
mental and motor development.
8. Height of Indians growing at one of
the slowest rates in the world: Study
• In India, the mean height of women increased
by 5 cm from 147 cm in 1914 to 152 cm in
2014 and that of men by only 3 cm from 161
cm to 164 cm. This is much less than countries
such as South Korea, where women grew by
20 cm and men by 15 cm over the century.
• Study shows the growth potentials are same
for children all over the world
9. India’s challenge
• 27 million births
• 1.1 million die before 4 weeks of age
• 1.7 million die before completing 1 year
• 2.2 million die before completing 5 years
• 110,000 mothers die in this process
10.
11. U-5 Child Deaths (%) Saved with Preventive
Interventions
6
5
4
4
3
3
2
2
2
2
1
1
13
- 5 10 15 20 25
*Breastfeeding
Complementary feeding
Zinc
Hib vac
Clean delivery
Water, sanitation, hygiene
Ante steroids
Vit A
TT
NB temp control
Nevirapine + no BF
Measles vac
Antibio for PROM
Breastfeeding is defined as exclusive
breastfeeding for first 6 months and continued
breastfeeding during 6-11 months Source: Jones et al. LANCET 2003; 632:65-71 1/17
12. Global causes of under-5 mortality
Neonatal
37%
Measles
4%
Pneumonia
19%
Malaria
8%
Injuries
3%
Others
10%
Diarrhoea
17%
HIV/AIDS
3%
Tetanus, 7%
Preterm, 28%
Congenital, 8%
Diarrhoea , 3%
Asphyxia, 23%
Sepsis/
pneumonia,
26%
Other, 7%
Causes of
neonatal deaths
Undernutrition is an underlying cause of
53% of deaths among children under
five years of age. 11,12
Source: World Health Report, 2005
13. Commerciogenic malnutrition
• He coined the
phrase commerciogenic
malnutrition to refer to
infant starvation caused
by inappropriate
promotion and use
of infant formula or
bottlefeeding in areas
with low income and
poor water supplies..
Dr.Jelliffe -1972
14. Solution to Insufficient milk syndrome
• . Formula is widely
viewed by mothers and
doctors alike as the
solution to
breastfeeding problems
rather than a cause or
contributor to
breastfeeding
problems.
15. Breastfeeding: The 1st Hour – Save ONE
million babies!
• According to global data, out of all 10.9 million
under-five deaths, roughly 4 million babies die during
the first month of life.
• Study showed if all women began breast feeding
within 1hr it would save one million of the 4 million
deaths
• In India, this means out of 11 lacs newborn (upto 28
days) deaths 2,50,000 lives can be saved annually by
just this ONE act
• Most cost-effective child survival intervention
23. Decline of Breastfeeding
In the 19th century
breastfeeding was almost
universal;
Borden developed
condensedmilk in 1856
Nestlé produced ‘Farine
Lactée’in 1867, substitute
feeding became feasible.
Overthe next 100 years,
breastfeeding rates declined
as women entered the
workforce and formula
companies began widespread
advertising campaigns.
Mortality in very young infants from
malnutrition,diarrhoea and pneumonia—
virtually unknown previously—increased
dramatically
24. Decline of Breastfeeding
• In 1944, 88% of Swedish
mothers were
breastfeeding their
infants at 2 months of
age; by 1970 the rate
had declined to 30%.
25. Milk and Murder
In 1939, Cicely Williams a
pediatrician working in
Singapore found the
link between promotion
of breast milk
substitutes and
increased malnutrition
and spoke at the
Rotatory club titled .
“Milk and Murder”
26. Milk and Murder
She Stated “Misguided propaganda on infant
feeding should be punished as the most criminal
form of sedition and these deaths should be
regarded as murder. Dr. Cicely Williams became
the first Director of Maternal and child health in
the world health organization.
She continued to highlight the plight of
innocent infants who were being deprived of their
mother’s milk only because of the gross over
promotion of Breast milk substitutes by
companies like Nestle.
27. Fight against Nestle
• 1972- International organization of
consumer unions(IOCU) suggested a
code of practice for Advertising of
Infant foods”
February 1974: War on Want publishes
The Baby Killer, a report on infant
malnutrition and the promotion of
artificial feeding in the Third World.
This article was translated into
German with a more appropriate title
“ Nestle KILLS Babies
• In 1973- A British magazine
published a cover story titled
“ The Baby food Tragedy”
• which highlighted the link between
promotion of infant food resulting in
decline of Breast feeding and
increased infant malnutrition.
28. Nestle Boycott
• 1974- WHA (World Health
Assembly) noted general
decline is Breast feeding and
urged member states
(Including India) to “Review
sales promotion activities on
Baby foods and introduce
remedial measures.
In 1977 Frustrated by Nestle’s
continued unethical marketing
practices, the “Nestle Boycott
” was launched by a group in
USA
29. In 1978, Edward M Kennedy, chairman of
the USA Senate Subcommittee on Health and
Scientific Research
“Can a product which requires clean water, good
sanitation, adequate family income and a
literate parent to follow printed instructions be
properly and safely used in areas where water is
contaminated, sewage runs in the
streets, poverty is severe and illiteracy high?”
May 21, 1981:The World Health Assembly
overwhelmingly adopts the International Code.
Only the US votes against the Code.
30. Innocenti Declaration
• In August 1990, government policymakers,
WHO, UNICEF and other organisations got
together and signed, which aimed to protect,
promote and support breastfeeding.
31. The Innocenti Declaration
• * Provides ideal nutrition for infants and
contributes to their healthy growth
* Reduces incidence and severity of infectious
diseases, lowering infant morbidity and
mortality
* Reduces the risk of breast and ovarian
cancer among women
32. The Innocenti Declaration
• Exclusive breastfeeding is “as a global goal for
optimal maternal and child health and
nutrition”.
• Obstacles to breastfeeding within the health
system, the workplace and the community
must be eliminated.
• All governments to develop national
breastfeeding policies and set appropriate
national targets.
33. The World Alliance for Breastfeeding
Action (WABA)
• 1991
• The idea of WBW was conceived
by WABA. The short history
follows …
• The birth of WABA
• The idea of the World Alliance for
Breastfeeding Action (WABA) was
born on the evening of 14
February 1991 in a little
restaurant in downtown New
York, following an NGO planning
meeting organised by UNICEF to
follow up on the Innocenti
Declaration and strategize for a
coordinated global effort to
protect, promote and support
breastfeeding.
Baby do the WABA Crawl
You can feel so big and tall
Throw the bottle to the wall
All the others, they feel small
34. World Breastfeeding week
• Commemorates the
Innocenti Declaration, ever
since, the World
Breastfeeding Week has
been celebrated every year
from August 1 to 7 from
1992. The initiative
encourages breastfeeding
and spreads awareness on
how mother’s milk helps
improve the health of
newborns around the world
and make their immunity
system stronger.
35.
36.
37.
38.
39. 1983- India adopted the”Indian National code for Marketing
of breast Milk Substitute”
This is only a code not a law.
In 1984,1986,1988,1990 and 1992 WHA urged the member
states to implement the international code.
1992- Indian parliament finally enacted the IMS Act
2002- Amendment of IMS Act is introduced in the Parliament
2003- Amendment act is passed
The Infant Milk Substitutes, Feeding Bottles and Infant
Foods Act 1992 and its 2003 amendment
40. Action taken under the IMS Act
1. In October 1994, Dr. Arun Gupta of BPNI filed a case against
Nestle for violating IMS Act in the Delhi court.
2. Johnson & Johnson was taken court for selling feeding bottles
on discount and for advertising feeding bottles
3. WOCKHARDT was also taken to court by ACASH in
Mumbai for violations of the labelling requirements
