Sharing Experiences from Bangladesh on Promotion, Protection and Support for Exclusive Breastfeeding Mohammad Abdul Mannan, PhD Vice-Chairperson Bangladesh Breastfeeding Foundation (BBF) World Breastfeeding Conference, Johannesburg; 11-14 Dec’ 2016

Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Introduction Exclusive breastfeeding for the first 6 months is required for optimal growth, development and health of infants. Exclusive Breastfeeding is essential in reducing malnutrition although it is not sufficient without necessary health, care and food practices. Childhood malnutrition occurs due to maternal under nutrition, inadequate IYCF and poor sanitation. Interventions to protect, promote and support breastfeeding improve child survival by averting over one-tenth of deaths of under 5 children. Bangladesh promotes early initiation of breastfeeding within one hour after birth and exclusive breastfeeding for complete 6 months, and complementary feeding there after. Bangladesh Breastfeeding Foundation (BBF)

Trends in Early Childhood Mortality Deaths per 1,000 live births Bangladesh Breastfeeding Foundation (BBF)

The Prime Minister of Bangladesh ‘Sheikh Hasina’ received MDG award in 2010 for reducing child mortality in Bangladesh

Bangladesh GDP Growth rate Bangladesh Breastfeeding Foundation (BBF)

Percent of nutritional status of children under age five Trend’s in Children's Nutritional Status Percent of nutritional status of children under age five Bangladesh Breastfeeding Foundation (BBF)

Breastfeeding Movement in Bangladesh Since then BBF continues its movement to promote, protect and support optimal breastfeeding. BBF receives the attention of the Hon’ble Prime Minister and her directives for improvement of maternal and child nutrition Breastfeeding movement starts in Bangladesh since April 1989. A group of devoted medical professionals, scientists, nutritionists, public health professionals, individuals from government and non-government and UN agencies joined hands in the name of Campaign for the Protection and Promotion of Breastfeeding (CPPBF). Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Hon’ble Prime Minister’s declaration on World BF Week from 2009-14 for improvement of maternal and child nutrition The offices, courts, shopping malls, banks, insurance, hospitals, all Government and Non Government Organizations are to arrange for breastfeeding and establish day care center; MOHFW and BBF are to work together to strengthen the activities on Breastfeeding, Appropriate Complementary Feeding and Maternal Nutrition; We will build up Bangladesh Breastfeeding Foundation as a strong organization. Maternity leave will be increased from 4 to 6 months. Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Hon’ble Prime Minister’s declaration on World BF Week from 2009-14 for improvement of maternal and child nutrition …… contd. Observe the World Breastfeeding Week from 1-7 August as National event by the Government from the next year. Arrange for the expression of the mental and intellectual development of children by appointing child psychologist in each school and hospital of the country. Revitalize the earlier, established breastfeeding corners and establish new corners in each community clinic and hospitals Take necessary measures to transform all the hospitals, health-complexes and clinics into baby-friendly and to revitalize the baby friendly hospitals of the country  Appoint a nutritionist in every hospital of the country Bangladesh Breastfeeding Foundation (BBF)

Call from the Prime Minister Bangladesh Breastfeeding Foundation (BBF) “Every office, court, bank, insurance, all Government and Non-Government organizations, and shopping malls have to establish breastfeeding corner, so that mother can breastfeed her baby any time without any worry and provide maternity leave for 6 months to all NGOs” ----Prime Minister Sheikh Hasina “We have approved the 2013 Act on Breast Milk Substitute, infant foods, commercially prepared complementary foods and accessories thereto. I want this Act be appropriately implemented”--- Prime Minister Sheikh Hasina Bangladesh Breastfeeding Foundation (BBF)

Breastfeeding Situation in Bangladesh Bangladesh Breastfeeding Foundation (BBF)

Trend’s in Early Initiation of Breastfeeding The BDHS reported that the early initiation of breastfeeding increased from 24% in 2004 to 57% in 2014 in Bangladesh. This is being possible due to regular dissemination of messages through communication media. Our efforts are still being continuing to improve the scenario. Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Breastfeeding although universal in Bangladesh, prevalence of EBF rates increased from 46% in 1993-94 to 64% in 2011, 55% in 2014.The global target of EBF for 2016 is 50%. Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) The BDHS reported that complementary feeding practices of children 6 to 23 months had increased from 21% in 2011 to 23% in 2014, but it is less than half of the target for 2016 (52%). The promotion of Complementary Feeding practices is being strengthened. Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Complementary Food intake by children 0-23 months BDHS 2011, 2014 Around 29% of children receive complementary foods earlier Nearly 35% of children start eating complementary foods later Bangladesh Breastfeeding Foundation (BBF)

Initiatives taken by Govt. of the Peoples Republic of Bangladesh Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Breast feeding protection, promotion and support is central to all FS &N policies Is included as a separate programme and strategy, with sub strategies and action areas under health, agriculture and food sectors National Food Policy 2006 National Food Policy Plan of Action 2008-2015 Country Investment Plan 2010-2015 National Health Policy 2009 National Neonatal Strategy 2010 National Nutrition Policy 2015 National Plan of Action on Nutrition 2016-2025 Bangladesh Breastfeeding Foundation (BBF)

Hon’ble Prime Minister Unwrapped the Bengali recipe book in WBW on 6 August 2014 Recipe book was prepared considering the research findings on existing complementary feeding practices in 7 divisions of Bangladesh using TIPS The book is being used in Community Clinics and training on agricultural extension services throughout the country.

National Dietary Guidelines for Bangladesh Bengali version of National Dietary Guidelines prepared through multisectoral collaboration The dietary guidelines include advice on colostrum feeding within 1 hour of birth Also includes advice on exclusive breastfeeding for 6 months and complementary feeding from 6 to 23 + months with continued breastfeeding It recommends improved complementary foods /recipes with a variety local ingredients Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Progress of Breastfeeding Activities in Bangladesh World Breast Feeding Week has been celebrated nationally since 2002 on a regular basis Paid maternity leave has been extended to 6 months in all Govt. sectors since 9 January 2011 and in a few Non govt. organizations. Annual funding through MoHFW is being given to strengthen the Bangladesh Breast Feeding Foundation (BBF) activities Law and judicial ministry has ordered the establishing of breastfeeding corners in every court building of the country. So far, 592 breastfeeding corners and 50 Daycare centers have already been established. Establishing breastfeeding corners in every garment enterprise and Non Govt. organization is ongoing with involvement of BGMEA. Revitalization of total 499 baby friendly hospitals at the district and sub district level has been ensured and 93 govt. & non govt. hospitals have been trained in baby friendly hospital initiatives. Enforcement of BMS Act 2013 (Control of marketing) is being done. Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Progress of Breastfeeding Activities in Bangladesh Seventy (70) advocacy seminars on breastfeeding have been held at the divisional and district levels. Director General of Drug Administration has ordered not to keep breast milk substitutes, infant foods, commercially manufactured complementary foods and their related accessories in any pharmacy of Bangladesh. Deployment of a nutritionist (first grade) at district level is now in its final stage of implementation. Countrywide 90,300 teenage girls at the 420 district level schools have been motivated to create proper awareness on nutrition and hygiene practices. A 3 day-long training on maternal nutrition and Infant and Young Child Feeding (IYCF) was organized at 80 different Non Govt. Medical College Hospitals, nursing institutes and paramedic institutes. Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Conclusion Political commitment, particularly Honorable Prime Minister’s support helps in improving IYCF activities in Bangladesh. Dedicated and motivated people’s contribution towards exclusive breastfeeding is important. Timely introduction of complementary foods with right amount and right quality is central to IYCF Bangladesh Breastfeeding Foundation (BBF)

Bangladesh Breastfeeding Foundation (BBF) Thank you Bangladesh Breastfeeding Foundation (BBF)