Breastfeeding is one of the best buys in global health to save lives and improve the health, social, and economic development of both individuals and Thailand as a nation. Bangkok, March 31, 2017 The Role of Medical Associations in the protection, promotion and support of breastfeeding

Medical institutions and professional organizations should play an important role in the protection, promotion, and support of breastfeeding

Physician & health staff role Family, Workplace and Societal pressures Maternal Concerns About Breastfeeding & Complementary Feeding Maternity Staff Relative Importance of Influence Obstetric staff Pediatric Staff Pre-& Wks 1-2 Wks 6-8 Mo. 4-6 Mo. 7-12 >1yr Pregnancy 3

Role of Medical Associations Protection – compliance with the International Code of Marketing of Breastmilk Substitutes and subsequent WHA recommendations Promotion – of three key breastfeeding practices Support – with timeline and ongoing counseling and to be successful at exclusively breastfeeding Protection – compliance with the International Code of Marketing of Breastmilk Substitutes and subsequent WHA recommendations to ensure mothers and families receive the most accurate information about optimal child feeding. Promotion – early initiation of breastfeeding within one hour of birth exclusive breastfeeding for six months continued breastfeeding with complementary feeding to 2 years and beyond Support –providing mothers and families with early and ongoing counseling and support they need to be successful at exclusively breastfeeding for the first six months, with continued breastfeeding up to 24 months.

Professional Associations Adopt Global IYCF Recommendations, disseminate and advocate with members Ensure continuing education of membership on latest nutrition guidelines Lead on and ensure BFHI compliance, accreditation & certification in the country No Code violations – especially sponsorships of materials and workshops Aware of tactics of infant formula companies Professional Associations should: Promoting achievement and maintenance of baby friendly status by maternity hospitals, wards and clinics, consistent with the Ten steps to successful breastfeeding and the principles of not accepting free or low cost supplies of breast milk substitutes, feeding bottles and teats Monitor members practices and compliance to code of conducts, laws and regulations protecting, promoting and supporting breastfeeding Developing Stronger Policies and Laws on Infant & Young Child Feeding in the ASEAN Region and Beyond 5

Alive & Thrive: partnership with medical associations Goals: Elevate the voices of key association leadership and spokespeople in support of IYCF and related policies, with both the media and with policy-makers. Ensure strong and visible association commitment to promote optimal IYCF—and especially exclusive breastfeeding—and to not promote breastmilk substitutes unless medically necessary. Leverage association networks to support adoption and implementation of national IYCF policies (e.g. BMS Code, maternity protections)

Bangladesh: Doctors pledge to promote IYCF best practices

Bangladesh OB/GYN Association: Strengthening Medical and Nursing Curricula Steps taken: Conduct gap analysis Hold national advocacy meeting Engage national medical and nursing teaching faculties to recommend revisions Proposed revised curricula for pediatrics, OB/GYN, community medicine, and nursing Prepare teaching tools, examination questions Launch new curricula nationally

Viet Nam: Scientific Workshops on IYCF

Creating opportunities for champions to speak with the media and in meetings The former president of the Viet Nam Pediatric Association speaks at the regional conference on IYCF policy change.

Medical Associations: Advocates with the Broader Medical Community Direct engagement with: Medical faculties Schools of public health Public and private training institutions for health workers, including midwives, nurses, nutritionists, and dieticians

Thank you! This research was supported by Alive & Thrive, an initiative funded by the Bill & Melinda Gates Foundation and the governments of Canada and Ireland. The initiative is managed by FHI 360. We also acknowledge the support of Jack Bagriansky for sharing the methodologies and data from previous studies that were funded by UNICEF. This study also benefited from input provided by the Ministries of Health, Departments of Health and development partners in Indonesia and health facilities and health offices in Bandung City. Citation: Walters, D., S. Horton, A.Y.M. Siregar, P. Pitriyan, N. Hajeebhoy, R. Mathisen, P.T.H. Linh, C. Rudert. The Cost of Not Breastfeeding in Southeast Asia. Forthcoming 2016. Additional citations include: 1. https://dhsprogram.com/pubs/pdf/FR275/FR275.pdf 2. World Health Organization. Global targets 2025. To improve maternal, infant and young child nutrition http://www.who.int/nutrition/topics/nutrition_globaltargets2025/en/