Glaring Gaps in policy and programmes on infant and young child feeding in 33 countries

IBFAN An experienced 32 year global network IBFAN aims to promote the health and well being of infants and young children and their mothers through protection, promotion and support of optimal infant and young child feeding practices. IBFAN works for the universal and full implementation of International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly (WHA) resolutions, Global Strategy for infant and young child feeding, Innocenti Declaration on Breastfeeding 1009, and For its contribution to the global livelihood, IBFAN received Right Livelihood Award in 1998, popularly known as “Alternative Nobel Prize”

In 2015 among other returns on investment “21.9 million more infants would be exclusively breastfed for the first six months of life”

First year is critical! Malnutrition strikes the most in infancy, most babies die during first month or first year, brain develops the most. Years of life Brain development undernourished

Neonatal disorders Diarrhoea Pneumonia Source: Robert et al. LANCET 2003;361: Three Major Killers Breastfeeding is the No. 1 preventive intervention compared to any other intervention Lancet Series on child survival, and now on newborn survival : 2003 and 2004 MOSTLY PREVENTABLE

Deaths attributed to sub-optimal breastfeeding among children

Neonatal Mortality Risk by early infant feeding practices Source: Edmond KM et al. Am J Clin Nutr :

U-5 child deaths (%) saved with key interventions in India Lancet Child Survival Series,2003

Millenium Development Goals Goal 4: reduction of child mortality gBICS: scaling up early, exclusive and continued breastfeeding

Magnifying glass

WBTi is central to gBICS

Donor partners

WBTi is a lens.. Before taking action, the gBICS conducts an important evaluation to establish a participatory process to assess the situation of breastfeeding in a country and establish priorities using the World Breastfeeding Trends Initiative (WBTi). The WBTi uses innovative web- based technology as well as the participatory involvement of key actors to press for effective policies and programmes at national level. It has been launched in 73 countries and 33 countries have completed the assessment work and reported. This is the 33 country analytical report

WBTi countries

Ranking of WBTi 33 countries in CountriesScores on a scale of 150 & color-coding Ranking Sri Lanka1241 st Malawi nd Maldives1193 rd Zambia11.54 th Mongolia1075 th Ghana th Mozambique th Nicaragua998 th Costa Rica959 th Bolivia9010 th Pakistan th Bangladesh8712 th Afghanistan th Uruguay th Argentina8515 th Uganda th CountriesScores on a scale of 150 & color-coding Ranking Brazil8117 th China th Nepal th Peru th Colombia7720 th Gambia7720 th Vietnam7621 st Philippines nd Rep. of Korea7323 rd Bhutan7224 th India6925 th Ecuador th Dominican Rep th Indonesia th Mexico4929 th Cape Verde43530 th Taiwan st

Average score for indicators on Policy and Programmes in 33 countries on a scale of Ten (10)

Average rates for the 5 IYCF Practices in 33 countries IYCF PracticesAverage Early Initiation of Breastfeeding (28 Countries having data) 51.2% Exclusive Breastfeeding for first 6 months (30 Countries having data) 46.0% Median duration of Breastfeeding Rates (28 Countries having data) 18.6 months Bottle-feeding Rates (25 Countries having data) 31.0% Complementary Feeding Rates (30 Countries having data) 67.7%

Key gaps in policy and programmes in 33 countries Lack of coordinated effort Lack of budgetary support Weak maternity protection Inadequate support to women at health facility Weak response during HIV and Emergency situations Continued interference by baby food industry

Key Recommendations Ensure both policy and programme attention through budgeting, coordination and focus on breastfeeding and infant and young child feeding Support to women be a reality to stay with babies 0-6 months, maternity protection is critical. All commercial promotion of baby foods should end. Accurate information and health system support for early and exclusive breastfeeding for the first six months Help women during HIV and emergency situations.

Next Step Reassessment : Take stock in 2012 Share and learn from others in 2012 World Conference on Breastfeeding : Where We stand and Where do we go