1. Breastfeeding in MEDICEL countries

2. Sources of data UNICEF – Albania, Algeria, Bosnia-Herzegovina, Croatia, Egitto, Lybia, Montenegro, Morocco, Palestine, Serbia, Macedonia, Tunisia, Turkey OECD – Cyprus, France, Greece, Italy, Malta, Slovenia, Spain National Agencies – France, Italy Papers, personal communications & regional agencies – Algeria, Greece, Malta, Italy, Slovenia,Tunisia, Turkey

3. Exclusive breastfeeding Only breastmilk, without other liquids with the exception of drugs (i.e. Vitamin drops). Predominant breastfeeding Breastmilk with the use of some non nutritive liquids (i.e. water, infusions, tea). Complete breastfeeding The sum of exclusive and predominant breastfeeding. Complementary breastfeeding Breastmilk with formula milk, nutritive liquids, semi-solid and solid food Formula milk feeding No breastfeeding, only formula milk and/or semisolid and solid food. Everbreastfed refers to those infants who have been put to the breast, even if only once Definitions

4. Multiple sources * * * * * * *at 3mo

5. Italy – Emilia-Romagna Region in the North

6. Actual weaning habits and guidelines targets: exclusive breastfeeding at 6 month

7. UNICEF * * 65%- Demographic and Health survey 2008

8. UNICEF

9. OECD – Family database * * 65%- Demographic and Health survey 2008

10. Other sources Algeria (Oran) - Karim Bouziane-Nedjadi – Exclusive BF: 52% at 3mo.; 34% at 6 mo. (1995) Tunisia - Khaldi F. Nutrition 2001 – Average length of exclusive BF from 5.2mo. (1973-4) to 1.6mp (1996-7) Slovenia - Dušanka Mičetić-Turk – Prevalence of BF at 6 mo. 50-70%

11. The Koran prescribes that mothers should breastfeed their babies for two or two and a half years (Ali 1938). The role of religion in the daily lives of women cannot be overlooked. Ramadan fast is the religious duty for Muslims during which they fast from sunrise to sunset for 30 days. For instance, some nursing mothers observe the Ramadan fast although they are granted a dispensation allowing them not to fast (Ertem et al. 2001, Shaikh & Ahmed 2006). According to the Koran, if a pregnant or breastfeeding mother fears for herself or her child because of fasting, then she is allowed not to fast, but she has to make up the days that she does not fast (Ali 1938). Ali YA (1938) The Meaning of the Glorious Quran. Dar al-Kitab, Cairo Basak Demirtas et al Journal of Clinical Nursing 2011;21:1109–1118 Breastfeeding experiences of Turkish women

12. Recommendations for a correct weaning Start at age 6 month Introduce semisolid and solid food according to availability and tradition Limit protein (especially from animal product) Limit salt Limit sugar

13. UNICEF

18. Issues for discussion and integrated work in MEDICEL partners We need to integrate the presented information with updated and accurate data on breastfeeding habits at 3 and 6 month, both using period prevalence (a measure of the proportion of infants on a specific BF habit over a specific period of time) or point prevalence (a measure of the proportion of infants on a specific BF habit at a particular time) We need to have data on modalities of weaning and the existence of recommendations and policies at regional or national level