United Nations System
Standing Committee on Nutrition

Working Group on Breastfeeding and Complementary Feeding

held during the ACC/SCN's 30th Session in Chennai, India, March 2003

Co-Chaired by Reina Buijs (The Netherlands), Miriam Labbok (UNICEF), and Randa Sadeh (WHO)

The purpose of the mid-cycle meeting was spend about one hour celebrating an active year, and to provide very brief updates and discussions of current issues.

UN activities on Breastfeeding, Complementary Feeding, related maternal nutrition, and HIV/ Infant Feeding—WHO and UNICEF

A summary of the WHO Consultation of February 10-13, 2003 was presented to underline the forward momentum towards global implementation of the Global Strategy for Infant and Young Child Feeding. It was noted that there would be a working session at UNICEF in April to review the findings of the last decade as this may inform specific programming steps and activities in support of each of the elements of responsibility spelled out in the Strategy.

Comments from Bilaterals, NGOs, and others

Discussion was wide-ranging and impassioned. It included highlighting the role of all partners, and clarification that all promotional materials from WHO/UNICEF will use language from the Strategy to avoid misunderstandings whenever controversies arise. Individuals expressed interest on serving on task forces and others noted the need for

urgent action, with a mechanism of accountability and specific timelines for governments and organisations
strategies to help each other gain access to resources
more information on what gets funded
strategies on how to move ahead and use existing resources, but without creating vertical programs

Several others questioned how we might repackage messages and strategies to revitalize interest among field offices. There are opportunities but perhaps we should consider what we have been doing wrong. It was suggested that BFHI must be connected to the community, and others noted the need to get these messages into Poverty Reduction Strategy Papers and national nutrition strategies.

The issue of reduced resources was raised by many. Suggested approaches included tap the resources of other sectors, such as HIV, rename our efforts to attract new attention, use new indicators that emphasize the benefits of breastfeeding, and use documented success (such as increases in breastfeeding and survival) to build the case for investing in infant feeding. The problem is not the name of the effort or where one places it to gain resources, but rather to maintain support when there are active private organizations and misinformed sectors working against breastfeeding.

Field reality was reflected by several who expressed that they are troubled by “repackaging”. There is a need to stick to the basic issues; there is no need to keep changing strategies.

Others suggested that bilaterals and NGOs have a major role in urging countries and governments to request support of multilaterals at Board meetings and through regular contact. It was also noted that since many bilaterals support national policy through sector-wide approaches, there is a need to ensure that national policies give appropriate emphasis to infant feeding. It was concluded that there needs to be ongoing encouragement by all to overcome negative messages and misunderstandings in HIV programs.

The discussion continued to be provocative, lively, and productive, highlighting the need to address specific issues, such as: the misunderstanding that infants need water, that breastfeeding is already universal, and that all we have to do is demonstrate the economic contribution of breastfeeding and it will take care of itself.

Breastfeeding: biology, politics and beyond (Rama Narayan)

The presentation by Rama Narayan was to be on exclusive breastfeeding and was introduced at this point to respond to the discussion. In summary, the presentation covered what the needs of women are in order to succeed with exclusive breastfeeding. While not at all uncommon in India (92 % breastfeed at 12 mo, 69% at 2 yrs, 55% EBF, having increased by 4% between 92/93 - 98/99), Ms Narayan noted that breastfeeding has been criticised by some groups. Women are married too young and births are too closely spaced. There is a need to look at this from the perspective of gender rights. In India it is all about choices. Dr. Narayan suggested we “call it what it is” and look at breastfeeding as one aspect in the totality of gender rights.

The discussion that followed examined this idea. What capacities must be strengthened? What can we do to support women? One person suggested that we challenge the direction of development, and that it be reconsidered from the perspective of social processes within a village.

There was agreement that we must create the conditions to support women, and that the debate as to whether this is a women's issue, a development issue or a health issue does not give the field the respect that it deserves.

It was noted that we need both legislation to help mothers, and individual support to help them succeed in their choices. We need to understand that the overall goal is the same: helping women decide what is best for them and their babies, and providing the support for every mother to breastfeed every child to successfully, acting on a well informed choice.

Task Forces