advocates in more than 170 countries worldwide will be celebrating World Breastfeeding Week for the 19th year with the theme “Breastfeeding: Just 10 Steps. The Baby-Friendly Way”.
Research shows that the best feeding option globally is the initiation of breastfeeding within the first half hour
of life, exclusive breastfeeding for a full six months and continued breastfeeding through the second year or
beyond. Breastfeeding improves short and long term maternal and child health; and thus contribute to the
attainment of the Millenium Development Goals (MDGs) 4: REDUCE CHILD MORTALITY and 5
IMPROVE MATERNAL HEALTH, to which many countries and agencies are committed.
UNICEF recently noted that the reduction of child deaths from 13 million globally in 1990 to 8.8 million in
20081 is partly due to the adoption of basic health interventions such as early and exclusive breastfeeding.
More and more studies have shown that implementation of the Ten Steps with continued postnatal support
contributes to increased breastfeeding initiation and exclusive breastfeeding at the local, national and global
levels. 2,3,4 Today, an estimated 28% of all maternity facilities in the world have at some point implemented the Ten Steps which has contributed to an encouraging increase in breastfeeding rates despite aggressive commercial promotion of infant formula and feeding bottles.
However this is a far cry from the original goal of ALL maternity facilities practising the Ten Steps by
1995 as stated in the Innocenti Declaration (1990) on the protection, promotion and support of
breastfeeding which had outlined what countries should do to support breastfeeding.
In 2005, fifteen years after the original Innocenti Declaration, the Innocenti+15 Declaration had called
upon individuals, health care professionals, communities, governments and multilateral, bilateral
organisations and international financial institutions to ensure that all women can succeed in
breastfeeding.
In 2007, UNICEF and WHO completed an update and revision of the Baby-Friendly materials which
acknowledge new research and experience, and suggest new approaches to Baby-Friendly beyond the
maternity hospital in other health settings and in the community.
Action at community level is particularly important since globally only 56% of women deliver their
babies in a health facility, (only 33% in the least developed countries) and they may be discharged
within a day or two. Women need ongoing support in the community whether they deliver in hospital or
at home.
Whilst rates of exclusive breastfeeding have increased in many countries, there has been stagnation or
decrease in some, partly because reduced political support for BFHI and poor compliance with the Ten
Steps in BFHI certified facilities.
Recent studies have shown that with more of the Ten Steps in place, the more likely women are to
achieve their breastfeeding goals.5 This confirms that importance for every maternity, hospital, clinic
and community to strive to increase the number of steps in place, even if they cannot achieve all ten
steps immediately. Therefore every step counts!
‘Let’s join hands in taking the reliable Ten Steps
to making this world
a Baby-Friendly World!’
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