The birth of a child brings awe and wonder. We marvel how a perfect human being can develop from just a tiny cell. We marvel how the mother's body has the capacity of producing such a miracle yet we give little thought to how the body is also capable of producing nurture for that same child in the months following its birth.
The natural production of milk is perhaps the least appreciated gift that nature has bestowed upon us, although almost all great religions recognise breastfeeding as essential for nurturing the young. The ancient Jewish sages write "breast milk is the primary source of nourishment and anything else is secondary". Buddhist writings describe that a woman who gives birth becomes Mata - one who protects her child. She holds the baby to her breast, keeps the child warm and provides milk - a substance considered the blood of her breast and the milk of human kindness filled with the "honey of goodness". She feeds her child strength and intelligence. Breastfeeding is consistently followed in Buddhist tradition while, in Islam, breastfeeding is considered an obligation and a major duty for mothers who are able, and is recognised as a way of providing natural immunity and intensifying the mother's affection for her child. Nursing is referred to in the Old Testament as early as the story of the birth of Isaac, who was nursed by his mother Sarah until the age of two. Jewish legal writings strongly recommend that a mother breastfeed for a period of at least two years - even more if the child is sickly. While Christianity prescribes no specific length of time for breastfeeding, Christian theologians point out that since Jesus was born into the Jewish religion, he must have been nurtured according to its tradition. Modern Christian churches emphasise family togetherness and some theologians cite the increased closeness within the family and the bonding that breastfeeding is known to encourage as reasons for promoting its practice.
Breastfeeding benefits all sectors of society economically, ecologically and socially. However, the United Nations Children's Fund (Unicef) reports that, every day, as many as 4,000 infants and young children die because they are not breastfed. According to James Grant, Unicef's executive director, this is because their mothers are not empowered with enough knowledge about breastfeeding and do not receive enough motivation and support.
In 1974, the 27th World Health Assembly noted the general decline in breastfeeding in many parts of the world. The assembly found this decline to be related to the promotion of manufactured breast milk substitutes. Over many years, companies have invented clever slogans, striking images, free samples or supplies and all kinds of appealing gifts to persuade mothers and health workers that while "breast is best", bottle feeding is almost as good as breastfeeding. The assembly urged "member countries to review sales promotion activities on baby foods and to introduce appropriate remedial measures, including advertisement codes and legislation where necessary". Years of discussion and debate resulted in the drafting and adoption, on May 21, 1981, of the International Code of Marketing of Breast Milk Substitutes. The code seeks mainly to "contribute to the provision of safe and adequate nutrition for infants by protecting and promoting breastfeeding and by ensuring that breast milk substitutes not be marketed or distributed in ways that may interfere with breastfeeding".
In 1990, a policymakers' meeting was convened in Florence, Italy, to reinforce a worldwide commitment to breastfeeding as the best possible nutrition for babies. The resulting Innocenti Declaration, signed by 30 governments, set specific targets that would guide countries in their efforts to protect, support and promote breastfeeding. The Unicef/WHO Baby Friendly Hospital Initiative (BFHI) was established to encourage maternity facilities, whether free standing or in a hospital, to achieve the Innocenti Declaration goals and to become centres of breastfeeding support. A hospital is certified as baby-friendly by successfully practising the "10 steps to successful breastfeeding". These represent the best available knowledge on what makes breastfeeding succeed and were arrived at after long study and deliberation by a broad consensus of health and nutrition experts from around the world. Since the BFHI began, more than 15,000 facilities in 134 countries have been awarded baby-friendly status. In many areas where hospitals have been designated Baby-Friendly, more mothers are breastfeeding their infants, and child health has improved. Furthermore, countries also report reduction in childhood illnesses that can be directly linked to feeding practices.
On November 22, 2005, policymakers again met in Florence, Italy to celebrate the 15th anniversary of the Innocenti Declaration. During this meeting, a number of actions were highlighted as being urgent and necessary "to ensure the best start in life for our children, for the achievement of the millennium development goals by 2015, and for the realisation of the human rights of present and future generations".
Nonetheless, the operational targets of the original Innocenti Declaration remain the foundation for action to achieve the "highest attainable standard of health and development for infants and young children, which is the universally recognised right of every child". In addition, each year, a World Breastfeeding Week (WBW) is organised around a theme by the World Alliance for Breastfeeding Action (WABA). Since its start, in 1992, WBW is the greatest outreach vehicle for the breastfeeding movement and is celebrated in over 120 countries, with government bodies, non-governmental organisations and private citizens joining in support of breastfeeding, drawing attention from the media and helping to promote the goals of BFHI. Officially it is celebrated from August 1 to 7. However, groups may choose other dates to make it a more successful event in their countries. In fact, this year, Malta is celebrating breastfeeding week until today. In conjunction with the Olympics, the theme of WBW 2008 is Mother Support: Going For The Gold calling for greater support for mothers in achieving the gold standard of infant feeding: breastfeeding exclusively for six months, and providing appropriate complementary foods with continued breastfeeding for up to two years or beyond. On the other hand, this year's theme in Malta is Breastfeeding - Nature's Gift.
Breastfeeding plays an important part in preventing disease, in population control, in economic security and in environmental enhancement. It is also a human right.
The mother has the right to give her child the best food, health and care. Breastfeeding will provide all this and the mother does not have to depend on another source to provide food. However, in spite of this empowerment, the mother should be appropriately supported at work and in other environments. By removing the barriers to breastfeeding, mothers are able to offer a healthy start in life for their babies.
Referring to recent scientific data, the Code, adopted in 1981, calls for the introduction not only of practices to enable women to breastfeed but also for the reintroduction of a "breastfeeding culture" where breastfeeding is as natural as the birth itself and babies are nurtured on the milk which mother nature has prepared particularly for them. Indeed many studies point out that the functions of the breast and the mother's milk cannot be replicated by substitutes and they may have effects reaching far beyond childhood.
Ms Bugeja is a midwife
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