Innocenti
DeclarationInnocenti
DeclarationOn August 1, 1990, a group of health policy-makers representing many national governments (but not Canada's), met at the Spedale degli Innocenti, in Florence Italy. The title of the conference was "Breastfeeding in the 1990s: A Global Initiative". The s tatement emerging from the two-day meeting, the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding, has become a guide for governments aiming to promote breastfeeding world wide.
The document squarely puts upon
all governments the responsibility of ensuring optimal nutritional
health for infants and women through effective breastfeeding policies.
The document affirms the importance of breastfeeding for the heatlhy growth and development of infants and stresses its contribution to women's health by reducing breast and ovarian cancer and by providing social and economic benefits.
The Innocenti Declaration sets a global goal, an important yet simple standard for achieving optimal health for infants and mothers:
all women should be enabled to practise exclusive breastfeeding and all infants should be fed exclusively o n breastmilk from birth to four to six months. Thereafter, children shoulc continue to be breastfed, while receiving appropriate and adequate complementary foods, for up to two years or beyond.
Most importantly, the document sets operational targets for all governments to achieve by the year 1995.
We'll quote the important recommendations from the declaration and discuss, in light of them, our national achievements.
Appoint a national breastfeeding coordinator or appropriate authoridy and establish a multisectoral national breastfeeding committee composed of representatives from relevant government departments, non-governmental organizations and health professional organizations
In 1991 Health Canada organized an annual national breastfeeding meeting that has since evolved into the Canadian Expert Working Group on breastfeeding. Although initially the meeting included representatives from the infant formula industry, the current membership consists of governmental representatives, non-governmental and health professional associations. INFACT Canada is a member and has provided briefing materials, including: the Innocenti Declaration; the WHO/UNICEF Joint Statement on the Promot ion, Protection and Support of Breastfeeding; and information on the International Code. To date, there are no specific achivements, and the committee continues to meet to discuss policy, International Code and Baby F riendly Hospital Initiative (BFHI) implementation, research and education.
Ensure that every facility providing maternity services fully practices all of the Ten Steps to Successful Breastfeeding
No hospital in Canada has yet received the Baby-Friendly Hospital Initiative (BFHI) designation to date. Advocacy for BFHI is gaining some momentum. Hospital and health professional associations are becoming more informed about the initiative. Several provinces (Alberta, BC and newfoundland) have organized coalitions to advance breastfeeding-friendly institutions and environments that include the BFHI.
Hospital implementation remains slow. many committed health-care personnel and lactation consultants have made significant improvements in their local hospitals such as better rooming-in rates and reduced supplementation of breastfed babies. As well, mo re personnel are receiving breastfeeding support training. However, institutional resistance to changing the relationship with the baby milk industry remains firm. The bribes, gifts, free formula supplies and free samples to new parents persist.
Governments have yet to develop national or provincial policies or legislation to ensure hospital practices are in accordance with the Ten Steps and the International Code. The BC Ministry of Health showed unique leadership by recommending code complianc e to provincial hospitals. BC Women's Hospital has since become the first hospital in Canada to deliberately purchase infant formula instead of accepting free suppplies.
Take action to give effect to the principles and aim of all the Articles of the International Code of Marketing of Breast-Milk Substitutes and subsequent relevant World Health Assembly resolutions in their entirety
Health Canada continues to stonewall against pressure from the breastfeedig community to regulate the International Code. It continues to seriously abrogate its responsibility to assure that women in Canada are enabled to breastfeed without being undermi ned and misled by the infant formula industry. Nothing has been done to ensure that breastfeeding in Canada is protected from aggressive, manipulative advertising. Since 1981, when Canada endorsed the International Code, the marketing has intensified. Direct promotions to pregnant women and new mothers have reached appalling intensity. If this trend is permitted to continue, breastfeeding rates will be seriously compromised, while efforts by institutional, public health and non-governmental organizai tons to promote breastfeeding will be overwhelmed.
Enact imaginative legislation protecting the breastfeeding rights of working women and establish means for enforcement.
Although maternity legislation in Canada is progressive and allows new mothers to breastfeed exclusively for the recommended time, gaining support for breastfeeding women who return to work remains a struggle. Penny van Esterik, York University, has deve loped model workplace policies which are now being implemented at a number of sites. She says that interst from public health and unions is growing, but that governmental support and leadership provincially or federally are lacking. Canada signed the Wo rld Declaraton and Plan of Action for Nutrition (Rome 1992). This document recommends supportive workplace policies for breastfeeding women and the removal of occupational hazards.