Saturday, October 1, 2011

Breast Milk... and Nothing Else

An informed communications campaign addressing infant and young child feeding, with an initial focus on the promotion of the WHO/UNICEF recommended indicator on exclusive breastfeeding (EBF) for the first six months of life has been identified as a key intervention toward improving child survival rates in Laos.

Laos has considerable past experience promoting the benefits of breastfeeding and to a lesser extent the more specific behaviour of exclusive breastfeeding for six months.  A public education effort on breastfeeding began in 1995. Today, approximately 90% of babies less than 9 months old are breast-fed.

Success has been modest, however, when it comes to true exclusive breastfeeding. Only about 26% of babies are breast-fed exclusively to six months. Babies get water very early; about 20% within the first month of life. For most mothers, breastfeeding is an acceptable behaviour; the challenge is exclusive feeding for 6 months. Thus the challenge is not to convince mothers to begin breastfeeding but to have a significant proportion drop all other foods (water, infant formula, condensed and skim milk, chewed sticky rice, rice water, and other foods... and practice true exclusive breastfeeding).

Many people are aware of the recommendation regarding exclusive breastfeeding, though they may not know exactly what it means. Nearly 30% of babies receive water plus other liquids plus complimentary foods (normally chewed sticky rice) within the first month.  It is reported that among the Hmong people, there is a far greater proportion of babies being exclusively breast-fed—a matter of tradition among the Hmong.

The case for proper EBF for the first six months (meaning nothing but breast milk) is medically substantial and the Ministry of Health wishes to achieve the target of 85% true exclusive breastfeeding for the first six months. Hence, while there are other related behaviours, this plan focuses only on one behavioural objective as the basis for a major effort -- proper exclusive breastfeeding in the first six months of life. It is this behaviour around which mothers, families, the community, and health staff will come together for joint action.

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