World Breastfeeding Week WBW 2007 Breastfeeding 1 st
World Breastfeeding Week (WBW) 2007 Breastfeeding 1 st Hour save ONE Million Babies SCN WG : BREASTFEEDING and COMPLEMENTARY FEEDING Arun Gupta on behalf of WABA WBW 2007 1 12/7/2020
Beginning Breastfeeding within ONE hour : Beginning life with “life” WBW 2007 2 12/7/2020
Objective n n To draw the world’s attention to save ONE million babies with just ONE action, just ONE hour support and just ONE message…. To encourage establishing breastfeeding within ONE hour as key indicator of health progress by all communities locally and globally. WBW 2007 3 12/7/2020
BFHI 1992 n Step 4 was, “Help mothers initiate breastfeeding within a half-hour of birth” WBW 2007 4 12/7/2020
World Summit for Children Commitments n n Millennium Development Goals (MDG) 4 to reduce U-5 child mortality 40% of all child deaths are neonates Need to scale action to reduce neonatal deaths as progress is reported to be slow Almost all deaths in developing countries WBW 2007 5 12/7/2020
Risk of neonatal mortality according to time of initiation of breastfeeding within ONE hour Pediatrics 2006; 117: 380 -386 WBW 2007 6 12/7/2020
Potential Mechanisms n n n Suckling shortly after birth have a greater chance of successfully establishing and sustaining breastfeeding throughout infancy. However, the effect of early initiation persisted after controlling for established neonatal breastfeeding patterns. Early feeding with non human milk proteins may severely disrupt normal gut function Rich immune and non-immune components that are important for early gut growth and resistance to infection. Promotion of warmth and protection may reduce the risk of death from hypothermia. WBW 2007 7 12/7/2020
Key findings of the study n n n 30% of the study population initiated breastfeeding after day 1 (late initiation) 30% were not exclusively breastfed in the neonatal period Exclusive breastfeeding was associated with a 4 fold reduction in risk of death when compared to infants who were fed solids or other milk. This confirms previous findings. WBW 2007 8 12/7/2020
Key findings n n Translating these benefits to the whole population of neonates (breastfed and not breastfed) means that 16% of neonatal lives can be saved if all babies were breastfed from day 1, and 22% if breastfeeding were started within the first hour. Neonatal mortality was also shown to increase markedly as delay in initiation increased. WBW 2007 9 12/7/2020
Global impact of increases in coverage and promotion of early initiation of breastfeeding in less developed settings. n n n Projected absolute numbers of lives saved and the proportion of neonatal deaths avoided if 99% of infants initiated breastfeeding during the first hour or during the first day of life. [1] Only 38 of the 60 countries had data available on initiation of breastfeeding within 1 hour and 1 day of birth. The neonatal mortality rate for these 38 countries ranged from 15 -70/1, 000 live births. [1] Karen M Edmond, Ellie C Bard, Betty R Kirkwood, Meeting the millennium development goals for child survival: global impact of early initiation of breastfeeding on neonatal mortality. (Un published) WBW 2007 10 12/7/2020
Contd n n An additional 2. 5 fold reduction in risk of death was demonstrated in babies who survived to day 2 who initiated breastfeeding on the first day of life (early initiation) compared to infants who initiated after the first day of life (late initiation). This type of effect of early initiation has never been reported. WBW 2007 11 12/7/2020
Contd… n n Neonatal mortality could be reduced by 24% if 99% of infants initiated breastfeeding on day 1 of life and by 31% if 99% of initiation was within the first hour. Numbers of lives saved were estimated to be 867, 000 and 1, 117, 000 in these two cases. " WBW 2007 12 12/7/2020
1 st ONE hour initiation cuts 22% of all neonatal deaths( 0 -28 days) Pediatrics 2006; 117: 380 -386 INITIATION OF BREASTFEEDING within ONE hour If ALL Women start BF within 15. 8%(IN DIA) ONE hour 100% NEONATAL DEATHS SAVED India: 1. 1 M 1 million World : 4 M WBW 2007 250, 000 babies can be saved in India and ONE 13 MILLION in the world 12/7/2020
Other benefits of ONE hour !!! n n Skin to skin Warmth Development Less bleeding postpartum WBW 2007 14 12/7/2020
Oxytocin factor n n Role of oxytocin which is best during first 45 minutes Suckling is at it best and babies are active during first hour WBW 2007 15 12/7/2020
Where we stand ? Initiation of breastfeeding within ONE hour n n In 38 countries : 26 -52( 36 median) South Asia worst hit , but needed most WBW 2007 16 12/7/2020
Why World Breastfeeding Week(WBW): 2007 for ONE hour support n n n Should not allow to get it old Too important to ignore Currently this is not a key indicator in reports like UNICEF SOWC. WBW 2007 17 12/7/2020
What next n n Advocacy for support to mothers during 4 th stage of labour Policy : Coverage, promotion and reporting should improve along with exclusive breastfeeding WBW 2007 18 12/7/2020
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