I was honoured to be invited to the annual conference of the World Alliance for Breastfeeding Action in Penang, Malaysia, last week.
For the event I prepared a paper by calling researchers whose work I had featured on FamilyIncluded.com – Tran Huu Bich (Vietnam), Jennifer Abbass-Dick, Lynn Rempel and John Rempel (Canada) and asking them to write a briefing with me. In 11 days we pulled together a strong case for engaging with families in order to improve breastfeeding: Supporting breastfeeding is a family endeavour (everywhere).
At the conference I met Larry Grummer-Strawn from the World Health Organisation, who is involved in revising the 10 Steps – the world’s most authoritative statement about how to organise breastfeeding support. The current version avoids any mention of families. So we offered WHO some revisions to recognise the health impacts of engaging families. We argued it thus.
We think the two key arguments for change are as follows.
The first is that WHO has itself “strongly recommended” involvement of men in maternal and newborn health (WHO recommendations on health promotion interventions for maternal and newborn health, 2015.)
Interventions to promote the involvement of men during pregnancy, childbirth and after birth are recommended to facilitate and support improved self-care of the woman, improved home care practices for the woman and newborn, and improved use of skilled care during pregnancy, childbirth and the postnatal period for women and newborns. (Strong recommendation, very low-quality evidence)…..Additional research is required.
It is significant that this recommendation was made even while admitting the evidence is weak. This acknowledges that progress is important on this front even though previous research has been designed within the paradigm that family influence is not a significant variable. WHO recommends further research and that certainly applies to breastfeeding support. An RCT on pre- and postnatal breastfeeding support will be published this spring in Australia, so things are on the move.
The second is the strength of the result in Vietnam when they moved from only working with the mother to a family and community approach: early initiation of breastfeeding after birth doubled from 40% to 81%, exclusive breastfeeding at 4 months also doubled from 11% to 21%, exclusive breastfeeding at 6 months quadrupled from 4% to 16%. (This is covered in our briefing, now on-line at http://familyincluded.com/breastfeeding-family-teamwork/.) These are not incremental shifts – they changed the paradigm and illustrated the powerful effect of doing so.
Photos: м Ħ ж. Creative Commons.