Post on 21-Dec-2015
04/19/23WBW 2007 1
World Breastfeeding Week (WBW) 2007
Breastfeeding 1st Hour save ONE Million Babies
SCN WG :BREASTFEEDING and COMPLEMENTARY FEEDING
Arun Gupta on behalf of WABA
04/19/23WBW 2007 2
Beginning Breastfeeding within ONE hour :Beginning life with “life”
04/19/23WBW 2007 3
Objective
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.
04/19/23WBW 2007 4
BFHI 1992
Step 4 was, “Help mothers initiate breastfeeding within a half-hour of birth”
04/19/23WBW 2007 5
World Summit for Children Commitments 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
04/19/23WBW 2007 6
Risk of neonatal mortality according to time of initiation of breastfeeding within ONE hour
0.71.2
2.32.6
4.2
00.5
11.5
22.5
33.5
44.5
With in 1hour
From 1 hourto end of day
1
Day 2 Day 3 After day 3
Pediatrics 2006;117:380-386
04/19/23WBW 2007 7
Potential Mechanisms
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.
04/19/23WBW 2007 8
Key findings of the study
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.
04/19/23WBW 2007 9
Key findings
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.
04/19/23WBW 2007 10
Global impact of increases in coverage and promotion of early initiation of breastfeeding in less developed settings. 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)
04/19/23WBW 2007 11
Contd
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.
04/19/23WBW 2007 12
Contd…
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."
04/19/23WBW 2007 13
1st ONE hour initiation cuts 22% of all neonatal deaths( 0-28 days)Pediatrics 2006;117:380-386
100%15.8%(INDIA)
India: 1.1 M
World : 4 M1 million
If ALL Women start BF
within ONE hour
250,000 babies can be saved in India and ONE MILLION in the world
INITIATION OF BREASTFEEDING within ONE hour
NEONATAL DEATHS SAVED
04/19/23WBW 2007 14
Other benefits of ONE hour !!! Skin to skin Warmth Development Less bleeding postpartum
04/19/23WBW 2007 15
Oxytocin factor
Role of oxytocin which is best during first 45 minutes
Suckling is at it best and babies are active during first hour
04/19/23WBW 2007 16
Where we stand ? Initiation of breastfeeding within ONE hour In 38 countries : 26-52( 36 median) South Asia worst hit , but needed
most
04/19/23WBW 2007 17
Why World Breastfeeding Week(WBW):2007 for ONE hour support Should not allow to get it old Too important to ignore Currently this is not a key indicator
in reports like UNICEF SOWC .
04/19/23WBW 2007 18
What next
Advocacy for support to mothers during 4th stage of labour
Policy : Coverage, promotion and reporting should improve along with exclusive breastfeeding