Battle to save lives through breastfeeding in Asia

18 February 2013

Asia ‘biggest cause for concern’ in battle to save lives through breastfeeding, says Save the Children

Breastfeeding rates are declining across Asia Pacific, despite new research estimating that 830,000 babies could be saved globally each year if new mothers around the world breastfed immediately after giving birth.

In the report, Superfood for Babies, Save the Children says that if babies receive colostrum – the mother’s first milk – within an hour of birth, it will kick start the child’s immune system, making them three times more likely to survive. And, if a child is breastfed for six months, it is 15 times less likely to die from killer diseases like pneumonia and diarrhoea.

Yet more than half of world’s children who are not exclusively breastfed live in just seven Asian countries: India, China, Indonesia, Philippines, Vietnam, Pakistan and Bangladesh. The charity refers to Asia Pacific in the report as the “greatest cause for concern” in the global fight to promote breastfeeding, with rates sharply dropping amid concerns around the marketing techniques of baby milk substitute companies.

However, it also notes there are success stories with Sri Lanka coming second on the global table for exclusive breastfeeding, and Cambodia increasing its rate in seven years from 12% to 74% - both due to strong government commitment to national programmes.

Key factors which contribute to lack of progress across the region are:

• Lack of adequate maternity legislation in many Asian countries. While more women enter the workplace, continuing to breastfeed after returning to work remains a challenge.
• Lack of empowerment and education for women means that the benefits of breastfeeding are poorly understood by new mothers.
• Half of the world’s shortage of health workers is in Asia, according to the WHO. This severe shortage of midwives and of other health workers across the region means that information on the benefits of breastfeeding is inadequate, and there is not enough support to help mums once they give birth.
• Marketing practices by some breast milk substitute companies that can result in mothers believing that formula is the best way to feed their baby even if they are unable to afford it.

Save the Children New Zealand acting Chief Executive Kay Enoka, said “Despite breastfeeding being a free, natural way to protect a new born baby, too little attention is being paid to promote the benefits of breastfeeding in countries across Asia.”

Superfood for Babies also highlights questionable marketing practices adopted by some breast milk substitute companies active in Asia emerging markets. Asia is a lucrative new market for the industry which is already worth $25 billion and set to grow as whole by 31% by 2015. In Asia, the number of breastfeeding mothers has fallen from 45% in 2006 to 29% in 2012.

However, new research by Save the Children in Asian countries found mothers who cited examples of marketing activity which violate the internationally agreed code for marketing of breast milk substitutes.

In Pakistan the charity worked with respected pollsters Gallup to survey new mothers and health workers finding that:

• 20% of health workers surveyed said they received branded gifts from representatives of breast milk substitute companies, including prescription pads, calendars, pens and note pads
• 11% of mothers surveyed said they had seen or read promotional literature about breast milk substitutes whilst at hospital or a clinic.

In a snapshot of the situation in China the charity also spoke to mothers finding that:

• 40% of mothers surveyed reported being given formula samples by some breast milk substitute’s company representatives or health workers. Of this 60% were said to be provided by baby food company representatives, and over 30% were said to be given by health workers.
• 40% of mothers surveyed said they had been contacted directly by representatives of breast milk substitutes companies; half of them had been contacted in hospitals and over one-third by phone.

Mr Anglade continued, “Governments have to be vigilant that the international code of the marketing of breast milk substitutes is adhered to. We have seen evidence in Asian countries, where mothers and health workers are influenced by marketing techniques. Governments should introduce legislation to support breastfeeding and then act to enforce it.”

Globally, the children’s agency is flagging that this year’s G8 in the UK in June, could be the beginning of the final push to end hunger. At a special hunger summit before the world leaders’ gathering, there will be rare opportunity to rally funds and support for governments in the developing world who have national plans on child nutrition, with breastfeeding as a key component.

The aid agency is calling on:
• All Asian governments to fund nutrition work with breastfeeding as its core component.
• For governments to include breastfeeding as part of the basic training toolkit for all health workers across the continent.
• All governments to turn the International Code and subsequent Resolutions into law and ensure it is independently monitored and enforced.

Background

To calculate that 95 babies could be saved every hour we projected trends in both Ghana and Nepal, alongside the most recent neonatal data. This is an estimate but uses the best possible evidence and reflects trends highlighted by WHO. This method assumes that the effects of breastfeeding are constant across various countries and contexts, and that the effects shown in Ghana and Nepal are a reasonable approximation to the global average.

• Superfood for Babies is here http://savethechildren.org.nz/news/publications/
• Predicted figures of East Asia growth have been taken from Euromonitor, Safety First: Global baby food opportunities and challenges to 2015, February 2011
• Rates of exclusive breastfeeding for seven Asian countries from UNICEF, World Breastfeeding Conference presentation, 2012.
• Indonesian legal information from UNICEF, State of the World’s Children 2012
• The International Code of the Marketing of Breast Milk Substitutes is here http://www.who.int/nutrition/publications/infantfeeding/9241541601/en/
• Sri Lanka breastfeeding information from Perera et al (2012) study, International Breastfeeding Journal
• UNICEF recently reviewed the declining rate of exclusive breastfeeding in the region and found that the overall rate, which in 2006 was 45% including China or 32% excluding China, had fallen to 29% for the whole region in 2012.47
• In a rough snapshot of evidence Save the Children spoke to 291 mothers of infants from Inner Mongolia Autonomous Region, Beijing, Jinan from Shandong Province, Shanghai, Nanjing from Jiangsu Province, and Shenzhen from Guangdong Province.
• In Pakistan Save the Children spoke to 2400 mothers and 1200 health workers across Pakistan through respected pollsters Gallup
• Cambodia exclusive breastfeeding rates taken from UNICEF State of the World’s Children report, 2012: http://www.unicef.org/sowc2012/pdfs/SOWC%202012-Main%20Report_EN_13Mar2012.pdf

ENDS

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