Concluding Observations of the CRC Committee - January 2011

The Committee on the Rights of the Child has finally released their Concluding Observations for the countries that were reviewed in January 2011 (Afghanistan, Belarus, Denmark, Lao PDR, New Zealand, Singapore and Ukraine) – and it has continuously stressed the importance of breastfeeding in promoting the right of children to the highest attainable standard of health.

The Concluding Observations refer to breastfeeding in all cases (but Belarus), reflecting the information that was sent as part of the IBFAN alternative reports. The Committee has stressed the importance of fully adopting and enforcing the International Code: this has been recommended to 6 countries out of 7. Also, it has reiterated the importance of implementing the BFHI, including breastfeeding in training programmes for nurses, and the need to strengthen the promotion of exclusive breastfeeding for children up to 6 months.

Governments have been urged to collaborate with NGOs in order to fulfil their human rights obligations. Therefore NGOs are encouraged to use these recommendations as a powerful tool for actions and initiatives to enhance the right of the child to the highest attainable standard of health.

The table contains a summary of the recommendations related to breastfeeding. The full text of the Concluding Observations for all countries can be accessed here: http://www2.ohchr.org/english/bodies/crc/crcs56.htm .

CRC Session 56 - January 2011

Country		Summary of specific recommendations on BF (and related issues)
1	Afghanistan	Direct (Para 51-52): - Enhance efforts to promote exclusive BF practices; - Comply with the International Code (IC); - Improve access to and quality of health care and nutrition services throughout the country; - Ensure the availability of qualified medical staff, including in remote rural areas.
2	Belarus	No
3	Denmark	Direct (Para 47-48): - Fully implement the IC; - Promote baby-friendly hospitals; - Encourage BF to be included in nursery trainings; - Collect systematic data on BF in accordance with international rules.
4	Lao PDR	Direct (Para 52-53-54) - Strengthen awareness raising efforts on the importance of exclusive BF for children up to 6 months; - Formally adopt and implement the IC; - Strengthen strategies to reduce and eliminate child malnutrition; - Strengthen efforts to reduce infant, child and maternal mortality; - Ensure the provision of adequate training for health personnel.
5	New Zealand	Direct (Para 38-39): - Continue efforts to increase exclusive BF up to 6 months; - Focus on awareness-raising on the benefits of exclusive BF among the Maori population; - Fully implement the IC; - Further promote the BFHI; - Encourage BF to be included in nursery trainings.
6	Singapore	Direct (Para 56-57): - Strengthen awareness raising efforts on exclusive breastfeeding up to 6 months; - Ensure that the main maternal hospital meets the standards required by BFHI; - Review, strengthen and enforce the Singapore voluntary code on the marketing of BMS; - Adopt and implement the ICMBS; - Include breastfeeding breaks in maternity legislation; - Ratify the ILO Convention 183 on maternity protection.
7	Ukraine	Direct (Para 53-54): - Strengthen promotion of BF; - Enforce the ICMBS; - Prioritize primary health care system and the quality of health care; - Increase budgetary allocation to the health care sector.

Ukraine at the CRC: The International code is violated in health facilities + very few hospitals are baby friendly.

The government of Ukraine presented its report in front of the Committee on the Rights of the Child on January 28^th 2011.

According to the government delegation, the promotion of breastfeeding is a very important element of the national health program. It is one of the key measures that are being taken to prevent child and infant mortality. The program on breastfeeding has existed in the last 10 years, the government representative said, however only 15% of children are born in baby friendly hospitals.

Committee members were very concerned by insufficient baby friendly medical facilities in Ukraine and they raised concerns over the lack of proper medical training to assist mothers during and after birth.  

The Committee chairperson also raised a concern over evidence of violations of the International Code of Marketing of Breastmilk Substitutes in Ukrainian health facilities. The government delegation responded insufficiently by acknowledging this problem. They said that all measures have been taken in this regard, however violations continue- as the chairperson pointed out.

Exclusive breastfeeding rates remain low in Singapore - where the Baby Friendly Hospital Initiative has not yet been adopted

The review of Singapore took place on the 20^th January 2011 by the Committee on the Rights of the Child.

When discussing health issues the Committee members raised questions about breastfeeding. One of the members noted that in 2003, the Committee had already recommended to Singapore to promote breastfeeding and the International Code. Nonetheless, exclusive breastfeeding under 6 months of age remains low. The Committee wanted to know what measures have been taken by the Singaporean government to promote bf. The Chair of the Committee also raised a question about the Baby Friendly Hospital Initiative: she wanted to know what is the current status of the BFHI in Singapore - given that the country has no certified hospitals up to now.

The government representative who responded on issues of health was Ms. Bhalla Ajay – Director of Hospital Services Division at the MoH.  She admitted that the rates of breastfeeding are low, but progress has been made and the rates have improved since 2003. Generally exclusive breastfeeing is good for the first 3 to 4 months - she said - and then for cultural reasons (like grandmothers who say babies should be fed on bananas or water) these rates decrease. 

 The government affirmed that it supports the work of associations and advocacy groups who promote breastfeeding and it is now working to provide a supportive environment for breastfeeding, like having room for the mothers who breastfeed, and is also working on a new program for early child nutrition. 

However, the direct question on the BFHI was not answered. Also new nutrition guidelines have been released and breastfeeding is one of the key elements.

In addition the maternity leave has been set to 4 months to allow for exclusive breastfeeding- the government representative said. Also the government affirmed that it strongly supports the International Code: Singapore - she said - is one of the first countries to have a committee on the infant food ethics. Also Singapore is one of the few countries to have stronger guidelines than the International Code and to have processed and sued formula producers