Thursday 1 March 2012

59TH CRC Committee: Governments to Improve Exclusive Breastfeeding and Enforce the International Code

The 59th session of the Committee on the Rights of the Child (CRC Committee) took place from 16 January to 3 February 2012 in Geneva. The Committee reviewed the progress of the implementation of the Convention on the Rights of the Child in 6 countries: Azerbaijan, Cook Islands, Madagascar, Myanmar, Thailand and Togo. 

The rates of exclusive breastfeeding in the group of countries under review are particularly low, e.g. 5% in Thailand, 12 % in Azerbaijan and 15% in Myanmar. Therefore, the CRC Committee stressed the necessity for the governments to take all possible efforts to improve exclusive breastfeeding in their countries. Governments were recommended to raise awareness among the public and educate the communities and mothers in particular about the importance of breastfeeding and the risks of artificial feeding.  

Almost all governments went home with a recommendation to adopt or strengthen their regulation of the marketing of breastmilk substitutes. Azerbaijan was urged to establish “monitoring and reporting mechanisms” with regards to their law which implements the International Code, and was advised to disseminate information widely about these measures. The government of Madagascar was given a recommendation to effectively enforce its National Code of Marketing of Breastmilk Substitutes and establish monitoring systems to detect cases of violations. Thailand was urged to adopt legal regulation for the marketing activities of breastmilk substitutes in accordance with the International Code and to ensure effective monitoring and compliance.
The Committee paid attention also to the issue of obesity and the marketing of junk, sugary and fatty foods to children. In the case of the Cook Islands, the Committee expressed concern for the increasing obesity rates and recommended the government to adopt regulation to restrict and monitor the marketing of these types of foods. 

The Committee considers important the role of the health systems in protecting, promoting and supporting breastfeeding. It urged countries to make their hospitals baby-friendly, to support the Baby-Friendly Hospital Initiative (BFHI) and to sensitize and train of health workers that are involved in maternity work. 

On issues related to child nutrition more generally, the Committee expressed its concern with regards to child malnutrition in all countries under review. It focused on the need to improve equal access to health care services and decrease inequalities, increase budget allocations to the health sector, strengthen the primary health care system, improve maternal health care services, etc.
For more details on the recommendations related to infant and young child feeding (IYCF) to each of the countries, please refer to the table below:

Summary of specific recommendations on IYCF
Direct: (para 59-60 on Breastfeeding): measures to improve excl bf; raise awareness about the importance of bf and risks of artificial feeding; pay particular attention to early initiation of bf; establish monitoring and reporting mechanisms to regulate marketing of BMS and disseminate info about access to these; strengthen BFHI and provide sufficient fund; strengthen maternity protection by extending its duration and scope and developing child care centres and workplaces; adopt and comply with the ILO 183.
Indirect (para 42-43 on Health care and health services): concerns about increasing rates of obesity; raise public awareness on negative health impacts of processed food; establish regulations to restrict and monitor advertising and marketing of junk, sugary and fatty foods.
Direct (para 49-50 on Health and health services): take all efforts to increase exclusive bf in the first 6 months; ensure enforcement and monitoring of the National Code of marketing of BMS.
Indirect (para 49-50): address acute and chronic malnutrition; strengthen programmes to prevent mother-to-child transmission of HIV; ensure adequate access to maternity health-care services. 
Direct (para 63-64 on Health and health services): promote exclusive bf till 6 months by raising awareness of health personnel and the public; reduce and eliminate child malnutrition; reduce infant, child and maternal mortality; increase resources for reproductive health; ensure free and equal access to primary health care.
Direct (para 60-61 on Breastfeeding): strengthen and expand its efforts to promote the early initiation of bf; promote exclusive and continued bf; raise awareness and educate the public, mothers in particular on the importance of bf and risks of artificial feeding; adopt legal regulation to implement the International code including effective monitoring and compliance; convert all maternity institutions into baby friendly hospitals; ensure that health-care professionals involved in maternity work are trained on breastfeeding.
Indirect (para 58-59 on Health care and health services): accelerate measures to ensure nutrition for all children and address disparities; conduct an analysis on the causes of malnutrition.
Indirect (para 53-54 on Health and health service): concerned about the high rates of child mortality and preventable diseases; strengthen primary health care; address preventable health problems among children such as diarrhoea, acute respiratory diseases, measles and malnutrition.

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