The 65th Session of the Committee on the Rights of the Child (CRC Committee) took place in Geneva from 13 to 31 January 2014. The Committee reviewed the progress of the implementation of the Convention on the Rights of the Child in 6 countries: Congo Brazzaville, Germany, Holy See, Portugal, Russian Federation and Yemen. IBFAN submitted 5 alternative reports on the situation of infant and young child feeding for Congo, Germany, Portugal, Russian Federation and Yemen. The reports were written in collaboration with IBFAN groups in the countries. In its Concluding Observations, the CRC Committee referred specifically to breastfeeding in only 4 out of the 6 countries (Congo, Germany, Portugal and Yemen). The Holy See and the Russian Federation did not receive any direct recommendation on breastfeeding.
The right of the child to health
A particular emphasis has been put on the importance of respecting the right of the child to the enjoyment of the highest attainable standard of health. The CRC Committee referred to its 2013 General Comment N° 15 on the right to health (art. 24) in its recommendations to all reviewed countries, including the Holy See. The General Comment N° 15 explicitly recognizes the importance of breastfeeding for the achievement this right. This General Comment urges States, to devote particular attention to neonatal mortality in their effort to diminish infant and child mortality, and suggests, inter alia, to “pay particular attention to ensuring full protection and promotion of breastfeeding practices”. Moreover, “exclusive breastfeeding for infants up to 6 months should be protected and promoted and breastfeeding should continue together with appropriate complementary foods preferably until two years of age as feasible.” States’ obligations in this area are defined in the “protect, promote and support” framework, adopted unanimously by the World Health Assembly” in its 2002 Global Strategy for Infant and Young Child Feeding. The Global Strategy calls, among other, for the improvement of the quality and availability of sex-disaggregated data, an issue that has been included in recommendations to Congo, Germany, Portugal and Yemen.
A great focus was placed on the need to regulate the impact of the business sector on children’s rights. In its recommendations to Congo, Germany and the Russian Federation, the CRC Committee expressly drew attention to its 2013 General Comment N° 16 on State obligations regarding the impact of the business sector on children’s rights, which specifically calls on States Parties to “implement and enforce internationally agreed standards concerning children’s rights, health and business including the [...] International Code of Marketing of Breast-milk Substitutes and relevant subsequent World Health Assembly resolutions” (hereafter referred as “the International Code”). Therefore, these three reviewed countries are recommended to ensure the compliance by companies of both international and national health and environmental standards and ensure appropriate sanctions in cases of violations. Congo and the Russian Federation are also recommended to require companies to undertake assessments of the environmental health-related and human rights impact of their business activities.
In addition, the CRC Committee expressly urged Germany to take every necessary measure to ensure the access to breastfeeding through the control of infant formula. More specifically, the CRC Committee urged Yemen, Congo and Germany to respectively implement and strictly enforce the International Code, while Portugal is asked to strengthen the monitoring of its marketing regulations related to breastmilk substitutes.
In the case of Congo, the CRC Committee stressed that preventable diseases, including diarrhoea, continue to impact negatively on child mortality rate. Thus, it urged the government to promote infant and young child feeding practices, in particular breast milk, and to adopt a holistic early childhood development strategy covering healthcare, nutrition and breastfeeding.
Furthermore, the CRC Committee raised the issue of new morbidity related to attachment disorders in Germany, which could be related to declines in exclusive breastfeeding practices. It underlined the decline of exclusive breastfeeding rates of children between four and six months and the aggressive marketing of breastmilk substitutes in Portugal. In the case of Yemen, it showed concern about the high rates of chronic malnutrition (stunting), acute malnutrition (wasting) and communicable diseases, especially diarrhoea, among children, linked to the lack of awareness about exclusive breastfeeding practices. Accordingly, the CRC Committee recommended Germany, Portugal and Yemen to promote exclusive breastfeeding.
In regard of General Comment N°15, Germany is specifically requested to better promote healthy eating habits and to pay special attention to children in vulnerable situations.
Congo is urged to ensure provision of primary health care services for all pregnant women and children within accessible health care service with trained health care providers. It is specifically recommended to increase the quality and coverage of training to staff at socio-health units.
The CRC Committee also stressed the need for Yemen to establish baby-friendly hospitals.The CRC Committee also focused on the need to prevent mother-to-child HIV/AIDS transmission by ensuring the implementation of effective HIV/AIDS preventive measures (Congo), by expanding the coverage of the National HIV/AIDS Prevention and Control Programme (Yemen) and by providing sufficient amount of breastmilk substitutes and anti-retroviral drugs in all regions (Russia).
Table 1. CRC Committee - Session 65 / 2014 -Summary of Concluding Observations on IYCF