Thursday, 5 June 2014

Inadequate Infant Feeding Practices in Indonesia (CRC)


On the 5th of June 2014, the Committee on the Rights of the Child completed its consideration of the combined 3rd and 4th periodic reports of Indonesia on the implementation of the provisions of the Convention on the Rights of the Child in the country. 

IBFAN presented an alternative report to inform the CRC Committee on the situation on the issue of infant and young child feeding in Indonesia.

General overview of breastfeeding

IBFAN’s alternative report highlighted that inadequate infant feeding practices co-exist with high rates of child mortality in Indonesia. Indeed, the rate of early breastfeeding initiation is low (less then 30 %) and more than half of the children are not breastfed until 6 months of age, while a third of the children under five years old are stunted. Besides, complementary foods are introduced too early to almost 45% of the children. The lack of any policy or programme on infant and young child feeding has also been emphasized, as well as an absence of sanctions in case of violations of the International Code of Marketing of Breastmilk Substitutes, despite the implementation of many provisions of this Code into national legislation. The absence of data on the number and quality of Baby-friendly hospitals has also been shown as problematic. Finally, the absence of maternity protection for women working in the informal sector, as well as the lack of public awareness about HIV/AIDS and infant feeding, have been emphasized.

Discussion on infant and young child feeding

The Committee noted that while in the 1990s, Indonesia had made progress in reducing neonatal and infant mortality, this advancement had slowed down in recent years. In addition, in regard to the high infant mortality rate in certain provinces, the expert has asked about the implementation of the Baby-friendly Hospital Initiative in Indonesia. In general, the expert has asked about the actions taken by State party to promote breastfeeding.

The Indonesian delegation responded by stating that there had been a national breastfeeding programme in place since 1990 promoting breastfeeding up until six months of age.  Nevertheless, the delegation admitted that the rate of early breastfeeding in Indonesia still remains low, and added that the provision of lactation rooms for breastfeeding mothers is scheduled in the government agenda.  

Concluding Observations

In its Concluding Observations, regarding the general implementation of the Convention, the Committee urged Indonesia to upgrade its system of data collection (para 7 (a)).

Regarding the issue of health, the Committee specifically requested the country to substantially increase the allocations in the area of health to adequate levels and to expand access to primary health-care services across all provinces (para 16 (a) and 48). It also emphasized the need to “ensure the provision of primary health-care services for all pregnant women, including access to postnatal care, and children, focusing on interventions to reduce preventable and other diseases, particularly diarrhoea, acute respiratory infections and undernutrition”, and called for the promotion of good infant and young child feeding practices (para 48 (a)). In addition, Indonesia has been urged to “strengthen and expand access to preventive health care for all pregnant women and children, particularly infants and children under the age of 5”. They should include preventive health interventions such as universal immunization services, oral rehydration therapy and treatment for acute respiratory infections (para 48 (b)). According to the Committee, the country should also “take all necessary efforts […] to reduce maternal mortality (para 48 (c)). Regarding the issue of HIV/AIDS, the government was requested to “sustain the measures in place to prevent mother-to-child transmission as well as provide for counselling and improve follow-up treatment for HIV/AIDS-infected mothers and their infants to ensure early diagnosis and early initiation of treatment (para 52).

Besides, the Committee emphasized the low rate of exclusive breastfeeding in the country and issued direct recommendations related to infant and young child feeding: it recommended Indonesia to “strengthen the promotion of breastfeeding, including by establishing a programme to promote and enable all mothers to successfully breastfeed exclusively for the first six months of the infant’s life” and to adopt the International Code of Marketing of Breast Milk Substitutes (para 56).