Wednesday, 21 January 2015

Colombia at the CRC: Concerns about Declining Breastfeeding Rates and Lack of Breastfeeding Promotion


On January 20th and 21st, 2015, the Committee on the Rights of the Child considered the combined fourth and fifth periodic reports of Colombia on the situation of the implementation of the Convention on the Rights of the Child in the country. The Colombian delegation was led by Mrs. Cristina Plazas Michelsen Costa, Director of the Colombian Institute of Family Wellbeing.

On this occasion, IBFAN presented an alternative report to inform the CRC Committee on the situation of infant and young child feeding in Colombia.

General overview of breastfeeding in Colombia

The report highlighted that despite a high rate of institutional delivery (95%), the rate of early initiation to breastfeeding is low (57%) and has recently declined, which indicates that health professionals are not enabled to ensure optimal breastfeeding practices within hospitals. Besides, the rate of exclusive breastfeeding under 6 months has decreased since 2004 and currently, almost 6 children out of 10 are not exclusively breastfed until 6 months of age. The Colombian National Demographic and Health Survey 2010 has also shown that on average, babies are given other liquids than breastmilk at 2.7 months and that the practice of bottle feeding, which is common during the first year of life, has increased in the last decade. This situation is closely connected with the lack of promotion strategy on optimal breastfeeding practices and aimed at mothers, caregivers and community through media.

Regarding protection of breastfeeding, IBFAN noted that the International Code of Marketing of Breastmilk Substitutes and its subsequent relevant World Health Assembly resolutions are still not fully implemented into legislation and that violations of the Code, including donations of infant formula to health institutions and delivering of gifts to mothers through health workers, are common.

The report also flagged the very low rate of implementation of the Baby-friendly Hospital Initiative in the country. The latest statistic, dating back to 2009, shows that only 0.06% of the total number of health facilities of the country are certified as “baby-friendly”. In addition, there is no monitoring of this accreditation process at the country level.

Finally, IBFAN expressed concern about the lack of maternity protection for women working in the informal sector as well as the lack of any national plan to ensure protection and support of breastfeeding in case of emergencies.

Discussion on infant and young child feeding


During its discussion with Colombia, the CRC Committee addressed specifically the issue of breastfeeding. It mentioned the low breastfeeding rates and noted with particular concern the decline of the rate of exclusive breastfeeding under 6 months. It asked which efforts have been made to ensure that health professionals are properly trained on optimal breastfeeding practices and that mothers are aware of the importance of breastfeeding their child.                                                                                                               

The Colombian delegation answered that the decline of the rate of exclusive breastfeeding is a concern for the government and states the importance of taking action on this regard. It noted that a national breastfeeding plan is in place and that breastfeeding is closely connected with the employment condition of mothers. As part of the gender equality governmental project, the length of the maternity leave has recently been increased to 14 weeks, and the legislation also entitles working fathers to 1 week of paternal leave. In addition, the delegation added that some 17 human milk banks have been implemented throughout the territory in order to make it easier for every child to have access to breastmilk, and that breastfeeding-friendly rooms have been settled in employment areas in order to support working mothers to breastfeed. Finally, regarding the specific problem of teenage pregnancies, the delegation assured the Committee that special facilities have been put in place to ensure that young mothers are able to continue to go to school while breastfeeding their child.

Concluding Observations

In its Concluding Observations, the Committee made several indirect and direct recommendations to Colombia in relation with infant and young child feeding.
Regarding health and health services, the Committee recommended Colombia to “ensure the availability and accessibility of health services for all children […] by allocating adequate resources and monitoring the implementation of relevant policies” (§ 40a). In particular, the Committee highlighted the child and maternal mortality rates which continue to be very high (§ 39f), and thus recommended the State party to “increase its efforts to reduce maternal and child mortality, including by implementing the OHCHR Technical guidance on child mortality” (§ 40c) which includes specific recommendations on breastfeeding protection (including the implementation of the International Code) and promotion. It is to be noted that this technical guidance includes specific recommendations on breastfeeding protection (including the implementation of the International Code) and promotion
Referring specifically to breastfeeding, the CRC Committee expressed its concerns on the decline of exclusive maternal breastfeeding in 2010 and on the persistence of inadequate baby feeding practices. It recommended Colombia to “strengthen efforts to promote breastfeeding through educational campaigns and training to professionals, adequately implement the International Code of Marketing of Breast-Milk Substitutes and the Child-Friendly Hospital initiative [sic]” (§ 40h).