On this occasion, IBFAN presented an alternative report to inform the CRC Committee on the situation of
infant and young child feeding in Jamaica.
General overview of breastfeeding in Jamaica
Despite the high rate of skilled attendance at birth (98.3%) and
institutional delivery (97.1%), optimal breastfeeding practices are still not
widespread in Jamaica. This is confirmed by the low rates of early initiation
of breastfeeding (62.3%), exclusive breastfeeding under 6 months (23.8%) and
continued breastfeeding ate at 2 years of age (31.2%). These figures show a
lack of knowledge on the importance of the early initiation of breastfeeding among
the health care workers assisting deliveries and, at the same time, constitute an
evidence of non-compliance with the step 4 of the Baby-Friendly Hospital Initiative (BFHI). Another alarming fact relates to the median duration
of exclusive breastfeeding, which is only three weeks for the average Jamaican
mother.
The draft National Infant and Young Child Policy, revised in 2014, states important goals related to supporting
breastfeeding in communities and the workplace, spreading the BFHI in all
institutions, improving the data collection system, building capacity within
all relevant agencies and at different levels of the health system, among
others. However, to date, this draft has not yet been accepted and thus, the
activities carried out by the National Infant and Young Child Feeding Committee
remain unclear. Breastfeeding and HIV-related strategies are mentioned in the
draft Policy, and thus, have not been endorsed yet. The same applies to infant
and child feeding in emergencies, which has been addressed in the draft Policy
in the form of specific provisions, but there is no information available on
its concrete application.
Regarding protection of breastfeeding, only voluntary measures are in
place to implement the International Code of Marketing of Breastmilk Substitutes and there is no enforcement mechanism.
The Jamaican legislation does not provide for an adequate duration of
maternity leave (12 weeks) and for proper relevant benefit coverage (only 8
weeks). Furthermore, employers are not required to provide breaks for nursing
mothers and fathers are not entitled to any paternity leave.
Discussion on infant and young child feeding
The CRC Committee addressed specifically the issue of breastfeeding in
Jamaica, asking the reasons behind such low breastfeeding rates in the country,
despite the tremendous positive developments Jamaica has presented in many
other areas of the Convention. It was also asked whether there could be a link
between the low breastfeeding indicators and the fact that the legislation does
not provide for employers to allow breastfeeding breaks to nursing mothers. The
delegation replied mentioning that Jamaica was one of the first countries in
the world to adopt in the 1970s an act on the maternity leave which gives women
the right to a paid 3-month leave. The delegation also highlighted that Jamaica
has a matriarchal society for which many mothers are working and that they do
breastfeed their children up to 6 months of age. Pointing out that
breastfeeding is encouraged in hospitals, the Head of Delegation described the
personal experience of going to the hospital to deliver her baby and being told
not to bring any bottles because that was a breastfeeding-policy hospital.
The CRC Committee commented that, however, it is important to provide
that the maternity leave is long enough and guarantees that mothers can breastfeed their
children up to 6 months exclusively, reminding that this is also a very strong
WHO recommendation. Maternity leave becomes thus an essential point when
discussing measures aimed at encouraging women to breastfeed their children, if
not up to 2 years, up to 6 months at least. The Committee then added that the
positive outcomes of breastfeeding are seen later, in the better health status
of children and, but not only, in the emotional bonding, which is also
essential.
Concluding Observations
The Committee issued both indirect and direct
recommendations related to infant and young child feeding to Jamaica (see the Concluding Observations).
After commending the State party for the
decrease in infant mortality rates, the Committee expressed concerns over the
“perinatal mortality levels, the increase in maternal mortality, the persistent
levels of undernourishment among the poorest children, the general shortage of
health care providers and access by children to quality health care, the low
levels of breastfeeding and the high rate of children classified as overweight
and obese” (§ 44).
Therefore, the Committee recommended Jamaica
to ensure adequate provision of prenatal and post natal care, as well as to
address the increase in maternal mortality (§ 45a) and to increase the number
and coverage of health care professionals for an improved children’s access to
health care services (§ 45c). Regarding nutrition, the Committee urged Jamaica
to “introduce targeted action to prevent the undernourishment of children,
including the promotion of proper infant and young child feeding practices” (§
45b). On children obesity in particular, the Committee recommended to intensify
measures to raise awareness of healthy nutrition among parents, children and
the public in general, and to promote healthy eating habits (§ 45f).
With regard to breastfeeding, the Committee specifically
recommended Jamaica to “take action to improve the practice of exclusive breastfeeding for the first
six months, through awareness-raising measures, including campaigns, providing
information and training to relevant officials, particularly staff working in
maternity units, and parents” (§ 45d). Finally, the Committee recommended the
State party to regulate the marketing of breastmilk substitutes (§ 45e).
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