Thursday 16 February 2012

Breastfeeding and the right to sexual and reproductive health

Breastfeeding has not been properly recognized by the international community as an essential part of women's reproductive cycle or as a sexual and reproductive right although there are sufficient medical, legal and social grounds to expound it as such. From a human rights perspective, several international instruments already provide basis for breastfeeding to be interpreted as a human right, related directly  to the right to health and to food. However, breastfeeding is constantly undervalued and threatened,  because of misinformation and commercial pressures, or because it is a maternal practice seen by some as being incompatible with other roles that women have, in particular their occupational role. Dominant social values, structures and institutions, which are rapidly spreading across the globe, often exploit and undervalue women's physical needs and both their productive and reproductive contributions.
Hence the international community needs to recognize the protection and facilitation of women's right to breastfeed as a component of their right to sexual and reproductive health.

IBFAN (International Baby Food Action Network) and WABA (World Alliance for Breastfeeding Action) have made a very interesting contribution to the General Comment on Sexual and Reproductive Health Rights, by the Committee on Economic Social and Cultural Rights (CESCR). Their submission explores the links between breastfeeding and women's sexual and reproductive health , and makes recommendation of how this should be dealt with in a huam rights framework. 



The 58th session of the Committee on the Rights of the Child (CRC Committee) took place from 19 September to 7 October in Geneva. The Committee reviewed the progress of the implementation of the Convention on the Rights of the Child in 6 countries: Iceland, Italy, Republic of Korea, Panama, Seychelles, Syria.
IBFAN presented alternative reports on the situation of infant and young child feeding, for all 6 countries under review. In 4 cases these reports were written by IBFAN groups in the countries (Iceland, Italy, Panama, and Seychelles). The reports on the Republic of Korea and Syria were written by the Geneva Infant Feeding Association (GIFA).
In its concluding observations, the CRC Committee referred specifically to breastfeeding in 5 out of the 6 countries. With the exception of Korea, all the other countries received concluding observations on infant and child nutrition and breastfeeding in particular. Unfortunately in the case of Korea, the late submission of IBFAN’s alternative report may have prevented the CRC Committee from making use of the information contained in the report.
The CRC Committee has shown a growing concern about the increasing rates of obesity among children both in developed and developing countries, due to unregulated marketing of foods to children and infants and early introduction of complementary foods. Thus the Committee has recommended that State parties establish regulations to restrict the marketing and advertisement of unhealthy foods and breastmilk substitutes for children and infants (Iceland, Italy and Seychelles).
The Committee has paid particular attention to the awareness among the public generally about the importance of breastfeeding and the risks of artificial feeding. It recommended concrete actions such as increasing access to materials on breastfeeding and to education and campaigns. The Committee also considers important the sensitization of government officials, parents and staff working in maternity units. It has also recommended that breastfeeding should be included in nursery trainings (Italy, Panama, Seychelles, Iceland, Syria).
The Committee has once more stressed the importance of the strict enforcement of the International Code of Marketing of Breastmilk Substitutes by Sate parties including through strengthening of national laws whenever necessary, and the need for action in cases of violations (Syria, Seychelles, Panama, Italy, Iceland).  
Moreover, the Committee has recommended that countries establish a National Breastfeeding Committee, improve data collection on breastfeeding and promote baby friendly hospitals (Syria).
On health more generally, the CRC Committee has focused on the need to improve equal access to health care services, and decrease inequalities in access to health care (Korea, Panama, Syria), with particular focus on children of immigrants (Iceland and Italy), disadvantaged areas, low income families (Korea). It has recommended that state parties increase their allocation to the health sector, with a focus on primary health care, and improve the training of their health personnel.

Summary of concluding observations on IYCF: CRC Session 58 - 2011
Summary of specific recommendations on Infant and Young Child Feeding (IYCF)
 Very low rates of exclusive breastfeeding; promote exclusive and continued breastfeeding; raise awareness to the public; enforce and monitor the International Code.
The problem of obesity among children: continued education on health and nutrition and the negative impacts of obesity
Improve exclusive breastfeeding for six months; awareness raising, campaigns, information and training of government officials, maternity unit staffs and parents; strengthen and regularly monitor regulations about the marketing of foods for children and breastmilk substitutes (BMS); take action against violations of these regulations.
Problem of obesity; awareness raising programs on the importance of physical health and healthy eating practices; effective implementation of the National Prevention Plan 2010-2012.
Child rights and the business sector: lack of comprehensive framework regulating and mitigating the adverse Human Rights impacts of companies in the country and abroad.
Strengthen promotion of breastfeeding; enforce the International Code.
Strengthen efforts to promote exclusive and continued breastfeeding; provide materials and education and raise awareness of the public on the importance of breastfeeding an risks of artificial feeding; strictly enforce the International Code.
Health care and health services: concerned about the increasing obesity among children; raise public awareness on the negative impacts of processed foods; establish regulations to restrict and monitor advertising of unhealthy foods.
Establish a breastfeeding committee; systematically collect data on breastfeeding; ensure the enforcement of the International Code; promote Baby-Friendly Hospital Initiative; include breastfeeding in nursery trainings.
Increase number of hospitals providing specialized services for children; improve the quality of nutritional education and counselling services.