The Issue of Breastfeeding in Armenia (CESCR)

On the 7^th of May 2014, the Committee on Economic, Social and Cultural Rights considered the combined second to third periodic report of Armenia on how the country is implementing the provisions of the International Covenant on Economic, Social and Cultural Rights.

IBFAN presented an alternative report on the situation of infant and young child feeding in Armenia, prepared by Confidence Health NGO.

General overview of breastfeeding

The report showed in particular how the International Code on Marketing of Breastmilk Substitutes is violated in hospitals. It additionally reported on how NGOs registered violations of the International Code in some baby-friendly certified hospitals since the implementation and monitoring of the Baby-Friendly Hospital Initiative (BFHI) has been discontinued in 2008. The report also mentions the existence of a draft law on the marketing of breastmilk substitutes, its weaknesses and possible improvements. Nevertheless, after the report was written, there have been some positive developments that resulted in a strengthening of the draft law. Other than that, the report also states that the overall situation of breastfeeding in Armenia has improved over the last decades by the increasing breastfeeding rates. Yet, in the last couple of years the situation of breastfeeding has come to a stall and progress has stopped.

One of the key challenges that Armenia is currently facing relates to complementary feeding, which is often nutritionally inadequate, as a result of lack of knowledge. This has led to increasing rates of stunting, anaemia and overweight among children.

Discussion on infant and young child feeding

No specific questions on breastfeeding or infant and young child feeding have been formulated. However, regarding the issue of payment of informal fees to healthcare by patients,  raised by the experts, the delegation stated that it had made all primary health services free of charge.

CECSR Concluding Observations

In its Concluding Observations, the Committee recommends Armenia to monitor and assess the impact of measures taken to advance the economic, social and cultural rights (para 7). It further recommends Armenia to adopt measures to expedite the elimination of discrimination against women and girls (para 22). 

Violations of the Code in Lithuania (CESCR)

On the 6th of May 2014, the Committee on Economic, Social and Cultural Rights considered the second periodic report of Lithuania on the implementation of the International Covenant on Economic, Social and Cultural Rights.

The IBFAN alternative report on the situation of infant and young child feeding in  Lithuania was prepared by the initiative group of breastfeeding mothers and breastfeeding promoters of NGO "Pradžiųpradžia" (IBFAN Lithuania). The report reflected the ‘Declaration on Breastfeeding Support and Relate Issues in Lithuania’ which was addressed to the highest authorities such as the Ministry of Health  and Ministry of Education of the Republic of Lithuania, and was also shared with all universities, medical colleges and faculties of the country during the World Breastfeeding Week in 2011.

General overview of breastfeeding

The alternative report highlighted the lack of an integral programme on protection, support and promotion of breastfeeding in the country. Indeed, dissemination of information and misleading advertising are the key reasons for refraining from breastfeeding or choosing a comparatively short period of breastfeeding. The article 24 of the Convention of the Rights of the Child is not appropriately respected and no mechanisms exist for the control of its implementation: a comparatively large number of mothers continue refraining from or choose especially short periods of breastfeeding. Currently, no substantial actions are taken to upgrade breastfeeding-related qualifications of health care specialists. Certain seminars on nutrition of infants and children for health care specialists are supported and organized by companies distributing breastmilk substitutes that violate the International Code of Marketing of Breastmilk Substitute and its subsequent resolutions. What is more, accessibility to personal health care services for breastfeeding women is not sufficiently communicated and organized. There are very few Baby-friendly Hospitals and in other health care institutions, the quality of services is very low or services that ensure successful breastfeeding are nonexistent. Consequently, a birth-giving mother, limited by time and distance, cannot freely choose a health care institution. Mothers and newborns experience discrimination as they end up in a hospital without the Baby Friendly Hospital Initiative status.

Discussion on infant and young child feeding

The Committee has not specifically addressed the issue of infant and young child feeding.

However, the delegation informed the Committee on the establishment of a working group on the draft law on reproductive health that was set up in January 2014. The government has launched a campaign to promote the availability of contraception methods and the risks of repeated abortion.

CECSR Concluding Observations

In its Concluding Observations, the Committee welcomes the priority given by the State to increase food quality, including the promotion of organic farming and locally made products. Furthermore, it encourages the State to continue and strengthen its efforts to promote healthy, balanced and environmentally sustainable eating habits among all segments of the population, and establish a monitoring mechanism to assess the impact of such measures in reducing the obesity rate, taking into account the Committee’s general comment No. 12 (1999) on the right to adequate food (para 19), that expressly refers to breastfeeding as an 'appropriate feeding pattern' to be maintained and strengthened. Finally, the Committee calls upon the State to intensify its efforts to combat domestic violence by ensuring that all cases of violence against women are effectively investigated, perpetrators are sanctioned and victims have access to remedies as well as protection (para 15).  

Inadequate Infant Feeding Practices in Indonesia (CESCR)

On the 1^st of May 2014, the Committee on Economic, Social and Cultural Rights concluded its consideration of the initial report of Indonesia on the implementation of the International Covenant on Economic, Social and Cultural Rights.

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

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 ofMarketing 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 has not discussed the issue of infant and young child feeding.  However, the delegation has pointed out that Indonesia’s efforts were raised on improvements of healthcare services and maternal mortality rate.

CECSR Concluding Observations

In its Concluding Observations, the Committee expresses concern about the increase of the maternal mortality rate in Indonesia due, among others, to insufficient sexual and reproductive health services The Committee calls on Indonesia to address disparities in the availability and quality of maternal health care services. Moreover, the Committee urges the State to ensure access to sexual and reproductive health services to unmarried women and teenagers as well as to married women without the consent of their spouses (para 32).