International Baby Food Action Network - IBFAN Rseau international des groupes daction pour lalimentation infantile

Geneva Infant Feeding Association - GIFA

Are Our Babies Falling Through the Gaps? launched in Geneva Report of the side-event to the 23rd session of the Human Rights Council

IBFAN-GIFA and IBFAN Asia organized a side-event to the 23rd Human Rights Council session, launching

the report Are our babies falling through the gaps?.

The report documents the state of policies and programme implementation of WHOs Global Strategy

for Infant and Young Child Feeding (2002) in 51 countries around the world, showing the results of the

World Breastfeeding Trends initiative (WBTi), a participatory monitoring initiative launched globally by

IBFAN in 2008.

The event included a panel discussion on how participatory assessment tools could contribute to

improve and expand human rights accountability in the area of infant and young child feeding. It was

held on May 28th at the beginning of the 23rd Human Rights Council session and the 63rd session of the

Committee on the Rights of the Child. The event aimed at building bridges between the human rights

and health communities.

The distinguished members of the panel were Dr. Arun Gupta, regional coordinator of IBFAN Asia and

initiator of WBTi; Dr. Hiranthi Wijemanne, member of the CRC Committee; Dr. Francesco Branca, WHOs

head of Nutrition Department; Dr. Prakash Shrestha, president of Nepal Breastfeeding Promotion Forum

and Ms. Joyce Chanetsa, regional coordinator of IBFAN in Africa, and with Ms. Lida Lhotska form GIFA as

moderator.

The panel discussion emphasized the important contribution of monitoring mechanisms, such as WBTi,

in measuring the level of implementation of legislation, programs and policies to improve infant and

young child feeding, in highlighting gaps and issues that need attention and in formulating a call for

action. Setting targets, measuring and monitoring action contribute to strengthening State

accountability, especially if a human rights perspective is adopted whereby the key principle of

participation is applied. The WBTi experience in the countries where it has been implemented has

drawn attention to the importance of a positive legal and policy environment for improving

breastfeeding rates, and the crucial role of collaboration and information sharing between different

actors, such as WHO, CRC Committee, Government, national NGOs and other stakeholders. Synergy of

contributions between different public-interest actors is to be sought and strengthened.

Panel discussion

After showing the critical importance of optimal breastfeeding practices1 for the health and survival of

children, especially during the first year of childrens lives, Dr. Gupta explained the process involved in

WBTi and illustrated some of the results. The results of WBTi show that in countries that have

undertaken the assessment more than once, WBTi indicators scores have improved; confirming the

importance of monitoring the situation in order to spur action.

Dr. Wijemanne highlighted the importance of breastfeeding in a human rights and child rights

perspective, as it relates to the childs right to optimum health and adequate food and therefore

nutrition. Breastfeeding incorporates all 5 sense: touch through touching the mother, sight through

seeing the mother, smell through the smell of the mother and of the breastmilk, hearing the voice of the

mother and nutrition through breast milk. It is the best start for early childhood development, and a

gateway to future education and learning. Building an enabling environment for the mother to

breastfeed is essential, particularly at the start, until breast feeding is well established. This includes a

total ban on using formula and promotion of artificial formula in maternities and any other sites where

there are mothers. She particularly emphasized State party obligations to curb and prevent any

marketing of artificial formula, including in hospital settings. She is of the opinion that we have to look at

the promotion of optimal infant and young child feeding practices as part of the good governance

practices by States to protect the rights of children; in this framework WBTi is a monitoring tool that is

considered valuable by the CRC Committee as well. Collaboration between WHO and the CRC

Committee in upholding WBTi efforts would be quite valuable. Finally, Ms Wijemanne mentioned that

breastfeeding is specifically included in the General Comment 15 done by the CRC Committee on Article

24 on the childs right to the highest attainable standard of health.

After expressing its concern at the slow pace with which states incorporate the International Code of

Marketing of Breastmilk Substitutes into their legislative systems, Dr. Branca once again stressed the

importance of implementation and monitoring of the Code for increasing breastfeeding rates. Other key

strategies for achieving this goal are the implementation of the Baby Friendly Hospital Initiative and

hospitals and health professionals capacity building. In addition, synergy and cross-fertilization between

WHO and human rights treaty bodies should be pursued. In particular the CRC Committee, based on its

own General Comment No.15, creates an obligation for states to implement and monitor the

International Code and to include information on these activities in state reports to the Committee.

Dr. Shrestha contributed to the discussion with his experience in coordinating the national process of

implementation of WBTi in Nepal, where the assessment was done already 3 times. In particular, Dr.

Shrestha shared that continuous advocacy by civil society actors is necessary to ensure that

governments keep breastfeeding high on their political agenda.

Ms. Chanetsa shared her views on the WBTi implementation in the African region (English and

Lusophone) showing the challenges and positive results achieved. In particular, she noted the potential

of WBTi in making the link between the international level and the national level and bringing the

recommendations contained in the concluding observations of the CRC Committee and other treaty

bodies to the attention of national governments.

1 Breastfeeding within one hour from birth, exclusive breastfeeding up to 6 months, introduction of complementary foods from

the sixth month along with continued breastfeeding until 2 years or beyond.

Questions and final remarks

At the end of the panel discussion the floor was opened for questions and suggestions.

One of the participants noted that WBTi results could be correlated to the GDP, to staffing levels in

health facilities and to urban vs. rural areas but a study on possible correlations has yet to be done.

A question was raised on whether governments actually listen to WBTi outcome recommendations and

the panellists that worked directly with the initiative confirmed the increase of the interest of

governments that completed more than one assessment to improve the country scores from one

assessment to the other. However, the panellists also emphasized that it might be necessary for NGOs

to be persistent in advocating for government participation in the WBTi process.

It was also suggested that the CRC Committee could play a role in enhancing state accountability with

regards to the International Code, for example by reviewing its reporting guidelines for State parties so

that they request information on the Code to be included in state reports.

It was further noted that participation of national human rights institutions and parliamentarians in the

WBTi process is lacking. Finally, the importance of making the CRC General Comment No.15 more

operational was mentioned and creation of a set of indicators revolving around key issues addressed in

the General Comment was suggested as a strategy to achieved such objective.

This event was made possible thanks to the support of the Republic and Canton of Geneva