BREASTFEEDING

The development of the breastfeeding policy varies broadly; it should include breastfeeding experts and avoid commercial links with products and companies regulated by the International Code of Human Milk Substitutes.

A committee including high-level representation from all stakeholders may be appointed to develop the policy. Once the necessary agreements are reached, the committee should continue to monitor the proper implementation of the policy.

Standards and policies to strengthen breastfeeding at birthing facilities should be written. This feature is important to sustain unanimity of criteria in practices.

Furthermore, the policy should consider the 10 steps set forth by the World Health Organization for successful breastfeeding, i.e.

- available for consultation by all personnel

- visibly displayed in all areas of the hospital

- written in the language(s) most frequently understood by patients and staff.

Early skin-to-skin contact and early breastfeeding are two closely linked interventions that should be carried out immediately after birth.
Immediate and prolonged skin-to-skin contact facilitates lactation, enriches the microbiome of newborns, prevents hypothermia and hypoglycemia, and stabilizes respiratory function.
Early suckling at the breast stimulates lactogenesis II (activation of milk secretion) and transfers colostrum, rich in immunoactive substances, especially important for those born prematurely.

The hospitalization of premature, small and/or sick newborns poses multiple challenges to breastfeeding, including:

In neonatal hospitalization areas, the unrestricted admission of mothers and fathers facilitates close contact with their newborns, the development of bonding and the provision of care for which they will be primarily responsible after discharge.

When a child is born prematurely, some things are important to initiate and sustain the mother’s milk production:

- In the birthing area:
• Immediate, direct and continuous skin-to-skin contact, whenever clinically possible.
• Extraction of colostrum for administration into the newborn’s oropharynx.

The theme of Breastfeeding Week 2023 is “Let's make breastfeeding and work work”.

After birth, breastfeeding is initiated by the newborn if he/she is in direct and uninterrupted skin-to-skin contact with the mother for at least one hour after birth.

Breastfeeding provides both short- and long-term benefits to the child and the mother.

For the child, breastfeeding provides optimal nutrition and reduces incidence of disease and death. Breastfeeding, particularly exclusive breastfeeding, protects children from diarrhea and pneumonia, the two leading causes of death among children under age five. Other infections, including otitis media, Haemophilus influenzae meningitis, and urinary tract infections, are less common and less severe in infants who are breastfed.

The Ten Steps involve changes in maternity services. Every facility providing maternity services
should have a breastfeeding policy and carry out structural changes and train all health care staff in skills necessary to implement this policy. They are aimed to protecting, promoting, and supporting breastfeeding in facilities that provide maternity services.