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World Breastfeeding Week (WBW) 2007 Breastfeeding 1 st Hour save ONE Million Babies SCN WG :BREASTFEEDING and COMPLEME

World Breastfeeding Week (WBW) 2007 Breastfeeding 1 st Hour save ONE Million Babies SCN WG :BREASTFEEDING and COMPLEMENTARY FEEDING . Arun Gupta on behalf of WABA. Beginning Breastfeeding within ONE hour :Beginning life with “life”. Objective.

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World Breastfeeding Week (WBW) 2007 Breastfeeding 1 st Hour save ONE Million Babies SCN WG :BREASTFEEDING and COMPLEME

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  1. World Breastfeeding Week (WBW) 2007Breastfeeding 1st Hour save ONE Million BabiesSCN WG :BREASTFEEDING and COMPLEMENTARY FEEDING Arun Gupta on behalf of WABA WBW 2007

  2. Beginning Breastfeeding within ONEhour :Beginning life with “life” WBW 2007

  3. Objective • To draw the world’s attention to save ONEmillion babies with just ONE action, just ONEhour support and just ONE message…. • To encourage establishing breastfeeding within ONE hour as key indicator of health progress by all communities locally and globally. WBW 2007

  4. BFHI 1992 • Step 4 was, “Help mothers initiate breastfeeding within a half-hour of birth” WBW 2007

  5. World Summit for Children Commitments • Millennium Development Goals (MDG) 4 to reduce U-5 child mortality • 40% of all child deaths are neonates • Need to scale action to reduce neonatal deaths as progress is reported to be slow • Almost all deaths in developing countries WBW 2007

  6. Risk of neonatal mortality according to time of initiation of breastfeeding within ONE hour Pediatrics 2006;117:380-386 WBW 2007

  7. Potential Mechanisms • Suckling shortly after birth have a greater chance of successfully establishing and sustaining breastfeeding throughout infancy. • However, the effect of early initiation persisted after controlling for established neonatal breastfeeding patterns. • Early feeding with non human milk proteins may severely disrupt normal gut function • Rich immune and non-immune components that are important for early gut growth and resistance to infection. • Promotion of warmth and protection may reduce the risk of death from hypothermia. WBW 2007

  8. Key findings of the study • 30% of the study population initiated breastfeeding after day 1 (late initiation) • 30% were not exclusively breastfed in the neonatal period • Exclusive breastfeeding was associated with a 4 fold reduction in risk of death when compared to infants who were fed solids or other milk. This confirms previous findings. WBW 2007

  9. Key findings • Translating these benefits to the whole population of neonates (breastfed and not breastfed) means that 16% of neonatal lives can be saved if all babies were breastfed from day 1, and 22% if breastfeeding were started within the first hour. • Neonatal mortality was also shown to increase markedly as delay in initiation increased. WBW 2007

  10. Global impact of increases in coverage and promotion of early initiation of breastfeeding in less developed settings. • Projected absolute numbers of lives saved and the proportion of neonatal deaths avoided if 99% of infants initiated breastfeeding during the first hour or during the first day of life. [1] • Only 38 of the 60 countries had data available on initiation of breastfeeding within 1 hour and 1 day of birth. • The neonatal mortality rate for these 38 countries ranged from 15-70/1,000 live births. [1]Karen M Edmond, Ellie C Bard, Betty R Kirkwood, Meeting the millennium development goals for child survival: global impact of early initiation of breastfeeding on neonatal mortality. (Un published) WBW 2007

  11. Contd • An additional 2.5 fold reduction in risk of death was demonstrated in babies who survived to day 2 who initiated breastfeeding on the first day of life (early initiation) compared to infants who initiated after the first day of life (late initiation). • This type of effect of early initiation has never been reported. WBW 2007

  12. Contd… • Neonatal mortality could be reduced by 24% if 99% of infants initiated breastfeeding on day 1 of life and by 31% if 99% of initiation was within the first hour. • Numbers of lives saved were estimated to be 867,000 and 1,117,000 in these two cases." WBW 2007

  13. 1st ONE hour initiation cuts 22% of all neonatal deaths( 0-28 days)Pediatrics 2006;117:380-386 INITIATION OF BREASTFEEDING within ONE hour If ALL Women start BF within ONE hour 15.8%(INDIA) 100% NEONATAL DEATHS SAVED India: 1.1 M World : 4 M 1 million 250,000 babies can be saved in India and ONE MILLION in the world WBW 2007

  14. Other benefits of ONE hour !!! • Skin to skin • Warmth • Development • Less bleeding postpartum WBW 2007

  15. Oxytocin factor • Role of oxytocin which is best during first 45 minutes • Suckling is at it best and babies are active during first hour WBW 2007

  16. Where we stand ? Initiation of breastfeeding within ONE hour • In 38 countries : 26-52( 36 median) • South Asia worst hit , but needed most WBW 2007

  17. Why World Breastfeeding Week(WBW):2007 for ONE hour support • Should not allow to get it old • Too important to ignore • Currently this is not a key indicator in reports like UNICEF SOWC . WBW 2007

  18. What next • Advocacy for support to mothers during 4th stage of labour • Policy : Coverage, promotion and reporting should improve along with exclusive breastfeeding WBW 2007

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