Overcoming breastfeeding barriers

BESIDES having enough information on normal breastfeeding, successful breastfeeding also depends on having support from knowledgeable people (be it the doctor, nurse, or a family member) and having a positive mindset that it can be done.

Yet, mothers today still experience barriers that can discourage them from breastfeeding. Health professionals might not know much about breastfeeding and some of them may not be supportive of breastfeeding, notes paediatrician Dr Koe Swee Lee.

On top of that, many mothers who delivered their babies in the 60s to 80s – when the bottle-feeding culture thrived – may not be supportive of breastfeeding, as they do not have enough information.

“The role of the father is also very important. If he supports the wife in breastfeeding, she would more likely be successful,” says Dr Koe.

To overcome the barriers to breastfeeding, the World Health Organisation (WHO) and United Nations Children’s Fund (UNICEF) launched a worldwide programme called the Baby Friendly Hospital Initiative, an effort to ensure all hospital maternity services support breastfeeding.

Mothers can now visit baby friendly hospitals (almost all Malaysian government hospitals and a few private hospitals) – hospitals that practise the Ten Steps (below) to successful breastfeeding as listed by WHO and UNICEF policymakers in the Innocenti Declaration in 1990 on the Protection, Promotion and Support of Breastfeeding.

The Ten Steps are:

1. Have a written breastfeeding policy that is routinely communicated to all healthcare staff.

2. Train all healthcare staff in skills necessary to implement this policy.

3. Inform all pregnant mothers about the benefits and management of breastfeeding.

4. Help mothers initiate breastfeeding within a half-hour of birth.

5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.

6. Give newborn infants no food or drink other than breast milk unless medically indicated.

7. Practise rooming-in – allow mothers and infants to remain together – 24 hours a day.

8. Encourage breastfeeding on demand.

9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

“It is best for mothers to tell their obstetrician or gynaecologist earlier that they would like to breastfeed their child exclusively,” says Dr Koe.

Today, although an estimated 28% of all maternity facilities in the world have at some point implemented the Ten Steps, it is still far from the original goal of ALL maternity facilities practising the Ten Steps by 1995 as stated in the Innocenti Declaration, says the World Alliance for Breastfeeding Action (WABA) in its press release.

As studies have shown that with more of the Ten Steps in place, the more likely women are to achieve their breastfeeding goals, it is important for every maternity, hospital, clinic and community to strive to increase the number of steps in place, even if they cannot achieve all ten steps immediately.

“Therefore, every step counts!” says WABA.

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