Better Breastfeeding, Healthier Lives

This issue of Population Reports on the topic of breastfeeding has the objective of supporting governments, public health programmes, and health care providers to:

• Encourage and support better breastfeeding by carrying out comprehensive strategies involving governments, health care services, and families and their communities - through a section entitled: 'Comprehensive Strategies Needed'.
• Counsel women on how breastfeeding can help space births up to six months postpartum and encourage switching to another contraceptive method thereafter - through a section entitled: 'Breastfeeding Increases Women's Contraceptive Options'.
• Inform and advise women on HIV and breastfeeding and on weighing the risks of breastfeeding and replacement feeding for HIV positive mothers - through a section entitled: 'Women with HIV Face Crucial Breastfeeding Decisions'.

The document contains the following sections:
"Breastfeeding Gains and Goals" is a call to action by the United Nations (UN) and World Health Organization (WHO) to revitalise breastfeeding efforts and apply lessons learned from past successes from growing local and international efforts that have helped mothers gain both protection and support for breastfeeding. Recently, according to this report, commitment to breastfeeding has faltered, largely due to concerns over HIV transmission through breast milk. In order to support action by governments, public health organisations, and health care providers, this section concludes with a page describing optimal breastfeeding.

"Comprehensive Strategies Needed" offers national strategies to inform and advise women about breastfeeding, extend promotion into communities, and make changes in government policies. The report recommends up-to-date medical advice and supportive hospital practices that encourage women to start breastfeeding as soon as possible after birth, as well as home and community support, and government policy recognition of the public health benefits of optimal breastfeeding. It also lists ten steps to maternity care practices that support women in their choice to breastfeed.

"Spotlight: Madagascar’s Comprehensive Approach Improves Breastfeeding" is a case study demonstrating that more women are breastfeeding due to the fact that the Ministry of Health, with several partner organisations, launched a major breastfeeding programme that combines improvements in health care services with policy-level and community approaches.

"Breastfeeding Increases Women’s Contraceptive Options" reports on the lactational amenorrhoea method (LAM) to delay pregnancy through the natural infertility that results from frequent breastfeeding. It gives information on non-hormonal contraceptive methods and progestin-only hormonal methods appropriate for nursing mothers who want continued contraceptive protection.

"Breastfeeding Is Best" is a section on the advantages of breastfeeding to infants and women, which can be used in educational consultations to promote breastfeeding.

"Women with HIV Face Crucial Breastfeeding Decisions" offers caregivers research-based information to advise on the decision faced by HIV positive mothers - whether to breastfeed, in order to give her infant important nutrients and protection from potentially fatal diseases, or not to breastfeed, in order to avoid the risk of transmitting HIV. It gives a 5-step counselling flow chart for supporting decisions of HIV infected mothers of infants. This section includes details on increased risk of HIV infection in pregnancy, the advantages of antiretrovirals introduced during pregnancy, and options for infant feeding by HIV postive mothers, including, among a number of options, heat treating breastmilk to kill the virus, wet-nurse services, commercial formulas, and modified animal milk.

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