Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-14T21:24:43.719Z Has data issue: false hasContentIssue false
  • English
  • Français

Protection, promotion and support of breast-feeding in Europe: current situation

Published online by Cambridge University Press:  02 January 2007

Adriano Cattaneo ,
Agneta Yngve ,
Berthold Koletzko  and
Luis Ruiz Guzman
Adriano Cattaneo
Affiliation:
Unit for Health Services Research and International Cooperation, Istituto per l'Infanzia, Trieste, Italy
Agneta Yngve*
Affiliation:
Unit for Preventive Nutrition, Department of Biosciences at Novum, Karolinska Institute, SE 146 57 Huddinge, Sweden
Berthold Koletzko
Affiliation:
Metabolic Diseases and Nutrition, Dr von Hauner Children's Hospital, University of Munich, Germany
Luis Ruiz Guzman
Affiliation:
Baby Friendly Hospital Initiative, Barcelona, Spain
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To describe the current situation regarding protection, promotion and support of breast-feeding in Europe, as a first step towards the development of a blueprint for action.

Design and setting

A questionnaire was completed by 29 key informants and 128 other informants in the EU, including member states, accession and candidate countries.

Results

EU countries do not fully comply with the policies and recommendations of the Global Strategy on Infant and Young Child Feeding that they endorsed during the 55th World Health Assembly in 2002. Some countries do not even comply with the targets of the Innocenti Declaration (1990). Pre-service training on breast-feeding practice is inadequate and in-service training achieves only low to medium coverage. The Baby Friendly Hospital Initiative is well developed only in three countries; in 19 countries, less than 15% of births occur in baby-friendly hospitals. The International Code of Marketing of Breastmilk Substitutes, endorsed in 1981 by all countries, is not fully applied and submitted to independent monitoring. The legislation for working mothers meets on average the International Labour Organization standards, but covers only women with full formal employment. Voluntary mother-to-mother support groups and trained peer counsellors are present in 27 and 13 countries, respectively. Breast-feeding rates span over a wide range; comparisons are difficult due to use of non-standard methods. The rate of exclusive breast-feeding at 6 months is low everywhere, even in countries with high initiation rates.

Conclusions

EU countries need to revise their policies and practices to meet the principles inscribed in the Global Strategy on Infant and Young Child Feeding in order to better protect, promote and support breast-feeding.

Keywords

Breast-feedingEurope
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 1 , February 2005 , pp. 39 - 46
Copyright
Copyright © CABI Publishing 2005

References

1 Global Strategy on Infant and Young Child Feeding. 55th World Health Assembly. Geneva: World Health Organization, 2002.Google Scholar
2 Nutrition & diet for healthy lifestyles in Europe: science & policy implications. Public Health Nutrition 2001; 4(2A): 265–73.CrossRefGoogle Scholar
3Yngve, A, Sjöström, M. Breastfeeding in countries of the European Union and EFTA: current and proposed recommendations, rationale, prevalence, duration and trends. Public Health Nutrition 2001; 4(2B) 631–45.CrossRefGoogle ScholarPubMed
4Yngve, A, Sjöström, M. Breastfeeding determinants and a suggested framework for action in Europe. Public Health Nutrition 2001; 4(2B): 729–39.CrossRefGoogle Scholar
5 Health and Human Nutrition: Elements for European Action. Brussels: European Commission, 2000.Google Scholar
6 Resolution on Health and Nutrition. Brussels: EU Council, 2000.Google Scholar
7 Innocenti Declaration. Florence: United Nations Children's Fund/World Health Oraganization, 1990.Google Scholar
8 Breastfeeding, management and promotion in a baby-friendly hospital: an 18-hour course for maternity staff. New York: United Nations Children's Fund/World Health Organization, 1993.Google Scholar
9 Breastfeeding counselling: a training course. Geneva: World Health Organization/United Nations Children's Fund, 1993.Google Scholar
10 International Code of Marketing of Breastmilk Substitutes. Geneva: World Health Organization, 1981.Google Scholar
11 Directive 91/321/EEC. Brussels: European Commission, 1991.Google Scholar
12 European Commission Directive 92/52/EEC. Brussels: European Economic Community, 1992.Google Scholar
13 European Council Resolution 92/C 172/01. Brussels: European Economic Community, 1992.Google Scholar
14 International Baby-Food Action Network (IBFAN). Breaking the Rules, Stretching the Rules 2001. Penang: IBFAN, 2002.Google Scholar
15 Maternity Protection Convention C183. Geneva: International Labour Organization, 2000.Google Scholar
16 Indicators for Assessing Breast-feeding Practices. Geneva: World Health Organization, 1991.Google Scholar
17 Indicators for Assessing Health Facility Practices that Affect Breastfeeding Practices. Geneva: World Health Organization, 1993.Google Scholar
18Cattaneo, A, Davanzo, R, Ronfani, L. Are data on the prevalence and duration of breastfeeding reliable? The case of Italy. Acta Paediatrica 2000 89(1): 88–93.CrossRefGoogle ScholarPubMed
19Nicoll, ATB, Newell, ML, Rundall, P. Breastfeeding policy, promotion and practice in Europe. Results of a survey with non-governmental organizations. Journal of Nutrition and Environmental Medicine 2002; 12 255–64.CrossRefGoogle Scholar
20 ESPGAN. Committee on Nutrition: Guidelines on infant nutrition. III. Recommendations for infant feeding. Acta Paediatrica 1982; (Suppl. 302): 1–27.Google Scholar
21 American Academy of Pediatricians. Work Group on Breastfeeding: Breastfeeding and the use of human milk. Pedatrics 1997; 100: 1035–9.CrossRefGoogle Scholar
22 Neonatologia SId. Raccomandazioni sull'alattamento materno per i nati a termine, di peso appropriato, sani. Medico e Bambino 2002; 21: 91–8.Google Scholar
23 Agence Nationale d'Accreditation et d'Évaluation en Santé (ANAES). Allaitement maternel: mise en oeuvre et poursuite dans les six premiers mois de vie de l'enfant. Paris: ANAES, 2002.Google Scholar
24Kramer, MS, Chalmers, B, Hodnett, ED, Sevkovskaya, Z, Dzikovich, I, Shapiro, S, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. Journal of the American Medical Association 2001; 285(4): 413–20.CrossRefGoogle ScholarPubMed
25Cattaneo, A, Buzzetti, R. Effect on rates of breast feeding of training for the baby friendly hospital initiative. British Medical Journal 2001; 323(7325): 1358–62.CrossRefGoogle ScholarPubMed
26Fairbank, L, O'Meara, S, Renfrew, MJ, Woolridge, M, Sowden, AJ, Lister-Sharp, D. A systematic review to evaluate the effectiveness of interventions to promote the initiation of breastfeeding. Health Technology Assessment 2000; 4(25) 1–171.CrossRefGoogle ScholarPubMed
27McInnes, RJ, Love, JG, Stone, DH. Evaluation of a community-based intervention to increase breastfeeding prevalence. Journal of Public Health Medicine 2000; 22(2): 138–45.CrossRefGoogle ScholarPubMed
28Dennis, CL, Hodnett, E, Gallop, R, Chalmers, B. The effect of peer support on breast-feeding duration among primiparous women: a randomized controlled trial. Canadian Medical Association Journal 2002; 166(1): 21–8.Google ScholarPubMed
29Waterston, T, Tumwine, J. Monitoring the marketing of infant formula feeds. British Medical Journal 2003; 326(7381): 113–4.CrossRefGoogle ScholarPubMed
30Galtry, J. The impact on breastfeeding of labour market policy and practice in Ireland, Sweden, and the USA. Social Science & Medicine 2003; 57(1): 167–77.CrossRefGoogle ScholarPubMed