|
Bangladesh was the focal point in 1995 in a UNICEF report for its success in increasing the number of Baby Friendly Hospitals (BFHs) in the country in a year. The number was significant because it helped the activists of breastfeeding promotion and protection to increase the rate of breastfeeding and cent percent use of Coloustrum.
Bangladesh Breastfeeding Foundation (BBF) has claimed that increase the of exclusive breastfeeding rate is now over 50 per cent and Coloustrum is no more rejected due to successful efforts at BFHs. BBF has claimed that the community level awareness has also increased in the areas where BFHs are situated.
Still, the BHF Initiative (BFHI) could not earn the success to kick out baby food through their efforts.
Official sources said although Bangladesh has high breastfeeding initiation and duration rates, exclusive breastfeeding is rare. With 95per cent of pregnant women delivering their infants at home, hospital-based exclusive breastfeeding promotion activities have limited effect.
The activists say due to lack of strong monitoring work, frequent transfer of trained staff and interference by the babyfood companies, the standard of the hospitals could not be maintained successfully.
BBF sources said their workers have found that multinational companies defying the ban on its campaign now motivate the hospital staffs, in cases the BFH workers and paediatricians, to advise the mothers to feed their food as substitute of breastmilk. These people cannot be caught as they prescribed it verbally or in white pads.
Hospitals are awarded the baby-friendly status when standard procedures in maternity wards are brought in line with the `10 steps to successful breastfeeding' drawn up in 1989 by WHO and UNICEF. According to BBF, 486 BFHs are now in the country.
The Baby Friendly Initiative works with health professionals to help them provide the best possible care so that all parents have the support they need to make informed choices about feeding including breastmilk and caring for their babies.
This is a high standard of care for mothers and babies and a mechanism to ask them to adopt recognised best practice standards in support of breastfeeding, said an expert adding that Baby Friendly health-care facilities are the ones which have adopted these standards and changed the way they care for pregnant women and new mothers.
In the country, the BFH initiative was launched under the Campaign for Protection and Promotion of Baby Friendly Hospital, in 1989. It was however convened by Bangladesh Breastfeeding Foundation (BBF) in 1995.
Since then, BBF conducted 264 BFHI Training of Trainers and trained 3172 doctors and nurses covering 520 centre in the country. In UNICEF Progress of Nation report-1995, Bangladesh was praised as the country which increased the number of BFHs 90 per cent in a year from 1993 to 1994. The number of BFHs was 3 in 1993 which increased to 48 in 1994.
Experts say the BFHI was important to reduce the child and mother mortality rates, which are still high in the country, adding that whatever the achievement attained by the country in reducing the infant mortality rate (IMR) was however for the success of the BFHs.
The recent UNICEF report showed that the infant mortality rate (IMR) declined from 87 per 1,000 live births in 1989 to 56 per 1,000 live births in 2001. The under-five mortality rate (U5MR) also dropped from 133 to 82 per 1,000 live births over the same period.
They said artificially-fed babies are at greater risk of gastro-intestinal infection, respiratory infections, necrotising enterocolitis, urinary tract infections, ear infections, allergic disease (eczema, asthma and wheezing) etc.
But breastfed babies may have better neurological development of the baby. It also helps reducing cardiovascular disease in later life, childhood cancer. Besides, mother who breastfed their kids are at lower risk of breast cancer and ovarian cancer.
The BFHI has got worldwide success as a mechanism to improve breastfeeding rates and thus improve health status.
A Swiss study in 2003 showed that the proportion of babies exclusively breastfed for their first 5 months of life was 42per cent for those born in Baby Friendly hospitals, compared with 34per cent for infants born elsewhere. Median breastfeeding duration for infants born in Baby Friendly hospitals, compared with infants born in other hospitals, was longer if the hospital showed good compliance with the Ten Steps (35 weeks vs 29 weeks for any breastfeeding, 20 weeks vs 17 weeks for full breastfeeding, and 12 weeks vs 6 weeks for exclusive breastfeeding).
To assess the effectiveness of baby friendly hospital initiative on exclusive breastfeeding status, a study of Department of Community Medicine of Dhaka Medical College was conducted in 2002. It found that duration of exclusive breastfeeding is longer among the mothers who have been delivered in a baby-friendly hospital than those mothers who have been delivered in a non-baby friendly hospital.
The median survival time of exclusive breastfeeding was 73.85 days among mothers of baby friendly hospitals and 30 days among mothers of non-baby friendly hospitals with a difference of 43.85 days.
But the BBF executives observed from field visits that the standard of BFHI in many hospitals could also not be maintained due to frequent transfer of health officials.
Although the Health Directorate has recently issued a circular to include BFH activities as an agenda in the monthly District Health Co-ordination Meeting, there is yet not any review done on the success of the instruction.
|