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In: Proceedings of the Interagency Workshop on Health Care Practices Related to Breastfeeding, December 7-9, 1988, Leavey Conference Center, Georgetown University, Washington, D.C., edited by Miriam Labbok and Margaret McDonald with Mark Belsey, Peter Greaves, Ted Greiner, Margaret Kyenkya-Isabirye, Chloe O'Gara, James Shelton. [Washington, D.C., Georgetown University Medical Center, Institute for International Studies in Natural Family Planning, 1988].  p.. (USAID Contract No. DPE-3040-A-00-5064-00)In 1986 the European Regional World Health Organization (WHO) Office convened a meeting of health workers' organizations to develop a strategy for implementing breastfeeding promotion. The elements in this strategy are outlined along with the reasons why some countries have seen increases in breastfeeding and a discussion of the possible ways international organizations can help. The "International Code of Marketing of Breast-Milk Substitutes" constitutes the clearest mandate for an "action program" in the field of breastfeeding. It provides a framework for action and for the formulation of a breastfeeding promotion strategy. Further, the "Code" identifies the obligations of both governments and health workers. According to the Resolution recommending the "Code," one of the obligations of governments is to report regularly to WHO on the progress in 5 areas of infant nutrition: encouragement and support of breastfeeding; promotion and support of appropriate weaning practices; strengthening of education, training, and information; promotion of health and social status of women in relation to infant and young child feeding; and appropriate marketing and distribution of breast milk substitutes. The WHO member states in the European Region have taken their reporting obligation seriously; 71 reports from 29 of the 32 members states have been received. The picture that emerges is one of large diversity with regard to breastfeeding both among and within countries. The European Strategy outlines 7 priority areas for action: the basic attitude of health workers; maternity ward routines; the formation of breastfeeding mothers' support groups; ways to support employed mothers who want to breastfeed; research in breastfeeding; commercial pressure on health workers; and the need for advocacy of breastfeeding. The promotion of breastfeeding is the cumulative effect of activities from several different disciplines that becomes evident in the statistics as an increase in breastfeeding. Factors that contribute to an increase in breastfeeding, based on the Scandinavian experience, are outlined. In regard to establishing a breastfeeding policy, the various activities that can encourage and support breastfeeding fall into 3 categories: making breast milk available to the baby by influencing the material conditions of breastfeeding; increasing knowledge either about human milk or about lactation management as well as about changing attitudes and behavior; and assuring the quality of the milk itself. Ideally, an organization with an advisory and to some degree an executive, decision-making function coordinates these activities.
PLANNED PARENTHOOD IN EUROPE: REGIONAL INFORMATION BULLETIN. 1986 Autumn; 15(2):3-13.This paper, prepared for European planned parenthood associations, reviews the range of political and ethical reactions to new reproductive technologies. Planned parenthood federations are committed to ensure that women and human living material are protected both from unethical scientific manipulation and exploitation for profit and that candidates for infertility treatment are given appropriate counseling. Within these limits, research into the causes and treatment of infertility has been encouraged. On the other hand, so-called pro-life forces challenge research in this area on the grounds that the sanctity of human life may be violated. A more recent development has been the emergence of feminist opposition to reproductive research on the grounds that it threatens to lead to the expropriation of women as childbearers. The potential removal of reproduction from people is viewed as a further devaluation of women's status and concern is voiced that pre-embryo screening may take the form of benign eugenics. Feminists further argue that in vitro fertilization services are disproportionately available to white, middle-class women. Finally, it is feared that the incorporation of sex preselection into the population programs of Third World countries will become possible as a logical extension of current importation to developing countries of chemical contraceptives (eg Depo-Provera) regarded as unsuitable for use in the US. In the face of such arguments, both from pro-life and feminist forces, planned parenthood federations are urged to be clear about potential uses and abuses of the new reproductive technologies.