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  1. 1
    055466

    National improvements: reasons and prospects in Sweden.

    Hofvander Y

    In: Programmes to promote breastfeeding, edited by Derrick B. Jelliffe and E.F. Patrice Jelliffe. Oxford, England, Oxford University Press, 1988. 86-93.

    The Nursing Mothers' Association was formed in Sweden in the early 1970s, and the group worked to gain access to mass media to influence attitudes through articles and interviews in which they demanded support and encouragement for breastfeeding. A large number of research reports also emerged in the 1970s, demonstrating the benefits and superiority of breastfeeding and breast milk. Further, the active support from international organizations such as WHO and UNICEF was of considerable value as was the controversy leading to the formulation of the Code of Marketing of Breast-milk Substitutes, which helped to focus the interest of the mass media on the issue. Sweden's Board of Health and Welfare appointed an expert group to propose a plan of action, and the group edited a comprehensive textbook on breastfeeding and breast milk to be used as a national guide. The Nursing Mothers' Association developed to a national organization with representatives visiting maternity units and offering to provide advice by telephone after the mother's discharge. 10 years after the rediscovery of breastfeeding there are several hundred thousand mothers with considerable breastfeeding experience. On a limited scale, Sweden has returned to earlier days when young women learned from older and more knowledgeable women. A wealth of personal experience has been gathered and is being conveyed to others in an informal person-to-person manner. Sweden's baby-food industry has adjusted well to the new situation and has accepted a considerable reduction in sales of breast milk substitutes and has complied with the Code. The dramatic increase in breastfeeding in almost all industrialized nations, including Sweden, suggests a strong movement and that breastfeeding is here to stay.
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  2. 2
    044175
    Peer Reviewed

    Infant feeding in the Third World.

    Ebrahim GJ

    POSTGRADUATE MEDICAL JOURNAL. 1986; 62(724):93-6.

    Breastfeeding has been on the decline in the 3rd world for the past 20 years or so. Modernization has been blamed, yet in the industrialized nations of Sweden, Britain, and the US, women play significant roles in the labor force, are active in professional and public life, and in most Western nations the educated women and those from the professional and upper classes are most likely to breastfeed their babies. Regarding milk substitutes, many products unacceptable in the Western market are on sale in developing nations. In the absence of strong governmental controls, consumer pressure, and professional vigilance, bottle feeding is taken lightly with disasterous consequences. 3 main dangers have been identified: those arising from the nonavailability of protective substances of breast milk to the infant; those arising from the contamination of the feed in a highly polluted environment of poverty and ignorance of simple principles of hygiene; and those arising from overdilution of feeds on the account of the costs of the baby foods. Market forces and competition led the manufacturers of baby foods to stake their claims to the markets of the 3rd world, and almost all of them adopted undesirable promotional methods. The ensuing uproar led to an International Code of Ethics being adopted at the 33rd world Health Assembly under the auspices of the World Health Organization. Although the matter should have rested there, some manufacturers developed their own codes and have persuaded governments to adopt alternative codes. The present situation with regard to infant feeding in the 33rd world should be considered in the context of the international developments identified and also in light of several social and demographic processes. At the current rates of growth in population up to 80% of humanity will be living in the 3rd world by the end of the 20th century. The 2nd demographic phenomenon of social and political significance is the unprecedented increase in the growth of the urban population with national health and social services failing to respond adequately to the challenge of this growth. In many developing countries national planners and economists are beginning to look upon human milk as an important national resource, and the need for a network of services to ensure the nutrition and health of pregnant and lactating women is obvious and is recognized internationally. With regard to the question of adequacy of breast milk, there are many gaps in knowledge. Each community needs to be studied separately, and those involved in scientific research in 1 environment should resist the temptation of extrapolating the results to communities and societies with a different set of circumstances.
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  3. 3
    038831
    Peer Reviewed

    Excerpts from the WHO Code for the Marketing of Breast-Milk Substitutes.

    World Health Organization [WHO]

    BIRTH. 1985 Winter; 12(4):243-4.

    This article sets forth excerpts from the World Health Organization (WHO) Code for the Marketing of Breastmilk Substitutes. The purpose of these guidelines is to ensure that infant formula is not marketed or distributed in ways that interfere with the protection and promotion of breastfeeding. It is specified that informational and educational materials dealing with infant feeding practices should include clear material on the following points: 1) the benefits and superiority of breastfeeding, 2) maternal nutrition in preparation for breastfeeding, 3) the negative effect on breastfeeding of the introduction of partial bottlefeeding, 4) the difficulty of reversing the decision not to breastfeed, and 5) the proper use of infant formula. Materials on infant formula should include the social and financial implications of its use, the health hazards of inappropriate foods, and the health hazards of unnecessary or improper use of infant formula. Donations of educational equipment or materials by manufacturers or distributors of infant formula should be made only at the request of the appropriate government authority and should be distributed only through the health care system. There should be no advertising or other promotion to the general public of infant formula products. Manufacturers should not provide samples of products to pregnant women or mothers, and there should be no point-of-sale advertising or giving of samples or gifts. No health care facility may be used for the purpose of promoting infant formula, and health care workers are expected to encourage and protect breastfeeding. Information provided to health professionals by manufacturers and distributors of infant formula should be restricted to scientific and factual matters and should not imply that bottlefeeding is equivalent or superior to breastfeeding.
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  4. 4
    026560

    When breasts are bad for business [letter]

    Chetley A

    BMJ. British Medical Journal. 1984 Sep 15; 289(6446):695.

    John Dobbing's review of the British television program, "When Breasts are Bad for Business," contained a number of inaccurate statements. The World Health Organization's international code for the marketing of breast milk substitutes was not developed by a group of emotional activists; it was carefully developed in consultation with governments, international agencies, and experts in science, medicine, and marketing, and subsequently, ratified by 118 governments. According to the reviewer, the industry is abiding by the code; in reality, only 1 company has agreed to abide by the code, 5 or 6 companies are considering some of the code's provisions, and the approximately 80 remaining companies have given no indication concerning their willingness to adopt the code. Contrary to the reviewer's interpretation, the code does not recommend the promotion of infant formulas by any health facility, including hospitals. Furthermore, the effort to reform the marketing of infant formulas is not a veiled attempt to abolish all processed baby foods. The purpose of the code is to ensure that infant formulas are used only when necessary and not for routine feeding. The benefits of breast feeding are clearly recognized by health professionals. The reviewer's contention that the infant formula industry has been an active supporter of research which has promoted breast feeding must be refuted. Recommendations stemming from research on breast feeding have not been implemented. Neither the medical profession nor the industry has made an effort to disseminate information on the value of breast feeding nor on the methods available for promoting breast feeding.
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