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  1. 1

    The World Health Organization Code and exclusive breastfeeding in China, India, and Vietnam.

    Robinson H; Buccini G; Curry L; Perez-Escamilla R

    Maternal and Child Health. 2018 Sep 8; [11] p.

    Promoting exclusive breastfeeding (EBF) is a highly feasible and cost-effective means of improving child health. Regulating the marketing of breastmilk substitutes is critical to protecting EBF. In 1981, the World Health Assembly adopted the World Health Organization International Code of Marketing of Breastmilk Substitutes (the Code), prohibiting the unethical advertising and promotion of breastmilk substitutes. This comparative study aimed to (a) explore the relationships among Code enforcement and legislation, infant formula sales, and EBF in India, Vietnam, and China; (b) identify best practices for Code operationalization; and (c) identify pathways by which Code implementation may influence EBF. We conducted secondary descriptive analysis of available national-level data and seven high level key informant interviews. Findings indicate that the implementation of the Code is a necessary but insufficient step alone to improve breastfeeding outcomes. Other enabling factors, such as adequate maternity leave, training on breastfeeding for health professionals, health systems strengthening through the Baby Friendly Hospital Initiative, and breastfeeding counselling for mothers, are needed. Several infant formula industry strategies with strong conflict of interest were identified as harmful to EBF. Transitioning breastfeeding programmes from donor-led to government-owned is essential for long-term sustainability of Code implementation and enforcement. We conclude that the relationships among the Code, infant formula sales, and EBF in India, Vietnam, and China are dependent on countries' engagement with implementation strategies and the presence of other enabling factors.
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  2. 2

    [Consensus declaration on the World Health Organization [WHO] / UNICEF consultation on HIV transmission and breast feeding] Declaration de consensus a l'issue de la consultation OMS / UNICEF sur la transmission du VIH et l'allaitement au sein.


    In 1992, WHO and UNICEF held a Conference on HIV Transmission and Breast Feeding to review available information on the risk of HIV transmission via breast milk and to formulate recommendations on breast feeding. In all populations, regardless of the HIV infection rate, one must continue to defend, promote, and protect breast feeding. Where infection and malnutrition are the main causes of death among newborns, the risk of death linked to these infections is especially high among newborns who are not breast fed. Under conditions where the infant is less likely to contract HIV infection by breast milk than die of other causes, it is best to breast feed. If women under these conditions have access to other infant feeding methods, it is necessary to offer them the option of an HIV test while respecting confidentiality. When infectious diseases are not the main causes of death, HIV infected pregnant woman should be advised to use breast milk substitutes. Pregnant women of unknown HIV status should be advised to undergo an HIV test before delivery. Pressure from manufacturers should not influence HIV infected mothers in their choice of artificial feeding, as stated in the International Code on the Commercialization of Breast Milk Substitutes. HIV-related counseling should aim to help HIV infected adults address infant feeding methods, the risk of HIV transmission to children if the woman becomes pregnant, and the risk of HIV transmission at the time of sexual relations and via blood. All HIV positive adults who wish to avoid pregnancy should use family planning services and information. In all countries, the first priority to prevent vertical HIV transmission is prevention of HIV infection in women of reproductive age. Women must be taught how to protect themselves from HIV infection. Society must grant them the means to easily procure condoms and assure prevention and treatment of sexually transmitted diseases.
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