Nutrition

Infant and Young Child Feeding – UNICEF response

Goal
In accordance with the Global Strategy on Infant and Young Child Feeding (WHO-UNICEF 2003), the overall goal of UNICEF’s infant and young child feeding programming is to protect, promote and support optimal infant and young child feeding, in order to improve nutrition status, growth and development, health and thus the survival of infants and young children.

Action
It is estimated that reaching all infants with a package of interventions to protect, promote and support optimal infant and young child feeding practices  - breastfeeding and complementary feeding -  can contribute to preventing 1.4 million and 600,000  child deaths respectively, or just over a fifth of the total annual child deaths. The good news is that breastfeeding rates are no longer declining on a global level and have increased during the last decade in many countries, thanks to concerted programming efforts. Recent data highlights that there has been substantial and encouraging progress over the last 10 years in over a dozen countries, where exclusive breastfeeding rates increased by 20 percentage points or more (UNICEF database, 2007). Many of these countries are in sub-Saharan Africa. These successes show that progress is possible, even in challenging situations. Positive outcomes are achieved when countries implement, at scale, a comprehensive approach to improving infant feeding practices. This could include efforts at the level of policy and legislation, health system strengthening and capacity building, community-level action and behaviour change communication initiatives.

UNICEF's strategy and actions in support of infant and young child feeding, through its Medium Term Strategic Plan, underline the importance of multi-sectoral approach to improve health and nutrition. The strategy is based upon the Convention on the Rights of the Child - Article 24 - which states that governments must ensure that all sectors of society are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, including the advantages of breastfeeding. Further policy basis for the strategy includes the 1990 and 2005 Innocenti Declarations on breastfeeding and infant and young child feeding respectively and the 2003 Global Strategy for Infant and Young Child Feeding. In addition, optimal infant and young child feeding supports all of the Millennium Development Goals and directly responds to the World Fit for Children goals (Paragraph 37.5).

UNICEF efforts will recognize children’s and families’ rights and responsibilities and include suggested proven activities for advocacy and support of government and non-governmental actions at three levels: national, health system and community. As per the strategies outlined in the Global Strategy for Infant and Young Child Feeding, UNICEF’s main areas of support include:

1. Support multi-sectoral national commitment and partnership by encouraging the development and implementation of: 

• National level coordination structures 
• Strategic public and private partnerships with other international and country-level actors in improving infant and young child nutrition 
• National infant and young child feeding policies, standards, strategy frameworks, guidelines and training tools
• Programme plans to operationalize the strategy at scale 
• Advocacy materials addressing policy and legislation, new and ongoing, to all relevant groups, such as health workers, political leadership, stakeholders and partners. 
• Legislation and enforcement of the International Code of Marketing of Breastmilk Substitutes, subsequent relevant WHA Resolutions, the ILO Maternity Protection Convention and  new legislation or other suitable measures for maternity protection and baby friendly workplaces as requiredMonitoring and evaluation

2. Enhance implementation of health services and training reform (baby-friendly health care):

• Support for full implementation of the Baby-Friendly Hospital Initiative in all maternity services
• Advocacy and technical assistance in the development of standards for baby friendly health care
• Support for inclusion of IYCF monitoring and evaluation into the National Health Information Systems. 
• Review of all health system contacts to ensure that each contact includes age-appropriate feeding counseling and support for mother and child. 
• Technical assistance for revision of pre-service and in-service training curricula to include appropriate breastfeeding and complementary feeding counseling and support skills, and appropriate job aids to support improved healthcare practices at all levels.
• Support for building-service training of health workers.
• Integration of maternal nutrition interventions, including micronutrient supplementation, nutrition assessment, nutrition rehabilitation and counseling integrated within antenatal care and healthy child consultations and other contacts with pregnant and lactating mothers.

3.  Provide support for community level programming:

• Support for IYCF actions within community based health and nutrition care through lay counselors, community health workers and other community cadres
• Emphasis on community social support for the mother (e.g. mother to mother support groups) and the ability to refer for medical support when needed, and on family and societal support for an optimal infant and young child feeding norm. 

4.   Support communication for social and behaviour change and advocacy:

• Support for national communication and social mobilization activities using multiple channels and aimed at behavior and social change related to optimal infant feeding practices.

5. Address IYCF in exceptionally difficult circumstances:

• Provision of guidance and operational support on feeding infants and young children in exceptionally difficult circumstances and on the related support required by mothers, families, and other caregivers, in unstable situations such as in families/communities living with HIV/AIDS or in emergencies.