Say Yes, Spring 2004: … Baby–friendly
The UNICEF and Turkuaz programme to promote exclusive breastfeeding during the first six months has been backed by an intensive media campaign.
Photograph by Rana Mullan © UNICEF Turkey 2004
The current drive to promote exclusive breastfeeding involved an extensive schedule of training seminars, briefings and one-to-one networking between health officials, academics, non-governmental organisations and local authorities in order to get the project off the ground in the pilot provinces of Diyarbakır and İstanbul during 2004. Over 240,000 babies are born in these two provinces every year -- one sixth of Turkey’s annual births.
Baby-friendly hospitals
The first step was to address the issue of making hospitals ‘Baby-friendly’ -- giving every baby the best start in life through the creation of a healthcare environment where breastfeeding is the norm, helping to reduce levels of infant morbidity and mortality. The second step was to empower mothers with the knowledge, guidance and support necessary to ensure that they can provide their babies with the best possible start in life by exclusively breastfeeding them during the first six months.
A provincial plan of action was introduced for both of the pilot provinces. For İstanbul, this would mean that seventy health centres and six hospitals would achieve baby-friendly status. Since Diyarbakır had no baby-friendly hospitals at the time, the primary objective was to manage the certification of four hospitals and the province as a whole as being baby-friendly.
In order to determine breastfeeding practices of mothers, a baseline survey in rural and urban areas of Diyarbakır established that:
- Only 1.2% of babies are exclusively breastfed during the first six months; 45% are given water as well; 55% are given water and additional food and 2% are not breastfed at all;
- 50% of new mothers are informed about breastfeeding practices by neighbours, relatives and elders; 18% are informed by health personnel and 20% receive no information at all.
The main reasons given for failure to initiate breastfeeding immediately after birth were:
- The misconception that colostrum, or
dirty milk
, should not be fed to a baby; - That the mother should wait for three ezan (prayers) to be said -- this can mean a delay of up to twelve hours;
- That the baby should first be given sweetened water while awaiting ezan.
The main reasons given for stopping were:
- Pregnancy;
- Anxiety during a mother’s illness that her breastmilk is harmful to the baby;
- The mother has not enough breastmilk.
Staff in hospitals and health centres throughout Diyarbakır and İstanbul were trained in baby-friendly practices. Trained staff subsequently acted as trainers for their colleagues and as a result of this cascading effect, staff in three Diyarbakır hospitals and eight health centres are fully versed in baby-friendly counselling. In İstanbul, 162 health staff have been trained and there are 34 baby-friendly health centres.
The Mothers Support System
Provincial Health Directorates act as coordinators for Mothers Support Groups offering support in exclusive breastfeeding to new and expectant mothers through:
- primary health care centres;
- involvement of community leaders in training and establishment of locally-based Mothers Support Groups.
Since Mother Support Groups are best-suited to the baby-friendly environment, Diyarbakır presented an interesting challenge since it was undergoing the transition to baby-friendly status and the two projects had to run simultaneously. İstanbul, however, has had baby-friendly hospitals for some years so much of the groundwork for Mothers Support Groups was already laid.
The situation
Control groups of 50 and 100 mothers in Diyarbakır and İstanbul respectively will be surveyed by Dicle University in order to determine rates of exclusive breastfeeding for mothers giving birth in target hospitals.
The campaign will be gradually expanded to cover other provinces until all maternity hospitals in Turkey are baby-friendly.
Visit the Programmes section for more information about Exclusive Breastfeeding during the First Six Months.
Read The Facts about Exclusive Breastfeeding.
Turkuaz, the Coca-Cola company’s water brand in Turkey also promotes the campaign on it’s commercial website.
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SAY YES, SPRING 2004
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