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Breastfeeding as a proven life-saver

© UNICEF/2009/Salman
Midwife Budi uses props to explain the proper way of breastfeeding.

JAKARTA, 25 January, 2010 - Bidan (midwife) Budi is one of the first people to greet visitors at the Klaten District Health Office, in Indonesia’s Central Java province. Her bright smile conveys her enthusiasm for everything she’s prepared to show off, and as a tireless advocate of breastfeeding promotion in her community, bidan Budi is known and respected by everyone – from the mothers in the community whose babies she delivers to the head of the District Health Office.

It is not only the Health Office of which she is so proud. There is a breastfeeding counselling centre that she helped to fund and establish at her local village health post, well stocked with breast-models and baby dolls, posters and brochures, videos and a television set. Then there is the monitoring system that she has created to track, via monthly meetings for lactating mothers, the feeding status of all babies less than six months of age.

Amongst those mothers is Esti, who had to return to work two months after delivery but continues to exclusively breastfeed her four month-old daughter. Esti manually expresses breast milk every day at work. She keeps it on ice, and gives it to her husband who comes to her place of work on his lunch break every day, and collects and delivers the breast milk home to their baby daughter.

The message of exclusive breastfeeding resonates through the stance of Budi’s colleagues - one of whom declined an offer from an infant formula company for an all-expense paid trip to Thailand. Budi also lobbies with hospitals to end ties with infant formula producers – for example by working with the senior management of the largest Islamic hospital in the district to advocate with smaller Islamic hospitals to break their contracts with the producers – in the Holy Quran, its verses call upon mothers to continue breastfeeding until the child is two years of age.

No matter whom the audience may be, Budi’s message is clear – breastfeeding is best.

© UNICEF/2009/Salman
Mothers gather at a health post to learn about the importance of breastfeeding.

Bidan Budi’s passion for promoting breastfeeding emerged from challenging circumstances – just two months after a massive earthquake wreaked destruction across the area in May 2006. It was then that she undertook a UNICEF-supported training programme, with a follow-up course a year later as part of UNICEF’s emergency response to the earthquake.

Another highly committed leader of Klaten’s Infant and Young Child Feeding programme is Dr. Rony, now the head of the District Health Office. At the time of the earthquake, he was responsible for maternal and child health programmes and admits that he found it strange that UNICEF and others were so focused on breastfeeding in the days and weeks following the disaster.

However, several weeks after the quake, as Rony visited affected communities and talked to mothers, he observed that all of the malnourished children he met were those who were not being exclusively breastfed. He realized that breastfeeding is not just “something that mothers do naturally anyway”, but that it was an essential practice that could easily be undermined in an emergency.

Witnessing the potential life and death differences that the practice could make, he subsequently set about transforming the way the health system promotes breastfeeding – through advocacy, intensive capacity building, innovative communications, and strengthening of health systems.

At the highest level of leadership in the district, the Bupati of Klaten is also a strong champion of breastfeeding. It was reported that one infant formula producer complained to the Bupati that their sales were dropping in the district, and warned that there would be less tax revenue from infant formula sales if the success of the Infant and Young Child Feeding programme continued.

“That’s no problem,” the Bupati reportedly replied. “The important thing is the health of our children.”

These three leaders, and many others like them, truly demonstrate the meaning of “commitment at all levels” – an important element of Klaten’s success in promoting exclusive breastfeeding. And it is a measurable success – between 2006 and 2008 the rate of exclusive breastfeeding amongst infants less than six months of age doubled, to over 43 per cent.

An independent survey in 2008 found that more than half of infants were immediately breastfed within an hour of birth, underlining how breastfeeding and its benefits were becoming firmly established in the community.



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