Are our babies off to a healthy start? The state of implementation of the Global strategy for infant and young child feeding in Europe

Abstract

Background To protect children’s right to optimal nutrition, WHO/UNICEF developed a Global Strategy for Infant and Young Child Feeding, endorsed by all 53 WHO/EURO Member States. The World Breastfeeding Trends Initiative (WBTi) is a tool for monitoring implementation of the Global Strategy. It comprises 15 indicators, ten referring to policies and programmes, and five to feeding practices. Each is scored on a scale of 10, giving a total score of 150 for Global Strategy implementation. To date, 18 WHO/EURO Member States – Armenia, Austria, Belgium, Bosnia and Herzegovina, Croatia, France, Georgia, Germany, Italy, Lithuania, North Macedonia, Malta, Moldova, Portugal, Spain, Turkey, Ukraine and United Kingdom – have conducted a WBTi assessment and produced a report. Methods Between June 2018 and May 2019, all 18 WBTi European reports were carefully read and analysed by a group of national WBTi coordinators. Descriptive data analysis, including inter-country comparisons, was conducted using frequencies and percentages. This paper summarises the findings. The full 88-page report will be published on the WBTi website. Results Three-quarters of 18 European countries have adequate maternity protection, and two-thirds have breastfeeding initiation rates of 50% or higher. However, ‘Preparedness and planning for appropriate and safe Infant and Young Child Feeding (IYCF) in emergencies’ is seriously neglected. Breastfeeding duration is far below WHO recommendations, with an average of 8.7 months. Only three European countries have a budget allocated for implementing IYCF policies and plans, and a third currently have no Baby-friendly designated maternity facilities. Bottle feeding is prevalent, despite its inherent risks, monitoring of IYCF practices is inadequate, with most countries not routinely collecting data, and violations of the International Code of Marketing of Breast-milk Substitutes are commonplace. Conclusions European governments are not doing enough to protect, promote and support sound infant and young child feeding practices. Political commitment at the highest level and adequate funding are required to ensure optimal IYCF for Europe’s babies. This report highlights worrying gaps, thereby providing governments, international organisations and other concerned parties with an opportunity to invest in priority areas and, by doing so, hopefully create a better future for our babies.

Breastfeeding Practices and Determinant Factors of Exclusive Breastfeeding among Mothers of Children Aged 0–23 Months in Northwestern Romania

“…The World Health Organization (WHO) recommends the practice of exclusive breastfeeding (EBF) for the first 6 months of life, followed by the gradual introduction of adequate solid foods and continuation of breastfeeding for up to 2 years of age or beyond [11]. Nevertheless, within the WHO European Region, breastfeeding practices do not meet the above-mentioned WHO recommendations [12]. Moreover, EBF practice in Europe does not reach the 2025 World Health Assembly's Global Target for Nutrition that aims to increase the rate of EBF in the first six months up to at least 50% [13].…”

Problem-based learning for in-service training on breastfeeding in Friuli Venezia Giulia, Italy

“…Whether this improvement is due to upgrading on health professionals’ training related to the implementation of the PBL project or to some other factors, and whether it is greater, if really associated with PBL courses, than the one reported after courses developed for the BFHI, is a matter for further research. The BFHI courses are effective in increasing breastfeeding rates [ 29 ], but in Europe only a handful of countries have a significant number of designated BFHI hospitals and breastfeeding rates fall short of what is recommended [ 30 ].…”

Childhood overweight and obesity abatement policies in Europe

“…47 The World Breastfeeding Trends Initiative in 2018 found that Croatia had the highest exclusive breastfeeding rate for the first 6 months (65%) among European countries and scored highly in several indicators, such as the adequacy of funding of national policy and the number of maternity wards that support the timely initiation and establishment of breastfeeding. 48 Other laws stipulate appropriate foods for infants and young children, including processed cereal-based foods for infants. 47 In Austria, "Healthy eating from the start!"…”