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INNOCENTI
DECLARATION
On the Protection, Promotion
and Support of Breastfeeding.
RECOGNISING
THAT:
Breastfeeding
is a unique process that:
Provides
ideal nutrition for infants and contributes to their healthy growth and
development Reduces incidence and severity of infectious diseases, thereby
lowering infant morbidity and mortality Contributes to women's health
by reducing the risk of breast and ovarian cancer, and by increasing the
spacing between pregnancies Provides social and economic benefits to the
family and the nation Provides most women with a sense of satisfaction
when successfully carried out
and
that Recent Research has found that:
these benefits
increase with increased exclusiveness of breastfeeding during the first
six months of life, and thereafter with increased duration of breastfeeding
with complementary foods, and programme intervention can result in positive
changes in breastfeeding behaviour
WE THEREFORE
DECLARE THAT:
- As a global goal
for optimal maternal and child health and nutrition, all women should
be enabled to practise exclusive breastfeeding and all infants should
be fed exclusively on breastmilk from birth to 4-6 months of age.
Thereafter, children should continue to be breastfed, while receiving
appropriate and adequate complementary foods, for up to two years
of age or beyond. This child-feeding ideal is to be achieved by creating
an appropriate environment of awareness and support so that women
can breastfeed in this manner.
- Attainment of this
goal requires, in many countries, the reinforcement of a "breastfeeding
culture" and its vigorous defence against incursions of a "bottle-feeding
culture". This requires commitment and advocacy for social mobilization,
utilizing to the full the prestige and authority of acknowledged leaders
of society in all walks of life.
- Efforts should be
made to increase women's confidence in their ability to breastfeed.
Such empowerment involves the removal of constraints and influences
that manipulate perceptions and behaviour towards breastfeeding, often
by subtle and indirect means. This requires sensitivity, continued
vigilance, and a responsive and comprehensive communications strategy
involving all media and addressed to all levels of society. Furthermore,
obstacles to breastfeeding within the health system, the workplace
and the community must be eliminated.
- Measures should
be taken to ensure that women are adequately nourished for their optimal
health and that of their families. Furthermore, ensuring that all
women also have access to family planning information and services
allows them to sustain breastfeeding and avoid shortened birth intervals
that may compromise their health and nutritional status, and that
of their children.
- All governments
should develop national breastfeeding policies and set appropriate
national targets for the 1990s. They should establish a national system
for monitoring the attainment of their targets, and they should develop
indicators such as the prevalence of exclusively breastfed infants
at discharge from maternity services, and the prevalence of exclusively
breastfed infants at four months of age.
- National authorities
are further urged to integrate their breastfeeding policies into their
overall health and development policies. In so doing they should reinforce
all actions that protect, promote and support breastfeeding within
complementary programmes such as prenatal and perinatal care, nutrition,
family planning services, and prevention and treatment of common maternal
and childhood diseases. All healthcare staff should be trained in
the skills necessary to implement these breastfeeding policies.
OPERATIONAL TARGETS
All governments
by the year 1995 should have:
- Appointed a national
breastfeeding coordinator of appropriate authority, and established
a multisectoral national breastfeeding committee composed of representatives
from relevant government departments, non-governmental organizations,
and health professional associations
- Ensured that every
facility providing maternity services fully practises all ten of the
Ten Steps to Successful Breastfeeding set out in the joint WHO/UNICEF
statement "Protecting, promoting and supporting breastfeeding: the
special role of maternity services".
- Taken action to
give effect to the principles and aim of all Articles of the International
Code of Marketing of Breast-Milk Substitutes and subsequent relevant
World Health Assembly resolutions in their entirety; and
- enacted imaginative
legislation protecting the breastfeeding rights of working women and
established means for its enforcement
WE ALSO CALL UPON INTERNATIONAL
ORGANIZATIONS TO:
- Draw up action strategies
for protecting, promoting and supporting breastfeeding, including
global monitoring and evaluation of their strategies
- Support national
situation analyses and surveys and the development of national goals
and targets for action; and
- Encourage and support
national authorities in planning, implementing, monitoring and evaluating
their breastfeeding policies
The Innocenti Declaration
was produced and adopted by participants at the WHO/UNICEF policymakers'
meeting on "Breastfeeding in the 1990s: A Global Initiative, co-sponsored
by the United States Agency for International Development (A.I.D.) and
the Swedish International Development Authority (SIDA), held at the Spedale
degli Innocenti, Florence, Italy, on 30 July - 1 August 1990. The Declaration
reflects the content of the original background document for the meeting
and the views expressed in group and plenary sessions.
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