Au­thor­i­ties act to sup­port breast­feed­ing moth­ers

An in­creas­ing num­ber of new moms are re­viv­ing the tra­di­tional ap­proach to neona­tal nu­tri­tion, but they need more help from pro­fes­sion­als, as Yang Wanli re­ports.

China Daily (Latin America Weekly) - - China - Con­tact the writer at yang­wanli@chi­nadaily.com.cn

ing enough milk so she looked for a so­lu­tion on the in­ter­net.

“I was as­ton­ished to dis­cover that lots of Chi­nese moth­ers were hav­ing prob­lems breast­feed­ing, but there were few sources of re­li­able in­for­ma­tion avail­able,” she re­called.

In response, she be­gan col­lect­ing clin­i­cal re­search pa­pers and stud­ies, and shar­ing them via in­ter­net plat­forms. More women joined her ac­tiv­i­ties, and in 2009 the Home­base was founded by tens of thou­sands of women from more than 100 cities across China. Nearly 10 years later, its web­site and ac­counts on Sina Weibo and WeChat have more than 1 mil­lion mem­bers.

Qual­i­fi­ca­tions

Un­like coun­tries such as the United States and Aus­tralia, where pe­di­a­tri­cians, nurses and peo­ple with re­lated back­grounds can gain cer­tifi­cates from the In­ter­na­tional Board of Cer­ti­fied Lac­ta­tion Con­sul­tants, China has no equiv­a­lent pro­fes­sional qual­i­fi­ca­tion. In­stead, li­censes are is­sued by pri­vate train­ing in­sti­tu­tions, and many prac­ti­tion­ers be­gin pro­vid­ing ser­vices af­ter just one or two weeks’ train­ing.

Sta­tis­tics based on thou­sands of ques­tion­naires col­lected na­tion­wide every five years as part of the Na­tional Health Sur­vey show that the pro­por­tion of chil­dren age 6 months or younger who were breast­fed ex­clu­sively was 58.5 per­cent in 2013, a sig­nif­i­cant in­crease from 27.6 per­cent in 2008.

How­ever, ac­cord­ing to Zhang Yue, di­rec­tor of the Chil­dren’s Health­care De­part­ment at the Chi­nese Cen­ter for Dis­ease Con­trol and Pre­ven­tion, dis­crep­an­cies in re­search meth­ods mean it is dif­fi­cult to es­tab­lish if China has al­ready reached the World Health Or­ga­ni­za­tion’s tar­get of rais­ing the rate of ex­clu­sive breast­feed­ing in the first six months of life to at least 50 per­cent by 2025.

The picture is un­doubt­edly bet­ter than a few decades ago. Re­search shows that in 1990 the ex­clu­sive breast­feed­ing rate for chil­dren age 4 months or younger in Bei­jing fell to 13.6 per­cent as a re­sult of many fac­tors, es­pe­cially the rising use of baby for­mula, she said.

To ad­dress the prob­lem, the WHO and UNICEF launched the Babyfriendly Hos­pi­tal Ini­tia­tive in 1991, and China’s more than 7,000 hospi­tals took part un­til 2002.

More re­cently, to fos­ter wider adop­tion of breast­feed­ing, the 2015 Ad­ver­tis­ing Law of the Peo­ple’s Re­pub­lic of China em­pha­sizes care­ful mon­i­tor­ing of the pro­mo­tion of baby for­mula and pun­ish­ments for false claims.

In ad­di­tion, the na­tional health au­thor­i­ties pro­vide an­nual train­ing about breast­feed­ing to med­i­cal pro­fes­sion­als na­tion­wide, and all hospi­tals al­lied to the Baby-friendly Hos­pi­tal Ini­tia­tive are re­quired to of­fer con­sul­ta­tions via hot­lines.

“De­spite this, med­i­cal pro­fes­sion­als are work­ing un­der great pres­sure be­cause of a short­age of re­sources. Many have very lim­ited time to pro­vide con­sul­ta­tions, let alone a per­son­al­ized ser­vice,” Zhang said. “Both the public and the gov­ern­ment need to make the ef­fort to build a pro­fes­sional train­ing sys­tem for peo­ple-ori­ented ser­vices to sup­port breast­feed­ing.”

Ed­u­ca­tion short­fall

Liang Qi, a breast sur­geon at Chengdu Women’s and Chil­dren’s Cen­tral Hos­pi­tal in Sichuan prov­ince, said med­i­cal schools do not of­fer lec­tures about the treat­ment of post­na­tal prob­lems such as se­verely swollen breasts or mal­func­tion of the mam­mary glands, and breast surgery spe­cial­ists have con­ducted lit­tle re­lated re­search.

“Those doc­tors fo­cus on ill­nesses such as breast cancer and se­vere in­flam­ma­tion. We have a se­vere short­age of per­son­nel to help moth­ers han­dle ba­sic breast­feed­ing prob­lems to pre­vent them turn­ing into a se­ri­ous ill­ness,” he said.

The out­pa­tient de­part­ment of the hos­pi­tal’s breast surgery clinic sees about 30,000 pa­tients an­nu­ally, and about 40 per­cent have in­flam­ma­tions as a re­sult of in­ap­pro­pri­ate treat­ment dur­ing breast­feed­ing.

“Many use a wooden comb to scrape oil over their swollen breasts, which is a treat­ment from an­cient times. Oth­ers were treated in­cor­rectly by ‘con­sul­tants’,” Liang said.

Since 2012, the Home­base for Breast­feed­ing Moth­ers has taken the ini­tia­tive by gath­er­ing to­gether ex­pe­ri­enced sup­port ser­vice providers and moth­ers pas­sion­ate about pro­mot­ing breast­feed­ing.

“We have used their ex­pe­ri­ences to de­vise stan­dard­ized pro­ce­dures and pro­duce guide­lines to train more prac­ti­tion­ers,” Dong said.

The group con­tin­ues to post ac­cred­ited re­search pa­pers on­line, along with prac­ti­cal ad­vice from doc­tors and other prac­ti­tion­ers in the field. More­over, in re­cent years, about 40,000 moth­ers have at­tended lec­tures given by qual­i­fied pro­fes­sion­als and 3,000 breast­feed­ing con­sul­tants have been trained.

“As the ben­e­fits of breast­feed­ing be­come bet­ter known, more young moth­ers are try­ing to feed their ba­bies on their own, so sup­port ser­vices should be bet­ter reg­u­lated as soon as pos­si­ble and treated with more re­spect,” said Ning Ping, di­rec­tor of the breast surgery clinic at the women’s and chil­dren’s hos­pi­tal in Chengdu.

The clinic is plan­ning to co­op­er­ate with pri­vate groups to hold sem­i­nars to pro­mote the ex­change of med­i­cal knowl­edge and ex­pe­ri­ence be­tween doc­tors and providers of breast­feed­ing ser­vices, who have been in­vited to ob­serve post­na­tal nurses at work and learn from them, he added.

Zhang, from the CDC, said the Na­tional Health Com­mis­sion is draft­ing a strat­egy to es­tab­lish a breast­feed­ing cer­tifi­cate sys­tem, and con­sul­tan­cies will be opened in hospi­tals in­volved in the Babyfriendly Hos­pi­tal Ini­tia­tive to pro­vide moth­ers in need with re­li­able, per­son­al­ized ser­vices.

PHO­TOS BY ZOU HONG / CHINA DAILY

Teacher Li Jing and new moth­ers dis­play breast­feed­ing pumps at a course run by the Home­base for Breast­feed­ing Moth­ers, which helps to pro­mote the prac­tice.

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