WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMITTEE Fifty-second session Brunei Darussalam 10--14 September 2001 Provisional agenda item 15
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ORIGINAL: ENGUSH
STATEMENT BY SITI NORJINAH MAIN, REPRESENTATIVE, CONSUMERS INTERNATIONAL Good morning Mr Chainnan, Regional Director Dr Omi, Distinguished Delegations of this session, I welcome the opportunity to speak on behalf of Consumers International on the issue of infant and young child nutrition. Consumers International is a partner with International Baby Food Action Network (IBFAN), a network of 150 citizens' groups who have been working for the last two decades to protect infant health in more than 90 countries. In 1998, ffiFAN received the alternative NOBEL Peace Price for its efforts. mFAN works in partnership with UNICEF, WHO and governments. It works together in various activities such as lactation management trainings, baby-friendly hospitals initiative assessment, developing code legislation and monitoring training seminars, CODEX Alimentarius workshops and creation of bondless support groups in breast-feeding counselling. We urge the member countries of the Western Pacific Region to actively work on a resolution for the Executive Board to pass at the World Health Assembly in May 2001. It is a resolution on the appropriate age for starting complementary feeding based on recent scientific evidences, as reviewed by UNICEF, WHO and teclmical experts. Recently, the WHOIUNICEF teclmical consultation on infant and young child feeding took place in March 2000 in Geneva. They came up with a concluding statement signed by nearly all participating experts on the duration of exclusive breast-feeding up to six months. As I quote "There
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is now sufficient scientific including epidemiologic evidence for changing the recommended duration of exclusive breast-feeding to above six months." There are indeed sufficient signs to make policy on this question of age. WHO has already published a review of the research on this subject titled Technical Report: WHOiNVT/98.
Complementary feeding of young children in developing countries- a review of current scientific knowledge That report states that optimal length of exclusive breast-feeding is about six months. What must be taken into account is that major respected national and international agencies such as the International Lactation Consultants Association, the La Leche League International, the USAIDfunded linkages, the American Academy of Pediatrics and UNICEF have already adopted the "six months" recommendation rather than the old "four to six months". In some summary of the evidences, there appears to be no evidence in favour of general use of complementary foods under six months of age, except in relatively uncommon and individually determined cases. Recent studies give scientific evidence against general use of complementary foods between four and six months because: 1. There is no growth advantage for most infants in Honduras study where breast-fed children given complementary food from four months even when food were of very high quality (Cohen et ai, 1994). WHO's review of complimentary feeding gave evidence that foods given to breast-fed infants from four months do not increase growth in most children (Brown et ai, 1998). A four-country study showed no significant growth advantage from complementary feeding between four and six months in Bolivia, Congo and New Caledonia, though some increase in length in Senegal (Simondon, 1996). 2. There is greater morbidity especially acute respiratory infection from diarrhoea, which are the greatest killers at ages four to six months of infants (Cesar, 1999; Bhandar, 2000; Habiet, 1997). The WHOIUNICEF joint Integrated Management of Childhood Illness publications stated "Most babies do not need complementary foods before six months of age ... but some time between the ages of four and six months some children begin to need foods in addition to breast-milk. The mother should only begin to offer complementary foods if the child shows interest in semi-solid foods, appears hungry after breast-feeding, or is not gaining weight adequately. The World Health Assembly passed resolutions WHA49.lS in 1996 and WHA47.S in 1994 stating that member
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countries are urged to "foster appropriate complementary feeding from the age of about six months" and "to ensure that complementary foods are not marketed for or used in ways that undermine exclusive and sustained breast-feeding". This is the year of the millennium from 1994-2000. Why are we still debating the issue of exclusive breast-feeding and age of introducing complementary feeding? This has been resolved and it is a matter of implementation. Why will WHO propose a delay of its stand? What will happen to our babies in this two months gap of four-six months? Our vulnerable babies of the Western Pacific Belongs to a large population. Who will profit from this gap? Shall the mother wait in fear for a wrong infant feeding choice? We are here as authorities to safeguard the best interest of the public.