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close this book4th Report on the World Nutrition Situation - Nutrition throughout the Life Cycle (ACC/SCN, 2000, 138 p.)
View the document(introduction...)
View the documentADMINISTRATIVE COMMITTEE ON COORDINATION/SUB-COMMITTEE ON NUTRITION - (ACC/SCN) THE UN SYSTEM’S FORUM FOR NUTRITION
View the documentINTERNATIONAL FOOD POLICY RESEARCH INSTITUTE
View the documentFOREWORD
View the documentHIGHLIGHTS
View the documentCONTRIBUTORS
View the documentACKNOWLEDGEMENTS
View the documentLIST OF ABBREVIATIONS
View the documentPREFACE
close this folderCHAPTER 1: NUTRITION THROUGHOUT THE LIFE CYCLE
View the document(introduction...)
View the document1.1 Intrauterine Growth Retardation (IUGR)
View the document1.2 Undernutrition in Preschool Children
View the document1.3 The Growth of School-Age Children
View the document1.4 Adolescent Nutrition
View the document1.5 Adult Malnutrition
View the document1.6 Nutrition of Older People in Developing Countries
View the documentSummary
close this folderCHAPTER 2: MICRONUTRIENT UPDATE
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View the document2.1 Iron Deficiency Update
View the document2.2 Iodine Deficiency Disorders Update
View the document2.3 Vitamin A Deficiency Update
View the document2.4 Multiple Micronutrient Deficiencies
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close this folderCHAPTER 3: BREASTFEEDING AND COMPLEMENTARY FEEDING
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View the document3.1 Evidence Linking Breastfeeding to Improved Outcomes
View the document3.2 Evidence Linking Complementary Feeding to Improved Outcomes
View the document3.3 Conceptualizing Infant Feeding Behaviours
View the document3.4 HIV and Infant Feeding
View the document3.5 Breastfeeding and Complementary Feeding Patterns and Trends
View the document3.6 Role of National and International Initiatives in Support of Optimal Infant Feeding
View the document3.7 Looking Forward: The Importance of Exclusive Breastfeeding
close this folderCHAPTER 4: NUTRITION AND HUMAN DEVELOPMENT
View the document(introduction...)
View the document4.1 The Relevance of Nutrition for Development
View the document4.2 The Implications of Some Global Phenomena for Nutrition
View the document4.3 The Ascent of Human Rights in Development
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close this folderCHAPTER 5: NUTRITION OF REFUGEES AND DISPLACED POPULATIONS
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View the document5.1 Trends in Numbers of People Affected
View the document5.2 Overview of the Humanitarian Response to Emergencies
View the document5.3 Trends in Assessment Methodologies
View the document5.4 Trends in Food and Nutrition Response Programmes
View the document5.5 Trends in Information Sharing and Learning
View the document5.6 Case Studies: The Scale and Severity of Nutritional Problems among Refugees and Displaced Populations
View the document5.7 Future Directions
View the documentSummary
close this folderAPPENDICES
View the documentAppendix 1: Conceptualizing Nutrition Problems in Society
View the documentAppendix 2: Countries in the UN Regions and Sub-Regions
View the documentAppendix 3: Methods to Estimate Trends in Undernutrition Prevalence: A Review
View the documentAppendix 4: Statistical Notes for Sections 1.1, 1.2, and 1.3
View the documentAppendix 5: Latest National Prevalence of Stunting and Underweight in Preschool Children
View the documentAppendix 6: Explaining Trends in Child Underweight in the Developing World
View the documentAppendix 7: Data Employed for Analysis of Child Underweight Rates in Sub-Saharan Africa
View the documentAppendix 8: Prevalence and Numbers of Overweight Preschool Children in 1995
View the documentAppendix 9: Countries Classified by WHO Regions
View the documentAppendix 10: National Implementation of the International Code of Marketing of Breastmilk Substitutes
View the documentAppendix 11: Summary of Five Studies of the Social Impacts of the Indonesian Crisis
View the documentAppendix 12: Some Food and Nutrition Information and Data Resources on the Internet
View the documentREFERENCES
View the documentBACK COVER

3.7 Looking Forward: The Importance of Exclusive Breastfeeding

Breastfeeding is widely practiced throughout the developing world and is actually improving in spite of demographic trends, such as urbanization, which exert a downward pressure.40 Nonetheless, there is a need to increase the duration of exclusive breastfeeding because this breastfeeding behaviour is most associated with infant health and survival. Three published studies have demonstrated the effect of breastfeeding promotion on the duration of exclusive breastfeeding.45-47 Interpersonal counselling was the key intervention. Breastfeeding promotion is one of the most cost-effective interventions to promote child health and is comparable to immunizations.48

Increasing the duration of breastfeeding does not necessarily lead to increases in the duration of exclusive breastfeeding. In Bolivia and Colombia, the duration of partial breastfeeding has increased at the same time the duration of exclusive breastfeeding has decreased. However, in countries where a concerted effort has been made to increase exclusive breastfeeding, shifts in population-level behaviours have been noted. In the Dominican Republic and Peru, the proportion of infants under four months of age who were exclusively breastfed doubled between 1991 and 1996 and between 1986 and 1996, respectively.29

The timing of interventions to promote the desired breastfeeding and complementary feeding behaviour is critical because it is likely to affect a mother’s decision-making, her motivation to overcome problems should they arise, and her persistence in maintaining a recommended behaviour despite negative influences. Therefore, interventions need to be delivered as close as possible to the time of the desired behaviour. Exclusive breastfeeding declines precipitously in the first month of life. Evidence shows that in the short term women can be encouraged to return to exclusive breastfeeding with counselling.46 However, once women cease exclusive breastfeeding they usually do not resume. Therefore, reaching women during the prenatal period, soon after delivery, and within the first month postpartum is critical to increasing the duration of exclusive breastfeeding.

The challenge from a public health perspective is to translate the vast scientific literature on breastfeeding and complementary feeding recommendations to effective interventions that are understood and accepted by the population at large. To some extent lessons learned from campaigns to promote breast-feeding can provide guidance. However, as important as breastfeeding is to infant health and survival, it is also necessary to look beyond breastfeeding and to integrate both breastfeeding and complementary feeding in campaigns to promote optimal nutrition of both the infant and young child. As noted in a recent review, providing safe and adequate amounts of foods appropriate for infants and young children is not simple.21 Complementary foods must be adequately dense in energy and micronutrients to meet the requirements of this age group. They must also be prepared, stored, and fed in hygienic conditions to reduce the risk of diarrhoea. Lastly, many feeding behaviours that affect infant and child nutritional status need further study. Qualitative and quantitative research is necessary, along with cost-effectiveness analysis. However, research is not sufficient to guarantee the success of public health interventions. The international community must work together to ensure that the same rigor applied to such research is applied to broad-scale interventions, to bring the benefits of nutrition research to those who need it most.