World Breastfeeding Week (WBW)
2007
Breastfeeding 1st Hour
save ONE Million Babies
SCN WG :BREASTFEEDING and
COMPLEMENTARY FEEDING
Arun Gupta on behalf of WABA
WBW 2007
1
4/13/2015
Beginning Breastfeeding within
ONE hour
:Beginning life with “life”
WBW 2007
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4/13/2015
Objective
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To draw the world’s attention to save
ONE million babies with just ONE action,
just ONE hour support and just ONE
message….
To encourage establishing breastfeeding
within ONE hour as key indicator of
health progress by all communities locally
and globally.
WBW 2007
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BFHI 1992

Step 4 was, “Help mothers initiate
breastfeeding within a half-hour of birth”
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World Summit for Children
Commitments
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Millennium Development Goals (MDG) 4
to reduce U-5 child mortality
40% of all child deaths are neonates
Need to scale action to reduce neonatal
deaths as progress is reported to be slow
Almost all deaths in developing countries
WBW 2007
5
4/13/2015
Risk of neonatal mortality
according to time of initiation of
breastfeeding within ONE hour
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
4.2
2.3
1.2
0.7
With in 1 From 1 hour
hour
to end of day
1
Pediatrics 2006;117:380-386
WBW 2007
2.6
Day 2
Day 3
6
After day 3
4/13/2015
Potential Mechanisms
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Suckling shortly after birth have a greater chance of
successfully establishing and sustaining breastfeeding
throughout infancy.
However, the effect of early initiation persisted after
controlling for established neonatal breastfeeding
patterns.
Early feeding with non human milk proteins may severely
disrupt normal gut function
Rich immune and non-immune components that are
important for early gut growth and resistance to infection.
Promotion of warmth and protection may reduce the risk
of death from hypothermia.
WBW 2007
7
4/13/2015
Key findings of the study
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30% of the study population initiated
breastfeeding after day 1 (late initiation)
30% were not exclusively breastfed in
the neonatal period
Exclusive breastfeeding was associated
with a 4 fold reduction in risk of death
when compared to infants who were fed
solids or other milk. This confirms
previous findings.
WBW 2007
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4/13/2015
Key findings

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Translating these benefits to the whole
population of neonates (breastfed and not
breastfed) means that 16% of neonatal lives
can be saved if all babies were breastfed from
day 1, and 22% if breastfeeding were started
within the first hour.
Neonatal mortality was also shown to increase
markedly as delay in initiation increased.
WBW 2007
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4/13/2015
Global impact of increases in coverage and
promotion of early initiation of
breastfeeding in less developed settings.
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Projected absolute numbers of lives saved and the proportion of
neonatal deaths avoided if 99% of infants initiated breastfeeding
during the first hour or during the first day of life. [1]
Only 38 of the 60 countries had data available on initiation of
breastfeeding within 1 hour and 1 day of birth.
The neonatal mortality rate for these 38 countries ranged from
15-70/1,000 live births.
[1] Karen M Edmond, Ellie C Bard, Betty R Kirkwood, Meeting
the millennium development goals for child survival: global
impact of early initiation of breastfeeding on neonatal mortality.
(Un published)
WBW 2007
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4/13/2015
Contd
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An additional 2.5 fold reduction in risk of
death was demonstrated in babies who
survived to day 2 who initiated
breastfeeding on the first day of life
(early initiation) compared to infants who
initiated after the first day of life (late
initiation).
This type of effect of early initiation has
never been reported.
WBW 2007
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Contd…
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Neonatal mortality could be reduced by
24% if 99% of infants initiated
breastfeeding on day 1 of life and by
31% if 99% of initiation was within the
first hour.
Numbers of lives saved were
estimated to be 867,000 and
1,117,000 in these two cases."
WBW 2007
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4/13/2015
1st ONE hour initiation cuts 22%
of all neonatal deaths( 0-28 days)
Pediatrics 2006;117:380-386
INITIATION OF BREASTFEEDING within ONE hour
If ALL Women start BF
within
15.8%(IN
DIA)
ONE hour
100%
NEONATAL DEATHS SAVED
India: 1.1 M
1 million
World : 4 M
WBW 2007
250,000 babies can be
saved in India and ONE
13
MILLION in the world
4/13/2015
Other benefits of ONE hour !!!
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Skin to skin
Warmth
Development
Less bleeding postpartum
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4/13/2015
Oxytocin factor
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Role of oxytocin which is best during first
45 minutes
Suckling is at it best and babies are
active during first hour
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4/13/2015
Where we stand ?
Initiation of breastfeeding within
ONE hour
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In 38 countries : 26-52( 36 median)
South Asia worst hit , but needed most
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Why World Breastfeeding
Week(WBW):2007 for ONE hour
support
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Should not allow to get it old
Too important to ignore
Currently this is not a key indicator in
reports like UNICEF SOWC .
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4/13/2015
What next
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Advocacy for support to mothers during
4th stage of labour
Policy : Coverage, promotion and
reporting should improve along with
exclusive breastfeeding
WBW 2007
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4/13/2015