by Michele Griswold, PhD, MPH, RN, IBCLC, ILCA Board President

How does the International Lactation Consultant Association
envision transforming world health through
breastfeeding and skilled lactation care?

Every day, ILCA’s staff, board members, and teams of volunteers focus on objectives that are connected to our mission: “to advance the International Board Certified Lactation Consultant profession worldwide through leadership, advocacy, professional development, and research.” One way that we are doing this work in the advocacy realm and amplifying the voices of IBCLCs worldwide is with the Global Breastfeeding Collective.

It is reasonable to say that we, as IBCLCs and others who provide skilled care to breastfeeding families, may all consider ourselves breastfeeding advocates. Yet, how does that passion translate to action? The world is a big place and sometimes it is overwhelming to know where to begin. For ILCA, working toward our mission involves the target goals and objectives outlined in our strategic map. With a specific objective that charges us “to engage in partnerships with global health leaders and relevant organizations,” we begin to open the door for breastfeeding families by working with other groups who aim to do the same thing. Together, we can go further than we could ever go alone. Currently, ILCA is engaged with more than 20 global organizations through the WHO/UNICEF Breastfeeding Collective and together, we are opening the door.

The Collective (formerly, the Global Breastfeeding Advocacy Initiative) was convened in 2014 with an overarching mission “to rally political; legal; financial; and public support, so rates of breastfeeding increase, which will benefit mothers, children, and society.” Ultimately the goal is to reach the 2025 World Health Assembly (WHA) global nutrition target that 50% of all infants breastfeed exclusively through 6 months of age.

The underlying message of the Collective is that breastfeeding is not and therefore should not be approached as the sole responsibility of the mother but rather, should be viewed as a collective societal responsibility. Thus, the Collective and its partners aim to galvanize donors and governments to invest in breastfeeding so that all mothers have the technical, financial, emotional and public support they need to breastfeed exclusively for 6 months and to continue breastfeeding for 2 years and beyond.

What does investing in breastfeeding mean?

In short, investing in breastfeeding means money. It means advocacy efforts that call for adequate funding that will be directed toward policies and programs that have been shown to improve breastfeeding practices. Globally, even in countries with emerging growth markets, investments for breastfeeding are low. A recent report generated by Collective partner, 1000 Days, cited that donors and governments allocate about $335 million in total to breastfeeding programs in low- and middle-income countries (LMIC). With an additional investment of $5.7 billion over the next 10 years, evidence-based programs could be scaled up to meet the WHA 2025 target. While this might sound like a big number, it amounts to less than $5 for every infant in LMIC. With support for this investment, the reported lives saved is 520,000. Estimates of the economic gains over 10 years are $300 billion, resulting from reduced health care costs and increased productivity.

This strategy recognizes that as important as it is to save lives, it is as important to assure that people have equal opportunities to achieve their full human potential. Breastfeeding is a critical factor in achieving health equity. In turn, health equity supports communities and nations by making them more prosperous economically, by lowering health costs as one example. These messages are compelling to policy makers. They go beyond traditional advocacy messages citing improved health as breastfeeding’s primary “benefit” and appeal to a greater societal good – that breastfeeding should be available to all as a basic human right.

The Collective calls on the decision makers in society – governments, donors and other stakeholders – because they are the people with the power to create conditions that support optimal breastfeeding practices. Asking the decision makers to assume some responsibility in clearing the path for breastfeeding on a global level is a groundbreaking advocacy strategy. In turn, the action items also provide direction and tools that local communities can use to create political will that ultimately improves policies.

The Collective specifically calls on governments to take the following actions:

1. Increase funding to raise the rate of breastfeeding from birth to 2 years.
2. Adopt and monitor the International Code of Marketing of Breastmilk Substitutes.
3. Enact paid family leave and workplace breastfeeding policies.
4. Implement the ‘Ten Steps to Successful Breastfeeding’ in maternity facilities.
5. Improve access to skilled breastfeeding counseling in health facilities.
6. Strengthen links between health facilities and communities to support breastfeeding.
7. Monitor the progress of policies, programs and funding for breastfeeding.

We know that all of these actions are relevant to the work that many of us do clinically to support breastfeeding in our own communities. ILCA knows that these specific policy “asks” support our mission through advocacy for the IBCLC. To address these actions, governments and program planners will need to recognize the value of skilled breastfeeding counseling in maternity facilities, health facilities and in the community.

How can you get involved with the Collective’s work?

The short answer is that you are the experts in your own communities! By connecting with others who are as passionate about these issues as you are, you will strengthen your advocacy position and messages. Most importantly, call on your national and local governments to implement the 7 calls to action. To help you to be informed in your advocacy work, the Collective launched the Global Breastfeeding Scorecard during World Breastfeeding Week 2017. The tool allows you to access country-specific data on indicators and breastfeeding outcomes. Because the scorecard did not identify any countries meeting the minimum indicator standards, there is much work to do.

Get involved with ILCA’s advocacy work.

Consider becoming an ILCA member so that you can connect with clinical lactation professionals worldwide. Clinicians can be powerful voices for advocating for policies that support the actions of the Collective at the local level.

Consider being an ILCA volunteer. Join with us in our mission-based work through volunteering to work with a specific committee, including but not limited to the Advocacy Committee.

Consider becoming an ILCA partner. ILCA’s Global Partner Program aims to bring together organizations who are established and those who are emerging in their communities, as leaders in breastfeeding support. ILCA partners will directly benefit from ILCA’s involvement with the Collective by receiving support and information relevant to issues in your communities.

Together, we can go far.

If you have further questions about the Collective, please email me at michelegriswold@ilca.org.

Michele Griswold, PhD, MPH, RN, IBCLC is the President of ILCA and has years of leadership experience in local, state and global breastfeeding advocacy. Her research interests involve unjust social barriers to breastfeeding, particularly among marginalized women and children. Michele represents ILCA to the WHO/UNICEF Breastfeeding Collective.