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THE MANY BENEFITS OF ATTENDING AN ILCA CONFERENCE OR HOW NILS BERGMAN ENDED UP IN CROATIA AND SLOVENIA

Irena Zakarija-Grković, MD, FRACGP, IBCLC, is a GP and passionate breastfeeding advocate from Melbourne, Australia who moved to Split, Croatia in 2004 with her husband and three children. Irena now works at the University of Split School of Medicine where she is involved in teaching and research. Irena is a founding member of the National Breastfeeding Committee, a BFHI educator, president of the Croatian Association of Lactation Consultants, 80-hour breastfeeding course provider, former IBLCE coordinator for Croatia and an active member of ILCA (volunteer member of Scholarship Committee and Multilingual Committee)and ABM. She also conducts breastfeeding classes for expectant parents, does some private practice as a lactation consultant and is the author of several chapters in Croatian on breastfeeding . Irena loves what she does and tries hard to infect others with her enthusiasm for breastfeeding.

Back in 2007, I was a fortunate recipient of an ILCA scholarship and so, thanks to the generosity of numerous friends of ILCA, I was able to attend my first ILCA Conference, held in San Diego, California.

It was an exhilarating experience and among the many interesting talks I attended, the one that stood out was the talk given by Nils Bergman, on the importance of skin-to-skin contact for brain growth. After the presentation I struck up a conversation with Nils and soon found out that Nils traveled to Europe regularly to visit family in Sweden. Immediately, the thought of Nils visiting Croatia came to mind but seemed too farfetched to mention at the time, so I left San Diego with some lovely memories and lots of useful information and resources.

Upon returning to Split, I realised that unless I tried to bring top experts to Croatia the likelihood of my colleagues hearing about the latest recommendations in the field of breastfeeding medicine was minimal, and hence I set about making plans on how to bring the exciting world of evidence-based breastfeeding medicine to Croatia. This wouldn’t have been possible without collaborating with neighbouring Slovenia, specifically the Slovenian Association of Lactation Consultants and UNICEF in Slovenia. Together we’ve brought several renowned speakers to our neck of the woods over the years and by doing so have raised the awareness of the importance of breastfeeding. This, in addition to organizing an annual 80-hour breastfeeding course for health professionals (5 years running) and getting the IBLCE exam translated into Croatian and offered in Split (since 2009), has brought the number of certified lactation consultants in Croatia from one in 2007 to 21 in 2011!

This year, for WBW, the Croatian Association of Lactation Consultants (CALC) was honoured to welcome Nils Bergman to Croatia. My dream had come true- thanks to Nils’s trust in me, his generosity of spirit, and to the support of my Croatian and Slovenian colleagues. Nils’s tour started off with a two-day visit to sunny Split where he was run off his feet meeting the media, giving talks to health professionals and demonstrating to mothers and staff at the University of Split Neonatal Unit how to practice kangaroo mother care.

The latter was the highlight of Nils’s visit because it brought home the importance of placing the baby in its proper environment, the beauty of which brought tears to the eyes of all present. For some mothers with babies in the Neonatal Unit, it was the first time they had held their children. The media were so impressed with what Nils had to say on the topic of caring for premature babies that he made the midday news and was featured on four other TV programs!

  Next, Nils spoke in Zagreb, the capital of Croatia, to a full house at the Hospital of the Holy Spirit and was then whisked off to Lasko, in Slovenia, where he was an eagerly awaited speaker at the Slovenian breastfeeding symposium.

Despite all the work involved in organising Nils’s visit, it was well worth the effort and has brought hope, joy and revelation to all those he met. Thanks Nils and good luck with all of your endeavours in promoting kangaroo mother care!

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Malaysian Breastfeeding Peer Counselor Program

Mother-to-Mother Support has been identified as one of the key factors contributing to the success rate of prolonged breastfeeding, or at least exclusive breastfeeding in the first 6 months. In recent years, more and more evidence has arisen on the effectiveness and impact of peer counseling support. In 2003, D’Souza and Garcia found that:

  • •peer support as a stand-alone intervention is very likely to increase breastfeeding initiation rates among low-income women who express the wish to breastfeed;
    •support from a mother experienced in breastfeeding, complemented by professional services, is very likely to increase the duration of breastfeeding; and
    •peer volunteers are particularly beneficial in mediating between low income mothers and healthcare professionals.

Latest statistics reveal that the Malaysian Exclusive Breastfeeding rate at 4 months is 19%, while at 6 months is only 14.5% (Salim et al, 2006), and this is far below the global rate, which is about 38% EBF at 6months (Moccia P, 2008). If we focus on the  local trend alone, exclusive breastfeeding rates over the past ten years have plummeted, from  29% at 4 months (1996), despite huge efforts to promote the Baby-Friendly Hospital Initiative and having higher initiation rates.

OBJECTIVES & GOALS
This project is focused on building capacity of breastfeeding counselors in Malaysia in order to sustain exclusive breastfeeding for 6 months, and continued breastfeeding with appropriate complementary foods up to 2 years and beyond. This project will go beyond the hospital setting, as it extends the circle of breastfeeding support, involving training of peer counselors among mothers and other non-medical personnel.

SusuIbu.com has been empowered by UNICEF to carry out a project called Malaysian Breastfeeding Peer Counselor Program. UNICEF initially funded the program that comprised of Train the Trainers, running the peer counselor training in 5 regions, and monitoring the overall project until the end of 2010. The project successfully trained 16 participants whom were trained by LLLI Leaders and program adapted from the Peer Counselling Program of LLLI. These 16 individuals are now functioning as Peer Counselor Program Administrators (PCPA) and Working Committee for this program. A nationwide training program for Peer Counselors was successfully conducted throughout 2010, comprised of existing breastfeeding support groups or mother-to-mother support individuals, who would benefit tremendously from the formal skills obtained from the training.

CURRENT SCENARIO IN MALAYSIA
In Malaysia there has been an on-going effort  to create a more effective Mother-to-Mother Support Group framework among the local mothers, but a more systematic and coordinated effort is needed to strengthen it. The Malaysian Ministry of Health is most supportive of breastfeeding, but its focus has largely been around hospital practices rather than support in the communities. All government hospitals in Malaysia are accredited as Baby-Friendly Hospitals and are continuously assessed as per requirements of the UNICEF/WHO Baby-Friendly Hospital Initiative. Since this initiative was introduced in 1993,  121 hospitals  have been accredited as  Baby-Friendly Hospitals (2004).

However, it was revealed that one of the major causes of Baby-Friendly Hospitals failing their reassessment was Step 10,  “Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.” . In the current practice, breastfeeding support groups would be formed by hospital nurses, rather than the community. This adds strain to the workload of the healthcare professionals, without adequately meeting the needs of mother support. Furthermore, mothers are normally discharged from hospitals only 1 or 2 days after delivery. Thus, not much support activities can be done within the hospital’s set up.

According to the current Project Manager, Puan Nor Kamariah Mohamad Alwi, “Many mothers are interested to participate in these activities and are willing to support each other. However, there has been inadequate training done for this group of mothers who aspire to become Peer Supporters/Counselors.  In the current situation, these mothers have had to be included in hospital’s lactation management training which is largely meant for the hospital set-up and staff. It has been noted then that the hospital training given may not be  relevant to the mother-to-mother support needs. For instance,  participants who underwent  this training did not receive any proper guidelines on how to operate as peer counselors yet Mother Support particularly peer counseling has shown to be a most effective intervention in supporting breastfeeding. Furthermore, the peer counselors’ activities are not being monitored by any party.”

FUTURE PLANS

We realise that there is still a long way to go, but the awareness on MBFPC, and importance of mother-to-mother support, is on the rise among the public in Malaysia. In 2010, 145 Peer Counselors completed their training.  As of Sept 2011, 84 Peer Couselors completed their training. For 2012, we will focus on strengthening the skills of the currently trained peer counselors in our group. We realise that we will need help to empower our members further so that they can contribute better to the community in the future. Other than securing future funding to ensure sustainability, we hope to create links with other global groups as we believe we all share a common goal. There is an unspoken universal language of love that we share and that is – Breastfeeding!

For more information regarding the program, please visit www.mbfpc.org

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Nurturing Concepts Sdn Bhd (NCSB)
Nurturing Concepts Sdn Bhd is a company founded by individuals and professionals who share a common mission which is to protect,  promote and support breastfeeding. NCSB operates 2 reputable entities:
1. Moms Little Ones – known as the Breastfeeding & Natural Parenting Store that purely focuses on producing and selling high quality breastfeeding and parenting range of products.
2. Susuibu.com – known as the Breastfeeding Support Centre that focuses on providing quality breastfeeding consultation services, education and training to the healthcare workers and the public. The popular online community forum “Mother-to-Mother” Support group now has more than 20,000 members worldwide and is recognised by The Ministry of Health Malaysia and WABA (World Alliance for Breastfeeding Action. The World Alliance for Breastfeeding Action (WABA) is a global network of individuals & organisations concerned with the protection, promotion & support of breastfeeding. We are proud to be a WABA endorser.

CONTACT
Nor Kamariah Mohamad Alwi, IBCLC
Lactation Consultant
Project Manager, Malaysian BFPC

+603-89254614 (Tel)
+603-89254615 (Fax)
pm@mbfpc.org

Malaysian Breastfeeding Peer Counselor Website – www.mbfpc.org

Article by: Rita Rahayu Omar, BSc, CISA, IBCLC
CEO, www.thenurturing.com

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Thank You!

The editorial staff of Lactation Matters and ILCA would like to take a moment to thank you.  Our first week in the blogosphere has been tremendous, full of excitement and new challenges.  We are sincerely grateful for the outpouring of support that we have received with the launch of this blog.  In one week we had over 2,000 visits and a number of wonderful commenters encouraging us along.  This blog has been created for all of you, to create an ongoing source of community and support for our fellow LC’s.

At times it can be hard to remember how small the world really is, and how connected we are.  While the facilities that we practice at may be different, we are all working towards the same mission.  Our goal with Lactation Matters is create a safe and informative place that LC’s can gather and never feel alone in their profession again.

Quite an ambitious goal that we’ve set for ourselves, to ensure that this blog stays current and meeting your needs we want to encourage you to submit questions, comments, suggestions, and thoughts to lactationmatters@gmail.com.  This blog is your blog and we want to make sure that Lactation Consultants and healthcare professionals working with breastfeeding mothers around the world are having their voices heard.  Stand as one, be united, and let us know what is happening in your own community.

We look forward to what the future holds for our ‘baby’ blog and watching how all of you connect and interact with us.

Again, thank you for subscribing, reading, and sharing. Stay tuned for some exciting posts next week and a poll coming your way this Friday!

Robin Kaplan, M.Ed., IBCLC, Lactation Matters Editor

Decalie Brown, RN, CM, CFHN, IBCLC, ILCA Director of Marketing

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