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World Breastfeeding Week 2013: The Government and Legislation Circle of Support

During World Breastfeeding Week 2013, we will be highlighting the work of IBCLCs in each of the 5 Circles of Support mentioned in this year’s theme ~ Breastfeeding Support: Close to Mothers. Each weekday during this celebratory week, we will be shining the light on innovative and exciting models of care in each of these areas. Check back everyday for more encouraging examples of breastfeeding supporters being close to mothers.

Susanna Scurry, Australia

photo sueWe were able to interview Susanna while at the 2013 ILCA Conference in Melbourne, Australia. Susanna is a midwife, and lactation consultant since 2005 and also a Baby Friendly Hospital Initiative (BFHI) assessor and educator. She was also on the board of Australian Lactation Consultant Association (ALCA) and Lactation Consultants of Australia and New Zealand (LCANZ). She shared with us the following responses.

This year’s World Breastfeeding Week theme is “Breastfeeding Support: Close to Mothers”. The organizers have identified 5 Circles of Support that are critical for breastfeeding mothers in our world and one of those circles is “Government and Legislation”. Can you describe for us a bit what work you are currently doing or hoping to do in the field of lactation and the government? How did you become involved in this work? What would a typical day of working at the government level, supporting breastfeeding look like?

I am a big fan of Marilyn Waring, a New Zealand economist who states “An economic model that does not value clean air, clean rivers, forests, unpaid work by women, and breastfeeding is unsustainable.” I am all for an economic system that promotes, protects, and supports normal birthing, breastfeeding, and sustained home visits to parents . I support anything that is making a community better for today’s parents, as they say , “it takes a village to raise a child”! What I value for future generations, including for my 6 lovely grandchildren, is for a sustainable future.

My focus is on women’s health. For many years, I have been advocating for a human milk bank in our neonatal unit and family centered care in our NICU facility as well as a public IVF clinic in Newcastle along with community birthing, and palliative and aged care. I talk about the public health implication of not using breastmilk and also my support of BFHI. I truly believe it is “from the cradle to the grave”. If we had skin to skin contact throughout life, we would have a much kinder world.

The World Breastfeeding Week organizers stated “Women who plan to breastfeed or who are already breastfeeding benefit from the support of international documents, protections for optimal infant feeding, plus active and well funded national commissions. Legislation that combats aggressive marketing of breastmilk substitutes and enacts paid maternity leave also benefits breastfeeding women.” Can you expand a bit on what some of the unique challenges are that women in your community face that could be improved through legislation?

I appeared before the Productivity Commission to argue the case for paid parental leave. I am proud of the four month paid parental leave granted but I think twelve months would be better and will continue to argue for this. I have also lobbied for many years for the implementation of the WHO Code in Australia. The Marketing in Australia of Infant Formula (MAIF) agreement is a toothless tiger and I would like to see it gone. Australia had a Parliamentary Inquiry into breastfeeding in 2007 and all of its recommendations should be implemented.

What are some of the current initiatives, laws, and policies that support breastfeeding women in your community? What are your hopes for the future?

We need to expand BFHI into the community, pediatric offices, child care centers, etc. We also need to reclaim breastfeeding in our culture. Australia needs, at a federal level, to have a paid breastfeeding coordinator as recommended by the World Health Organization and breastfeeding representation at an International level as well. I will continue to work towards these goals.

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IBCLCs Traveling the Globe: Conference in Uppsala, Sweden: Part 2

On September 14-16, 2011, 215 participants from 26 countries around the world took part in a 3 day Neo-BFHI program in Uppsala, Sweden. Ten Australians, from New South Wales, South Australia and Victoria were amongst the multidisciplinary group.

The purpose of the conference and workshop was to present and discuss evidence for adaption of the WHO/UNICEF 10 steps to Successful Breastfeeding for neonatal intensive and intermediate care and to discuss a draft document prepared by a working group from the Nordic countries and Quebec.

IBCLCs at the Uppsala Workshop

Day One of the conference was opened by Professor Paula Meier from the United States. She spoke of breastfeeding support for infants in neonatal units. Human milk banking was the norm in many units and Professor Meier stated ‘that by giving the at-risk premature infant artificial milk, it was putting them at further risk of complications’. The predominantly female lineup of speakers spoke on varying aspects of care with Renee Flacking, a health care worker and mother of a premature infant, discussing the U.K. and Swedish experience.

Randa Saadeh gave the WHO perspective on adaption of the ten steps, while Yvette Sheehy, from Sydney, discussed their Hospital in the Home: ‘The Discharge on Tubes – DOTS program’-infants discharged home on tube feeds with health care support.
The closing speaker for Day One, Birgitte L Ekeberg, spoke of ‘Moving towards family centered care , the first Family Centered Neonatal Intensive Care Unit in Norway’.

On days two and three, participants chose workshop groups to attend, and discussed the draft BFHI Initiative in Neonatal Units document and the Ten Steps, and came together in the afternoon of the final day to present the outcomes of their discussions. The final document, which is a Global document, will need to be representative of all participants and there was considerable debate on how this could be implemented worldwide. As bottle feeding and pumping is the norm in some parts of the Western world the impact of including this in developing countries was an issue.

Uppsala University hosted the meeting and welcomed participants with a welcome reception opened by Vice-Chancellor Anders Hallberg followed by the conference dinner which was held at the Norrlands Student Club. Participants were serenaded by the student choir during the dinner.

Kersten Hedberg Nyqvist

Kersten Hedberg Nyqvist, one of the conference organizers, was overwhelmed by the number of participants who wished to visit the Uppsala Family centered neonatal unit and after discussions with the unit managers decided the numbers were too many. With the interests of those within the unit in mind and the interest shown by conference participants she opted on a presentation that was to challenge the practice of many. Parents live in the neonatal units with the babies and infants from 32 weeks. They are given the opportunity to have Kangaroo Mother Care, 24 hours a day, while parents are taught to recognize the cues of the baby and breastfeed them when they are ready. Babies are discharged at 34 weeks partially breastfeeding, partially tube-feeding. Kersten stated ‘that there is no such thing as non-nutritive sucking’. She also said that the program has taken time to implement and one of the biggest problems is staff attitudes to change.

While walking to the bus to leave Uppsala for home, the chilly wind was blowing as winter was closing in. Thousands of bikes were chained up in this university town and I thought how lucky these babies are to be cared for in a society so socially aware.

Susanna Scurry
RN,RM, BFHI Educator & Assessor, LCANZ Board of Director, IBCLC

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