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INNOCENTI DECLARATION

On the Protection, Promotion and Support of Breast­feeding

RECOGNIZING that

Breast­feeding is a unique process that:

and that:

Recent research has found that:

these benefits increase with increased exclusiveness of breast­feeding (exclusive breast­feeding means that no other drink or food is given to the infant; the infant should feed frequently and for unrestricted periods) during the first six months of life, and thereafter with increased duration of breast­feeding with complementary foods, and

program interventions can result in positive changes in breast­feeding behaviour;

WE THEREFORE DECLARE that

As a global goal for optimal maternal and child health and nutrition, all women should be enabled to practice exclusive breast­feeding and all infants should be fed exclusively on breast milk from birth to 4-6 months of age. Thereafter, children should continue to be breastfed, while receiving appropriate and adequate complementary foods, for up to two years of age or beyond. This child-feeding ideal is to be achieved by creating an appropriate environment of awareness and support so that women can breast­feed in this manner.

Attainment of the goal requires, in many countries, the reinforcement of a "breast­feeding culture" and its vigorous defence against incursions of a "bottle-feeding culture". This requires commitment and advocacy for social mobilization, utilizing to the full the prestige and authority of acknowledged leaders of society in all walks of life.

Efforts should be made to increase women's confidence in their ability to breast­feed. Such empowerment involves the removal of constraints and influences that manipulate perceptions and behaviour towards breast­feeding, often by subtle and indirect means. This requires sensitivity, continued vigilance, and a responsive and comprehensive communications strategy involving all media and addressed to all levels of society. Furthermore, obstacles to breast­feeding within the health system, the workplace and the community must be eliminated.

Measures should be taken to ensure that women are adequately nourished for their optimal health and that of their families. Furthermore, ensuring that all women have access to family planning information and services allows them to sustain breast­feeding and avoid shortened birth intervals that may compromise their health and nutritional status, and that of their children.

All governments should develop national breast­feeding policies and set appropriate national targets for the 1990's. They should establish a national system for monitoring the attainment of their targets, and they should develop indicators such as the prevalence of exclusively breastfed infants at discharge from maternity services, and the prevalence of exclusively breastfed infants at four months of age.

National authorities are further urged to integrate their breast­feeding policies into their overall health and development policies. In so doing they should reinforce all actions that protect, promote and support breast­feeding within complementary programs such as prenatal and perinatal care, nutrition, family planning services, and prevention and treatment of common maternal and childhood diseases. All healthcare staff should be trained in the skills necessary to implement these breast­feeding policies.

OPERATIONAL TARGETS:

All governments by the year 1995 should have:

appointed a national breast­feeding coordinator of appropriate authority, and established a multisectoral national breast­feeding committee composed of representatives from relevant government departments, non-governmental organization, and health professional association;

ensured that every facility providing maternity services fully practices all ten of the Ten Steps to Successful Breast­feeding set out in the joint WHO/UNICEF statement (World Health Organization, Geneva, 1989) "Protecting, promoting and supporting breast­feeding: the special role of maternity services";

taken action to give effect to the principles and aim of all Articles of the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions in their entirety; and

enacted imaginative legislation protecting the breast­feeding rights of working women and established means for its enforcement.

We also call upon international organizations to:

draw up action strategies for protecting, promoting and supporting breast­feeding, including global monitoring and evaluation of their strategies;

support national situation analyses and surveys and the development of national goals and targets for action; and

encourage and support national authorities in planning, implementing, monitoring and evaluating their breast­feeding policies.

The Innocenti Declaration was produced and adopted by participants at the WHO/UNICEF policymakers' meeting on "Breast­feeding in the 1990s: A Global Initiative", co-sponsored by the United States Agency for International Development (A.I.D.) and the Swedish International Development Authority (SIDA), held at the Spedale degli Innocenti, Florence, Italy, on 30 July - 1 August 1990. The Declaration reflects the content of the original background document for the meeting and the views expressed in group and plenary sessions.

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