Ομιλία του Στέλιου Παπαβέντση στην συνεδρίαση της Επιτροπής για τα Δικαιώματα του Παιδιού του ΟΗΕ στη Γενεύη, σχετικά με την βρεφική διατροφή στην Ελλάδα τον Ιούνιο του 2011.
Statement delivered on behalf of IBFAN by Dr Stylianos Papaventsis MRCPCH DCH IBCLC.
Dear members of the Committee on the Rights of the Child,
I am very honoured to be here today on behalf of IBFAN, and speak about the situation of infant and young child feeding in Greece.
IBFAN has been contributing with alternative reports on the situation of infant and young child feeding for more than 10 years now. However this is the first time that we have the opportunity to participate in the pre-sessional working group for Greece and we are very thankful for this.
The report that we have submitted to the CRC on Greece was prepared by “Galaxias” group, the Association of Lactation Consultants in Greece. I am a Paediatrician, Lactation Consultant and Vice President of this organization.
Given the short time that I have at my disposal, I would like to highlight some of the main issues with regards to the situation of infant and young child feeding in Greece, without repeating what you have already received through our report.
Let us take a look at the general situation of breastfeeding in Greece today.
If you look at the statistics on breastfeeding that we have presented in our report, you will see that breastfeeding indicators are extremely low in Greece, even compared to the European average. In particular, if we look at exclusive breastfeeding, when the child is 3 months old, only 1 out of 10 children is exclusively breastfed. At 6 months of age, only around 0.6% of children, that is 2 out 300 children are exclusively breastfed! This is an extremely low number! In addition, only around 7 children out of 100 continue to enjoy any breastfeeding at 1 year of age.
In contrast, if we go back and look at the intention of women to breastfeed prior to giving birth, the numbers are very high: 89% of them. Also, around 87.5% of women initiate breastfeeding at birth. These numbers clearly show that many women want to breastfeed, however within the following few months very few manage to continue. All the rest face a hostile environment which deprives women in Greece from their right to breastfeed and also deprives their children from the highest attainable standard of health, which would be provided through breastfeeding.
So one should ask: why is this so? What are the obstacles that lead to such extremely low numbers of breastfeeding in Greece?
In order to find answers to this question, our group conducted an online survey during the month of March 2011, and we received responses from parents on about 2300 children born in between 2000 and 2011. We also looked at different studies, and undertook a monitoring campaign to document violations of the International Code of Marketing of Breastmilk Substitutes.
As a result, we found that one significant obstacle to breastfeeding for women in Greece is the aggressive and largely uncontrolled promotion of infant formula, in general, but especially within health care facilities, which is strictly prohibited by the International Code of Marketing of Breastmilk Substitutes.
As you can see in Annex 2 of the report, we have documented a high number of cases of marketing of infant formula, both in public and private hospitals. These vary from free gifts, free samples, promotional display of breastmilk substitutes, sponsorships, etc. We are aware that hospitals and doctors are even getting paid by the companies to promote a specific formula brand.
The experience of the parents that responded to our survey fully confirm this: 58% of surveyed parents were given free samples of infant formula; half of them were exposed to advertising material while in hospitals… and the list goes on. We have brought more examples of violations of the Code with us today in Annex 3, and they depict a picture of ubiquitous, nationwide and systematic violations.
This situation is the result of poor implementation of the Code and the EU Directive that enacts the International Code in EU countries. There is no monitoring mechanism and no sanctions are in place for cases of violations. And we make a clear recommendation on this point in our report.
Health care personnel are systematically undermining breastfeeding through pushing infant formulas in the health care facilities. The experience from parents shows that doctors do not give the right advice to mothers with regards to breastfeeding, and we have documented many cases that clearly demonstrate this. Our survey showed that 71% of children received formula by hospital staff, and 56% of parents received a prescription for a specific brand of infant formula.
All these facts point to the failure of the health care system to comply with the International Code and failure to protect infants and comply with the recommendations of the World Health Organisation for exclusive breastfeeding for 6 months, followed by continued breastfeeding for at least 2 years.
There is a clear need to train health care professionals on breastfeeding and the risks of artificial feeding so as to create an enabling environment for mothers and babies. Indeed, Greece is one of the few countries in Europe, if not the only country to have no hospital certified as Baby Friendly as yet. The few steps undertaken so far have been a result of isolated individual efforts and not of policies by the Ministry of Health.
Other factors and obstacles that undermine optimal infant feeding also exist, and we elaborate more on them in our report: such as the extremely high rate of medicalized births and of caesarean sections, the lack of a National Infant Feeding Coordinator, the fact that lactation experts are not employed in the health care system, the situation of maternity protection for women employed in the private and unofficial sector being precarious, etc.
We strongly believe that the extent of depriving women in Greece from making and sustaining optimal well – informed choices on infant feeding is resulting in a major human rights’ issue. Adverse experiences of hundreds of unhappy mothers everyday confirm this. We believe that in order to address this dire situation on breastfeeding in Greece, urgent action by the government is required: action to fully implement and monitor the International Code of Marketing of Breastmilk Substitutes; action to form and communicate a National Plan for Infant and Young Child Feeding; action to set up an Initiative for Mother Friendly and Baby Friendly care; action to develop a comprehensive National Breastfeeding Campaign, that will synchronize the different steps needed to address all these obstacles, while targeting the media, the parents, the community, the health system, and the educational system.
Thank you for your attention, and I look forward to receiving your questions.