Breastfeeding Is Accepted Globally As One of the Cornerstones

Question: Breastfeeding Is Accepted Globally As One Of The Cornerstones? Answer: Introduction Breastfeeding is accepted globally as one of the cornerstones of postnatal child health and development (Kuhn et al., 2007). There is convincing testimony that breastfeeding is preventive of a myriad health challenges (Kornides Kitsantas, 2013; McDowell, Wang Kennedy-Stephenson, 2008). Various policy documents have been published governments and non-governmental organizations to promote exclusive breastfeeding and after that to breastfeed together with complementary feeding up to two years. One such document is policy directive from the Australian Government titled Breastfeeding in NSW: Promotion, Protection, and Support. The policy was drafted to serve two purposes within the NSW region. The first purpose is to provide a framework targeted at initiating, sponsoring and protecting, safeguarding and upholding breastfeeding. The second purpose is to clarify the duties and responsibilities necessary for coordination of breastfeeding in NSW Healthcare system. The policy also outlines the mandatory requirements necessary to ensure breastfeeding across specific key areas triumphs. There is a section outlining actions that must be undertaken to ensure that every mandatory requirement is met. Assigning various departments, groups or individuals is easier for implementers to guarantee that the policy is effected wholly. Monitoring and surveillance are one of the mandatory requirements of the policy. Without a carefully coordinated monitoring and surveillance plan, it is difficult to keep track of statistics related exclusivity and duration of breastfeeding and more importantly the areas requiring improvement or even resources (DUrso, 2006; Chapman Prez-Escamilla, 2009). In the wisdom of the drafters of the policy, they saw it fit to provide for the use of WHO standards parameters coupled with nationally recognized breastfeeding terminologies. This is crucial in ensuring the accuracy of the data as well as allow for comparisons with other regions. Monitoring and surveillance have six sections that can be distributed to various agencies or individuals for execution. For example, developing a breastfeeding dashboard indicator can be tasked to a few individuals and piloted in various facilities to determine its workability before it is rolled out nationally. In order to realize the full potential of breastfeeding, the policy advocates for the training of healthcare professionals. Healthcare personnel play a fundamental responsibility in delivering health education and support critical in supporting postnatal growth and development of children (Ekstrm, Kylberg Nissen, 2012). It is only through continuous education that updated and relevant knowledge can be passed to the pregnant and lactating women. Healthcare professionals who are adequately trained are confident at their jobs. It has also been proven to be instrumental in addressing barriers related to initiation and maintenance of successful breastfeeding. Training may involve merging of experience and research with peer support group (Hannula, Kaunonen Tarkka, 2008). Some actions have been outlined in the policy to be key to supporting training of healthcare personnel. One such action is the provision of education related to Baby Friendly Hospital Initiatives (BFHI). BFHI is a conce pt that outlines steps that a maternity healthcare facility has to follow to ensure successful initiation and continuity of breastfeeding in the initial six post natal and after that up to around twenty four months. It is a relatively new concept thus requiring training to ensure healthcare professionals are BFHI savvy (Zareai, O'Brien Fallon, 2007). The policys inclusion of breastfeeding friendly environment including workplaces as a priority area is an adequate demonstration of its depth. Exclusive breastfeeding, which needs to last for the first six months of life, has proven to be challenging for the working women. The duration of paid leave of 126 days in Australia falls short of the first six months life by 8 weeks (Whitehouse et al., 2006; Pincombe et al., 2008; Hewitt, Strazdins Martin, 2017). The policy explicitly advocates for breastfeeding friendly working environments. The benefits that can be ripped from such an undertaking can have far-reaching implications for both the employee and employer. To the employer, breastfeeding friendly environments can be instrumental in ensuring workforce retention and reducing absenteeism and employee turnover. To the employee, a calm and friendly environment translates to reduced stress and adequate care for the growing child. Of the many supportive actions outlined, participating i n talks about ABA Breastfeeding Friendly Workplace Accreditation of all Local Health Districts is instrumental to ensuring that employers take part in the noble course with full knowledge. Reason for choosing policy Advocating for monitoring and surveillance, training of healthcare professionals and inclusion breastfeeding friendly environment and many other mandatory requirements makes the policy an appealing document to analyze. I chose this policy because of immense potential in impacting lives positively, both in the short and long terms. I have a keen interest in studying its implementation at the facility level and document any challenges unique to facilities and how they are being addressed. Policy Summary In summary, the policy aims at promoting, protecting and supporting frameworks to form the basis for ensuring breastfeeding, where possible, is not interrupted. The primary aims center on a number of mandatory requirements, with each split to actions that needed to be done by the Department and Local Health Districts not later than 2015. The actions can be split into executable activities during the implantation stage. Understanding of policy issues Childcare touches everyones live both directly and indirectly. When childcare practices (including breastfeeding) are carried out properly, there can be far-reaching implications. It is difficult for individuals to establish a linkage between simple actions such as proper breastfeeding to legal, economic, social and political goings on around the world. In this section, we shall explore the legal, economic, social and political implications of the policy in the Australian and even the global context. Political Context National budgetary allocations are influenced by political decisions ad prioritization. The policy provides a framework to ease implementation glitches at the national level within the context of the national level. There are many other parameters and documents that were taken into consideration as potential supporters of the current policy including BFHI, Maternal Health and Infant service and Aborigines and Health seeking behaviors among others. All these parameters have an attachment to the national and global politics in various ways. The evidence that public health interventions require high-level support is overwhelming. It means that without the support of the political leadership, leadership within the healthcare and throughout the chain of command to the lowest unit of organization, the policy is just another piece of paper. From the topmost leadership to the implementing healthcare professionals on the ground is a long list of stakeholders who make various decisions and even implement them; this requires collaboration, cooperation and complementation in various capacities. The policy puts emphasis collaboration between NSW Health and stakeholders with similar goals. Economic Context Breastfeeding can have tremendous economic implications to the infant, mother, and society at large. Studies indicate that breastfed infants thrive both physically and mentally into adulthood. In addition, there are reduced instances of childhood illnesses among breastfed infants. The milk if free and therefore the mother does not need to pay to feed the infant. Other benefits related to breastfeeding include prolonged postpartum anovulation, reduces maternal stress, reduced risk of cancer and cardiovascular diseases to the mother. Medical treatment of such diseases cost a lot of money. To the society, having a physically and mentally stable workforce translates to high output per an employee. Despite these benefits, the policy is not clear on how to educate society about all these benefits to ensure each stakeholders efforts, no matter how infinitesimal, is harnessed. Nonetheless, there is dotted compensation of economic of the economic context of the policy by talking about BFHI an d support from the highest level of governance. With BFHI in place, mothers can be more relaxed impacting on employee turnover positively. BFHI has also been implicated in retaining of talent and boosting employee morale. Legal Context The global business environment presented challenges that needed to be addressed legally (Aguayo, Ross, Kanon Ouedraogo, 2003). NSW Health is under the obligation of the law to comply with the World Health Organisations ethics on Global Marketing of Breast Milk Substitutes (BMS). The policy stipulates an avenue that can support staff to notify the advisory committee of any breaches by the manufacturers and any dealers of BMS. NSW Health created a complaint form that can be filled and mailed to the advisory panel. In addition, the NSW Health provides guidelines for the healthcare practitioners to follow when launching a complaint against all BMS handlers; from manufacturing to selling. Social Context The policy recognizes the need social support to ensure that the policy meets its goals. The community plays an integral role in shaping peoples perception and flow and interpretation of information. For that reason, the NSW Breastfeeding policy sought to offer adequate support to breastfeeding mothers with regards to lessening the intricacies related to access and referrals from and from maternity, neonatal and pediatric health services at the community level. Some of key areas of interest include support from professionals, peer support groups and creation and maintaining social networks that promote cohesiveness between pregnant and/or lactating mothers. Appointing peer counselors who work in collaboration professionals is a sure way promoting breastfeeding and addressing any challenges. The policy also recognizes the changing technological environment. As such, it creators were keen on advocating for use technology to pass messages along. This is particularly important for young mothers. They digital platform provides an ease means of forth and back communication. A mother experiencing any challenges can post their messages and get guidance from more experienced peers. Critical discussion and analysis Objectives and goals As discussed under economic context, the policy is not very elaborate the role the employer may have to perform to ensure that policy succeeds with regards to ensuring a friendly breastfeeding working environment. To ensure that happens, the following objectives have been set: To train employers on breastfeeding friendly work place requirement and benefits accrued. To lessen the Breastfeeding Friendly Workplace Accreditation process by half the time taken. To advocate for incentives for employers who implement breastfeeding friendly and baby friendly protocols. Identification of decision parameters Realization of the outlined objectives requires three markers including resources, timeframes, and accurate prioritization. Some of the most critical resources required include capital, personnel, space and time. Availing all these resources from the start is critical to the success of the whole process once set in motion. Capital is essential during training, hastening the Breastfeeding Friendly Workplace Accreditation and offering incentives to the employers. Organizing for training may include preparation of training materials, hiring of training and making reconnaissance visits, to mention just but a few, require money. The government will be a contributor. Other stakeholders with similar goals can also chip in for support. Hastening the process of Breastfeeding Friendly Workplace Accreditation may require frequent and hastened visits to companies seeking installation breastfeeding friendly facilities. The Work-Life Grant set aside is hardly enough. In addition is too general. It covers a wide range of issues from disability to breastfeeding friendly workplace initiatives. Having a breastfeeding support grant will expedite many of the steps known to stall. Having adequate and well-trained workforce on breastfeeding skills is important for the overall realizing of the set objectives. Trainers well versed with workplace breastfeeding can be able to convince an employer that installing such gadgets is a strategic step towards enhancing company performance. Employers will need to be versed with creating an extra conducive room fitted with furniture and a means of refrigerating the milk. The room should provide adequate privacy. Ideally, an electric outlet and sink will be required for hand washing before and after expressing. The employer will need to be taught how long breastfeeding or expressing milk may take so as to allow mothers to take 2-3 breaks of 15-30 minutes per day. Without a timeframe, the realization of the set objectives is likely to prove difficult. To ensure this happens, the following time frames have been set: Table One: Timeframe Objective Timeframe To train employers on breastfeeding friendly workplace requirement and benefits accrued. 2017-2022 To lessen the Breastfeeding Friendly Workplace Accreditation process by half the time taken. 2017-2018 To advocate for incentives for employers who implement breastfeeding friendly and baby friendly protocols. 2017-2019. Prioritization is an important element to ensure all activities are coordinated smoothly. Preliminary activities will take precedence to lay the groundwork for objectives listed. The second objective will become the priority to ensure that the employers are well versed with workplace support needed to support breastfeeding. The procedure may involve a tour to various companies applying for the exercise to gauge the complexity of their management. Small companies will be advised to elect project leaders who will serve as contact persons for future follow ups on the progress of the process. Huge companies may need to hire consultancy services to evaluate the requirements necessary to set up rooms and gadgets required for the exercise. Compared to the first and third objectives, the first objective spans for a relatively shorter period, that is 2017 to 2018. The third objective which seeks to provide employers with incentives will come second. This objective seeks to ensure many employe rs get enticed to roll out the program in their workplace. As the third objective is taking speed, the first objective will be set in motion. Some of the potential contributors to the Work-Life Grant would be employers themselves. Alternatives Breast milk is an ideal food there can be for an infant. However, once in a while, breastfeeding may not be possible due to various reasons (Aguayo, Ross, Kanon Ouedraogo, 2003). Various companies such as Nestle specialize in producing breast milk substitutes. Time and again, such companies have found in awkward positions putting profits before customers. Their notoriety for excessive marketing in yesteryears cannot go unnoticed (Brady, 2012). Before the introduction International Code of Marketing of Breast-milk Substitutes, the companies had almost managed to convince everyone that MBS were superior to breastmilk in term of nutrient composition (World Health Organization, 2013). However, this has long been disputed with scientific studies that have proven than breast milk has antibodies that BMS cannot provide. In addition to the physical benefits of milk to the infants, breast milk also confers psychological benefits. In circumstances where breastfeeding has proven impossible, BM S is next possible idea meal for an infant. Preparation of BMS requires keenness and high hygienic standards that are hard to maintain (World Health Organization, 2010). The other alternative available to nursing mothers is buying of already human expressed milk. It is a new concept that has taken the world by surprise. Some women can produce more milk than infant may require. They have a decision to make about the extra milk. Some opt to express and store and some discard (Akre, Gribble Minchin, 2011). With the help of the internet, it has become a common phenomenon to find women asking what to do with the extra milk (Weber et al., 2011). Slowly but surely, the idea of selling the surplus is gaining popularity. However, one of the biggest challenges of the online platform is that it is unregulated. There are multiple websites currently dedicated to facilitating the trade. However, the FDA warns against feeding a child directly milk acquired from another source other than the mother of the child. Such milk comes with high risks of the child contracting viruses such as HIV and cytomegalovirus (CMV (Keim et al., 2013). Some countries have established milk banking system with similar workings as blood banks; an example is Human Milk Banking Association of North America. It has fully installed systems of that are instrumental in screening for infections and usage of elaborate lifestyle questionnaires to determine the suitability of the milk (Geraghty, Heier Rasmussen, 2011). Conclusion Breastfeeding certainly remains unparalleled as the most suitable mode of infant feeding. The option of BMS and buying of human milk cannot, however, go unnoticed. However, the Breastfeeding in NSW: Promotion, Protection, and Support does not provide offer guidance on how society can deal with these new occurrences. Purchasing of already expressed human milk presents new challenges. The quality of the human milk purchased online is difficult to determine in terms of microbial contamination. In addition, one is left wondering if a child who feeds on purchased human milk in the six months postnatal should be considered to have been exclusively breastfed. To address the challenges posed, we recommend that the policy be revised taking into account new challenges. References Aguayo, V. M., Ross, J. S., Kanon, S., Ouedraogo, A. N. (2003). Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso. Bmj, 326(7381), 127 Akre, J. E., Gribble, K. D., Minchin, M. (2011). Milk sharing: from private practice to public pursuit. International breastfeeding journal, 6(1), 8. Brady, J. P. (2012). Marketing breast milk substitutes: problems and perils throughout the world. Archives of disease in childhood, 97(6), 529-532. Chapman, D. J., Prez-Escamilla, R. (2009). US national breastfeeding monitoring and surveillance: current status and recommendations. Journal of Human Lactation, 25(2), 139-150. DUrso, S. C. (2006). Whos watching us at work? Toward a structuralperceptual model of electronic monitoring and surveillance in organizations. Communication Theory, 16(3), 281-303 Ekstrm, A., Kylberg, E., Nissen, E. (2012). A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding: an intervention study. Breastfeeding Medicine, 7(2), 85-92. Geraghty, S. R., Heier, J. E., Rasmussen, K. M. (2011). Got milk? Sharing human milk via the Internet. Public Health Reports, 126(2), 161-164. Hannula, L., Kaunonen, M., Tarkka, M. T. (2008). A systematic review of professional support interventions for breastfeeding. Journal of clinical nursing, 17(9), 1132-1143. Hewitt, B., Strazdins, L., Martin, B. (2017). The benefits of paid maternity leave for mothers post-partum health and wellbeing: Evidence from an Australian evaluation. Social Science Medicine. Keim, S. A., Hogan, J. S., McNamara, K. A., Gudimetla, V., Dillon, C. E., Kwiek, J. J., Geraghty, S. R. (2013). Microbial contamination of human milk purchased via the Internet. Pediatrics, 132(5), e1227-e1235. Kornides, M., Kitsantas, P. (2013). Evaluation of breastfeeding promotion, support, and knowledge of benefits on breastfeeding outcomes. Journal of Child Health Care, 17(3), 264-273 Kuhn, L., Sinkala, M., Kankasa, C., Semrau, K., Kasonde, P., Scott, N., ... Aldrovandi, G. M. (2007). High uptake of exclusive breastfeeding and reduced early post-natal HIV transmission. PloS one, 2(12), e1363. McDowell, M. M., Wang, C. Y., Kennedy-Stephenson, J. (2008). Breastfeeding in the United States: findings from the national health and nutrition examination surveys, 1999-2006. NewYork: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Pincombe, J., Baghurst, P., Antoniou, G., Peat, B., Henderson, A., Reddin, E. (2008). Baby Friendly Hospital Initiative practices and breast feeding duration in a cohort of first-time mothers in Adelaide, Australia. Midwifery, 24(1), 55-61. Weber, D., Janson, A., Nolan, M., Wen, L. M., Rissel, C. (2011). Female employees' perceptions of organisational support for breastfeeding at work: findings from an Australian health service workplace. International breastfeeding journal, 6(1), 19. Whitehouse, G., Baird, M., Diamond, C., Hosking, A. (2006). The parental leave in Australia survey: November 2006 report. World Health Organization. (2010). International code of marketing of breast-milk substitutes. 1981. World Health Organization: Geneva. World Health Organization. (2013). Country implementation of the international code of marketing of breast-milk substitutes: status report 2011. Zareai, M., O'Brien, M. L., Fallon, A. B. (2007). Creating a breastfeeding culture: a comparison of breastfeeding practises in Australia and Iran. Breastfeeding Review, 14(2), 15-24.