Fellow Citizens and Residents of St. Kitts and Nevis:
During the period August 18-24, 2019 the Federal Ministry of Health will be highlighting the practice and benefits of breastfeeding via the celebration of Breastfeeding Week. In keeping with the tenets of World Breastfeeding Week – which was held from August 1-7, 2019 - our local activities are being observed under the theme “Protect Breastfeeding in the Workplace”. The Federal Ministry of Health views this week of activities as a perfect opportunity to join with premiere international health agencies such as the Pan American Health Organisation (PAHO) and the World Health Organisation (WHO) in advocating for, sustaining and strengthening - where necessary - those measures designed “to protect, promote and support the right to breastfeeding”1.
The Federal Ministry of Health has, for decades, consistently advocated for the time-honoured, maternal practice of breastfeeding, given the numerous health benefits to both mother and child. Human history provides undeniable proof that the survival of our race could not have been possible without the consistent practice of breastfeeding. The Ministry continues to remind everyone that breastfeeding is a natural and progressive building block that should immediately follow childbirth. In this way, our Nation’s children will have the best chance at living strong, long and resilient lives and, in so doing, minimize the likelihood of illnesses, diseases and nutritional deficiencies throughout the entire life course. Breastfeeding’s benefits to the mother are also being promoted by the Ministry, including the fact that breastfeeding (a) reduces the risk of breast and ovarian cancers; (b) assists the uterus in returning to normal size after childbirth – due to the uterine contractions produced during breastfeeding times; (c) helps in spacing of pregnancies; and (d) improves the bonding experience between mother and child.
As the leading global health agency, the WHO is a keen and consistent advocate of breastfeeding, and has determined that the chances of survival among newborns would be dramatically increased if they are breastfed within one hour after birth. Together with the United Nations Children’s Fund (UNICEF), the WHO also recommends that breastfeeding be exclusively done for the first six (6) months of life, and that solid foods be introduced at (six) 6 months – to complement ondemand breastfeeding – up to age 2 or beyond.
The WHO has also estimated that the lives of over 820,000 infants under the age of five (5) could be spared if breastfeeding practices are optimized. Moreover, the good nutrition provided in breast milk is clearly linked to improvements in Intelligence Quotient (IQ), school attendance, and higher incomes in adulthood – as children who are healthy and well-fed learn better, and generally obtain better grades and higher levels of education which together improve earnings over time. Unfortunately, poor nutrition is clearly linked to some 45% of all global deaths of children2. In 2016 alone, some 155 million children under the age of five (5) were deemed to be too short for their age, while about 52 million were deemed to be too thin for their height, and another 41 million were classified as overweight or obese. However, it is being reported globally that only two out of every five newborns are breastfed within one hour of birth. Additionally, only 40 percent of children under the age of six (6) months are being breastfed exclusively. The other 60 percent are being fed a combination of breast milk and complementary food.
Thankfully, these unfortunate global statistics on breastfeeding do not mirror the current situation in the wider Caribbean, and more specifically, St. Kitts and Nevis. We are happy to report that in the Federation our exclusive breastfeeding rates are relatively high and continue to increase. Data obtained from both JNF General Hospital on St. Kitts and Alexandra Hospital on Nevis demonstrate that the rate among newborns with exclusive breastfeeding by the time of hospital discharge was 80% to 100% during the period February – May 2019. By extension, during the same period, both hospitals recorded a range of 85% to 100% for babies who were breastfed within one (1) of hour of life. Data obtained from the USAID Assist project demonstrate that at the start of the project in September 2018 only 40% of babies were being breastfed within one hour of birth. However, by May 2019, this figure shot up to 100%. Marked improvements were also seen insofar as (a) skin-to-skin contact between mother and baby immediately after birth; and (b) the number of babies who were exclusively breastfed by the time of hospital discharge. A rate of 100% was achieved in the month of May 2019 alone.
It is worthy of note that breastfeeding policies and practices in St. Kitts and Nevis continue to be informed by a number of international agreements and guidelines pertaining to breastfeeding, and maternal and child health.
These include the “Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding” and the WHO/UNICEF Baby Friendly Hospital Initiative, both of which I will describe as follows:
- “Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding” which was endorsed in Florence, Italy in 1990 by the United Nations (UN) Member States. The Declaration acknowledges that the practice of breastfeeding provides infants with the best nutrition possible in early life, and lowers the likelihood of infant deaths and disabilities, while benefitting mothers with lower risks of developing breast and ovarian cancers. Among other matters, the Declaration also emphasizes that women should be free to practice breastfeeding in both the workplace and the community, and that any barriers to such must be eliminated. The Declaration also called on governments to establish positive breastfeeding policies in collaboration with key stakeholders including parents, and organisations representing workers and employers.
- The WHO/UNICEF Baby Friendly Hospital Initiative – launched in 1991 - which outlines 10 Steps to Successful Breastfeeding to be followed by all Governments and private sector agencies when providing maternity services to mothers and expectant mothers.
These steps are as follows:
1) Having a written breastfeeding policy that is routinely communicated to all health care staff.
2) Training all health care staff in skills necessary to implement this breastfeeding policy.
3) Informing all pregnant women about the benefits and management of breastfeeding.
4) Helping mothers initiate breastfeeding within a half-hour of birth.
5) Showing mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
6) Giving newborn infants no food or drink other than breastmilk, unless medically indicated.
7) Practicing rooming-in -- allow mothers and infants to remain together -- 24 hours a day.
8) Encouraging breastfeeding on demand.
9) Giving no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
10) Fostering the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
As Minister of State with responsibility for health I am happy to report that at all 17 of our Nation’s health centres and four hospitals, these critical steps are being practiced and encouraged by our health care workers, particularly those charged with maternal and child health programming. As was done during last year’s celebration of Breastfeeding Week, I again take this opportunity to commend all of our public sector healthcare workers for their untiring efforts in the encouragement and advocacy of breastfeeding among nursing and expectant mothers in our Country.
In light of the fact that the theme for this year’s Breastfeeding Week is “Protect Breastfeeding in the Workplace” it should be noted, that while it is not common national practice for lactating mothers to bring their infants on the job and breastfeed them there, it has been the practice of successive governments in St. Kitts and Nevis to support and promote maternity rights and employment protection during maternity leave. History would record that St. Kitts and Nevis is long past the era of granting just one (1) month’s maternity leave to women. By the mid-1980s the PAM-Administration would have considerably extended maternity leave to 13 weeks of paid leave, with 65% of normal wages paid by Social Security. In many cases, private sector employers have observed the unwritten practice of paying the remaining 35% of wages directly to employees during maternity leave, so that they would not be financially challenged during their time away from work.
Our Government notes that United Nations’ (UN) agencies such as PAHO and the International Labour Organisation (ILO) are now advocating for wide-scale ratification of the optional ILO Convention #183 on Maternity Protection which calls for, among other matters (1) the granting of a minimum of 14 weeks maternity leave; (2) the granting of at least one (1) daily break for breastfeeding or reduced hours of work with pay to accommodate breastfeeding; and (3) the protection of pregnant and breastfeeding women from work that would compromise their health or that of their unborn children, as determined by a competent State authority. The matter of ILO Convention #183 will be reviewed by Government with a view to assessing how national law and practice can be enhanced in order to further protect the maternal rights of pregnant and breastfeeding women.
A programme of activities for the 2019 observance of Breastfeeding Week has been prepared by the Nutrition Programme staff within the Federal Ministry of Health.
The highlights of these activities are as follows:
- Locally produced breastfeeding documentary - to be aired daily in work places and health facilities throughout the week.
- Locally produced breastfeeding animation - to be aired throughout the week in the following locations: St. Kitts and Nevis Eateries; St. Kitts and Nevis Ferry Terminals; and the Pelican Mall in St. Kitts;
- Twenty-hour (20) training programme on the Baby Friendly Hospital Initiative for Community & Maternity Nurses – tentatively scheduled for August 19th – 21st
It should be noted that a number of activities have been planned for the island of Nevis. It must also be noted that at least one activity was executed in advance of Breastfeeding Week, that is, an appearance on the weekly Government Information Programme, “Working for You” which aired on Wednesday, August 14th on ZIZ Radio & Television on the topic of Breastfeeding and the Baby Friendly Hospital Initiative I mentioned earlier. I take this opportunity to commend the following maternity nurses who took part in that programme, namely Assistant Nurse Manager, Jacquelin Duncan and Staff Nurse Naomi Brownbill; and Clinical Instructor, Mary Caines of JNF General Hospital.
The Federal Ministry of Health again commends the staff of the Nutrition Surveillance Programme for their ongoing efforts in planning and preparing for this annual week of activities in recognition of the importance of Breastfeeding to infant health and development. The Ministry also salutes the consistent efforts of our nurses and midwives; general healthcare practitioners; and obstetricians, gynaecologists and paediatricians who continue to advocate for health and wellness for our people throughout the life course. The Ministry recognises that without good health and wellness St. Kitts and Nevis cannot be a prosperous Nation where the goals of development can be fully realised and the gains can be shared by all.
On behalf of the Government of St. Kitts and Nevis I am pleased to declare Breastfeeding Week 2019 in the Federation officially open.
May God bless us with good health and well-being.
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