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LLLI representation at WABA HIV and Infant Feeding Meeting

(2004) Jacquie Nutt, LLL Leader and Area Coordinator for LLL of South Africa, represented La Leche League International (LLLI) at the HIV and Infant Feeding Meeting, organized by the World Alliance for Breastfeeding Action (WABA) and held in Lusaka Zambia from 2-6 February. As one of WABA's Core partners, LLLI was invited by WABA to participate in this special meeting to plan WABA's response to the HIV and infant feeding issue. After 2 days of visits to field projects, the workshop started with presentations from the Core partners. Jacquie's presentation emphasized LLLI's experience and background in breastfeeding peer counseling training and the development and publication of materials that support the breastfeeding woman. Following the presentations, the meeting participants (25) divided into groups to work on action plans.

The following is Jacquie's detailed report.

SWIMMING WITH THE WHALES:
WABA HIV AND INFANT FEEDING PLANNING MEETING

By Jacquie Nutt, ACL LLL South Africa
Lusaka, Zambia
February 2-6 2004
Submitted by: Jacquie Nutt, LLL Leader, LLL of South Africa

Imagine spending a week with highly energetic breastfeeding activists and promoters. people like Felicity Savage, Audrey Naylor, Michael Latham, Ted Greiner, Nomajoni Ntombela, Beth Styer, Anwal Fazal, Arun Gupta, Sally Page Goertz, and Betty Sterken.

Those were my companions recently in Lusaka, Zambia, at a workshop designed to format a master plan for dealing with the immense infant-feeding dilemma posed by HIV/AIDS.

I represented LLLI along with other Core Partners of the World Alliance for Breastfeeding Action (WABA) LINKAGES, IBFAN, Wellstart International, Academy of Breastfeeding Medicine (ABM) and the International Lactation Consultants Association (ILCA), as well as donor agencies and Zambian government health workers.

Meeting participants benefited from having this particular workshop in a country where the HIV infection rate is high and so is the culture of breastfeeding.

Our introduction to the situation was through two day-long field trips one to the north of Zambia where we visited a LINKAGES project where volunteers support mothers in exclusive breastfeeding, and the other to the south to see a UNICEF funded project. Initially the UNICEF project donated free artificial milk to HIV positive mothers until UNICEF's policy changed and free supplies were withdrawn.

For the past few years, breastfeeding advocates have been asking that artificially fed babies be followed up and the proponents of the MTCT (mother to child transmission) pilot sites have not responded to this request.

One of the priority plans from the WABA HIV and Infant Feeding Meeting is to try and get such figures from all of the pilot sites and to figure out how to ensure the best health outcomes for infants of HIV infected mothers.

Other plans involve:

1) Improved communication between breastfeeding advocates and those recommending replacement feeding to show that everyone wants only what is best for babies. Funding will be sought to send WABA delegates to the major HIV conferences. Personal contact will be made with the major HIV researchers and it was proposed that WABA consider organising a conference with such researchers within 3-5 years.
2) Greater access for anyone interested to HIV-related literature through the WABA website.
3) Increased training by all Core Partners (LLLI, ILCA, Wellstart, and IBFAN) on integrated breastfeeding and HIV counselors (BFHIV counselors) in an attempt to clarify what are now conflicting messages.
4) Identifying gaps in the research.
5) Strengthening support for the Code of Marketing of Breast Milk Substitutes.

LLLI’s role in the WABA action plan

La Leche League’s role can be with training (through the successful Peer Counsellor Training Programme) and in information dissemination. It is proposed that infant feeding in the light of HIV be considered as a topic for LLL sponsored workshops and conferences. LLLI can also inform all LLL Leaders of the WHO/UNICEF Global Strategy for Infant and Young Child Feeding (GSIYCF).

Another idea is to maximize World Breastfeeding Week activities. The 2004 theme is particularly appropriate:

Exclusive Breastfeeding: The Gold Standard.
Safe Sound, Sustainable

The Golden Bow Initiative is also highlighted in the 2004 WBW Action Folder, as well as the GSIYCF. The Global Strategy calls for all governments to “promote and support exclusive breastfeeding for six months and continued breastfeeding up to two years or beyond, while providing women with the support that they require to achieve this goal.”

And more about whales: On my flight back home via Johannesburg, I sat next to Audrey Naylor, President and CEO of Wellstart International, and she told me a fascinating tale of being called in to the San Diego Zoo in the late 1970s to help a baby whale latch. It was one of the first whales born there in captivity and something had gone wrong, so this 3.5-day-old baby had never suckled. All sorts of tricks were tried, including releasing thousands of litres of water from the tank to allow the helpers to manoevre the calf, but sadly all efforts were in vain and the calf died. Since then, however, San Diego zoo has had successful births, including their 19th calf on 9 February 2004.

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