Recent happenings linking maternal child health and planetary health

Late this autumn, I went for a hike with my family that moved me to tears. As I looked over the rolling foothills cascading in green, its beauty, while simultaneously reflecting on the horrors in this world, provoked a surge of emotion like the swell of ocean waves just over the mountain range we perched upon. 

I shared this experience with one of my dearest mentors and she replied: “I also find nature a powerful midwife and teacher about life. I remember being moved to tears by redwoods standing firm bearing deep gouges and gaping wounds from lightning strikes and subsequent fires… yet continuing to grow and foster another generation.” 

Photo by Tatiana Syrikova: https://www.pexels.com/photo/anonymous-little-kid-touching-tree-with-hand-3932861/

When I returned to my neglected inbox after this respite hiking and exploring new-to-me land, I came across the juxtaposed images of a human fingerprint and the dissection of a tree trunk suggesting that ‘we are nature’. 

With my mentor’s poetry in mind and the concept of “human nature,” I’d like to invite you to explore the following happenings, documents and projects as they all pertain to the inextricable connection between planetary and human health and the influence of infant and young child feeding practices on greater population health, a concept coined One Health

First up, the 46th Session of the Codex Alimentarius Commission (CAC46) came to a close this month. The CAC is a UN body established by the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) in 1963 with a mission to protect consumer health and promote fair practices in food trade.

The International Baby Food Action Network (IBFAN) participated in the session, and as the organization reports:  “After more than a decade of challenging negotiations within the industry-dominant Nutrition Committee, the Revision of the 1987 Follow-up Formula Standard has been officially adopted this week – now renamed the Standard for Follow-up Formula for Older Infants and Product for Young Children.

Thanks to the relentless advocacy efforts of IBFAN, WHO, UNICEF, public interest NGOs, Brazil, Ecuador, Nigeria, and numerous [other] countries, the new standard now makes specific references to the International Code of Marketing of Breastmilk Substitutes and relevant WHA Resolutions in a Preamble. Despite sustained opposition from the USA, these safeguards were retained during CAC, although some of IBFAN’s warnings were removed from the CAC46 report.” 

You can find more detailed coverage at the Baby Milk Action blog here

Also this month, WHO hosted a webinar covering the release of the new WHO guideline for complementary feeding of infants and young children 6-23 months of age

Dr. Francesco Branca began by pointing out some hopeful news.

“The past decade we have seen important gains in improving maternal and child nutrition, including a one-third decline in the proportion of children suffering from stunting, and a tend point increase in exclusive breastfeeding on the way to reaching the 2025 World Health Assembly nutrition target of 50 percent of infants below six months exclusively breastfed. Yet multiple forms of malnutrition, poor growth, micronutrient deficiencies and overweight continue to jeopardize children’s ability to survive and thrive…” 

Dr. Larry Grummer-Strawn summarized that while some of what is in the report is repetitive, there are several key updates. 

For instance:

  • “Milks 6–11 months: for infants 6–11 months of age who are fed milks other than breast milk, either milk formula or animal milk can be fed… Milks 12–23 months: for young children 12–23 months of age who are fed milks other than breast milk, animal milk should be fed. Follow-up formulas are not recommended… (p. 15)
  • “Starchy staple foods should be minimized. They commonly comprise a large component of complementary feeding diets, particularly in low resource settings, and do not provide proteins of the same quality as those found in animal source foods and are not good sources of critical nutrients such as iron, zinc and Vitamin B12. Many also include anti-nutrients that reduce nutrient absorption. (p. 24) 
  • “Foods high in sugar, salt and trans fats should not be consumed… Sugar-sweetened beverages should not be consumed… Non-sugar sweeteners should not be consumed…Consumption of 100% fruit juice should be limited…” (p.32) 

There is also an emphasis on responsive feeding (pages 43 to 47). 

Around 38 minutes into the recording of the webinar, Grummer-Strawn recognizes the reality of consumption of unhealthy food and beverages, the convenience of UPFs and calls on the need for broad policy actions to protect child health. 

Finally, Conference of Parties (COP) 28 wrapped up this month. At COP27, Healthy Children Project’s (HCP) Karin Cadwell presented research on the environmental impact of powdered baby formula milks in North America and HCP’s Kajsa Brimdyr on skin-to-skin contact (SSC) in the first hour after birth as a simple and easy, inexpensive, appropriate for all dyads with countless benefits intervention. (Read more coverage here.) 

Notable from this year’s session, among other important endeavors, includes work by the London School of Hygiene and Tropical Medicine (LSHTM) like the Children, Cities and Climate Action Lab and a partnership to understand how floods and heat driven by climate change affect the delivery of maternal and child health care in Brazil and Zambia

For further reading on climate action, check out Hidden Brain’s newsletter blurb:

“Psychologists have studied how to raise awareness about climate change and get people to take action on the issue. The answer can vary depending on a range of factors, like culture, age, gender, political ideology — the list goes on. An international team of scientists behind a recent paper has created a tool that shows which messages and interventions are most effective with different demographics. ‘To maximize their impact, policymakers and advocates can assess which messaging is most promising for their publics,’ said study co-author Kimberly Doell, who also helped lead the project. Check out the tool for yourself here.

Breastfeeding is eco-friendly.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is eco-friendly.

Planetary protection has never been more crucial, and the undeniable relationship between planetary health and human health has never been more evident.

In November 2022, world leaders, policy-makers and delegates from nearly 200 countries attended the COP27 UN climate summit, held in Sharm El-Sheikh, Egypt.

Fabrication of Bodies Joined by a Molecule of Air(2022), by Invisible Flock and Jon Bausor, manufactured by MDM Props Limited in Lebanon, represented by Architect & Engineer Karim Attoui. ©Courtesy of Invisible Flock. https://invisibleflock.com/portfolio/bodies-joined/

Presenters made poignant remarks about the climate crisis we find ourselves in.

“We are on a highway to climate hell with our foot on the accelerator,” António Guterres, Secretary-General of the United Nations said.

Sherry Rehman, Minister of Climate Change, Pakistan argued that  “The dystopia has already come to our doorstep …”

Mark Brown, Prime Minister of the Cook Islands, shared, “Our survival is being held to ransom at the cost of profit and an unwillingness to act despite the ability to do so.”

On Decarbonization Day of the summit, Dr. Abla Al Alfy convened a panel of speakers who presented on the importance of the 1,000 Golden Days and the relationship between the climate crisis and mother baby health. [You can access the United Nations Egypt’s recording here which starts at 19 minutes in.]

Dr. Nevein Dous, UNICEF health specialist, covered infant mortality rates, micronutrient deficiencies, mental health challenges, among other global health challenges and called for the integration of services rather than siloing health strategies.

WHO

Frederika Meijer with UNFPA Egypt highlighted UNFPA’s work confronting medical violence and reducing the country’s cesarean section rate which soars over 60 percent.

Meijer brought light to the need to create resilient health systems that will withstand the inevitable shocks of the climate crisis.  She noted the important role skilled midwives play in the reduction of unnecessary c-sections, giving way to the work of Dr. Kawther Mahmoud, President of the Nurses Syndicate, Assistant Undersecretary for Nursing and head of the Central Department for Nursing in Egypt, who helps lead the national plan for the midwife.

Many presenters emphasized the importance of family planning counseling and the environmental and health implications of pregnancy spacing.

Dr. Naeema Al-Gasseer’s remarks drew attention to a recent WHO report which states that “Almost the entire global population (99%) breathes air that exceeds WHO air quality limits, and threatens their health.”

Dr. Camilla Kingdon, President of the Royal College of Pediatrics and Child Health, further described that 26 percent of child deaths under 5 years of age have an element of environmental cause like heat waves, water scarcity, vector-borne diseases and flooding. UNICEF has identified that air pollution will be the leading cause of death for children by 2050, she shared. Additionally, there is a clear link between air pollution and miscarriage. Dr. Kingdon went on to describe the prevalence of visible air pollution particles on the placenta.

WHO

In connection to these harrowing accounts, Healthy Children Project’s Dr. Karin Cadwell presented research on the environmental impact of powdered baby formula milks in North America. Read about that work here.

Healthy Children Project’s Dr. Kajsa Brimdyr acknowledged the mess we are in and noted how many solutions that may contribute to planetary and population health are expensive and complex. Skin-to-skin contact (SSC) in the first hour after birth though, is simple and easy, inexpensive, is appropriate for all dyads, and touts priceless benefits.

Brimdyr noted just some of the benefits: SSC in the first hour after birth decreases infant mortality by 25 percent in low birth weight (LBW) infants, decreases transfers to the NICU,  decreases maternal stress and depression, improves paternal parental stress, and allows baby to self attach to the breast improving maternal confidence in breastfeeding and increasing breastfeeding rates overall.

The effects of SSC in the first hour extend far beyond the first hours, the first days and first weeks of life. Feldman et al. (2014) followed mothers and their premature infants who had been in SSC and control groups for 10 years. They found that children who had been in the SSC group had better cognitive development, better autonomic nervous system functioning, and mother–child interactions were more reciprocal 10 years later.

Photo credit: United States Breastfeeding Committee

Silke Mader of the European Foundation for the Care of Newborn Infants (EFCNI) and her colleagues are fighting for SSC and breastfeeding support for all dyads. Mader calls for a zero separation policy which is supported by evidence even in the context of the pandemic, she reported. Mader added that fathers and partners are not second-class citizens and should be included in the policies that help shape proper parent infant bonding.

As the climate emergency becomes more and more bleak, breastfeeding is a safeguard for infant and young child health. Read our coverage on infant and young child feeding in emergencies (IYCF-E)  in Prioritizing infant and young child feeding in emergencies during National Preparedness Month and beyond and National Preparedness Month: the U.S.’s deficit in Infant and Young Child Feeding preparedness during emergencies.

COP27 held the first-ever Youth-led Climate Forum ensuring that young people have a place in the conversation about the climate crisis. More on that here.

 

More resources to explore  

RCPCH Climate Change Working Group

Baby Milk Action’s coverage on COP27

Breastfeeding can help tackle climate crisis but it’s on governments, not mums to save the world

The climate crisis is a health crisis short video

 

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us: Where have you seen predatory marketing of breastmilk substitutes?

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.