Tomorrow we kick off World Breastfeeding Week (WBW) 2022! As always, WBW is a time to focus, reflect, galvanize and forge forward protecting, promoting and supporting breastfeeding to address inequalities that stand in the way of achieving Sustainable Development Goals in commemoration of the 1990 Innocenti Declaration. 
Coordinated by the World Alliance for Breastfeeding Action (WABA), this year’s theme, Step Up for Breastfeeding: Educate and Support, focuses on strengthening the capacity of actors at different levels of society to protect maternal child health and ultimately global health. Target audiences including governments, health systems, workplaces and communities make up the warm chain of support for breastfeeding and must be informed, educated and empowered to strengthen their capacity to provide and sustain breastfeeding-friendly environments for families in the post pandemic world. [https://worldbreastfeedingweek.org/]
The following story is an example of multi-level engagement– from community members to the Ministry of Health– working toward the shared goal of ensuring food security and reducing inequalities.
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There’s a sliver on the globe, a place called Timor Leste, one of the newest countries in the world. It gained independence from Indonesia in 2002.
In the spring of 2021, the small island country of about 1.3 million people endured major flooding, killing 44 people and affecting over 30,000 households. [More figures about this tragedy can be found in the OCHA situation report here.]
Prior to the flooding, families in Timor Leste were already challenged by extreme child malnutrition. One in 24 children under five years old will not survive to celebrate their fifth birthday. [UNICEF 2018]
Nearly 2,000 people were displaced during the flooding, seeking safety at evacuation centers and camps. As is often the case during emergencies, those in Timor Leste dealt with the subsequent flooding of infant formula, baby cereals and feeding material donations. Artificial feeding methods can be dangerous especially during emergency situations and undermine breastfeeding.
Dr. Magdalena Whoolery reported in Strategies for Infant and Young Child Feeding in Climate-Related Emergencies that the Indonesian Bank donated 180 kgs of infant formula during this emergency. The conditions in the camps are dire, she said. The situation did not welcome a safe environment for artificial feeding. Dr. Whoolery went on to show photos of children eating artificial milk powder from packages.
In an effort to properly serve those facing disasters and emergencies, Whoolery and her colleagues developed the first “Nurturing Care Centers of Excellence (NCCE) for Emergencies and Beyond”, a cost-effective and innovative package of care for rapid integration of MCH-IYCF recommended practices. The centers were developed based on WHO’s five components of nurturing care.
Whoolery proudly reported that over 1,000 families were supported through NCCE; 571 children under 5 and over 600 lactating and pregnant women.
The initiative included strategies like emphasizing the importance of skin-to-skin. While skin-to-skin is often overlooked during emergencies, it helps mothers continue producing milk, offers calming effects to both mother and child and limits child trafficking because there is zero separation of the dyad.
The program offers instruction on relactation and bottle amnesty where caregivers are made aware of the risks of bottle feeding and offered cups in exchange for their bottles.
NCCE places an emphasis on cooking traditional foods to uphold a sustainable food system.
Community members are also trained to manage and intercept artificial baby milk and other ultra-processed food product donations.
Following the successful pilot of NCCE at an evacuation center, and improved outcomes of maternal, child and infant health and nutrition, the Ministry of Health requested UNICEF support in replicating the program in all 20 evacuation centers. NCCE is now integrated as part of the National Mother Support Group under the Alola Foundation’s directive. [https://www.globalbreastfeedingcollective.org/strategies-infant-and-young-child-feeding-climate-related-emergencies]
Whoolery offers a higher understanding of these numbers and successes. Behind the statistics are children, she reminded us. Juxtaposed photos– the first of a 2 year old depicted with his arm measurement in the red (a danger sign for risk of death) and the next of him thriving, held by his smiling mother after she was able to feed him her expressed milk– demonstrate the power of human milk and the importance of supporting efforts like those of Whoolery and her colleagues.
Timor Leste’s “Country Profile for Early Childhood Development”, developed by UNICEF in collaboration with Countdown to 2030 Women’s, Children’s and Adolescent’s Health is available here.
For more stories like this, read the Global Breastfeeding Collective’s Compendium of Skilled Breastfeeding Counselling Case Studies.
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