The Innocenti Declaration

by Asheya on June 2, 2010

Written by Melissa
What’s the big deal about breastfeeding?

Why did the medical community undergo such a shift in infant feeding practices in a single generation?
For baby boomers who grew up to embrace a more natural view of life and parenting, breastfeeding and bottle feeding were equal choices. You want to be au natural and breastfeed? Great! You want to bottle feed? Great! But this all changed in a single generation. By the time Generation X and Millennial Generation women were having babies, the medical community shifted to being strongly in favour of breast over bottle. Why?

UNICEF and the World Health Organization mandate for themselves a concerted effort to research and make recommendations regarding infant health around the world, maximizing each child’s optimal chance of health and survival, and recognizing areas of vulnerability where health campaigns can positively impact infant health outcomes in developing nations and in wealthy, developed nations like Canada. Research regarding the appropriateness of human milk for human infants had been published for some time by the late 1980s, but putting that research into practice was proving difficult. In 1990 UNICEF and the World Health Organization decided an organized effort was warranted, so from July 30th to August 1st of 1990, a global initiative meeting was held in Florence, Italy. The result of that meeting was, in part, The Innocenti Declaration. This was a document which made recommendations for every country, developed or developing, regarding optimal infant feeding practices and how governments and policies can impact infant health.

The UNICEF in action website says that:

The Innocenti Declaration was produced and adopted by participants at the WHO/UNICEF policymakers’ meeting on “Breastfeeding in the 1990s: A Global Initiative, co-sponsored by the United States Agency for International Development (A.I.D.) and the Swedish International Development Authority (SIDA), held at the Spedale degli Innocenti, Florence, Italy, on 30 July – 1 August 1990. The Declaration reflects the content of the original background document for the meeting and the views expressed in group and plenary sessions. [Unicef]

The Innocenti Declaration states:


On the Protection, Promotion and Support of Breastfeeding.

Recognising that:

Breastfeeding is a unique process that:

Provides ideal nutrition for infants and contributes to their healthy growth and development
Reduces incidence and severity of infectious diseases, thereby lowering infant morbidity and mortality
Contributes to women’s health by reducing the risk of breast and ovarian cancer, and by increasing the spacing between pregnancies
Provides social and economic benefits to the family and the nation
Provides most women with a sense of satisfaction when successfully carried out

and that Recent Research has found that:

these benefits increase with increased exclusiveness of breastfeeding during the first six months of life, and thereafter with increased duration of breastfeeding with complementary foods, and programme intervention can result in positive changes in breastfeeding behaviour

We therefore declare that:

As a global goal for optimal maternal and child health and nutrition, all women should be enabled to practise exclusive breastfeeding and all infants should be fed exclusively on breastmilk from birth to 4-6 months of age. Thereafter, children should continue to be breastfed, while receiving appropriate and adequate complementary foods, for up to two years of age or beyond. This child-feeding ideal is to be achieved by creating an appropriate environment of awareness and support so that women can breastfeed in this manner.

Attainment of this goal requires, in many countries, the reinforcement of a “breastfeeding culture” and its vigorous defence against incursions of a “bottle-feeding culture”. This requires commitment and advocacy for social mobilization, utilizing to the full the prestige and authority of acknowledged leaders of society in all walks of life.

Efforts should be made to increase women’s confidence in their ability to breastfeed. Such empowerment involves the removal of constraints and influences that manipulate perceptions and behaviour towards breastfeeding, often by subtle and indirect means. This requires sensitivity, continued vigilance, and a responsive and comprehensive communications strategy involving all media and addressed to all levels of society. Furthermore, obstacles to breastfeeding within the health system, the workplace and the community must be eliminated.

Measures should be taken to ensure that women are adequately nourished for their optimal health and that of their families. Furthermore, ensuring that all women also have access to family planning information and services allows them to sustain breastfeeding and avoid shortened birth intervals that may compromise their health and nutritional status, and that of their children.

All governments should develop national breastfeeding policies and set appropriate national targets for the 1990s. They should establish a national system for monitoring the attainment of their targets, and they should develop indicators such as the prevalence of exclusively breastfed infants at discharge from maternity services, and the prevalence of exclusively breastfed infants at four months of age.

National authorities are further urged to integrate their breastfeeding policies into their overall health and development policies. In so doing they should reinforce all actions that protect, promote and support breastfeeding within complementary programmes such as prenatal and perinatal care, nutrition, family planning services, and prevention and treatment of common maternal and childhood diseases. All healthcare staff should be trained in the skills necessary to implement these breastfeeding policies.

Operational Targets

All governments by the year 1995 should have: Appointed a national breastfeeding coordinator of appropriate authority, and established a multisectoral national breastfeeding committee composed of representatives from relevant government departments, non-governmental organizations, and health professional associations

Ensured that every facility providing maternity services fully practises all ten of the Ten Steps to Successful Breastfeeding set out in the joint WHO/UNICEF statement “Protecting, promoting and supporting breastfeeding: the special role of maternity services”.

Taken action to give effect to the principles and aim of all Articles of the International Code of Marketing of Breast-Milk Substitutes and subsequent relevant World Health Assembly resolutions in their entirety;

and enacted imaginative legislation protecting the breastfeeding rights of working women and established means for its enforcement

We also call upon international organizations to:

Draw up action strategies for protecting, promoting and supporting breastfeeding, including global monitoring and evaluation of their strategies

Support national situation analyses and surveys and the development of national goals and targets for action;

and Encourage and support national authorities in planning, implementing, monitoring and evaluating their breastfeeding policies

“Gladys and Elizabeth” by Kate Hansen

Canada was a participating country at the global initiative meeting in Florence, and as such agreed to implement these recommendations in order to optimize health for Canadian infants. This organized effort and policy recommendations initiated change in maternity care that resulted in our present day emphasis on breastfeeding as the optimal infant feeding practice.

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