How A City Increased Exclusive Breastfeeding Rates From 13% To 40%

How A City Increased Exclusive Breastfeeding Rates From 13% To 40%

Leading health organisations from around the world, such as the World Health Organization, recommend exclusive breastfeeding for the first 6 months, and thereafter for breastfeeding to continue, alongside suitable complementary foods, for 2 years and beyond.

Despite the recommendations, many countries fall short of these goals. There is still much to be done to help increase breastfeeding rates. In fact, 2015 UNICEF global databases report only 38% of children under 6 months of age are exclusively breastfed.

However, one of the seven Emirates of the United Arab Emirates (UAE), Sharjah, has taken measures to help increase exclusive breastfeeding rates, launching an extensive breastfeeding campaign called the Sharjah Baby-Friendly Campaign (SBFC) in 2012.

Sharjah reported exclusive breastfeeding rates at 6 months to be 13.3% in 2006, and 18.1% in 2011. However, in 2013, within 2 years of the launch of SBFC, the exclusive breastfeeding rate at 6 months had increased to 39.9%.

So, how did the SBFC help increase Sharjah’s exclusive breastfeeding rates so dramatically and what can other countries learn from this? Read on to find out.

The SBFC consisted of the following four complementary initiatives:

#1: Baby-Friendly Health Facility Initiative

This initiative was based on an internationally accredited Baby-Friendly Health Initiative (BFHI), launched in 1991 by WHO and UNICEF. The aim of this initiative is to create a healthcare environment that supports breastfeeding as the norm. In order for a health facility to obtain the Baby-Friendly accreditation, it must:

Since 1993, the UAE MOH (Maternal and Child Health Central Administration) has promoted the BFHI. Between 1993 and 2011, 11 health facilities received BFHI accreditation.

Since the SBFC launch in 2012, BFHI accreditation of 22 MOH primary health centres, 4 MOH hospitals, and 3 private hospitals in Sharjah has been facilitated.

#2: Mother-Friendly Workplace Initiative

This initiative supports mothers to continue breastfeeding after returning to work. A workplace is designated as ‘Mother-Friendly’ when it has:

  • A written breastfeeding policy
  • A designated breastfeeding/expressing room
  • An approved work break time to allow for breastfeeding/expressing
  • Peer support of breastfeeding

#3: Breastfeeding-Friendly Nursery Initiative

This initiative provides information and support to mothers to help them continue breastfeeding. Nurseries or day-care centres are designated as ‘Breastfeeding-Friendly’ if they have:

  • A written breastfeeding policy
  • A room for the mothers to breastfeed/express
  • Staff trained in breastfeeding support
  • Literature and visuals depicting breastfeeding as the normal way to feed babies

#4: Mother-Baby Friendly Public Place Initiative

This initiative supports breastfeeding in public. A public place is designated as ‘Mother-Baby Friendly’ if it has:

  • A written breastfeeding policy
  • A room for mothers to be able to breastfeed/express in comfort and privacy.

Additionally, the following 11 strategies were undertaken to assist with the implementation of the above initiatives:

#1: Health Professional Education

The SBFC undertook to provide 10 free workshops between 2012 and 2015. In doing so, 1,400 health professionals were trained and 25,844 hours of continuing medical education were awarded.

#2: Professional Support

Between 2012 and 2015, the SBFC conducted up to 700 meetings and visits to public and private bodies and facilities, to familiarise various stakeholders about the SBFC’s objectives.

#3: Prenatal Education

The SBFC launched prenatal breastfeeding education classes, providing various health facilities with evidence-based breastfeeding educational materials.

#4: Back To Work Education Classes

The SBFC introduced classes at various workplaces, to support the Mother-Friendly Workplace Initiative.

#5: Well Baby, Infant And Young Child Feeding Classes

The SBFC launched these classes to educate mothers on the nutritional needs for their child’s specific age bracket.

#6: Breastfeeding Educational DVD

The SBFC obtained copyrights to a breastfeeding education DVD, From Bump to Breastfeeding, made by the Best Beginnings charity from the United Kingdom.  The SBFC titled the DVD From Pregnancy to Breastfeeding, in Arabic, and distributed copies to all UAE hospitals. They were also distributed during various events and exhibitions.

#7: SBFC Website And Social Media Accounts

To enable SBFC to reach a diverse range of stakeholders, the team developed:

  • A website
  • A Twitter account (@sharjahbabyfriendly)
  • An Instagram account (@shjbabyfriendly)
  • A Facebook account (sharjahbabyfriendlycity)
  • A blog

#8: SBFC Android And iOS Apps

SBFC developed and launched Android and iOS apps to reach a diverse range of people within the community, especially targeting young people.

#9: Mobile Mother Room

The SBFC developed a Mobile Mother Room – a caravan placed at various public places to provide a relaxed and private environment where mothers can breastfeed or express.

#10: Community-based Breastfeeding Promotion And Support

The SBFC provided 1,000 mothers with  mother-to-mother breastfeeding support training.

#11: Breastfeeding Support Hotline

The SBFC provided a breastfeeding support hotline for mothers, in addition to the existing hotline, so that other cities within the Emirate of Sharjah could also benefit from this service.

So what can other countries learn from this? Well, it’s often said it takes a village to raise a child. Often, the same goes for breastfeeding. Successful breastfeeding requires an entire community effort. The significant improvements in exclusive breastfeeding rates in Sharjah reflect the success of SBFC.

SBFC’s  innovative and extensive strategies, which involve the whole community, have helped develop an all-encompassing breastfeeding culture, where breastfeeding is valued, protected and considered normal – not only within healthcare facilities but also in workplaces, day-care centres, nurseries and public places.

Indeed, other countries can learn a lot from Sharjah, the world’s first breastfeeding friendly city.

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Renee Kam is a mother of two daughters, an International Board Certified Lactation Consultant (IBCLC), a physiotherapist, author of 'The Newborn Baby Manual' and an Australian Breastfeeding Association Counsellor. In her spare time, Renee enjoys spending time with family and friends, horse riding, running and reading.

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