母乳餵哺是史上最實惠、最有效的兒童救星

 

母乳餵哺是史上最實惠、最有效的兒童救星

國際消息 00:27

母乳餵哺是史上最實惠、最有效的兒童救星

 

紐約/香港,2013年8月1日──每年一度的「國際母乳哺育周」今天展開,聯合國兒童基金會(UNICEF)一直致力於母乳餵哺的工作,藉此重申母乳餵哺是眾多拯救兒童的生命中,最有效、最實惠的方法。然而,全球6個月以下兒童當中,僅有不足一半能受惠於純母乳餵哺,反映強而有力的主導倡議是不可或缺的。

「世上沒有任可單一的健康措施,能像母乳餵哺一樣,可對母嬰帶來如此巨大的益處,而對政府所帶來的經濟負擔卻極輕微。」UNICEF副執行主任吉塔.饒.古普塔(Geeta Rao Gupta)續指,「母乳餵哺是嬰兒的第一道疫苗,同時是史上最有效、最實惠的救星。」

在出生後接受純母乳哺育的兒童,他們的生存率較非母乳哺育的兒童於首6個月的存活率足高出14倍;而在出生後的第一天,開始餵哺母乳,更可減低新生兒死亡風險達45%。

母乳餵哺同時有助提高兒童的學習能力、預防肥胖,及將來患上慢性疾病的機會。英、美兩國近期的研究亦指出,母乳餵哺猶如建立龐大的健康寶庫,因為接受母乳哺育的兒童患病的機會,較非母乳哺育的兒童明顯少。

Niger, November 2012. Haouaou Abdou, 52, mother of 6 children is smiling at her youngest son Issiakou, 8 months, in the village of Mazadou Abdou. By Jessica Mony In 2011, droughts across the Sahel plunged millions of families into a food crisis. A year after UNICEF and partners’ emergency response began, we ask ourselves how can we stop this vulnerability and persistent cycle of suffering? A poor, rural Nigerien village 600 people may hold the answer. Here, despite every family’s struggle during the drought, no child suffered malnutrition in 2012. Just three years ago it was rare for a week to go by without a child dying from combinations of malnutrition, diarrhoea and malaria in Mazadou Abdou village. During the frequent droughts, at times this would rise to two or three. No family was spared the pain of loss and mourning. Haouoau and Loli Abdou are just one set of parents that faced this tragedy. Loli holds up three fingers and lists that in 2000, 2002 and then again in 2004 they lost three children to malaria. Looking solemnly at their healthy 8 month baby boy Issiakou, it is clear the scars will likely never heal for this family. Sadly, their situation is not unique in this or any other village across the Sahel. Fortunately, in 2008 a simple UNICEF programme of family practices helped change all of this. The practices are simple and include exclusive breastfeeding for the first six months of life; complementary feeding for children after six months; proper hand-washing techniques; treatment of diarrhoea; knowledge of how to seek medical care; immunisation; using mosquito nets to prevent malaria; promotion of delayed pregnancies and girls education. The results of adhering to these practices for the children of Mazadou Abdou have been significant. Moutari Louali, a community volunteer who is helping to implement the programme explains the impact. “Before the programme started, around four to five children would die every month from malaria, diarrhoea and other diseases. Now, during the whole of this year only three children died, and this was because of miscarriages.” From the chief through to parents and children themselves, the whole village is determined that no child should die from preventable diseases. Haouaou is clearly proud of the result “In this village we didn’t have any malnutrition because we take care of our children. I am very happy about how healthy our children are.” At the heart of the programme are volunteers like Moutari who, along with two other volunteers selected by the community, ensure that every family implements the practices and monitors progress. Every week the group visit up to five families to run information sessions. Today, Moutari is visiting Hoauoau’s household. Starting with an update on the health of their children, Moutari then calls a mother and her child forward to demonstrate a particular practice. Today it’s the use of mosquito nets and hand washing. Everyone here comes to listen and learn. Haouaou points at two of her daughters who were born before and after the programme started and she learnt about the benefits of exclusive breastfeeding. “Look you can see this one is much stronger.” Whilst drought, hunger and vulnerability are an ongoing reality for these families, their efforts to implement the programme are the key to ensuring their children not only survive, but are resilient through times of drought and extreme hardship. Issa Ibrahim the 63 year old chief of Mazadou Abdou describes the precarious situation many families across the Sahel live in. “In this village our life is based around farming. The difficulty of this life is that if the rainy season doesn’t give a good harvest, life becomes extremely difficult for us.” For now the health of their children is safe, but the challenges ahead for the village are immense. A community run cereal bank will help tide them over for a while, but after this the only other option for many families is for husbands and fathers to head to Nigeria to search for work. Haouaou has thirty bowls of millet to feed her family until the harvest a year away. It will only last a month. She holds out the bowl and laughs nervously. “What can we do?” Whilst Mazadou Abdou’s families continue to walk a tightrope of vulnerability, their newfound knowledge will keep their children alive and healthy. It is not the whole solution, but it provides the hope of a future for their most precious resource, their children. The Chief is thankful for how far they have come. “We are very proud and happy for what we have done here. We thank God, we thank the people who taught us these practices”, but he is also conscious of the toll of chronic hunger on the future of this community; “If a man is hungry he cannot hear, he cannot learn anything.” The impact of the emergency response across the Sahel can be seen in the short term in the lives saved and the malnutrition prevented. For vulnerable families like Haouaou’s though, building resilience and food security will be key to long term change. This village has demonstrated the success of community driven initiatives to improve children’s health, but more support is needed to ensure communities across the Sahel are able to withstand crises. Haouaou tries not to think about what might happen a year from now; “Nobody can forsee the future. Even if we wait and hope for the best, anything can happen at any moment.” UK Natcom - for local copies of the files: Y:Key-initiativesIFSahel-Stories-2012Niger Niger, November 2012. Haouaou Abdou, 52, mother of 6 children is carries her youngest son, is Issiakou, 8 months, in the village of Mazadou Abdou. By Jessica Mony In 2011, droughts across the Sahel plunged millions of families into a food crisis. A year after UNICEF and partners’ emergency response began, we ask ourselves how can we stop this vulnerability and persistent cycle of suffering? A poor, rural Nigerien village 600 people may hold the answer. Here, despite every family’s struggle during the drought, no child suffered malnutrition in 2012. Just three years ago it was rare for a week to go by without a child dying from combinations of malnutrition, diarrhoea and malaria in Mazadou Abdou village. During the frequent droughts, at times this would rise to two or three. No family was spared the pain of loss and mourning. Haouoau and Loli Abdou are just one set of parents that faced this tragedy. Loli holds up three fingers and lists that in 2000, 2002 and then again in 2004 they lost three children to malaria. Looking solemnly at their healthy 8 month baby boy Issiakou, it is clear the scars will likely never heal for this family. Sadly, their situation is not unique in this or any other village across the Sahel. Fortunately, in 2008 a simple UNICEF programme of family practices helped change all of this. The practices are simple and include exclusive breastfeeding for the first six months of life; complementary feeding for children after six months; proper hand-washing techniques; treatment of diarrhoea; knowledge of how to seek medical care; immunisation; using mosquito nets to prevent malaria; promotion of delayed pregnancies and girls education. The results of adhering to these practices for the children of Mazadou Abdou have been significant. Moutari Louali, a community volunteer who is helping to implement the programme explains the impact. “Before the programme started, around four to five children would die every month from malaria, diarrhoea and other diseases. Now, during the whole of this year only three children died, and this was because of miscarriages.” From the chief through to parents and children themselves, the whole village is determined that no child should die from preventable diseases. Haouaou is clearly proud of the result “In this village we didn’t have any malnutrition because we take care of our children. I am very happy about how healthy our children are.” At the heart of the programme are volunteers like Moutari who, along with two other volunteers selected by the community, ensure that every family implements the practices and monitors progress. Every week the group visit up to five families to run information sessions. Today, Moutari is visiting Hoauoau’s household. Starting with an update on the health of their children, Moutari then calls a mother and her child forward to demonstrate a particular practice. Today it’s the use of mosquito nets and hand washing. Everyone here comes to listen and learn. Haouaou points at two of her daughters who were born before and after the programme started and she learnt about the benefits of exclusive breastfeeding. “Look you can see this one is much stronger.” Whilst drought, hunger and vulnerability are an ongoing reality for these families, their efforts to implement the programme are the key to ensuring their children not only survive, but are resilient through times of drought and extreme hardship. Issa Ibrahim the 63 year old chief of Mazadou Abdou describes the precarious situation many families across the Sahel live in. “In this village our life is based around farming. The difficulty of this life is that if the rainy season doesn’t give a good harvest, life becomes extremely difficult for us.” For now the health of their children is safe, but the challenges ahead for the village are immense. A community run cereal bank will help tide them over for a while, but after this the only other option for many families is for husbands and fathers to head to Nigeria to search for work. Haouaou has thirty bowls of millet to feed her family until the harvest a year away. It will only last a month. She holds out the bowl and laughs nervously. “What can we do?” Whilst Mazadou Abdou’s families continue to walk a tightrope of vulnerability, their newfound knowledge will keep their children alive and healthy. It is not the whole solution, but it provides the hope of a future for their most precious resource, their children. The Chief is thankful for how far they have come. “We are very proud and happy for what we have done here. We thank God, we thank the people who taught us these practices”, but he is also conscious of the toll of chronic hunger on the future of this community; “If a man is hungry he cannot hear, he cannot learn anything.” The impact of the emergency response across the Sahel can be seen in the short term in the lives saved and the malnutrition prevented. For vulnerable families like Haouaou’s though, building resilience and food security will be key to long term change. This village has demonstrated the success of community driven initiatives to improve children’s health, but more support is needed to ensure communities across the Sahel are able to withstand crises. Haouaou tries not to think about what might happen a year from now; “Nobody can forsee the future. Even if we wait and hope for the best, anything can happen at any moment.” UK Natcom - for local copies of the files: Y:Key-initiativesIFSahel-Stories-2012Niger

母乳哺育除了惠及嬰兒外,母親亦可得到莫大的益處。純母乳哺育的母親在分娩後首6個月,將不大機會再度懷孕、身體復元的速度較快、回復懷孕前體重亦較容易。有證據顯示,純母乳餵哺的母親更較少患上產後抑鬱,將來患上卵巢癌和乳癌的風險也較低。

儘管這些全球研究均指出母乳餵哺的好處,在2012年錄得接受純母乳餵哺的6個月以下兒童只有39%。而過去數十年間,全球母乳餵育率只有極輕微的增長,部分原因可歸咎於全球多個大國的母乳餵哺率低,而及普遍缺乏有利環境予母乳餵哺的母親。

然而,在有支援政策和全面計劃的國家裡,母乳餵哺率在所有社區中都有明顯的增長。

在純母乳餵哺率僅得28%的中國,最近基於國民對嬰兒配方奶粉的龐大需求,導致外國配方奶粉出現短缺恐慌,引起傳媒的關注。為了推動這個世上最高人口和低母乳餵哺率的國家,UNICEF和中國疾病預防控制中心婦幼保健中心在5月聯合啟動了「母愛10平方」運動,透過標示、註冊、認證和宣傳育嬰室,以提高大眾對母乳餵哺的支持和認識。

該活動已建立專屬網站unicef.cn/10m2,讓任何機構均可以登記為員工或顧客而設,符合基本國際標準的育嬰室。手機用戶也可以透過應用程式找出所有「母愛10平方」育嬰室的位置。

On 13 March, Aissatou Soumaiga breastfeeds 8-month-old Amadou Harouna in the hospital in the conflict-affected city of Gao, capital of the north-eastern Gao Region. Amadou is being treated for severe malnutrition and resulting kwashiorkor, which is characterized by oedema and a loss of appetite. In mid-March 2013 in Mali, renewed insecurity in central and northern parts of the country continues to exacerbate existing humanitarian needs. An estimated 270,765 people are displaced, while 176,777 continue to seek refuge in neighbouring countries. Additionally, Mali remains one of eight countries in the Sahel region – also including Burkina Faso, Chad, Mauritania, Niger and the northern parts of Cameroon, Nigeria and Senegal – facing a severe food and nutrition crisis. The emergency is the result of repeated drought-related food shortages, from which people have had insufficient time to recover before being again affected. Conditions have improved since the height of the crisis in early 2012. Still, an estimated 10.3 million people throughout the Sahel remain food insecure. In Mali, the pairing of food shortages with conflict has left children increasingly vulnerable: 210,000 children under age 5 are at risk of severe acute malnutrition, and 450,000 are at risk of moderate acute malnutrition. Limited access to basic services, including water, sanitation and hygiene, is another key concern. Additionally, some 200,000 children from conflict-affected areas are at risk of injury or death due to explosive remnants of war. Despite the reopening of some schools, access to education remains severely constricted. To respond to these and other needs throughout the year, UNICEF, together with multiple humanitarian partners, including other United Nations agencies as well as NGOs, have called for over US$370 million in the 2013 Consolidated Appeal for Mali. (UNICEF’s portion of the Appeal is approximately US$84.7 million.) Only 15 per cent of the Appeal has been funded to date.

Social worker Oumarou Zeïnabou conducts an awareness session for women, many holding their infants on their laps, at the Zinder Maternity Centre for Integrated Health, in Zinder, capital of Zinder Region. Ms. Zeïnabou is holding an educational flipchart bearing illustrations of two women, one feeding and one breastfeeding her infant, as well as a variety of nutritious foods. The chart says, in French, “Your sick child should eat and breastfeed more than is typical in order to heal and avoid malnutrition.” In May 2013, Niger continues to host an estimated 50,000 Malian refugees – further constraining the country’s already limited resources. Both Niger and Mali are among nine countries in the Sahel region – also including Burkina Faso, Chad, the Gambia, Mauritania, Senegal, and the northern parts of Cameroon and Nigeria – facing a severe food and nutrition crisis. The emergency is the result of repeated drought-related food shortages. Though conditions have improved since the height of the crisis in early 2012, an estimated 3.1 million people in the Niger are affected by food insecurity, including over 376,700 children under age 5 suffering from severe acute malnutrition. In April, ongoing wet feeding activities benefitted 5,769 children aged 6 to 59 months in four refugee camps. UNICEF is also supporting programmes in education and child protection, including the provision of child-friendly spaces, in the camps. Initiatives to provide safe water and sanitation facilities to refugees are extending to some host communities, and responses to a recently declared cholera epidemic are also ongoing. To continue emergency responses throughout 2013, UNICEF requires nearly US$33.8 million, of which half remained unfunded by 22 May.

柬埔寨在純母乳餵哺率方面取得顯著成效,6個月以下嬰兒的純母乳餵哺率從2000年的11.7%,上升至2010年的74%。多哥和贊比亞的純母乳餵哺率在1990年後期至2000年間也分別增加了10%和20%。

然而,突尼斯的純母乳餵哺率從2000年的46.5%急劇下降至2010年的6.2%。印尼的純母乳餵哺率亦正在下降,尼日利亞的餵哺率在多年來也沒有改善,全球純母乳餵哺率最低的國家分別是索馬里,乍得和南非。

以上的例子反映了全球母乳餵哺的領導力不足,因為母乳哺育對兒童生活的重要性仍然被低估。各國需要優先提倡母乳餵哺和兌現承諾,實行針對性的政策和達致更多共識,使全球參與提倡這個拯救生命和重要的習慣。

雖然母乳餵哺是天然的和人類的天賦,不過母乳餵哺需要一個有利的環境讓它成為平常事。富經驗的醫療人員和社區工作者支持母親進行母乳餵哺,富文化敏感度的溝通和具保護性的法律和政策,特別是圍繞銷售母乳代用品及產假方面,使母乳餵哺的母親獲益。

UNICEF提倡孕婦分娩後首6個月進行純母乳餵哺,直至嬰兒兩歲或以上,並藉著創意以喚起大眾的關注。UNICEF最近在烏拉圭和阿根廷倡議這項運動, 由烏拉圭女演員納塔利婭(Natalia Oreiro)提倡「母乳餵哺是給自己最好的禮物」,以推動在職母親餵哺母乳為目標。

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