Protection, promotion and support of breast-feeding in Europe: progress from 2002 to 2007.
OBJECTIVE
To assess progress in the protection, promotion and support of breast-feeding in Europe.


METHODS
Data for 2002 and 2007 were gathered with the same questionnaire. Of thirty countries, twenty-nine returned data for 2002, twenty-four for 2007.


RESULTS
The number of countries with national policies complying with WHO recommendations increased. In 2007, six countries lacked a national policy, three a national plan, four a national breast-feeding coordinator and committee. Little improvement was reported in pre-service training; however, the number of countries with good coverage in the provision of WHO/UNICEF courses for in-service training increased substantially, as reflected in a parallel increase in the number of Baby Friendly Hospitals and the proportion of births taking place in them. Little improvement was reported as far as implementation of the International Code on Marketing of Breastmilk Substitutes is concerned. Except for Ireland and the UK, where some improvement occurred, no changes were reported on maternity protection. Due to lack of standard methods, it was difficult to compare rates of breast-feeding among countries. With this in mind, slight improvements in the rates of initiation, exclusivity and duration were reported by countries where data at two points in time were available.


CONCLUSIONS
Breast-feeding rates continue to fall short of global recommendations. National policies are improving slowly but are hampered by the lack of action on maternity protection and the International Code. Pre-service training and standard monitoring of breast-feeding rates are the areas where more efforts are needed to accelerate progress.
Health Services Research, Epidemiology and International Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. cattaneo@burlo.trieste.it
Adriano
A
Cattaneo
Tea
T
Burmaz
Maryse
M
Arendt
Ingrid
I
Nilsson
Krystyna
K
Mikiel-Kostyra
Irena
I
Kondrate
Marie José
MJ
Communal
Catherine
C
Massart
Elise
E
Chapin
Maureen
M
Fallon
D000328:Adult; D001942:Breast Feeding / Q000453:epidemiology* / Q000523:psychology* / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D006291:Health Policy; D006293:Health Promotion; D006761:Hospitals; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology; D017063:Outcome Assessment, Health Care; D011795:Surveys and Questionnaires