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In addition, the FAO Assistant Director- General stressed that "food security and nutrition have been consolidated as central axes in the development agendas of all regions of the world with notable actions that demand us to promote greater joint cooperation, through an open and permanent dialogue."
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573063524.pdf
https://ab.gov.ag/pdf/FAO_&_SICA_sign_agreement.pdf
In this line, Lubetkin highlighted the agreement reached between FAO and SICA, ensuring that "this agreement adds cooperation efforts to expand investments and sustainable solutions in the large territory of the Dry Corridor, supporting countries in the transformation of agriculture, to make it more resilient and adapted to climate change and in turn, generating food and more employment opportunities and income, based on sustainable production systems".
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573063524.pdf
https://ab.gov.ag/pdf/FAO_&_SICA_sign_agreement.pdf
FAO and various SICA bodies work in a coordinated manner to ensure an agricultural sector that not only meets food production needs but also contributes to restoring ecosystem integrity. Together, they develop policies prioritizing forest integrity and implementing solutions for climate change adaptation and mitigation, thus promoting sustainable economic development while ensuring the conservation of carbon stocks and biodiversity.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573063524.pdf
https://ab.gov.ag/pdf/FAO_&_SICA_sign_agreement.pdf
These joint efforts are vital steps to reduce climate vulnerability in the SICA region. The FAO-SICA agreement serves as a model for regional cooperation and demonstrates the collective strength and commitment of the participating organizations to address the complex challenges facing the agricultural sector and the environment in the SICA region.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573063524.pdf
https://ab.gov.ag/pdf/FAO_&_SICA_sign_agreement.pdf
Post-crisis scenario Latin America and the Caribbean have been impacted by a series of successive crises that have led to an increase in hunger and malnutrition in all its forms. Income inequality in the region, climate change, and a generalized economic crisis have been major factors in this situation. Food insecurity in the region increased by nearly 100 million people, and the number of hungry people rose from 43.3 million to 56.5 million between 2019 and 2021.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573063524.pdf
https://ab.gov.ag/pdf/FAO_&_SICA_sign_agreement.pdf
In SICA member countries, a growth from 7.2 to 7.5 million people was evidenced, values recorded 20 years ago, also an impact caused by the COVID-19 pandemic.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573063524.pdf
https://ab.gov.ag/pdf/FAO_&_SICA_sign_agreement.pdf
MEDIA CONTACT: Ingrid Saravia, FAOSLM Communicator ingrid.saraviavillacorta@fao.org +507 65810769 Dainalyn Swaby, National Communications Consultant dainalyn.swaby@fao.org + 876 5799497 Marquita Sugrim National Communication Consultant to the Sub-Regional Office for the Caribbean Food and Agriculture Organization of the United Nations (FAO SLC) United Nations House, Bridgetown, Barbados (+1 246) 467 6241 fao.org
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573063524.pdf
https://ab.gov.ag/pdf/FAO_&_SICA_sign_agreement.pdf
UN Report: 131 million people in Latin America and the Caribbean cannot access a healthy diet The region has the highest cost for a healthy diet compared to the rest of the world, at USD 3.89 per person per day, while the world average is USD 3.54. January 18, 2022, Santiago, Chile. The new United Nations report Overview of Food Security and Nutrition 2022 finds that 22.5% of the Latin America and the Caribbean population cannot afford a healthy diet.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
In the Caribbean this figure reaches 52%; in Mesoamerica, 27.8%; and in South America, 18.4%. It should be noted that the high figure in the Caribbean is mainly attributed to the inclusion of Haiti, which has the highest level of undernourishment and food insecurity in the region. The publication reports that 131.3 million people in the region could not afford a healthy diet in 2020.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
This represents an increase of 8 million compared to 2019 and is due to the higher average daily cost of healthy diets in Latin America and the Caribbean compared to the rest of the world's regions, reaching in the Caribbean a value of USD 4.23, followed by South America and Mesoamerica with USD 3.61 and USD 3.47, respectively. This problem is related to different socioeconomic and nutritional indicators.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
The report presents a clear relationship between the inability to afford a healthy diet and such variables as a country's income level, the incidence of poverty, and the level of inequality. The report also reveals that the rise in international food prices experienced since 2020, exacerbated after the start of the conflict in Ukraine, and a regional increase in food inflation above the general level, have increased the difficulties for people to access a healthy diet.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
The document also includes recommendations based on evidence and an analysis of policies already implemented to improve the availability and affordability of nutritious foods, focusing on supporting the most vulnerable people and low-income households that spend a more significant proportion of their budget on food. "There is no individual policy that can solve this problem independently.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
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National and regional coordination mechanisms need to be strengthened to respond to hunger and malnutrition," said Mario Lubetkin, FAO Assistant Director and Regional Representative for Latin America and the Caribbean.
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https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
"To contribute to the affordability of healthy diets, it is necessary to create incentives for the diversification of the production of nutritious foods aimed mainly at family farming and small-scale producers, take measures for the transparency of the prices of these foods in markets and trade, and actions such as cash transfers and improving school menus," Lubetkin concluded. Trade and market policies can play a fundamental role in improving food security and nutrition.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
Greater transparency and efficiency improve inter-regional agri-food trade by replacing uncertainty with market predictability and stability. "We are talking about the region of the world with the most expensive healthy diet, which particularly affects vulnerable populations – small farmers, rural women, and indigenous and Afro-descendant populations – who allocate a greater percentage of their income to the purchase of food," said IFAD Regional Director Rossana Polastri.
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"To reverse this situation, we must promote innovative solutions that diversify production and increase the supply of healthy food, and that improve small producers' access to markets and quality food, including digital solutions that articulate food supply and demand." The report also describes how some nutrition-sensitive social protection programs have worked and are essential to support the diets of the most vulnerable population, particularly in periods of crisis.
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“Food insecurity will continue to rise due to the food and fuel price crisis caused by the conflict in Ukraine and the aftermath of COVID-19,” said Lola Castro, WFP Regional Director. “We must act now, but how can we do it? Supporting governments to expand social protection networks because the pandemic once again demonstrated that social protection is useful to improve the affordability of a healthy diet, preventing crises like this from hitting affected populations even more”.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
Other food policies, such as nutritional labelling, subsidizing nutritious foods, and taxing unhealthy or non-nutritious foods that do not contribute to healthy diets, if well designed, can improve the affordability of healthy diets and prevent debilitating conditions and diseases related to overweight and obesity.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
"We must redouble efforts to address malnutrition in all its forms by promoting public policies to create healthy food environments, eliminate industrially produced trans fats, implement front-end warning labeling, regulate advertising of unhealthy foods, tax sugary drinks, and support healthy eating and physical activity in schools," PAHO Director Carissa F. Etienne said.
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"Understanding the factors that determine poor dietary practices is key to finding solutions and ensuring that everyone in the region has access to healthy foods," she said. For example, countries with higher levels of poverty and inequality tend to have more significant difficulties accessing a healthy diet, which is directly associated with a higher prevalence of hunger, chronic malnutrition in boys and girls, and anemia in women aged 15 to 49.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
“For children to grow up healthy, it is not only urgent to ensure the availability of nutritious food at affordable prices. It is also necessary to develop public policies that guarantee adequate nutrition, in addition to nutritional counseling, focusing actions on the most vulnerable populations,” said Garry Conelly, UNICEF Regional Director for Latin America and the Caribbean. The socioeconomic panorama of Latin America and the Caribbean is not encouraging.
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The most affected population groups are children under five and women, who suffer a higher prevalence of food insecurity than men. The Regional Panorama of Food and Nutrition Security 2022 is a joint publication of the Food and Agriculture Organization of the United Nations (FAO); the International Fund the Pan American Health Organization/World Health Organization (PAHO/WHO); the United Nations Children's Fund (UNICEF) and the United Nations World Food Program (WFP).
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for Agricultural Development (IFAD); The number of hungry people in the region continues to rise Between 2019 and 2021, the number of hungry people in the region increased by 13.2 million, reaching 56.5 million hungry people in 2021. The highest increase was in South America, where an additional 11 million people suffered from hunger. Between 2019 and 2021, hunger reached a prevalence of 7.9% in South America, 8.4% in Mesoamerica, and 16.4% in the Caribbean.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
In 2021, 40.6% of the regional population experienced moderate or severe food insecurity, compared to 29.3% worldwide. Severe food insecurity was also more frequent in the region (14.2%) than in the world (11.7%). Other figures presented in the report indicate that the region registers an important and positive evolution regarding the prevalence of chronic malnutrition in children under five years of age.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573066466.pdf
https://ab.gov.ag/pdf/Panorama_Jan_18.pdf
In 2020, this figure was 11.3% in Latin America and the Caribbean, approximately ten percentage points below the world average. However, 3.9 million children up to five years of age are overweight. For more information contact: Diana Rosero diana.rosero@fao.org
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QU Dongyu of China re-elected FAO Director-General Overwhelming support confirms second term as head of the Food and Agriculture Organization of the United Nations 02/07/2023 Rome - QU Dongyu was today re-elected to a second term as Director-General of the Food and Agriculture Organization of the United Nations (FAO). In ballot by FAO member countries, Qu received a total of 168 out of 182 votes deposited. Nominated by China, Qu was the only candidate to FAO’s top position in today’s election.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573074271.pdf
https://ab.gov.ag/pdf/QU_Dongyu_re-elected.pdf
His new term will run from 1 August 2023 to 31 July 2027. The election took place on the second day of the FAO Conference (1-7 July). Since being elected FAO Director-General for the first time in 2019, Qu has championed a wide range of reforms and initiatives to overhaul the Organization’s business model, improving efficiency and implementing best practices that support programme and administrative effectiveness.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573074271.pdf
https://ab.gov.ag/pdf/QU_Dongyu_re-elected.pdf
FAO’s transparency, visibility and reputation has continued to increase over the last four years, amid major global challenges such as the COVID-19 pandemic, the war in Ukraine and other protracted conflicts, economic downturns, and the intensifying climate crisis.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573074271.pdf
https://ab.gov.ag/pdf/QU_Dongyu_re-elected.pdf
Qu has strongly advocated for the transformation of agri-food systems to make them more efficient, more inclusive, more resilient and more sustainable, with the ultimate goal of helping Members achieve the Sustainable Development Goals (SDGs) and promote the Four Betters: better production, better nutrition, a better environment and a better life, leaving no one behind. For that, FAO has focused on boosting science and innovation and launched some important strategic initiatives.
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The Hand-in-Hand Initiative, for example, supports the implementation of nationally led, ambitious programmes to accelerate agri-food systems transformations. It uses advanced geospatial modeling and analytics, as well as a robust partnership building to raise incomes, improve the nutritional status and well-being of poor and vulnerable populations, and strengthen resilience to climate change.
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In the emergency and humanitarian response, FAO has been advocating for greater investment in medium and long-term resilience building, livelihood protection and disaster risk reduction support alongside humanitarian actions, especially in fragile contexts. In this sense, the Organization has stepped up its work in prevention and anticipation with the aim to address the root causes of food crises. Another highlight of Qu’s leadership was the creation of the World Food Forum (WFF) in 2021.
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Over the past two years, the WFF has identified powerful ideas, scientific and evidence-based knowledge, innovations, policies and solutions, while forging new partnerships and investment opportunities to transform our agrifood systems. The WFF will continue to expand its reach in 2023, and draw a clear connection to the theme of climate action, while the global events in October will again encompass three pillars: the Global Youth Forum, the FAO Hand-in-Hand Forum and the FAO Science and Innovation Forum.
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Contact FAO News and Media (+39) 06 570 53625 FAO-Newsroom@fao.org Marquita Sugrim National Communication Consultant to the Sub-Regional Office for the Caribbean Food and Agriculture Organization of the United Nations (FAO SLC) United Nations House, Bridgetown, Barbados (+1 246) 467 6241 fao.org
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FAO and CARICOM launch a virtual course on Trade, Food Security, and Nutrition The four-week training course will assess the challenges and opportunities posed by greater trade openness for food and nutrition security in the Caribbean. July 7, 2023 – Hunger and malnutrition are the main obstacles to achieving the Sustainable Development Goals (SDGs) by 2030. In this regard, trade can play a key role.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573077108.pdf
https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
In this regard, trade can play a key role. The expansion of trade has increased food availability and affordability and positively influenced food security and quality. Trade has also contributed to the stability of food supplies and prices by smoothing seasonal fluctuations in availability and the negative effects of domestic supply shocks. In the context of climate change, this is even more important given the significant risks to agricultural production in certain regions.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573077108.pdf
https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
This is the case for the Caribbean, where FAO and CARICOM are jointly implementing a virtual course entitled "Trade, Food Security and Nutrition" for more than 200 government representatives and professionals directly involved in formulating and implementing agricultural policies and programs in the region.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573077108.pdf
https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
The four-week training course combines online self-paced modules with two live webinars, and its main goal is to analyze the role of trade policy in promoting food and nutrition security to design evidence-based policies. "In the three years 2019-2021, 7 million people in the Caribbean (16% of the population) were undernourished, and 14.6 million suffered severe food insecurity (33.6%).
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573077108.pdf
https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
On average, one in 4 adults is obese, with rates of obesity among women being much higher than among men, and the related burden of non-communicable diseases (NCDs) has far reached economic and social implications, particularly given the fact that most households are female-led in the Caribbean", warned Renata Clarke, FAO Sub-regional Coordinator for the Caribbean.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573077108.pdf
https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
In his opening remarks, Ambassador David Prendergast, CARICOM Secretariat Director of Sectorial Programmes, underlined that it is urgent to understand "the linkages between food systems and healthy diets in the Caribbean and assess the critical role of regional trade for food security and nutrition. Through this training, participants will be equipped with a deeper knowledge of these linkages, specifically in your policy, formulation, policy making, or other practical roles".
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https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
Daniela Godoy, FAO Senior Policy Officer for Latin America and the Caribbean, highlighted the contributions of trade to the multiple dimensions of food security and to making healthy diets more accessible. "Latin America and the Caribbean is the region with the highest average of incoming inequality and the highest cost of a healthy diet. The prevalence of hunger increased. Those are challenges we cannot underestimate", claimed Godoy.
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https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
Pablo Rabczuk, Officer responsible for Trade and Agrifood systems from FAO Regional Office, moderated this webinar and included a presentation on "Agrifood trade and food system transformation in the Caribbean" by Dennis Crawford, Agricultural Specialist, CARICOM Single Market and Trade, and Milagro Matus, Deputy Programme Manager for the Agricultural and Agro-Industrial Development at the CARICOM Secretariat, who highlighted that by the end of 2023, several non-tariff barriers in the Caribbean will be eliminated.
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https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
The course will be active until July 26th and is part of FAO and CARICOM joint efforts in the region to strengthen capacities in agricultural trade and other related matters. Currently, the FAO Regional Office and its Capacity Development Area have 12 free self-paced English courses tailor-made for the Caribbean. And from headquarters in Rome, the FAO eLearning Academy offers 95 free self-paced courses on 25 topics.
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Virtual Course: Trade, Food Security and Nutrition (TFSN) – special edition for CARICOM https://www.fao.org/in-action/capacitacion-politicas- publicas/cursos/ver/en/?uid=1640191 Marquita Sugrim National Communication Consultant to the Sub-Regional Office for the Caribbean Food and Agriculture Organization of the United Nations (FAO SLC) United Nations House, Bridgetown, Barbados (+1 246) 467 6241 fao.org
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573077108.pdf
https://ab.gov.ag/pdf/FAO_CARICOM_virtual_course_on_Trade.pdf
Mario Lubetkin Growing food insecurity calls for greater coordination By Mario Lubetkin, FAO Assistant Director-General and Regional Representative for Latin America and the Caribbean According to the latest Global Report on Food Crises, in 2022, almost 258 million people in 58 countries faced the highest levels of acute food insecurity, which includes the categories of "Crisis", "Emergency", and "Catastrophe", meaning that it can range from malnutrition to the risk of death due to lack of food.
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https://docs-lawep.s3.us-east-2.amazonaws.com/1694573079399.pdf
https://ab.gov.ag/pdf/Growing_food_insecurity_Mario_Lubetkin.pdf
The number of acutely food-insecure people in Latin America and the Caribbean reached 17.8 million. Haiti reports one of the most challenging situations, with 4.72 million people affected, representing 26% of the region's total.
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https://ab.gov.ag/pdf/Growing_food_insecurity_Mario_Lubetkin.pdf
This situation has led the affected regional population to take extreme measures, such as selling their animals, eating seeds knowing very well that they will have nothing to plant later, selling their homes, or begging for food, which turns into a spiral of vulnerability, particularly among the rural populations. Currently, many people suffering food crises depend on agricultural livelihoods for survival. This is most critical for rural women.
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https://ab.gov.ag/pdf/Growing_food_insecurity_Mario_Lubetkin.pdf
This is most critical for rural women. In a household with insufficient food, evidence indicates that women will be worse off than men. There are also significant gaps in the food security of indigenous populations. The food crisis or emergency reported in the region in 2022 is mainly due to several factors, such as the war in Ukraine, the social and economic consequences of the COVID-19 pandemic, and the impact of extreme weather events.
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https://ab.gov.ag/pdf/Growing_food_insecurity_Mario_Lubetkin.pdf
We must increase humanitarian efforts with populations that can no longer meet their minimum food needs. But it is also essential to invest in agriculture and local food production, as this also contributes to humanitarian work in contexts of food crises. Currently, only four percent of humanitarian assistance in countries in food crisis goes to agricultural and livelihood support.
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We must provide humanitarian aid to protect agricultural livelihoods, act proactively on alerts anticipating the deterioration of an acute food insecurity situation before it becomes an extreme emergency, and ensure social protection for rural people, and increase economic and climate resilience. Investing in agriculture and the resources that sustain it is strategic and cost- effective.
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https://ab.gov.ag/pdf/Growing_food_insecurity_Mario_Lubetkin.pdf
According to our studies, the benefits of investing in agriculture can be ten times greater than if investing only in food aid, and the effects can be prolonged over time. Without successful recovery and sustainable development initiatives, there will be a perpetual need for urgent humanitarian action and an increased risk of deterioration into a chronic emergency.
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We must achieve these results with more coordinated efforts by international organizations, governments, the private sector, regional organizations, civil society, and communities.
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3 The health and economic benefits of breastfeeding Overview 3.1 3.2 3.3 Over the last few decades, a growing number of scientific studies have shed light on the extensive health benefits of breastfeeding for both babies and mothers. These benefits are diverse, relating to the physiological, nutritional and cognitive aspects of infant development as well as maternal well-being. The first part of this chapter examines the health benefits of breastfeeding for babies and mothers.
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These health benefits are immediate and also persist until later in life. The chapter will also focus on the unique properties of human breast milk and the valuable role of milk banks. Breastfeeding is also examined from an economic perspective, with an analysis of the short and long-term impacts on Australia’s health system. Breast milk is also an environmentally friendly product. Many consumables are needed for the packaging of infant formula and the production of bottles and teats.
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This requires significant resources and poses the problem of waste disposal for some of these items. Although breastfeeding is environment friendly it is often overlooked in environmental programs. 38 Health benefits for the baby 3.4 3.5 3.6 3.7 There is solid evidence for the protective effects of breastfeeding against three classes of infectious disease in babies: gastrointestinal illnesses, respiratory tract infections, and otitis media (middle ear infections).
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Studies suggest that the longer a baby is breastfed, the greater the protective effect against infections (known as a ‘dose-response’ effect). Exclusive breastfeeding appears to confer a greater protective effect against gastrointestinal and respiratory illnesses, while partial or minimal breastfeeding is not as protective.1 Even an extra two months of breastfeeding can make a difference.
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A recent study showed that babies exclusively breastfed for four to six months only were four times more likely to suffer from pneumonia and twice as likely to suffer recurrent ear infections than those breastfed for six months or longer.2 A landmark study in breastfeeding research was the Promotion of Breastfeeding Intervention Trial (PROBIT) in the Republic of Belarus, which examined more than 17,000 mother and baby pairs.
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The findings showed that exclusive breastfeeding in the first year of life decreased the risk of gastrointestinal tract infections by 40 per cent.3 Babies who are not breastfed have a significantly increased risk of developing middle ear infections.4 Breastfeeding also protects against recurrent otitis media, which can eventually result in hearing loss in children. Again, the shorter the duration of breastfeeding, the greater the risks of contracting these infections.
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It is worth noting that the rates of recurrent otitis media are also ten times worse in Indigenous children than in the general population (see chapter 7). 1 Raisler J et al, ‘Breastfeeding and infant illness: a dose-response relationship?’, American Journal of Public Health (1999), vol 89, no 1, pp 25-30.
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2 Chantry C et al, ‘Full breastfeeding duration and associated decrease in respiratory tract infection in US children’, Pediatrics (2006), vol 117, no 2, pp 425-432; NSW Centre for Public Health Nutrition, sub 178, p 6; Australian Breastfeeding Association, sub 306, p 14. 3 Kramer M et al, ‘Promotion of breastfeeding intervention trial (PROBIT) – a randomised trial in the Republic of Belarus’, Journal of the American Medical Association (2001), vol 285, no 4, pp 413-420.
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4 Heinig M and Dewey K, ‘Health advantages of breastfeeding for infants: a critical review’, Nutrition Research Reviews (1996), vol 9, p 97; Duffy L et al, ‘Exclusive breastfeeding protects against bacterial colonisation and day care exposure to otitis media’, Pediatrics (1997), vol 100, no 4, p e7; Australian Breastfeeding Association, sub 306, p 10. THE HEALTH AND ECONOMIC BENEFITS OF BREASTFEEDING 39 3.8 3.9 The incidence of asthma and allergies may also be reduced by breastfeeding for longer.
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Dr Wendy Oddy and colleagues from the Telethon Institute for Child Health Research conducted the Western Australian Pregnancy Cohort Study, which followed 2187 children to six years of age. They found that a significant reduction in the risk of childhood asthma at the age of six years occurs if exclusive breastfeeding is continued for at least four months after birth.
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While the exact reasons are still unknown, protection against allergies may be because breastfed babies are less exposed to foreign dietary antigens (e.g. from cow’s milk).
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from cow’s milk). The special properties of breast milk may also promote a more effective immune system.5 The extent to which breastfeeding can protect against asthma and allergies is still to be determined, with a recent Australian study at the Children’s Hospital at Westmead, finding that longer duration of breastfeeding did not prevent the onset of these conditions by the age of five years.6 Some studies suggest that breastfeeding could also have a positive effect on a child’s neurodevelopment.
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However, the links between breastfeeding and increased cognitive ability and intelligence are subject to debate. It is difficult to attribute greater intelligence to breastfeeding alone, when environmental factors could also have an influence.7 For example, a recent study examined the effect of breastfeeding on the IQ of preschool children.
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Results showed that neither the mode of feeding (breastfed or formula fed) nor the duration of breastfeeding were related to the IQ of children at four years of age when the quality of the home environment and socio- economic status of families were taken into account.8 3.10 Breastfeeding may help to prevent a number of other conditions including some childhood leukaemias, urinary tract infections, inflammatory bowel disease, coeliac disease and sudden infant death 5 Oddy W, Telethon Institute for Child Health Research, sub 216, pp 19-25; Oddy W et al, ‘Association between breastfeeding and asthma in 6 year old children: findings of a prospective birth cohort study’, British Medical Journal (1999), vol 319, pp 815-819.
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6 Mihrshahi S et al, ‘The association between infant feeding practices and subsequent atopy among children with a family history of asthma’, Clinical and Experimental Allergy (2007), vol 37, no 5, pp 671-679.
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7 Allen J and Hector D, ‘Benefits of Breastfeeding’, NSW Public Health Bulletin (2005), vol 16, p 43; Der G et al, ‘Effect of breastfeeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis’, British Medical Journal (2006), vol 333, pp 945-948; Jain A et al, ‘How good is the evidence linking breastfeeding and intelligence?’, Pediatrics (2002), vol 109, pp 1044-1053; Mortensen E et al, ‘The association between duration of breastfeeding and adult intelligence’, Journal of the American Medical Association (2002), vol 287, no 18, pp 2365-2371; Allen J, sub 316.
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8 Zhou S, Makrides M and Gibson R, sub 270, p 1. 40 3.11 syndrome (SIDS). There is also evidence of possible associations between breastfeeding and lower rates of dental occlusion9, bacteraemia, meningitis and type 1 diabetes.10 Further research is required to determine the significance of these associations. The fact that breastfeeding provides important health benefits for both mothers and babies is demonstrated in the consistency of results from a growing body of breastfeeding research.
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However, most breastfeeding studies are observational as it is considered unethical to conduct controlled infant feeding experiments.
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Therefore, it is important to note that there are limitations to breastfeeding research methods.11 Obesity, early nutrition and chronic disease risk 3.12 3.13 There is growing interest amongst public health researchers in exploring the links between early nutrition and chronic disease risk in childhood and into adulthood.12 Given that obesity has become a serious health problem in Australia, the association between breastfeeding and weight gain is of particular interest to the committee.
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Strong evidence is accumulating to show that children are less likely to be overweight or obese if they have been breastfed as babies.13 Babies who are breastfed for at least three months have a lower rate of obesity during childhood, with the protective effect increasing if 9 Brown L, sub 121, pp 1-2.
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10 Allen J and Hector D, ‘Benefits of Breastfeeding’, NSW Public Health Bulletin (2005), vol 16, p 44; Heinig M and Dewey K, ‘Health advantages of breastfeeding for infants’, pp 89- 110; National Health & Medical Research Council, Dietary Guidelines for Children and Adolescents in Australia (2003), p 6. 11 Smith J, Harvey P, Australian Centre for Economic Research on Health, sub 319, p 11; Allen J and Hector D, ‘Benefits of Breastfeeding’, NSW Public Health Bulletin (2005), vol 16, p 42.
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12 National Health & Medical Research Council, Dietary Guidelines for Children and Adolescents in Australia (2003), p 5. 13 Oddy W, Telethon Institute for Child Health Research, sub 216, pp 5-15; Harder T et al, ‘Duration of breastfeeding and risk of overweight’, American Journal of Epidemiology (2005), vol 162, no 5, pp 397-403; Grummer-Strawn L and Mei Z, ‘Does breastfeeding protect against pediatric overweight?
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Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System’, Pediatrics (2004), vol 113, no 2, pp e81-86. THE HEALTH AND ECONOMIC BENEFITS OF BREASTFEEDING 41 3.14 3.15 3.16 3.17 3.18 breastfeeding continues until six months. This protective effect may also extend into adulthood.14 Professor Colin Binns of the School of Public Health at Curtin University has emphasised the importance of the association between breastfeeding and obesity.
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He argues that evidence of this single health impact is more than sufficient justification to implement a major public health promotion campaign for breastfeeding.15 There are several ways in which breastfeeding may lower the risk obesity. One hypothesis is that breastfed babies grow at a slower rate.
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Putting on weight too quickly may reduce the likelihood of growing into a leaner body shape.16 The Perth Infant Feeding Study Mark II found a positive association between weight gain at one year of age and early and regular consumption of formula.17 Satiety, or the feeling of fullness, could be another key to explaining the breastfeeding and obesity relationship. Breastfeeding babies know when they have consumed enough.
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The practice of encouraging formula-fed babies to finish all of the milk in a bottle could make them less responsive to natural hunger cues and feelings of fullness as they move onto solids later in life.18 Conversely, breastfeeding may help to program and regulate appetite at an early age.19 Evidence also suggests that breastfeeding protects against a range of chronic illnesses which can develop in adulthood, including type 2 diabetes, heart disease, atherosclerosis, and high blood pressure.20 Breastfeeding can provide optimal nutrition from birth, and confers health advantages that persist until later in life.
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As seen later in the chapter, these long-term health benefits can also have more pronounced effects at the population level, with broader implications for economically sustainable health care. 14 Binns C, transcript, 26 March 2007, pp 14-15. 15 Binns C, sub 86, pp 2-3. 16 Binns C, sub 86, p 3. 17 Oddy W, Telethon Institute for Child Health Research, sub 216, p 12. 18 Hector D, NSW Centre for Public Health Nutrition, transcript, 4 June 2007, p 43. 19 Binns C, sub 86, p 3.
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19 Binns C, sub 86, p 3. 20 Allen J and Hector D, ‘Benefits of Breastfeeding’, NSW Public Health Bulletin (2005), vol 16, pp 43-44; Oddy W, Telethon Institute for Child Health Research, sub 216, pp 5-6. 42 Health benefits for the mother 3.19 3.20 3.21 Convincing evidence exists for breastfeeding’s positive impact on maternal health.
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It is beneficial in promoting the mother’s recovery from childbirth; ensuring the delayed return of menstruation and fertility; and significantly reducing the risk of pre-menopausal breast cancer. Breastfeeding promotes a more rapid return of the uterus to its pre-pregnant state.
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It stimulates the release of the hormone oxytocin, stimulating uterine contractions and minimising the risk of haemorrhage.21 Breastfeeding also contributes to a longer period of infertility after birth, leading to increased spacing between pregnancies.
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However, the extent of both the maternal recovery process and suppressed fertility also depends on the duration, intensity and frequency of breastfeeding.22 The protective effect of breastfeeding against pre-menopausal breast cancer has been shown in a number of studies.
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Protection against post-menopausal breast cancer is also probable.23 A recent review of 47 studies throughout 30 countries indicated that for every 12 months of breastfeeding, the risk of breast cancer decreases by 4.3 per cent.24 3.22 A number of other possible health benefits for mothers include: (cid:132) accelerated weight loss and return to a pre-pregnancy body weight;25 (cid:132) reduced risk of ovarian and endometrial cancers; 26 21 Heinig M and Dewey K, ‘Health effects of breastfeeding for mothers: a critical review”, Nutrition Research Reviews (1997), vol 10, pp 35-56; NHMRC, Dietary Guidelines, p 5; Hensby J, sub 269, pp 15-16.
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22 Allen J and Hector D, ‘Benefits of Breastfeeding’, NSW Public Health Bulletin (2005), vol 16, p 43; Heinig M and Dewey K, ‘Health effects of breastfeeding for mothers’, NSW Public Health Bulletin (2005), vol 16, pp 41-42.
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23 Bernier M et al, ‘Breastfeeding and risk of breast cancer: a meta-analysis of published studies’, Human Reproduction Update (2000), vol 6, no 4, pp 374-386; Lipworth L et al, ‘History of breastfeeding in relation to breast cancer risk: a review of the epidemiologic literature’, Journal of the National Cancer Institute (2000), vol 19, no 4, pp 302-312; Heinig M and Dewey K, ‘Health effects of breastfeeding for mothers’, p 43.
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24 Beral V, ‘Breastfeeding: collaborative reanalysis of individual data for 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973 women without the disease’, The Lancet (2002), vol 360, pp 187-195; Dyson T, sub 32, pp1-2. 25 Heinig M and Dewey K, ‘Health effects of breastfeeding for mothers’, pp 38-41.
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26 Tung K et al, ‘Reproductive factors and epithelial ovarian cancer risk by histologic type: a multiethnic case-control study’, American Journal of Epidemiology (2003), vol 158, no 7, pp THE HEALTH AND ECONOMIC BENEFITS OF BREASTFEEDING 43 (cid:132) improved bone mineralisation, leading to decreased risk of osteoporosis;27 (cid:132) protection against rheumatoid arthritis; 28 and (cid:132) protection against type 2 diabetes.29 3.23 Given that Australian women are having babies later in life, when they are at a higher risk for obstetric complications, the promotion of the health benefits of breastfeeding for mothers is all the more crucial as public health strategy.30 Emotional benefits to the mother and baby 3.24 3.25 The emotional closeness generated by breastfeeding benefits both the mother and the baby.
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It is a pleasurable and positive skin-to-skin interaction. The hormones oxytocin and prolactin are stimulated, reducing maternal stress and fostering emotional bonding.31 Some studies have shown that breastfeeding can prevent or limit the duration of post-natal depression in mothers.32 Others have suggested a link between breastfeeding and child and adolescent mental health.
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For example, Dr Oddy has found an association between breastfeeding for six months or longer and a reduction in mental health problems throughout childhood and adolescence. However, evidence in this field is still limited, given the environmental factors that need to be taken into account.33 629-638; Newcomb P and Trentham-Dietz A, ‘Breastfeeding practices in relation to endometrial cancer risk, USA’, Cancer Causes and Control (2000), vol 11, no 7, pp 663-667.
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27 Polatti F et al, ‘Bone mineral changes during and after lactation’, Obstetrics and Gynaecology (1999), vol 94, no 1, pp 52-56. 28 Karlson E et al, ‘Do breastfeeding and other reproductive factors influence future risk of rheumatoid arthritis?’, Arthritis and Rheumatism (2004), vol 50, pp 3458-3467. 29 Steube A et al, ‘Duration of lactation and incidence of type 2 diabetes’, Journal of the American Medical Association (2005), vol 294, pp 2601-2610.
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30 College of Lactation Consultants Victoria Inc, sub 158, p 2. 31 National Health & Medical Research Council, Dietary Guidelines for Children and Adolescents in Australia (2003), p 7; Australian College of Midwives, Baby Friendly Health Initiative, sub 185, p 3. 32 Mezzacappa E, ‘Breastfeeding and maternal stress response and health’, Nutrition Reviews (2004), vol 62, pp 261-268; Hoyle Z, Post and Antenatal Depression Association, transcript, 7 June 2007, pp 58-64.
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33 Oddy W, Telethon Institute for Child Health Research, sub 216, pp 16-18. 44 The unique properties of breast milk 3.26 Breast milk is a complex living substance and a food that is nutritionally complete for babies until six months of age.34 No formula product can exactly replicate breast milk.35 It is a ‘bioactive fluid’ with changing physical properties and concentrations of nutrients.
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It is also extremely important in providing protection against infection: Human milk represents a most valuable weapon for enhancing the immature immunologic system of the neonate and for strengthening its host defence mechanisms against infective or other foreign agents.36 3.27 3.28 3.29 Colostrum, the secretion produced in the first few days after birth, is nutrient-rich, and contains essential proteins, vitamins, enzymes, growth factors, antibodies and non-pathogenic bacteria to protect against illness.37 This first secretion gradually changes into mature milk during the first one to two weeks after birth.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
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For example, there are lower concentrations of fat in colostrum than in mature milk but higher concentrations of protein and minerals.38 Breast milk is dynamic and interactive. Its composition varies between individuals, depending on diet and stages of lactation. Breast milk’s complex biochemistry means that it changes from morning to night and even over the course of a feed.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
https://docs-lawep.s3.us-east-2.amazonaws.com/1694573080032.pdf
https://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?url=haa/breastfeeding/report/chapter3.pdf
The milk first ingested by a baby during a feed has a lower fat content, which steadily increases until the feeling of ‘satiety’ is reached.39 The concept of breast milk as a food should be better emphasised.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
https://docs-lawep.s3.us-east-2.amazonaws.com/1694573080032.pdf
https://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?url=haa/breastfeeding/report/chapter3.pdf
Dr Debra Hector from the New South Wales Centre for Public Health Nutrition noted that there had been ‘somewhat of a separation between breastfeeding and the introduction of solid foods into the diet.’ 40 People may not perceive breast milk as a food, considering 34 National Health & Medical Research Council, Dietary Guidelines for Children and Adolescents in Australia (2003), pp 4-5. 35 Stockwell D, Food Standards Australia New Zealand, transcript, 13 June 2007, p 11.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
https://docs-lawep.s3.us-east-2.amazonaws.com/1694573080032.pdf
https://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?url=haa/breastfeeding/report/chapter3.pdf
36 Oddy W, ‘Breastfeeding protects against illness and infection in infants and children: a review of the evidence’, Breastfeeding Review (2001), vol 9, no 2, p 15. 37 National Health & Medical Research Council, Dietary Guidelines for Children and Adolescents in Australia (2003), p 4. 38 Wagner C, ‘Human milk and lactation’, eMedicine, 2006, viewed on 30 July 2007 at http://www.emedicine.com/ped/topic2594.htm.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
https://docs-lawep.s3.us-east-2.amazonaws.com/1694573080032.pdf
https://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?url=haa/breastfeeding/report/chapter3.pdf
39 Wagner C, ‘Human milk and lactation’, eMedicine, 2006, viewed on 30 July 2007 at http://www.emedicine.com/ped/topic2594.htm. 40 Hector D, NSW Centre for Public Health and Nutrition, transcript, 4 June 2007, p 43. THE HEALTH AND ECONOMIC BENEFITS OF BREASTFEEDING 45 that nutrition begins with solids. This can lead to a diminished understanding of the crucial importance of breast milk in establishing good nutrition from birth.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
https://docs-lawep.s3.us-east-2.amazonaws.com/1694573080032.pdf
https://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?url=haa/breastfeeding/report/chapter3.pdf
Promoting the health benefits of breastfeeding 3.30 Given the extensive health benefits for both babies and mothers that can be attributed to breastfeeding, the committee believes there should be greater public promotion of the benefits of breastfeeding. This was recommended in a number of submissions to the inquiry.41 3.31 3.32 3.33 There were strong views expressed about the way in which public health messages around breastfeeding ought to be framed.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
https://docs-lawep.s3.us-east-2.amazonaws.com/1694573080032.pdf
https://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?url=haa/breastfeeding/report/chapter3.pdf
Some argued that the slogan ‘breast is best’ is misleading, and can be interpreted as meaning that breastfeeding is a lofty ideal, but unattainable for many mothers in reality.
Maternal health care and reproductive rights
Malnutrition stunting pasteurizing legislation
Australia
https://docs-lawep.s3.us-east-2.amazonaws.com/1694573080032.pdf
https://www.aph.gov.au/parliamentary_business/committees/house_of_representatives_committees?url=haa/breastfeeding/report/chapter3.pdf