Joint Statement
in celebration of
World Health Day
 
7 April 2015
Food Safety
The 2015 World Health Day (WHD) theme is “Food Safety.” From the World Health Organisation (WHO): 
Unsafe food is linked to the deaths of an estimated 2 million people annuallyincluding many children. Food containing harmful bacteria, viruses, parasites, or chemical substances is responsible for more than 200 diseases, ranging from diarrhea to cancers.1
There are many opportunities for food contamination to take place. Today’s food supply is complex and involves a range of different stages including on-farm production, slaughtering or harvesting, processing, storage, transport, and distribution before the food reaches the consumer.2
Food Safety Facts from the World Health Organisation1:
  • Access to safe and nutritious food is key to sustaining life and promoting good health.
  • Unsafe food containing harmful bacteria, viruses, parasites, or chemical substances causes more than 200 diseasesranging from diarrhea to cancers.
  • Food safety, nutrition and food security are inextricably linkedunsafe food creates a vicious cycle of disease, malnutrition and death.
Breastfeeding and Food Safety
Breastfeeding provides safe, nourishing food for infants and children:
  • Human milk is perfectly suited to the nutritional needs of the child. It develops in accordance to a child’s growth—from newborn to toddler and beyond.
  • Human milk—delivered directly from the breast—bypasses any need for equipment to collect and store the milk. This reduces the chances of milk contamination due to poor sanitation practices.
  • A newborn’s digestive tract contains no bacteria. The food he/she consumes populates the gut and helps develop “friendly” gut bacteria, e.g. those produce which lactic acid and are vital for good health.3
  • Breastfeeding acts as a potable source of water for infants and children. Exclusively breastfed infants do not need supplementary water.
  • The closer the consumer (child) is to the producer (mother) of the food, the lower the risk of contamination.  
  • The production, transportation, and distribution of infant formula increases the risk of contamination which can be bypassed by breastfeeding.
Breastfeeding plays an important role in the overall health of both baby and mother. In general, diseases have the least negative impact on those who are strong and healthy to begin with.
“Breastmilk gives growing children nutritious affordable food and helps protect against a variety of illnesses and infections…”4
What about Complementary Food?
Breastfeeding provides all the nutrition, including water, needed by a child during the first six months of his/her life. Complementary food is not needed at this stage but by the time it is introduced, the baby will be stronger and more able to withstand potential contamination from complementary food.

Once the infant begins eating solid food (usually beginning in the middle of the first year), it is important that this food is carefully selected based on nutritional value and safety. The WHO’s Five Keys to Food Safety1 are:
  • Key 1: Keep clean
  • Key 2: Separate raw and cooked food
  • Key 3: Cook food thoroughly
  • Key 4: Keep food at safe temperatures
  • Key 5: Use safe water and raw materials
Breastfeeding for at least two years—or as long as mother and child wish to continue—will provide the child with nutritious and safe human milk which can offset the potential risk of solid food.
What about Expressed (or Pumped) Breast Milk?
Many mothers express milk for their babies—by hand or pump—which may allow for contaminants to get into the milk. The potential points of contamination include skin (hands, breast), pump equipment, storage vessels, storage practices (where, how long), and delivery of the milk to the infant.

Fortunately, there are simple steps mothers can take—washing hands and any vessels used to collect and store the milk—to reduce contamination. Although expressed milk separates the “consumer” (child) from the “producer” (mother), it is still fewer degrees of separation in comparison to infant formula production and delivery. Guidelines for safe collection and storage of human milk can be found here: http://www.llli.org/faq/milkstorage.html
Expressed breastmilk is a relatively safe alternative—and far superior to infant formula—when breastfeeding is not an option. 
What Happens if the Mother is on Medication? 
Usually, medication given to breastfeeding mothers will not pose a serious threat to the child. However, safer alternatives can often be used, in combination with appropriate timing of feedings and dosage of medication. It is always better to discuss medication consumption with a healthcare provider, and to weigh this against proven benefits of breastfeeding.
What about Environmental Pollutants?
Mothers want the best for their children, and may worry about news reports which are quick to present cases of pollution in human milk samples. Measuring contaminants in human milk samples alone does not provide the full picture. Environmental pollutants are everywhere, not just in human milk. Still, the benefits of breastfeeding far outweigh the potential risks of environmental pollutants. 
“Studies have shown that breastfeeding, even in a contaminated environment, has a positive impact on the development of children as compared to those who are artificially fed. Breastfeeding supports infant growth and health as well as maternal health in ways that breastmilk substitutes cannot. Indeed, breastmilk contains substances that help the child develop a stronger immune system and other protections against environmental pollutants and pathogens.

Therefore, educational and advocacy efforts to promote a toxic-free future for our children should recognise, encourage, and support collective actions aimed at promoting breastfeeding, reducing chemical contamination and developing the strongest possible pollution prevention laws.”6
The Key Message
Providing safe food for our children is imperative, and the simple act of breastfeeding provides a safe, clean, nourishing, and protective source of food from birth through a child’s early years. The protection developed during these critical first years will provide a strong base that lasts a lifetime.
For more information, please contact:
Key Writer: Melissa Clark Vickers                WABA Secretariat: Chuah Pei Ching
                 LLL Leader                                                       Health & Information Officer
References:
  1. http://www.who.int/campaigns/world-health-day/2015/event/en/
  2. WHO--10 Facts for Food Safety 
  3. Establishment of Intestinal Microbiota during Early Life: a Longitudinal, Explorative Study of a Large Cohort of Danish Infants; Anders Bergström, Thomas Hjort Skov, Martin Iain Bahl, Henrik Munch Roager, Line Brinch Christensen, Katrine Tschentscher Ejlerskov, Christian Mølgaard, Kim F. Michaelsen and Tine Rask Licht; Appl. Environ. Microbiol. May 2014 vol. 80 no. 9 2889-2900; DOI: 10.1128/AEM.00342-14. 
  4. Ten Links for Nurturing the Future Action Tool: Food Security. Penny Van Esterik
  5. Water and Sanitation (ILCA/LLLI/WABA statement) 
  6. Working Together for a Toxic-Free Future. A Call for Endorsement. . . a joint statement by participating organisations of the World Alliance for Breastfeeding Action (WABA) & International POPs Elimination Network (IPEN). 2004.  
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