The World Alliance for Breastfeeding Action (WABA) is a global network of individuals
& organisations concerned with the protection, promotion & support of breastfeeding worldwide.
WABA action is based on the Innocenti Declaration, the Ten Links for Nurturing the Future and the
Global Strategy for Infant & Young Child Feeding. WABA is in consultative status with UNICEF & an NGO
in Special Consultative Status with the Economic and Social Council of the United Nations (ECOSOC)
Health Care Practices

To promote health care practices in hospitals and in the community that protect, promote and support breastfeeding according to the WHO/UNICEF Joint Statement on the Ten Steps to Successful Breastfeeding. 

This task force will link with various organisations like BAMBI (Childbirth/Breastfeeding Foundation ), WEDO (Women Environment and Development Organisation) and ICM (International Confederation of Midwives), among others. 

 Breastfeeding saves mothers' lives - Midwives Magazine

 Lactation consultant Alison Blenkinsop discusses how breastfeeding affects maternal mortality in the developing world. Read More...

 A Brief Exploration of the Impact of Birthing Practices on Breastfeeding

 "Solid scientific evidence shows that returning to birthing practices that preserve normalcy can accomplish many things: faster, easier births; healthier, more active and alert mothers and newborns; and mother-baby pairs physiologically and optimally ready to breastfeed."

                                    - Impact of Birthing Practices on Breastfeeding, Mary Kroeger


 The following provides a brief summary of what the scientific evidence shows regarding the way birthing practices and interventions influence both mother and baby's ability to breastfeed. For more information, please see the references:

 Importance of a Labor Support Person

  • Evidence shows that continuous female labor support reduces the need for many labor interventions, especially for first time mothers.
  • The resulting interventions, such as epidural anesthesia, cesearan section and hormones often delay the initiation of breastfeeding.
  • Most hospitals in resource poor countries continue to prevent a labor support person from accompanying a laboring woman despite the evidence of the benefits to mother and baby and cost effectiveness. 

Ability for Mom to chose any Position during Labor and Delivery

  • Evidence shows that the ability of a woman to move around freely during the first stage of labor and take an upright (including squatting) position during the second stage of labor leads to less interventions, a faster delivery, fewer episiotomies, and therefore a mother and child more able to initiate breastfeeding. 
  • There is no evidence that continuous electronic fetal monitoring improves maternal outcomes, and it generally requires that the mother stays in bed, therefore disallowing the laboring woman to walk or take the position of her choice for an easier labor and delivery. 

Benefits of giving Oral Fluids and Food during Labor

  • Withholding food and drink during labor, a common practice in both the developing and developed world, is an outdated practice that has been shown to negatively affect birth outcomes. 
The dangers of IV Hydration

         Some commonly used IV solutions can lead to electrolyte imbalances, jaundice, and other problems in the newborn; conditions which may lead to prolonged separation of the mother and baby, and therefore would effect the initiation and continuation of breastfeeding.

Side effects of Labor Pain Medication

  • Epidural anesthesia can lead to poor progress of labor, a longer second stage, a lower rate of spontaneous vaginal delivery (a higher rate of the delivery with instruments such as forceps and a vacuum), an increase in maternal fever, and an increase of newborns evaluated and treated for sepsis.
  • Evidence also shows that both epidural and narcotic analgesia adversely impacts breastfeeding.
  • Drugs such as Demerol (meperidine) given during labor leads to central nervous system depression in the fetus and newborn and negatively impacts breastfeeding. 
  • Alternative (non pharmacologic) pain relief  methods such as offering the mother a hot bath or shower and giving her a massage can be helpful and facilitate an easier birth, which can in turn lead to a faster initiation of breastfeeding.
  • Many pain medications actually block the body's natural endorphins that the body releases to block pain close to delivery.

Potential harm of Episiotomies

  • Episiotomies can have a negative impact on the mother's comfort and therefore her ability to initiate and continue breastfeeding.  Recent evidence supports the idea that episiotomies actually increase the rate of tarring that surgical cuts heal more slowly than does a natural tare of the perineum.

Potential harm of Cesarean Section and Assisted Delivery

  • New evidence outlines a clear link between cesarean sections and a later initiation, later onset of lactogenesis, and shorter duration of breastfeeding.
  • Globally, the rate of cesarean sections is increasing yearly and has reached astounding levels in some South American countries.  [made new bullet]
  • Delivery with a vacuum or forceps may have a direct impact on the anatomy and physiology of the newborns head, jaw and cranial nerves, hindering the ability of the baby to properly suckle

Detrimental effects of stress and fear

  • Oxytocin, the primary hormone involved in both birth and breastfeeding is inhibited by adrenaline produced by the mother when she is fearful and anxious during labor.
  • Labor events, such as episiotomies, surgical interventions, and multiple procedures are stressful to the mother and are associated with less frequent suckling and later onset of lactation.

The Values of Immediate Skin-to-Skin Contact directly after birth

  • A baby left on its mother's abdomen has inborn behaviors that lead it to the breast to feed.
  • Interventions during childbirth and immediately after birth can interfere with bonding, mothering and optimal initiation of breastfeeding.  This is especially relevant in cases of cesarean sections.
  • Kangaroo care (prolonged skin-to-skin contact) for premature infants stabilizes temperature, heart rate, respiratory rate, reduces crying, and supports breastfeeding for babies who would, if places in an incubator, be formula fed.

 References and More Information:

For more information about this task force, please contact the WABA Secretariat.

World Alliance for Breastfeeding Action
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