Lactation Matters

LAST CHANCE to REGISTER for the #ILCA18 Virtual Conference

Whether you plan to participate live or watch the recording, TODAY is the last chance to register for the 
#ILCA18 Virtual Conference.
Don’t miss out!

The #ILCA18 Virtual Conference begins tomorrow, July 20 and continues through 21 July. You won’t want to miss the opportunity to join us . . . right from your computer!

We will be offering up to 12 Continuing Education Credits, a special online community, and an easy-to-use platform with lots of support. Watch live or on your own time for up to 60 days.

Click below for more information and to register. Questions? Email us at info@ilca.org.

ILCA Statement on WHA Resolution on Infant and Young Child Feeding

All families deserve public health policies designed to improve their health and well-being that are free from corporate interests. This is why the International Lactation Consultant Association® (ILCA®) calls upon governments to protect, promote and support breastfeeding. This includes holding businesses accountable for misleading marketing practices that unfairly target vulnerable women and children and directly impact breastfeeding.

This statement is in response to events reported by the New York Times. The article, “Opposition to Breast-Feeding Resolution by U.S. Stuns World Health Officials” reported on U.S.-delegation opposition to a resolution that aimed to call upon member states to strengthen promotion, protection and support for breastfeeding.

The resolution was to be introduced by Ecuador and “expected to be approved quickly and easily by the hundreds of government delegates who had gathered . . . ” According to the article, Ecuador unexpectedly withdrew the resolution in response to threats made by delegates representing the United States. “The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced.”

Ultimately, a weaker resolution was adopted after being introduced by Russia. These actions took place at the World Health Assembly in Geneva in May 2018.

The proposed resolution included a number of key protections for breastfeeding families, including strengthening efforts to reduce predatory marketing of breastmilk substitutes and providing additional supports for families in emergencies. To be clear, it did not deny families access to breast milk substitutes.

As an organization, ILCA envisions “world health transformed by skilled lactation care;” a world in which human beings have every opportunity to thrive through breastfeeding. As such, ILCA stands in support of The Code and subsequent resolutions. ILCA also stands in unwavering support of families everywhere, to make decisions that are best for their families. When breast milk substitutes are desired or required, International Board Certified Lactation Consultants® (IBCLCs®) and other skilled lactation professionals are qualified to assist families in the safe preparation, storage and feeding according to WHO guidelines. For parents choosing to breastfeed, this means navigating a host of unique challenges to the breastfeeding family. Challenges may be clinical but also social. Social policies such as adequate maternity leave and the right to breastfeed or express milk in the workplace work in favor of breastfeeding continuation whereas the absence of supportive and protective policies work against breastfeeding continuation.

The NYT article sheds light on how corporate interest interferes with public health policy designed to improve health and well-being. The article also highlights the role that governments have to promote, protect and support breastfeeding rather than side with businesses to support corporate gains. ILCA strongly supports systems and structures that shift the responsibility for breastfeeding success away from parents and toward social policies that make breastfeeding easier, not more difficult.

As frontline health professionals, IBCLCs and other lactation caregivers around the globe know first-hand the challenges that families face in providing their children with the best nutritional start to life. Therefore, ILCA calls upon governments to protect, promote and support breastfeeding.

ILCA has for many years provided representation at key meetings like the WHA, and will continue to do so. ILCA stands with other global allies and urges its members and partners to continue to advocate for policies that strengthen the promotion, protection and support of breastfeeding at the government level. ILCA urges skilled lactation professionals all over the world to continue to provide individualized specialized clinical care to families while advocating at the local/regional/country level for policies that support the families in our care.

On behalf of the Board of Directors,

 

 

 

Michele Griswold, PhD, MPH, RN, IBCLC

ILCA President

In just one week! Hear why others are attending the ILCA Virtual Conference

We asked past conference participants what they valued most about the virtual conference:

It has given me the confidence I needed to be a better lactation consultant.

Why join the #ILCA18 virtual conference?

We all have busy lives between our roles at work and home.The virtual conference allows participation in the annual ILCA conference that many of us would miss otherwise. The speakers are both fascinating and informative.Thank you, ILCA!

Earn up to 12 Continuing Education Credits, a special online community, and an easy-to-use platform with lots of support. Watch live or on your own time for up to 60 days.

Great way to feel a part of ILCA on the international scale. So many of us are a bit isolated and the virtual conference helps to connect us to the big picture of what an IBCLC can mean to mothers who would like some help and encouragement.

Only one more week to register!

I want to thank the organizers for including this opportunity to view again. It allows me the opportunity to have better clarity of the information.

Click below for more information and to register. Questions? Email us at info@ilca.org.

Get Ready for World Breastfeeding Week: 1-7 August 2018

In a world filled with inequality, crises, and poverty, breastfeeding is the foundation of lifelong good health for babies and mothers. Please join us in celebrating Breastfeeding: Foundation of Life, the theme of World Breastfeeding Week (WBW) 2018. The week of 1-7 August 2018 is coordinated by the World Alliance for Breastfeeding Action (WABA) and highlights that breastfeeding is a universal solution that levels the playing field, giving everyone a fair start in life. Lactation Matters will feature blog posts and resources throughout the week to make sure you can make the most of this important week.

Need help preparing for #WBW2018? Check out this list of ideas and resources:

Visit the WBW 2018 website for general information and downloadable promotional materials, including the WBW 2018 Action Folder. The action folder information on the theme, and includes useful facts and figures, infographics, case studies, and suggested ways to take action.

Share your commitment to breastfeeding advocacy and education. The links between breastfeeding and nutrition, food security, and poverty reduction may be obvious to breastfeeding advocates, but there is still work to be done to make these connections clear to others. We know what needs to be done to support and enable families to breastfeed optimally, but we need to be more proactive and engage more people to make this a reality.

Look for information and action steps throughout WBW at Lactation Matters, where you’ll find articles, images, action steps, and more to help with your successful WBW 2018 observance.

For the most up-to-date information about WBW 2018 and to download promotional materials, please visit the World Breastfeeding Week website by clicking here.

Joint Position On Separation of Parents and Children from IBLCE, ILCA, and LEAARC

 

The International Lactation Consultant Association® (ILCA®), the International Board of Lactation Consultant Examiners® (IBLCE®), and the Lactation Education Accreditation and Approval Review Committee (LEAARC) stand together in opposition to policies that unnecessarily separate a parent from their infant or young child.

 

The unnecessary separation of parents and young children has lifelong physical, psychological, and emotional impacts that have been well documented by health organizations worldwide, including UNICEF and the American Academy of Pediatrics (regardless of feeding status). In addition to these serious consequences, separation also disrupts breastfeeding, leading to further potential harm.

 

For breastfeeding to occur, mothers and babies must have unrestricted access and physical proximity to one another. The importance of breastfeeding for both infants and parents is well documented. These health protections extend into adulthood. Because of the range of health benefits conferred on the breastfeeding dyad, breastfeeding is recommended by the World Health Organization for up to two years of age or beyond. Separating parents from their breastfeeding children during this critical time has long-term consequences.

 

As organizations committed to ensuring worldwide health through support of parents and young children, we stand in opposition to policies that unnecessarily limit access to or separate parent and child.

 

JHL Call for Papers: State of the Science

Journal of Human Lactation (JHL) invites submissions to an upcoming issue with the theme State of the Science. State of the science articles are valuable to clinicians, educators and researchers, because their critical analyses provide evidence for standards of practice, establish the current level of knowledge on a topic, and highlight gaps in the evidence pointing the directions for future research. Click here to view JHL‘s new author submission guidelines.

It is our goal to bring our readership the most up-to-date information available. To facilitate this goal we are calling for critical literature reviews and meta-analyses, using established methodologies, about any one of the many and varied aspects of lactation. We are not interested in a summary or a synthesis of a body of literature, rather accepted manuscripts will provide a critical analysis of the evidence that identifies gaps in what we know, evaluates methodologies researchers have used and hypotheses the next steps needed to continue building our evidence.

The submission deadline for the special issue is 1 February 2019.

Click HERE to submit your manuscript online.

Journal of Human Lactation (JHL) is the top-ranked breastfeeding journal and the most valued benefit of ILCA membership. It is a quarterly, peer-reviewed journal publishing original research, insights in practice and policy, commentaries, and case reports relating to research and practice in human lactation and breastfeeding. JHL is relevant to lactation professionals in clinical practice, public health, research, and a broad range of fields related to the trans-disciplinary field of human lactation.

ILCA Announces New Directors

The International Lactation Consultant Association (ILCA) Board of Directors is pleased to announce two new Directors: Stephanie George and Angela Love-Zaranka. Stephanie comes to the Board through election by ILCA membership. Board member Lisa Akers is stepping down from her second term as Board Treasurer so she can devote more time to the newest member of her family. Angela has been appointed by the Board to finish the last two years of Lisa’s term. Both of our new Directors will begin their terms in July 2018 at the Annual Conference. We look forward to working with them to continue ILCA’s mission: to advance the International Board Certified Lactation Consultant® (IBCLC®) profession worldwide through leadership, advocacy, professional development, and research.

Stephanie is an IBCLC and Aboriginal Midwife from Jarvis, Ontario, Canada. She is passionate about honoring and empowering all women through her healthcare practice. She also advocates for this platform through her roles on the National Aboriginal Council of Midwives, the Baby-Friendly Initiative Strategy of Ontario, and the Expert Panel of the Registered Nurses Association of Ontario. She hopes to continue this important work as a Board Member at ILCA, specifically through increasing access to education for lactation consultants around the world. Stephanie has served ILCA in the past as a member of the Conference Program Task Force.

Angela has always enjoyed both serving breastfeeding families in a clinical setting and doing behind-the-scenes work to support the profession. She began her career as a mother-to-mother breastfeeding support professional in 1990. As she worked to earn her IBCLC, Angela began volunteering for the Virginia and West Virginia Chapter of La Leche League International, eventually serving as their Finance Director and President. Another project she completed on the state level was serving as faculty for the Virginia Maternity Quality Improvement Collaborative, which supported hospitals in moving towards baby-friendly accreditation. Her next step was to the international level. She joined the International Board of Lactation Consultant Examiners as a Board Member in 2006. Some of her duties included chairing the Finance, Audit, and Governance committees and overseeing the revision of several documents key to the lactation consultant profession. Angela is originally from Oklahoma and is proud of her Native American ancestry. She has resided in the Washington D.C. Metropolitan area for the past thirty years.  Her current passion is learning about integrative medicine and traditional medicine from around the world.

We are proud to have Stephanie George and
Angela Love-Zaranka join the ILCA Board of Directors.

The ILCA Board would like to thank each of you for your continued support. To find out more, please visit our website at www.ilca.org.

Ramadan and Breastfeeding

 

by Nor Kamariah Mohamad Alwi, BE, MIT, IBCLC

Ramadan is the most holy month of the year for Muslims. During the month, those who follow Ramadan abstain from eating, drinking, and sexual activities between sunrise and sunset. Additionally, they practice being extra patient, kind, and generous throughout the four weeks. These observances can have an impact on breastfeeding so it is important that International Board Certified Lactation Consultants® (IBCLCs®) understand how to best provide guidance to families.

Muslims scholars, or “ulama,” have been discussing breastfeeding while fasting for decades. Many rulings or “fatwas” have been issued to address this issue, enabling women to make wise decisions for themselves. Muslim women are encouraged to refer to the rulings of their respective local scholars to determine the options most suitable for their situations.

While fasting during Ramadan is not obligatory for all breastfeeding women, here is some guidance that I have found useful in my practice with clients in Malaysia who choose to fast during this time:

  • STAYING HYDRATED: Daily water intake is very important to keep the body sufficiently hydrated. It is recommended to drink bit by bit throughout the permitted time, from sunset to early sunrise. Drinking too much just before fasting will just fill up the bladder and gets urinated out soon after, resulting in the mother feeling thirstier for the rest of the day.
  • EATING WISELY: Eating well-balanced food, including proteins and complex carbohydrates, during “suhoor” – the meal right before the start of a fasting day – is very essential. This will provide the energy that mothers need for the rest of the day, until the breaking of the fast.
  • BREAKING THE FAST: As the fasting day ends, mothers should break her fast as early as possible, by eating natural high-energy foods, to quickly regain energy. A common option among the muslim community (which is also culturally recommended) are black dates. Mothers can opt for creative preparations such as blending the dates with milk.
  • HANDS-ON BREASTFEEDING: For mothers who are breastfeeding directly throughout the day, some will notice that their baby became a bit fussier at the end of the fasting day, as the mother’s body is impacted by the fast. Additionally, the milk ejection reflex can slow down due to the stress of the fast. When breastfeeding at this point, breast compressions while feeding will help drain out milk from the back of the breast. Mom will notice improved milk transfer, which can satisfy the baby faster.
  • EXPRESSING MILK: Expressing milk (for mothers who have to be separated from their baby) can be a varied experience. Some mothers find no change at all in terms of the quantity of expressed milk, especially in the first half of the day. However, some may find that the yield of milk collected at the end of the day is lower compared to earlier in the day. When this occurs, the mother needs to stay calm and understand how milk supply is produced. When milk is expressed from the breast regularly, a new milk supply will be produced. However, when the amount of body liquid reduces as part of the effects of fasting, the quantity of breast milk can be a bit lower than the usual, and mothers will find that their milk at this point usually looks thicker.

At any point in time during a fasting day that a mom feels too lethargic, it is important for her to carefully consider her condition, as well as her baby’s condition, before deciding to continue the fast. Consult with the local scholars and doctors, on how to deal with such situations.

Are there any religious and/or cultural implications that you find useful in your practice?

 

Nor Kamariah Mohamad Alwi resides in Bandar Baru Bangi, Selangor, Malaysia. She created the online breastfeeding support forum susuibu.com in 2004 and is a co-founder and President of Malaysian Breastfeeding Peer Counselors. She is on the Local Governance Task Force Coordinator for World Alliance for Breastfeeding Action (WABA). Kamariah is working with IBCLCs to establish a Malaysian Lactation Consultant Association. She is currently a private practice lactation consultant. (Read more about Kamariah in her ILCA Board of Directors nominee profile.) 

Win a FREE #ILCA18 Virtual Conference Registration!

Join Us for the #ILCA18 Virtual Conference:

LEARNING: INNOVATIVE EDUCATION on the topics you need. 12 Continuing Education Units will be available for the Virtual Conference.

CONNECTION: BUILD RELATIONSHIPS with the entire #ILCA18 community by joining our Online CONNECT Community, exclusively for conference participants. Chat with both face-to-face and virtual contributors, get your questions answered by speakers, and find and share resources on the topics discussed at the conference.

BUILD THE SESSIONS YOU NEED: In addition to the scheduled sessions, #ILCA18 virtual attendees get FREE additional continuing education. Choose the content YOU need most by selecting an additional credit from our on-demand learning in the Knowledge Center.

LIVE OR ON YOUR TIME: Participate LIVE 20 – 21 July or watch on YOUR time – 60 full days of ACCESS to your content.

EASY TO USE + HELP WHEN YOU NEED IT: We are here to help! You will receive a direct link to our EASY-TO-USE conference platform with dedicated and patient tech support. During the live sessions, our professional tech support is staffed by skilled moderators. We love bringing your online questions to the floor of #ILCA18!

 

Equity Access Pricing:

ILCA is committed to ensuring the lactation community has access to #ILCA18, even in low-resource countries. Live streaming pricing is based on the same equity pricing model as our annual membership dues:

Category A: Standard/Clinical Members – $165, Students/Breastfeeding Supporters – $89, Retired – $66

Category B: Standard/Clinical Members – $32, Students/Breastfeeding Supporters – $19, Retired – $13

Category C: Standard/Clinical Members – $8, Students/Breastfeeding Supporters – $5, Retired – $4

Category D: Standard/Clinical Members – $4, Students/Breastfeeding Supporters – $2, Retired – $2

Non-Member Pricing: $241

To find which category your country is in, click here.

 

Earn a chance to win a FREE registration for the #ILCA18 Virtual Conference!

We want to know which speaker you are most excited to hear this year. Leave a comment here on the blog telling us from whom you are most looking forward to learning during the #ILCA18 Virtual Conference! See the complete #ILCA18 Virtual Conference agenda online by visiting our website!

We’ll pick one person who leaves their comment to receive a FREE #ILCA18 Virtual Conference registration!

Bonus entry if you also leave your comment in this thread on Facebook!

Our winner will be chosen on 18 June 2018.

Announcing the 2018 IBCLC Care Award Recipients

 

The IBCLC Care Awards have been announced! Congratulations to the Community-Based Care Award and Hospital-Based Facility recipients! What are the IBCLC Care Awards?

Hospital-Based Facilities and Community-Based Health Agencies that staff currently certified International Board Certified Lactation Consultant (IBCLC) certificants, host dedicated lactation support programs, and have completed specific projects promoting breastfeeding, can apply online to become a recognized IBCLC Care Award facility and be included in the IBCLC Care Directory.

The IBCLC Care Awards are promoted to new families and the general public which means Care Award facilities can enjoy the benefits of positive public relations in your community, including:

  • Enhanced attractiveness to potential patients
  • Competitive edge in recruiting lactation consultants, nurses, midwives, mother support counselors and other medical staff
  • General good will in the community by providing excellent care in helping new families reach their breastfeeding goals
Who are this year’s recipients?

To see a full list of the Care Award Recipients, click here.

The award was created by International Board of Lactation Consultant Examiners® (IBLCE®) and International Lactation Consultant Association® (ILCA®). Learn more and apply here.

Take the World Breastfeeding Week Pledge

Please join us in celebrating World Breastfeeding Week (WBW) 2018, coordinated by the World Alliance for Breastfeeding Action (WABA), 1-7 August 2018!

The theme this year is Breastfeeding: Foundation of Life. Breastfeeding helps to prevent malnutrition in all its forms, ensures food security for infants and young children, and thus, helps to bring people and nations out of the hunger and poverty cycle. It is because of these life-supporting and life-altering qualities that we refer to it as a foundation of life.

Even though it is still months away, we encourage everyone to start planning how you can participate in WBW this year. Tailor your event to best meet your local needs and interests: host a lecture, show a movie, plan a support group, have a picnic, organize a panel, write your legislators, or develop a unique event for your community. Once you plan your event, be sure to sign the WBW 2018 Event Pledge Form. This pledge will track your commitment to celebrate by hosting a WBW event.

For every pledge that is received, the WBW 2018 logo will appear on a world map on their website, with celebrants names and the locations of events. See what others are doing the world over to mark the occasion by viewing the events so far. Do not forget to hashtag your event with #WBW2018!

Need inspiration or resources? Here are some other ways you can get ready for WBW!

Visit the WBW 2018 website for general information and downloadable promotional materials, including the WBW 2018 Action Folder. The action folder information on the theme, and includes useful facts and figures, infographics, case studies, and suggested ways to take action.

Share your commitment to breastfeeding advocacy and education. The links between breastfeeding and nutrition, food security, and poverty reduction may be obvious to breastfeeding advocates, but there is still work to be done to make these connections clear to others. We know what needs to be done to support and enable mothers to breastfeed optimally, but we need to be more proactive and engage more people to make this a reality.

Look for information and action steps throughout WBW at Lactation Matters, where you’ll find articles, images, action steps, and more to help with your successful WBW 2018 observance.

For the most up-to-date information about WBW 2018 and to download promotional materials, please visit the World Breastfeeding Week website by clicking here.

International Kangaroo Care Day: An Interview with Dr. Nils Bergman

 

In just two months, Dr. Nils Bergman, one of the world’s experts on the impact of skin-to-skin contact between an infant and their new family, will present at TOGETHER: Changing YOUR Community and the World, ILCA’s annual conference, in Portland, Oregon, United States, which will be held 18 – 21 July. Attendees at both our in-person and virtual conferences will be able to hear his presentation Skin-to-Skin Contact: Current Research and Mediating Mechanisms.

Dr. Bergman, who has shared his expertise on six continents, worked with Midwife Agneta Jurisoo in Zimbabwe to develop and implement Kangaroo Mother Care (KMC) for premature infants right from birth. This resulted in a five-fold improvement in survival of very low birth weight babies. He introduced KMC to South Africa in 1995, and after 5 years, KMC became official policy for care of premature infants in the hospitals of the Western Cape province. Dr Bergman continues to live and work in Cape Town as a Consulting Public Health Physician. He is also an Honorary Research Associate at the Karolinska Institute, Stockholm, Sweden.

In celebration of International Kangaroo Care Awareness Day, celebrated this year on 15 May, we’ve reached out to find out more about what drew Dr. Bergman to this work, why skin-to-skin contact is critical for infants, and what we can look forward to in his presentation.

 

Lactation Matters (LM): How did you come to be interested in early skin-to-skin contact between infants and their parents?

Nils Bergman (NB): Way back in 1988, I began working in a remote mission hospital in a low income country, with no incubators or realistic means to transfer small babies for care. We had learnt of Kangaroo Mother Method before we came. Since we had no incubators to stabilise babies, we started skin-to-skin contact immediately after birth. We saw a startling difference, instead of taking 6 days to stabilise, it took 6 hours. And we lowered mortality by 40%. The small babies had clear personas, rather than seemingly amorphous immature protoplasm.

 

(LM): Why is this such a critical issue for those who support new families to understand?

(NB): Perhaps it was an accidental discovery, but what we have to understand is that skin-to-skin contact is NORMAL, normal biology and part of reproductive fitness. Worse: separating mothers from babies is actually harmful. Toxic stress is defined as the ‘absence of buffering protection of adult support’, and this applies to premature babies more, not less. And it is very much a ‘family’ thing, the family fabric may also be adversely affected.

 

(LM): What new research or new techniques are you MOST excited to share with us in July?

(NB) Bill & Melinda Gates Foundation have funded a multicentre study, being conducted by WHO in Ghana, India, Malawi, Nigeria and Tanzania. We will randomise 4200 babies weighing between 1000g and 1800g to normal care in warmers and compare them to the same normal care in “Immediate KMC”.

Want to learn more? Join us for #ILCA18!

Warm Chain of Support for Breastfeeding

World Alliance for Breastfeeding Action (WABA), an ILCA Global Collaborator, has introduced a new initiative and vision for quality, consistent pre- and post-natal care: Warm Chain of Support for Breastfeeding. The Warm Chain strives to coordinate efforts at all levels to provide a continuum of care, from pregnancy through a child’s second birthday. There are usually many people providing care and support along the way to new families or families-to-be. The Warm Chain seeks to intentionally connect these “links” with consistent messaging and proper referral systems so that parents and children can benefit from ongoing support and skilled assistance.

International Board Certified Lactation Consultants® (IBCLC®s) play a multidisciplinary role that straddles generalized support for breastfeeding and allied healthcare. This improves maternal and infant survival, health, and well-being rates over the antenatal, birth, and postnatal periods.

As an IBCLC, there are many ways in which the care you provide can serve to further strengthen the links along the Warm Chain. Empowering parents to achieve their breastfeeding goals; providing accurate lactation information and training; and facilitating the establishment of programs, research, and policies in support of breastfeeding and lactation support are ways you can—and probably already DO—encourage connectivity between all actors along the continuum of care.

 

Find more suggestions on ways IBCLCs can support the Warm Chain HERE.

Take advantage of new Warm Chain of Support for Breastfeeding seed grants for projects “that focus on either starting a project or strengthening an existing effort to create an enabling environment for mother to continue breastfeed.” Seed grants are available up to $3000.00 (USD) per project. Find out more HERE.

Complete the Warm Chain survey to highlight both the links and the gaps between those links in the current model of care. Access the survey HERE.

2018 ILCA Elections: Board of Directors

The ILCA Board of Directors has presented a ballot for ILCA voting members to select their next Director.

All ILCA members who are certified as an International Board Certified Lactation Consultant® (IBCLC®) and are in good standing should have received an email from ILCA on 23 April 2018 containing a link to the ballot (subject line: Your 2018 ILCA Board of Directors Ballot). If you did not receive an email and you should have, please contact the ILCA Office at admin@ilca.org (or) 1+ 919-861-5577 (or) 888-452-2478. Our ILCA staff is eager to make sure you get a ballot so your vote can be counted. To ensure a timely and secure election, all voting will take place through an online survey.

Prior to casting a vote, all voting ILCA members are encouraged to thoughtfully consider all information provided below. This will enable you to make an informed decision. Vote carefully: Once your vote is cast, it cannot be changed, repeated, or cancelled.

The balloting commences 23 April 2018 and concludes 07 May 2018, at which time all electronic votes will be tallied by the ILCA staff.

Board of Director Elections

On behalf of the Board of Directors, we are pleased to present the 2018 ballot for election of one Director. The Nominations Task force used an objective scoring system to conduct a fair and impartial assessment of each application. After thorough review and analysis, the following candidates were approved by the ILCA Board of Directors. This year, we will be electing one new director.

A Director must be elected by a majority of ILCA voting members. (Note: ILCA Bylaw 3.4 confers voting privileges to those dues-paying ILCA members who are also IBCLC certificants.)

To run for the position of ILCA Director, ideally, candidates would:

  1. Have prior experience within ILCA; or experience in other national or international breastfeeding/professional advocacy groups, preferably in a board/director post or demonstrated leadership in other positions;
  2. Have verbal, written, organizational, teamwork, and delegation skills;
  3. Be sensitive to the challenges of ensuring equitable access to positions of leadership within ILCA for historically underrepresented groups; and
  4. Be sensitive to the challenges of ensuring equitable access to breastfeeding and skilled lactation care in areas where breastfeeding practices are unequal.

Please take time to review the profiles of each nominee, by clicking on their names, prior to casting your vote. You will vote for one.

Stephanie George, Bachelor of Arts (Honors), Aboriginal Midwife, IBCLC, Postpartum Depression Support Person, Crisis Trauma Responder; Jarvis, Ontario, Canada

Meena Sobsamai, Bachelor of Science in Nutrition and Dietetics, Registered Nurse Midwife, Graduate Diploma in Childbirth Education, IBCLC; Bangkok, Thailand

The ILCA Board extends a special thanks to the Nominations Task Force for their efforts on behalf of the entire membership.

Questions? Comments? Share them here! We want to hear from you.

 

Iniziativa Ospedale Amico Dei Bambini (BFHI) 2018 Guida All’Applicazione Revisionata

Cari Colleghi,

Dopo mesi di discussioni approfondite e proficue con le nostre cinque organizzazioni internazionali che promuovono l’allattamento, il giorno 11 aprile 2018 l’Organizzazione Mondiale della Sanità (OMS) ed il Fondo delle Nazioni Unite per l’Infanzia (UNICEF) hanno pubblicato la versione definitiva della Implementation Guidance: Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018  (“Guida all’Applicazione: Proteggere, promuovere e sostenere l’allattamento in strutture che offrono servizi per la maternità e per I neonati, l’Iniziativa Ospedale Amico dei Bambini 2018”). Il documento finale riflette in gran parte le raccomandazioni formulate dalle nostre organizzazioni e ci congratuliamo con l’OMS e l’UNICEF per il lancio ben riuscito.

Siamo pienamente d’accordo on l’OMS e l’UNICEF che “l’allattamento rappresenta una componente vitale del diritto di ogni bambino di godere del miglior stato di salute possibile, nel rispetto del diritto di ogni madre di prendere una decisione informata su come alimentare suo figlio, basata su informazioni complete sostenute da prove di efficacia, libere da interessi commerciali, e con il sostegno necessario che le permette di portare a termine la sua decisione.”

Concordiamo anche che “le prime ore ed i primi giorni di vita di un neonato formano una finestra temporale critica per stabilire la lattazione e per fornire alle madri il sostegno necessario per allattare con successo” e che lo “scopo fondamentale dell’Iniziativa Ospedali Amici dei Bambini (BFHI) è di assicurare che le madri ed i loro bambini ricevano un’assistenza tempestiva ed appropriata prima e dopo il ricovero in una struttura che offre servizi per la maternità e per I neonati, per consentire l’instaurarsi di un’alimentazione ottimale dei neonati, che promuova la loro salute ed il loro sviluppo.”

Ci congratuliamo per l’inserimento nel Passo 1 del pieno rispetto del Codice Internazionale sulla Commercializzazione dei Sostituti del Latte Materno e le pertinenti Risoluzioni dell’Assemblea Mondiale della Sanità (il Codice Internazionale), di tutte le politiche relative all’alimentazione dei neonati e dei bambini basate sulle prove di efficacia e del monitoraggio interno costante delle relative pratiche cliniche.

Ci uniamo all’OMS e all’UNICEF per raggiungere l’obiettivo della copertura universale della BFHI e per garantirne la sostenibilità nel tempo.

IL CONTESTO

Preoccupati  per il disomogeneo, e relativamente basso, tasso di adozione globale della BFHI, l’OMS e l’UNICEF hanno deciso di valutarne i punti di forza e le criticità e tracciare un percorso per rivitalizzare sia l’iniziativa in generale che gli standard globali. È stata un’impresa enorme.

Una bozza iniziale del nuovo approccio proposto è stata rilasciata per un commento pubblico l’11 ottobre 2017. Le nostre cinque organizzazioni si sono riunite e, su invito dell’OMS e dell’UNICEF, hanno messo a disposizione la propria esperienza e collaborazione  per  modificare alcune parti che non erano state prese pienamente in considerazione nella bozza e per sviluppare ulteriormente la guida.

Vogliamo ringraziare l’OMS e l’UNICEF per la loro apertura e disponibilità al confronto e per il grande lavoro che l’integrazione  delle nostre raccomandazioni ha richiesto. In sei mesi di riunioni, tutte le parti hanno collaborato con l’obiettivo comune di rafforzare la guida per consentire a tutti i paesi di raggiungere l’adozione universale dell’iniziativa.

PUNTI SALIENTI DELLE PRINCIPALI RACCOMANDAZIONI

  • I governi dovrebbero essere coinvolti nell’attuazione nazionale della BFHI e dovrebbero impegnarsi a integrare gli standard internazionali nei sistemi nazionali.
  • Gli enti responsabili per la formazione pre-laurea dovrebbero incorporare nei propri curricula le prove di efficacia e le pratiche rappresentate dai Dieci Passi per un allattamento efficace (i Dieci Passi).
  • Sforzi andrebbero intrapresi per attirare l’attenzione pubblica sull’importanza dell’allattamento, sui rischi della formula e sulle pratiche che aiutano a proteggere, promuovere e sostenere l’allattamento.
  • Sforzi andrebbero intrapresi per proteggere l’allattamento, le famiglie e gli operatori dal marketing commerciale e dalle pressioni non etiche.
  • La BFHI dovrebbe essere integrata in altri interventi, in programmi internazionali e/o nazionali esistenti e coordinata con gli sforzi per sostenere l’allattamento nella comunità e nei luoghi di lavoro.
  • Per quei paesi che attualmente dispongono di un programma di riconoscimento ben funzionante in grado di raggiungere la maggior parte delle strutture che forniscono servizi di maternità e per neonati a livello nazionale, questa nuova guida non dovrebbe essere vista come un motivo per interrompere un programma di successo.

PUNTI SALIENTI DEI COMPONENTI CHIAVE DELLA GUIDA

  • Enfatizza l’importanza dell’allattamento esclusivo per 6 mesi per fornire il nutrimento, i nutrienti e l’energia necessari per lo sviluppo e la crescita fisici e neurologici.
  • Comprende un insieme di criteri globali chiari, con la possibilità di adeguarli al contesto nazionale.
  • Mantiene i Dieci Passi nell’ordine originale e con i contenuti tematici di ognuno. Modifica la loro formulazione per renderla più generica e consentire l’integrazione futura di prove di efficacia nuove e/o aggiornate. Spiega lo scopo di ognuno dei passi ed offre indicazioni chiare per l’attuazione.
  • Riconosce il contributo di ognuno dei dieci passi nel migliorare il sostegno per l’allattamento, e sottolinea la necessità che tutti i dieci passi vengano implementati come un pacchetto di interventi al fine di realizzare un impatto ottimale sulle pratiche riguardanti l’allattamento.
  • Fornisce una guida aggiornata per l’attuazione sicura delle pratiche e del monitoraggio dei pazienti. Ricorda agli operatori sanitari l’importanza di un’attenzione e di un’assistenza personalizzata.
  • Descrive l’importanza delle Cure Amiche della Madre e dell’impatto delle pratiche del travaglio/parto sull’allattamento. Ribadisce l’importanza delle conoscenze degli operatori su queste pratiche e la loro responsabilità di condividere queste informazioni con le madri. Rimanda ad altre linee guida OMS per ulteriori dettagli sulle specifiche pratiche.
  • Evidenzia l’importanza dell’allattamento e/o dell’alimentazione con latte materno per tutti i bambini ricoverati nella struttura, includendo alcune linee guida, indicatori e standard per fornire un sostegno ai neonati pretermine in aggiunta alle linee guida, gli indicatori e gli standard che sono stati storicamente indirizzati ai nati a termine sani.
  • Dà un mandato affinché le prove di efficacia e le pratiche contenute nei Dieci Passi vengano incluse nei programmi di formazione pre-laurea, mentre la formazione continua post laurea prosegue finché non si raggiunga una massa critica di nuovi professionisti formati che si sono laureati ed abbiano preso servizio.
  • Spiega le responsabilità delle strutture e degli operatori sanitari per il rispetto del Codice Internazionale, collocandolo in primo piano nel Passo 1, ponendo le basi perché il Codice Internazionale venga inserito in tutti gli aspetti dell’assistenza.
  • Propone e sottolinea l’importanza dei sistemi per monitorare e sostenere le pratiche.
  • Fornisce degli indicatori ben definiti che sono di facile valutazione e che permetteranno un confronto fra paesi. Mantiene tutti gli indicatori minimi all’80%.
  • Riconosce l’importanza di un riconoscimento pubblico, come l’accreditamento, come fattore fondamentale per il cambiamento. Indica la necessità di una valutazione esterna come uno dei principi chiave in un percorso di miglioramento della qualità e riconosce la natura trasformativa del percorso per diventare Baby-friendly, con effetti che si estendono all’intero ambito attorno all’alimentazione infantile. Questi comprendono un’assistenza più centrata sulle famiglie, un miglioramento netto negli atteggiamenti e nelle competenze degli operatori nei confronti dell’alimentazione infantile, una riduzione significativa dell’uso dei sostituti del latte materno e dello spazio “nido” del reparto. Dichiara che la qualità dell’assistenza riguardante l’allattamento migliora nettamente nelle strutture riconosciute “Amiche dei Bambini”.
  • Offre una guida robusta per percorsi di miglioramento della qualità alternativi in quei paesi dove l’opzione di un accreditamento tradizionale non è fattibile.
  • Rafforza il ruolo delle strutture che offrono servizi di maternità e per neonati nell’identificare le risorse appropriate disponibili sul territorio per un sostegno continuativo e consistente all’allattamento, che sia culturalmente e socialmente sensibile ai bisogni delle famiglie. Ricorda alle strutture la loro responsabilità di interagire con il territorio locale per potenziare tali risorse.

Cosa potete fare

Visto che questo documento ha dato risposta alle preoccupazioni sorte attorno alla bozza iniziale del 2017, chiediamo adesso a tutte le persone che lavorano con le famiglie nell’ambito dell’alimentazione dei neonati e dei bambini di unirsi, di sostenere i suoi obiettivi, e di lavorare all’interno dei singoli paesi per attuarlo nella maniera più efficace.

Prossimi Passi

Stiamo lavorando affinché venga inserita una clausola in una Risoluzione per la prossima Assemblea Mondiale della Sanità che chiede al Direttore Generale dell’OMS di lavorare in collaborazione con l’UNICEF per sviluppare degli strumenti per la formazione, per il monitoraggio e per l’advocacy sull’Iniziativa Ospedale Amico dei Bambini per aiutare gli Stati Membri nell’attuazione. Continueremo a seguire il percorso della Risoluzione, lo sviluppo degli strumenti e l’attuazione della guida.

Grazie.

Sinceramente,

Trish MacEnroe
Coordinator Baby-Friendly Hospital Initiative Network of Industrialized Nations, Central and Eastern European Nations and Independent States (BFHI Network)

Elisabeth Sterken
Co-chair IBFAN Global Council
International Baby Food Action Network (IBFAN)

Michele Griswold
President International Lactation Consultant Association (ILCA)

Ann Calandro
Chair La Leche League International (LLLI)

Felicity Savage
Chairperson World Alliance for Breastfeeding Action (WABA)

Altre traduzioni di questo post sono disponibili in inglese, spagnolo e francese.

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2018 Baby-Friendly Hospital Initiative (BFHI) Revised Implementation Guidance

The document commonly known as the “Ten Steps” has recently been updated. ILCA has been actively advocating on behalf of the lactation community throughout the revision process. Below is a open letter to the community with an update on the revisions. ILCA would like to extend significant gratitude to the volunteers who have devoted many, many hours to this effort.

Dear Colleagues,

After months of thoughtful and productive discussion with our five global breastfeeding promotion organizations, on April 11, 2018, the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) released the final version of the Implementation Guidance: Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018. The final document is highly responsive to the recommendations made by our organizations, and we congratulate the WHO and UNICEF on a successful launch.

We strongly agree with the WHO and UNICEF that “breastfeeding is a vital component of realizing every child’s right to the highest attainable standard of health, while respecting every mother’s right to make an informed decision about how to feed her baby, based on complete, evidence-based information, free from commercial interests, and the necessary support to enable her to carry out her decision.”

We also concur that “the first few hours and days of a newborn’s life are a critical window for establishing lactation and providing mothers with the support they need to breastfeed successfully” and that the “core purpose of the Baby-Friendly Hospital Initiative (BFHI) is to ensure that mothers and newborns receive timely and appropriate care before and during their stay in a facility providing maternity and newborn services, to enable the establishment of optimal feeding of newborns, which promotes their health and development.”

We applaud the full application of the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly Resolutions (the International Code), comprehensive, evidence-based infant feeding policies and ongoing internal monitoring of adherence to relevant clinical practices being incorporated into Step One.

We stand united with the WHO and UNICEF on the goal of scaling up to universal BFHI coverage and ensuring its sustainability over time.

BACKGROUND

Motivated by deep concerns about the uneven and relatively low global adoption of the BFHI, the WHO and UNICEF undertook the important tasks of evaluating the strengths and weaknesses of the initiative and charting a course to revitalize both the overall initiative and the global standards. It was an enormous undertaking.

An initial draft of their new proposed approach was released for public comment on October 11, 2017.  Our five organizations came together and, at the invitation of the WHO and UNICEF, shared our collective expertise and worked with them to recommend changes in some areas that were not fully addressed in the proposal and further develop the guidance.

We would like to thank the WHO and UNICEF for their openness and willingness to engage in discussions and undertake the extra effort required to incorporate our recommendations.  During the 6-month period of meetings, all parties worked together with the mutual goal of strengthening the guidance to empower countries to scale up to universal adoption.

HIGHLIGHTS OF KEY HIGH-LEVEL RECOMMENDATIONS

  • Governments should become involved in the national implementation of the BFHI and should undertake efforts to integrate international standards into national systems.
  • Professional organizations responsible for pre-service education should incorporate the evidence and practices embodied in the Ten Steps to Successful Breastfeeding (the Ten Steps) into their curricula.
  • Efforts should be undertaken to draw public attention to the importance of breastfeeding, the risks of formulas and the practices that will help to protect, promote and support breastfeeding.
  • Efforts should be undertaken to protect breastfeeding, families and staff from commercial marketing and unethical pressures.
  • BFHI should be integrated into other interventions, existing international and/or national programs, and coordinated with efforts to support breastfeeding in communities and the workplace.
  • For those countries that currently have a well-functioning designation program able to reach the majority of facilities providing maternity and newborn services nationwide, this new guidance should not be viewed as a reason to discontinue a successful program.

HIGHLIGHTS OF KEY COMPONENTS OF THE GUIDANCE

  • Stresses the importance of exclusive breastfeeding for six months to provide the nurturing, nutrients and energy needed for physical and neurological growth and development.
  • Includes a clear set of global criteria, with the option to tailor for applicability to national standards.
  • Retains the Ten Steps in their original order and subject matter. Includes wording changes that are more generalized and designed to allow for the future incorporation of new and/or updated evidence. Explains the intent of each of the steps and offers clear guidance for their implementation.
  • Acknowledges the contribution of each of the ten steps to improving the support for breastfeeding, and stresses the need for all ten steps to be implemented as a package in order to attain an optimal impact on breastfeeding practices.
  • Provides updated guidance for the safe implementation of practices and monitoring of patients. Reminds health care providers of the importance of individualized attention and care.
  • Describes the importance of mother-friendly birth practices and the impact of birth practices on breastfeeding. Stresses the importance of healthcare professionals being knowledgeable about those practices and their responsibility for educating mothers. Refers them to other WHO guidelines for more details on the specific practices.
  • Stresses the importance of breastfeeding and/or breast milk feeding for all infants cared for in a facility by including some guidelines, indicators and standards for providing breastfeeding support for preterm infants in addition to the guidelines, indicators and standards that have been traditionally included for healthy term infants.
  • Sets a mandate for the evidence and practices embodied in the Ten Steps to be included in health care pre-service curricula while retaining the need to continue with in-service education until this is accomplished and several classes have graduated and entered into practice.
  • Explains the responsibility of healthcare facilities and professionals for implementing the International Code and places it prominently in Step 1, setting the stage for the International Code to be embodied in all aspects of patient care.
  • Stresses the importance of and proposes systems for monitoring and sustaining the practices.
  • Provides clearly defined indicators that are easy to assess and will allow for comparisons between countries. Retains all indicators at the 80% level.
  • Acknowledges the importance of public recognition, such as accreditation, as a key driver for change. Points to the need for external evaluation or assessment as one of the key principles of quality improvement and acknowledges the process of becoming Baby-friendly as transformative, with impacts pertaining to the entire environment around infant feeding.  This included the care being more patient centered; staff attitudes and skill levels about infant feeding improving dramatically; the use of infant formula and newborn nurseries being significantly reduced. States that the quality of care for breastfeeding clearly improved in facilities designated as “baby-friendly”.
  • Offers robust guidance for additional quality improvement options for countries where the traditional accreditation options are beyond reach.
  • Reinforces the role of facilities providing maternity and newborn services of identifying appropriate community resources for continued and consistent breastfeeding support that is culturally and socially sensitive to the needs of families. Reminds facilities they have a responsibility to engage with the surrounding community to enhance such resources.

 

Call to Action:

Given the responsiveness of this document to the concerns raised around the initial 2017 draft, we now call upon all those working with families on infant and young child feeding to band together, support its goals, and work within your countries to implement it in the most effective manner.

Next Steps:

We are working to ensure that a provision is included in a resolution for the upcoming World Health Assembly (WHA) to request the Director General of WHO to work in collaboration with UNICEF to develop tools for training, monitoring, and advocacy on the Baby-Friendly Hospital Initiative to assist Member States with implementation. We will continue to monitor the progress of the resolution, the development of tools, and implementation of the BFHI guidance.

Thank you.

 

Sincerely,

Trish MacEnroe
Coordinator
Baby-Friendly Hospital Initiative Network of Industrialized Nations, Central and Eastern European Nations and Independent States (BFHI Network)

Elisabeth Sterken
Co-chair IBFAN Global Council
International Baby Food Action Network (IBFAN)

Michele Griswold
President
International Lactation Consultant Association (ILCA)

Ann Calandro
Chair
La Leche League International (LLLI)

Felicity Savage
Chairperson
World Alliance for Breastfeeding Action (WABA)

 

Additional translations of this blog post are available in Spanish and French.

Iniciativa Hospital Amigo De Los Niños Y Las Niñas 2018 (IHAN) Guia Revisada De Implementacion

Estimados colegas,

Tras meses de profundo y productivo debate entre nuestras cinco organizaciones mundiales de promoción de la lactancia materna, el 11 de abril de 2018, la Organización Mundial de la Salud (OMS) y el Fondo de las Naciones Unidas para la Infancia (UNICEF) publicaron la versión final de la Guía de Implementación: Proteger, promover y apoyar la lactancia materna en instituciones que brindan servicios de maternidad y neonatología: la Iniciativa Hospital Amigo de los Niños y las Niñas 2018 revisada. El documento final responde en gran medida a las recomendaciones formuladas por nuestras organizaciones y felicitamos a la OMS y al UNICEF por el éxito de su lanzamiento.

Estamos completamente de acuerdo con la OMS y UNICEF en que “La lactancia materna es un componente vital para hacer realidad el derecho de todos los niños y niñas a gozar del más alto nivel posible de salud, al tiempo que se respeta el derecho de todas las madres a tomar una decisión informada sobre cómo alimentar a su bebé, basada en información completa y basada en la evidencia, libre de intereses comerciales, y el apoyo necesario para que pueda llevar a cabo su decisión”.

También estamos de acuerdo en que “las primeras horas y días en la vida de un recién nacido son una ventana crítica para establecer la lactancia y proporcionar a las madres el apoyo que necesitan para amamantar con éxito” y que “el propósito central de la Iniciativa Hospital Amigo de los niños y las niñas (IHAN) es asegurar que las madres y los recién nacidos reciban atención oportuna y apropiada antes y durante su estancia en una institución que proporciona servicios de maternidad y neonatología, que permita el establecimiento de una alimentación óptima para los recién nacidos, lo que promueve su salud y desarrollo.”

Aplaudimos la plena aplicación del Código Internacional de Comercialización de Sucedáneos de Leche Materna y Resoluciones relacionadas de la Asamblea Mundial de la Salud (el Código Internacional), la incorporación en el Primer Paso de políticas integrales de alimentación infantil basadas en la evidencia y la monitorización continuada de la observancia de las prácticas clínicas relevantes.

Nos alineamos con OMS y UNICEF en su objetivo de ampliar a universal la cobertura de la IHAN para las instituciones de salud materno infantil y garantizar su sostenibilidad en el tiempo.

ANTECEDENTES

Motivados por la profunda preocupación ante la adopción desigual y relativamente baja de la IHAN en todo el mundo, la OMS y el UNICEF emprendieron la importante tarea de evaluar las fortalezas y debilidades de la IHAN y trazar un rumbo para revitalizar tanto la iniciativa como los estándares globales. Una tarea ingente.

l 11 de octubre de 2017 se abrió un periodo de comentario público sobre el primer borrador con propuestas de un nuevo enfoque. Nuestras cinco organizaciones se reunieron y atendiendo a la invitación de la OMS y el UNICEF, compartieron experiencia y trabajaron conjuntamente para aportar a un mayor desarrollo de la guía y recomendar cambios en determinadas áreas no abordadas plenamente por la propuesta.

Deseamos agradecer a la OMS y al UNICEF su apertura y disposición para el debate y haber realizado el necesario esfuerzo adicional para incorporar nuestras recomendaciones. Durante el período de seis meses en que se celebraron las reuniones, todas las partes trabajaron conjuntamente con el objetivo común de fortalecer la guía para empoderar a los países hasta alcanzar la adopción universal.

RECOMENDACIONES PRINCIPALES: ASPECTOS DESTACADOS.

  • Los gobiernos deben involucrarse en la aplicación nacional de la IHAN y realizar esfuerzos para integrar los Criterios Globales en los sistemas nacionales de salud.
  • Las organizaciones profesionales responsables de la educación pre-grado deben incorporar en sus planes de estudio las evidencias y prácticas concernientes a los Diez Pasos para una feliz Lactancia Materna (los Diez Pasos).
  • Se deben realizar esfuerzos para atraer a la atención pública la importancia de la lactancia materna, los riesgos de las fórmulas y las prácticas que ayudaran a proteger, promover y apoyar la lactancia materna.
  • Se deben realizar esfuerzos para proteger a la lactancia materna, las familias y los trabajadores de las presión y las prácticas no éticas de la industria.
  • La IHAN debe ser integrada en otras intervenciones y programas internacionales y/o nacionales ya existentes, y coordinarla con otros esfuerzos de apoyo a la lactancia materna en las comunidades y lugares de trabajo.
  • En aquellos países que actualmente cuentan con un programa de acreditación que funciona correctamente y capaz de llegar a la mayoría de los centros que prestan servicios de maternidad y neonatología del país, esta nueva guía no debe ser considerada una razón para interrumpir un programa con éxito.

GUIA DE IMPLEMENTACION: ASPECTOS DESTACADOS DE LAS PRINCIPALES RECOMENDACIONES

  • Destaca la importancia de la lactancia materna exclusiva durante 6 meses para proporcionar la nutrición y la energía necesarios para el crecimiento y el desarrollo físico y neurológico.
  • Incluye un conjunto claro de criterios globales, con la opción de adaptar la aplicabilidad a las normas nacionales.
  • Mantiene los Diez Pasos en su orden y tema original. Incluye cambios de redacción más generalizados y diseñados para permitir la incorporación futura de pruebas nuevas y/o actualizadas. Explica la intención de cada uno de los pasos y ofrece una guía clara para su implementación.
  • Reconoce la contribución de cada uno de los Diez Pasos a la mejora del apoyo a la lactancia materna, y subraya la necesidad de que para lograr un impacto óptimo en las prácticas de lactancia materna, los Diez Pasos se implementen como un todo.
  • Proporciona una guía actualizada para la implementación segura de las prácticas y el seguimiento de los pacientes. Recuerda a los proveedores de salud la importancia de la atención y el cuidado individualizados.
  • Describe la importancia de las prácticas de parto amigables con la madre y el impacto de las mismas sobre la lactancia materna. Destaca la importancia de que los profesionales de la salud conozcan estas prácticas y su responsabilidad en la educación de las madres. Les remite a otras guías de la OMS para más detalles sobre las prácticas específicas.
  • Destaca la importancia de la lactancia materna y/o la leche materna para todos los lactantes atendidos en una institución, mediante la inclusión de directrices, indicadores y normas para la prestación de apoyo a la lactancia materna de los lactantes prematuros, además de las directrices, indicadores y normas que tradicionalmente se han incluido para los lactantes a término sanos.
  • Establece un mandato para que la evidencia y las prácticas incorporadas en los Diez Pasos sean incluidas en los planes de estudio de pre-grado de las profesiones sanitarias, manteniendo la necesidad de continuar con la educación post grado hasta que esto se logre y varias generaciones se hayan graduado y estén trabajando.
  • Explica la responsabilidad de las instituciones de salud y de los profesionales de la salud en la implementación del Código Internacional y lo coloca en un lugar pre eminente en el Paso 1, sentando las bases para que el Código Internacional se incorpore en todos los aspectos de la atención al paciente.
  • Propone sistemas para monitorizar y asegurar la sostenibilidad de las prácticas y destaca la importancia de las mismas.
  • Proporciona indicadores claramente definidos fáciles de evaluar y permitirán comparaciones entre países. Mantiene todos los indicadores al nivel del 80%.
  • Reconoce la importancia de medidas de reconocimiento público, como la acreditación, como motor clave del cambio. Señala la necesidad de una evaluación o valoración externa como uno de los principios clave de la mejora de la calidad y reconoce que el proceso de convertirse en “IHAN” es transformador, con repercusiones en todo el entorno de la alimentación infantil. Esto incluye que la atención se centra más en el paciente; que las actitudes y los niveles de destreza del personal con respecto a la alimentación infantil mejoran drásticamente; y que se reduzca significativamente el uso de fórmulas para lactantes y de las “nido” para recién nacidos. Afirma que la calidad de la atención de la lactancia materna mejora significativamente en las instituciones IHAN.
  • Ofrece una guía sólida para opciones adicionales de mejora de la calidad para países donde las opciones tradicionales de acreditación están fuera de alcance.
  • Refuerza el papel de las instalaciones que proporcionan servicios de maternidad y neonatología en la identificación de recursos comunitarios apropiados para un apoyo continuo y consistente a la lactancia materna que sea cultural y socialmente sensible a las necesidades de las familias. Recuerda a los establecimientos que tienen la responsabilidad de involucrarse con la comunidad para mejorar dichos recursos.

Llamada a la acción:

Dada la receptividad de este documento a las preocupaciones planteadas en torno al borrador inicial de 2017, hacemos ahora un llamamiento a todos los involucrados en la alimentación de lactantes y niños y niñas pequeños, que trabajan con las familias, para que se unidos, apoyen sus objetivos y trabajen dentro de sus países para implementarlo de la manera más eficaz posible.

Siguientes Pasos:

Estamos trabajando para asegurar que se incluya una disposición en una resolución de la próxima Asamblea Mundial de la Salud, que solicite al Director General de la OMS que trabaje en colaboración con UNICEF para desarrollar herramientas para la capacitación, el monitoreo y la promoción de la Iniciativa de Hospitales Amigos de los Niños que ayuden a los Estados Miembros con la implementación. Continuaremos monitorizando el progreso de la resolución, el desarrollo de herramientas y la implementación de la guía IHAN.

Gracias.

Sinceramente,

Trish MacEnroe
Coordinadora
Red IHAN de las Naciones Industrializadas, las Naciones de Europa Central y Oriental y los Estados Independientes (BFHI network)

Elisabeth Sterken
Copresidenta del Consejo Mundial de IBFAN
Red Internacional de Acción para la Alimentación Infantil (IBFAN)

Michele Griswold
Presidenta
Asociación Internacional de Consultores en Lactancia (ILCA)

Ann Calandro
Presidenta
Liga Internacional de la Leche (LLLI)

Felicity Savage
Presidenta
Alianza Mundial para la Acción pro Lactancia Materna (WABA)

Las traducciones adicionales de esta comunicación están disponibles en inglés francés.

 

 

2018 Initiative Hôpitaux Amis Des Bébés (IHAB) Nouvelles Lignes Directrices

Chères collègues,

Après plusieurs mois de réflexions et de discussions productives avec nos cinq organisations internationales en promotion de l’allaitement, l’OMS et l’UNICEF ont publié la version finale des lignes directrices pour les IHAB, le 11 avril 2018, Implementation Guidance: Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018. Le document final reflète très clairement les recommandations apportées par nos cinq organisations et nous félicitons l’OMS et l’UNICEF pour cette publication réussie.

Nous sommes entièrement en accord avec l’OMS et l’UNICEF que “l’allaitement représente un élément essentiel pour que soit reconnu pour tout enfant le droit fondamental au plus haut niveau de santé, tout en respectant le droit de la mère de prendre une décision éclairée sur la façon de nourrir son enfant. Cette décision doit être prise en se fiant à une information complète, basée sur des données probantes et libre de tout intérêt commercial. Le soutien nécessaire doit aussi être présent pour l’aider à actualiser sa décision.”

Nous sommes aussi de l’avis de l’OMS et de l’UNICEF lorsqu’ils affirment que “les premières heures et les premiers jours d’un nouveau-né sont critiques pour l’initiation de la lactation et pour soutenir les mères à allaiter avec succès” et que “le but de l’IHAB est de s’assurer que les mères et les nouveau-nés reçoivent les soins appropriés et en temps requis, avant et pendant leur séjour en maternité, en vue de faciliter la meilleure nutrition possible pour favoriser la santé et le développement des bébés.”

Nous nous réjouissons du fait que la condition 1 comprend dorénavant l’application complète du Code international de commercialisation des substituts du lait maternel (le Code international) et les résolutions subséquentes de l’Assemblée mondiale de la santé (AMS) qui le concernent, de même que des politiques complètes de nutrition de l’enfant basées sur des données probantes et le monitoring des pratiques cliniques liées à ces politiques.

Nous unissons nos voix à celles de l’OMS et de l’UNICEF pour que l’IHAB soit implantée partout dans le monde et que sa durabilité soit assurée au fil du temps.

CONTEXTE

Préoccupés par l’adoption inégale et assez faible de l’IHAB au niveau mondial, l’OMS et l’UNICEF ont entrepris d’évaluer les forces et les faiblesses de l’Initiative et de la revitaliser ainsi que les critères internationaux qui s’y rattachent. C’était une lourde tâche.

Des lignes directrices ont d’abord été proposées pour critique publique en octobre 2017. Nos cinq organisations se sont réunies et, à l’invitation de l’OMS et l’UNICEF, ont partagé leurs expertises en vue de bonifier ce premier jet dans lequel certains aspects n’avaient pas été touchés en profondeur.

Nous désirons remercier l’OMS et l’UNICEF pour leur ouverture et leur intérêt à poursuivre les discussions avec nous et à intégrer nos recommandations dans ce premier jet. Nous nous sommes attelés à la tâche tous ensemble durant 6 mois pour renforcer les lignes directrices en vue de permettre aux pays d’évoluer vers une adoption universelle de l’IHAB.

Traduction libre par Louise Dumas, Comité canadien pour l’allaitement; texte original en anglais “2018 Baby-Friendly Hospital Initiative (BFHI) Revised Implementation Guidance” du 11 avril 2018.

FAITS SAILLANTS DES RECOMMANDATIONS PRINCIPALES

Les gouvernements doivent s’impliquer dans l’implantation nationale de l’IHAB en plus de s’efforcer à intégrer les critères internationaux dans leurs systèmes nationaux.

Les responsables de la formation initiale des professionnels de la santé doivent intégrer dans leur curricula les évidences et la pratiques cliniques sous-jacentes aux Dix conditions pour le succès de l’allaitement (les Dix conditions).

Il faut attirer l’attention du public quant à l’importance de l’allaitement, des risques des substituts du lait maternel et des pratiques qui aident la protection, l’encouragement et le soutien à l’allaitement. Des efforts doivent être entrepris pour protéger l’allaitement, les familles et les travailleurs de la santé des pressions et de la commercialisation non-éthiques exercées par les compagnies de substituts du lait maternel. L’IHAB doit être intégrée dans d’autres interventions et programmes nationaux ou internationaux, en vue de coordonner les efforts pour le soutien de l’allaitement dans les communautés et les lieux de travail.

Les pays ayant développé un programme de reconnaissance et de certification pour tous les établissements de santé prodiguant des soins et services périnatals n’ont pas à cesser ces activités si elles sont productives. Ce n’est pas le but des lignes directrices actuelles.

FAITS SAILLANTS EN REGARD DES PRINCIPAUX ÉLÉMENTS DES LIGNES DIRECTRICES

Mettent l’accent sur l’exclusivité de l’allaitement pour les 6 premiers mois en vue de prodiguer à la fois les soins, les nutriments et l’énergie nécessaires à une croissance et à un développement physique et neurologique optimal.

Incluent une liste de critères internationaux clairs qui peuvent aussi être adaptés selon les standards des différents pays.

Maintiennent les Dix conditions dans leur ordre original de même que les sujets touchés dans chaque condition. Le langage utilisé permettra leur mise à jour éventuelle lors de la publication de nouvelles données probantes. Chaque condition est bien expliquée et contient une orientation claire quant à son implantation.

Reconnaissent la contribution de chaque condition dans l’amélioration du soutien à l’allaitement et soulignent le besoin d’implanter les Dix conditions comme un tout pour obtenir un meilleur impact sur les pratiques lies à l’allaitement.

Fournissent des directives claires pour l’implantation sécuritaires des pratiques et pour le monitoring de celles-ci. Rappellent aux professionnels de la santé l’importance des soins attentifs individualisés.

Décrivent l’importance des pratiques favorables aux mères (Mother-Friendly) et leur impact sur l’allaitement. Mettent l’accent sur l’importance pour les professionnels de la santé de bien connaître ces pratiques et leur responsabilité d’en informer les mères. Réfèrent aux autres lignes directrices en vigueur à l’OMS pour plus de détails concernant ces pratiques.

Soulignent l’importance de l’allaitement et/ou du lait maternel pour tous les bébés soignés dans un établissement, en incluant des directives, des indicateurs et des standards pour le soutien aux bébés prématurés.

Traduction libre par Louise Dumas, Comité canadien pour l’allaitement; texte original en anglais “2018 Baby-Friendly Hospital Initiative

(BFHI) Revised Implementation Guidance” du 11 avril 2018 en plus de directives, d’indicateurs et de standards qui ont toujours fait partie de l’initiative pour les nouveau-nés à terme.

Définissent un mandat clair quant à l’intégration des évidences et des pratiques sous-jacentes aux Dix conditions dans la formation initiale des professionnels de la santé, tout en poursuivant pour le moment l’éducation continue et ce, jusqu’à ce que plusieurs nouveaux gradués ainsi formés soient entrés en milieu clinique au cours des années.

Expliquent les responsabilités des établissements de santé et des professionnels de la santé dans l’implantation du Code international maintenant partie intégrante de la condition 1, décrivant ainsi les bases pour l’adoption du Code international dans tous les aspects des soins aux patients. Soulignent l’importance de la surveillance continue des pratiques et proposent des systèmes pour en assurer la pérennité.

Fournissent des indicateurs clairement définis et faciles à évaluer qui permettent les comparaisons entre les pays. Conservent le niveau de passage à 80% pour tous les indicateurs.

Admettent l’importance de la reconnaissance publique telle la certification, comme élément-clé de changement. Soulignent l’importance de d’évaluation externe comme principe de base pour améliorer la qualité des interventions. Reconnaissent la valeur transformative du processus menant à la certification Ami des bébés sur tout l’environnement lié à la nutrition infantile, entre autres des soins davantage centrés sur le patient, des soignants démontrant des attitudes et des habiletés bonifiées en nutrition infantile, un recours moins fréquent aux substituts du lait maternel et un nombre important de pouponnières fermées. Stipulent que la qualité des soins en regard de l’allaitement évolue grandement quand les maternités sont certifiées Ami des bébés. Offrent des alternatives solides pour améliorer la qualité des soins autrement que par la certification dans les pays où cette option n’est pas envisageable.

Renforcent le rôle des établissements de santé dans l’identification de ressources communautaires appropriées, culturellement et socialement acceptables pour les familles en vue d’un soutien conséquent en allaitement. Rappellent à ces établissements qu’ils ont la responsabilité de s’engager dans leur communauté pour améliorer l’offre de ressources appropriées.

Ce que vous pouvez faire

Étant donné que ce document répond maintenant aux préoccupations que nous avions exprimées suite à la publication d’octobre 2017, nous demandons à toutes les personnes oeuvrant auprès des familles au niveau de la nutrition des nouveau-nés et des jeunes enfants, de se rallier autour de ces Lignes directrices, d’en soutenir les objectifs et de travailler pour l’implanter dans tous les pays de la façon la plus efficace possible.

Prochaines étapes Nous travaillons à nous assurer que la résolution qui sera déposée à l’AMS en mai prochain demandera au Directeur général de l’OMS de travailler en collaboration avec l’UNICEF au développement d’outils pour la formation, la surveillance et la défense de l’IHAB en vue d’assister les états membres à l’implanter dans leur pays respectif. Nous continuerons à suivre le cheminement de cette résolution, le développement des outils requis en vue de l’implantation des lignes directrices sur l’IHAB.

Merci.

Respectueusement vôtre,

Trish MacEnroe
Coordonnatrice
Baby-Friendly Hospital Initiative Network of Industrialized Nations, Central and Eastern European Nations and
Independent States (BFHI Network)

Elisabeth Sterken
Vice-présidente
International Baby Food Action Network (IBFAN)

Michele Griswold
Présidente
Association internationale des consultantes en lactation (ILCA)

Ann Calandro
Présidente
La Ligue La Leche Internationale (LLLI)
Felicity Savage
Présidente
World Alliance for Breastfeeding Action (WABA)

Des traductions supplémentaires de cette communication sont disponibles en anglais et espagnol.


「赤ちゃんにやさしい病院運動」実施ガイド2018年改訂版

親愛なる仲間の皆さんへ

世界保健機関(WHO)と国連児童基金(ユニセフ)は、世界的な母乳育児推進組織である、私たち5団体と数々の慎重かつ生産的な議論を重ね、2018年4月11日に実施ガイドの最終版を公開しました。

www.who.int/nutrition/publications/infantfeeding/bfhi-implementation/en/

産科施設と新生児医療施設における母乳育児支援:「赤ちゃんにやさしい病院運動」の2018改訂版です。最終文書は、私たち5団体*の勧告を十分取り入れたものであり、WHOとユニセフが無事に改訂版を出したことを祝福します。

 

(*訳注:BFHIネットワーク、乳児用食品国際行動ネットワーク (IBFAN)、国際ラクテーション・コンサルタント協会(ILCA)、ラ・レーチェ・リーグ・インターナショナル、世界母乳育児行動連盟(WABA))

 

私たちは、WHOとユニセフが、次のように述べたことに、強く同意します。

「母乳育児は、すべての子どもの達成可能な最高水準の健康への権利を実現するための重要な要素である。それと同時に、すべての母親が自分の子どもの栄養法を情報に基づいて決定する権利を尊重する。ただし、その情報は完全で、科学的根拠に基づき、商業的利益が排除されたものであり、母親が自分の決定を実行するために必要な支援が得られることが前提になる。」

 

私たちは、次のことにも同意します。

「新生児の出生直後の数時間と数日は、乳汁分泌を確立し、母乳育児がうまくいくように必要な支援を提供するための重要な時期である。」そして、「赤ちゃんにやさしい病院運動(BFHI)の大切な目的は、産科施設と新生児医療施設において、産前と入院中に母親と新生児がタイムリーで適切なケアを受けられるようにし、新生児の最適な栄養法を確立できるようにすることである。それが新生児の健康と発達を促すことになる」

 

私たちは、「母乳代用品のマーケティングに関する国際規準と、それに関連する世界保健総会決議(国際規準)」がステップ1に完全な形で取り入れられたことに対し、拍手喝采します。

また、包括的で科学的根拠に基づいた乳児栄養方針と、関連する臨床実践の順守に関する継続的な内部モニタリングが、ステップ1に組み込まれたことを称賛します。

 

私たちは、WHOとユニセフとともに、世界中にBFHIを広げ、長きにわたって持続性を確保するという目標に一致団結して向かいます。

 

背景

 

BFHIが世界の中で均等に普及しているというわけではなく、また、その割合も比較的低かったことを憂慮して、WHOとユニセフはBFHIの長所と短所を評価し、BFHI全体と世界共通評価基準の両方を活性化させるための航路を作成するという重要な仕事に取り掛かりました。それは膨大な取り組みでした。

 

2017年10月11日に、WHOとユニセフの新しいアプローチの最初の草案がパブリックコメントのため公開されました。WHOとユニセフの招待で、私たち5つの団体が集まり、専門知識を共有し、WHOとユニセフに協力して、当初の草案では充分に扱われていなかった領域についての変更を勧告し、実施ガイドをさらに発展させました。

 

WHOとユニセフが、話し合いへ参加することへの寛大さと意欲を示し、私たちの勧告を取り入れるためにさらなる労力を使ってくれたことに感謝いたします。6か月の間会合を繰り返し、すべての団体が共通のゴール、すなわち、実施ガイドを強化し、世界中でBFHIが採択されるように各国をエンパワーするということに向かって協働しました。

 

推奨度の高い重要な勧告の注目点

 

・  各国政府はBFHIの全国的実施に関与すべきであり、国際標準を国内制度に統合する努力を行うべきである。

・  現場に出る前の教育を担う職能団体は、「母乳育児を成功に導く10のステップ(改訂版10カ条)」に具体化されている科学的根拠と実践をカリキュラムに組み込むべきである。

・  母乳育児の重要性、人工乳のリスク、母乳育児を保護し、推進し、支援するのに役立つ実践に人々の関心を引く努力が行われるべきである。

・  母乳育児、家族やスタッフを商業的なマーケティングや非倫理的な圧力から保護するための努力が必要である。

・  BFHIは、他の介入、既存の国際的・国家的プログラムと統合され、地域社会および職場における母乳育児支援への努力と協調されるべきである。

・  産科施設と新生児医療施設の大多数に対して、よく機能する認定プログラムが全国的に行き届いているような国では、この新しい実施ガイドがあるからといって、現在成功しているプログラムを中止する理由にはならない。

 

実施ガイドの重要な要素の注目点

 

・  身体的・神経学的な成長と発達に必要な、養育・栄養・エネルギーを提供するために、生後6ヵ月間母乳だけで育てることの重要性を強調している。

・  明確な一連の世界共通評価基準を含み、国内基準への適用に合わせて調整するというオプションもある。

・  10のステップは元の10カ条の順序と項目のままとしている。文言を変えて、より一般化し、新しい科学的根拠が出たり更新があったりした時に、それを組み込むことができるようにデザインされている。

各ステップの意図を説明し、実施の明確なガイダンスを提供している。

・  母乳育児支援の改善に、10のステップ1つひとつが寄与していることを示し、母乳育児の実践に最適な影響を与えるために10のステップすべてを1つのまとまりとして実施する必要性を強調している。

・  実践の安全な実施と患者のモニタリングのための最新のガイダンスを提供している。医療保健従事者に、個別化された注意とケアの重要性について確認を促している。

・  母親にやさしい出産の実践の重要性と母乳育児への出産の実践の影響について説明している。医療保健専門家が母親にやさしい出産の実践についての知識を持つことと母親を教育する責任があることの重要性を強調している。具体的な実践の詳細については、WHOの他のガイドラインを参考としている。

・  これまで健康な正期産児が対象だったガイドライン、指標、基準に、早産児の母乳育児支援のためのガイドライン、指標、基準を含めることで、施設内でケアを受けるすべての乳児の母乳育児と母乳栄養の重要性を強調している。

・  10のステップに具体化された科学的根拠と実践を、サービスにつく前の教育のカリキュラムに含める義務を設定している。現場スタッフの教育が達成され、学生が卒業して現場に入るまで教育の必要性は継続する。

・ 保健医療施設や専門家が「国際規準」を実施する責任を説明し、それを目立つようにステップ1に配置し、「国際規準」が保健医療サービスのあらゆる面に具現化するように設定している。

・  実践をモニタリングし、維持するためのシステムの重要性を強調し、提案している。

・  評価が容易で、国と国との比較が可能な、明確に定義された指標を提供している。すべての指標を80%レベルに保持している。

・  変化の主要な推進要因として、認定などの公的認知の重要性を認めている。質の改善の重要原則の1つとして外部評価やアセスメントの必要性を指摘し、赤ちゃんにやさしい(病院)になる過程が、乳児栄養に関連する環境全体に影響を与える、変化させる力のあるものと認めている。これには、よりお母さんと赤ちゃんを中心とするケアをすること、乳児栄養に関するスタッフの態度やスキルレベルを飛躍的に改善すること、人工乳および新生児室の使用を大幅に減少させることを含んでいる。母乳育児に対するケアの質は、「赤ちゃんにやさしい」と認定された施設ではっきりと改善したことを明言している。

・  従来型の認定が困難な国に対して、質の改善のための追加オプション用の強力なガイダンスを提供している。

・  産科施設と新生児医療施設が、継続的かつ一貫した母乳育児支援のための適切な地域資源を見つけてそれを提供するという役割を果たすことを強調している。それは家族のニーズに文化的社会的に敏感なものでなければならない。そのような資源を強化するために周辺のコミュニティと関わる責任があることを施設に念を押している。

 

行動への呼びかけ

 

2017年の当初の草案に対して私たちが提起した勧告が取り入れられたので、私たちは今、乳幼児の栄養について家族とともに活動しているすべての人々に、一緒に団結し、目標を支持し、あなたの国で最も効果的な方法で実施されるよう呼びかけます。

 

次のステップ:

 

私たちは、来る世界保健総会での決議に、WHO事務局長がユニセフと協力して、「赤ちゃんにやさしい病院運動」のトレーニング、モニタリング、アドボカシーのツールを開発して加盟国による実施を支援するための条項が確実に入るように働きかけています。 私たちは、決議の進捗、ツールの開発およびBFHIガイドの実施を引き続き監視していきます。

 

Trish MacEnroe

Coordinator

先進国、中央ならびに東ヨーロッパの国々および独立国家共同体の

赤ちゃんにやさしい病院運動ネットワーク(BFHI Network)

 

Elisabeth Sterken

Co-chair IBFAN Global Council

乳児用食品国際行動ネットワーク(IBFAN)

 

Michele Griswold

President

国際ラクテーション・コンサルタント協会(ILCA)

 

Ann Calandro

Chair

ラ・レーチェ・リーグ・インターナショナル (LLLI)

 

Felicity Savage

Chairperson

世界母乳育児行動連盟 (WABA)

 

***************  【参考】  *************

 

「母乳育児を成功に導く10のステップ」(「母乳育児成功のための10カ条」2018改訂版)

 

施設として必須の要件

1a. 「母乳代用品のマーケティングに関する国際規準」と世界保健総会の関連決議を完全に順守する。

1b. 乳児栄養の方針を文書にしスタッフと親にもれなく伝える。

1c. 継続したモニタリングとデータ管理システムを確立する。

  1. スタッフが母乳育児を支援するための十分な知識、能力、スキルを持つようにする。

 

臨床における必須の実践

  1. 母乳育児の重要性と方法について、妊娠中の女性およびその家族と話し合う。
  2. 出産直後からのさえぎられることのない肌と肌との触れ合い(早期母子接触)ができるように、出産後できるだけ早く母乳育児を開始できるように母親を支援する。
  3. 母親が母乳育児を開始し、継続できるように、また、よくある困難に対処できるように支援する。
  4. 医学的に適応のある場合を除いて、母乳で育てられている新生児に母乳以外の飲食物を与えない。
  5. 母親と赤ちゃんがそのまま一緒にいられるよう、24時間母子同室を実践する。
  6. 赤ちゃんの欲しがるサインを認識しそれに応えるよう、母親を支援する。
  7. 哺乳びん、人工乳首、おしゃぶりの使用とリスクについて、母親と十分話し合う。
  8. 親と赤ちゃんが継続的な支援とケアをタイムリーに受けられるよう、退院時に調整する。

(NPO法人日本ラクテーション・コンサルタント協会 訳)

 

このブログ記事の追加翻訳は、スペイン語イタリア語フランス語、および英語で利用できます。