So the scene is yours. Welcome. Thank you and good afternoon. It's my pleasure to join you all today. And my sincere thanks to the organisers for the opportunity to share some of the work that we're doing here in the WHO European region to protect, promote and support breastfeeding.

As a mother, I also experienced firsthand how essential community and healthcare support are in making breastfeeding successful. And I also recognize how critical supportive policies like adequate paid maternity leave, for one, are in enabling mothers to breastfeed for as long as they choose.

Breastfeeding is not just a biological act. Breastfeeding is not just a biological act. It's a practice that really thrives with the right support. And ensuring that every mother has access to both the structural and social support needed for breastfeeding is really key to improving health outcomes for children and families.

And today, my presentation will really focus on what global targets and WHO's recommended policies are in place that protect, promote and support breastfeeding, ensuring that every child and every mother has the best possible start in life through ensuring strong health systems, supportive environments and effective regulations.

Next slide, please. So to start, many of us know that good nutrition is really essential for overall health and wellbeing, supporting physical growth, mental development, and the prevention of diseases throughout the life.

It is also linked to the success of the majority of the sustainable development goals. Now, these are a set of global targets established by the United United Nations to end poverty, protect the planet, and ensure good health and wellbeing for all.

Protecting, promoting and supporting breastfeeding helps achieve many of the sustainable development goals, not just those ones related to nutrition. So they contribute to zero hunger, good health and wellbeing by, of course, improving infant nutrition and reducing child mortality and promoting lifelong benefits.

But breastfeeding also fosters gender equality by empowering women with better health and economic opportunities. So breastfeeding, as we know, is a critical first step on a child's path to a healthy future.

Next slide, please. Next slide, please. Next slide, please. Next slide, please. Perry Lockhe lightning We have an established body of evidence that really shows us how exclusive breastfeeding ensures not only a child's healthy growth and development, but also protects the baby and the mother from non-communicable diseases.

And these include cardiovascular diseases, diabetes, respiratory diseases and cancers. These non-communicable diseases, so this group of diseases are one of the leading causes of death and disability in our region.

And whilst some parts of the region also face, you know, persistent challenges of inadequate nutrition. So policies that support, promote and protect breastfeeding and appropriate infant and young child feeding are really key to tackling this double burden of the inadequate nutrition and the NCD, so the double burden of malnutrition that we're seeing.

And so protecting, promoting and supporting breastfeeding in the first six months of life is what is considered a WHO best buy. And what this means is that these policies are considered to be amongst the most cost effective and feasible interventions to tackle non-communicable diseases.

Next slide, please. The World Health Organization provides clear recommendations for breastfeeding. And as many of us are familiar, this includes early initiation, exclusive breastfeeding for the first six months of life, and thereafter, nutritionally adequate and safe complementary foods and continued breastfeeding up to two years.

and then, regardless of jeopardy, para extension, which are highlyяг if you're using breastfeeding, which is to deal withpirate, can the Easter days? the World Health Organization and these resolutions to support it are supported by the member states.

Next slide, please. And the World Health Organization has several key policies to protect, promote and support breastfeeding, ensuring, of course, that all infants receive the best possible start in life.

And these policies are intended to guide governments, healthcare systems and communities in creating environments that enable successful breastfeeding. And we've subcategorized them here under preventing barriers to breastfeeding.

So many of you may already be familiar with the International Code of Marketing of Breast Milk Substitutes, which really restricts the aggressive marketing of the commercial milk formula industry, ensuring that there are maternity protection policies in place, ensuring that there are laws to support breastfeeding at work and in public places, encouraging breastfeeding awareness.

So we have a global strategy for infant and young child feeding. So this helps guide national breastfeeding policies. And we have a global World Breastfeeding Week, which is a global campaign for advocacy and education, ensuring that public health campaigns integrate breastfeeding into the campaign messages, in schools, in schools, in schools, in schools, in schools, in schools, and of course, within other health programs.

And by helping mothers breastfeed successfully. So we have the Baby Friendly Hospital Initiative, ensuring that doctors and nurses are trained to provide breastfeeding counseling, and to ensure that there is enough support in the community to support mothers and families to continue breastfeeding for as long as they can.

So we choose. Next slide, please. However, despite several health benefits, known health benefits, and the policy recommendations and initiatives for optimal breastfeeding practices, the data from our latest survey, which is 2019, still indicates that exclusive breastfeeding to six months breastfeeding breastfeeding really remains far below the global recommendation in our region.

The WHO European region has some of the lowest breastfeeding rates globally. And you can see from the graph that I've presented here, the rates really vary substantially across the region. And there is data, and so I'm sharing data that countries have reported up to the six months of exclusive breastfeeding.

And there is data, and there is data to indicate that initiation of breastfeeding is very high in some countries. I believe it's around 90 something percent in Denmark. However, the rates really drop rapidly between four and six months, and therefore are quite low at the six months of age.

And this data really adds to the increasing evidence suggesting that breastfeeding support and interventions are needed to enhance the duration of breastfeeding. Next slide, please. The WHO Regional Office for Europe.

So here in our office, we coordinate the largest childhood obesity project in the world. And this is called the WHO European Childhood Obesity. Surveillance Initiative. Surveillance Initiative. And we use the acronym COSY. And this initiative is aimed at monitoring and combating childhood overweight and obesity across the region.

And through standardized data collection and analysis, COSY really provides valuable insights into the prevalence trends and determinants of childhood overweight and obesity. And this enables countries to develop evidence-based policies and interventions.

Denmark is one of the 22 countries who participated in collecting data on various health indicators and breastfeeding practices, which included breastfeeding practices amongst children. What I'm showing to you today is data that was collected from round four of data collection.

So this is in 2022. 22 countries participated, including Denmark. And the data was used to describe the association between breastfeeding, exclusive breastfeeding and obesity among children. The findings showed that breastfeeding is associated with a reduced risk of developing childhood overweight and obesity.

And so this data collected through COSY and the participating countries really underscores the crucial role of breastfeeding in addressing childhood overweight and obesity. We know that trends of childhood overweight and obesity are increasing globally.

And so it is a priority for us to halt the rise in childhood overweight and obesity. And through these initiatives, particularly those that encompass that we encourage breastfeeding practices and encourage breastfeeding practices and create breastfeeding friendly environments, WHO is really calling on policymakers to implement a suite of interventions to protect, promote and support breastfeeding under the childhood overweight and obesity initiatives.

Next slide, please. Next slide. And before I wrap up. I've given a lot of detail on the policy context and some of the data that we have in the region on breastfeeding rates and how we aim to support member states to improve breastfeeding rates.

We have also been doing some research looking at what some of the barriers are to continued breastfeeding. As I mentioned, we often see high initiation rates, but there is a drop off between those four and six months.

And we have been looking at the marketing of breastfeeding. And we have been looking at the marketing of breast milk substitutes, bottles, teats, et cetera, that undermine breastfeeding as they influence parents' choices through either misleading claims, aggressive promotion.

The WHO... The WHO have a number of products to support member states in regulating the marketing of breast milk substitutes. We are also all committed to the International Code of Marketing of Breast Milk Substitutes.

And what we are seeing is that the digital marketing space is largely unregulated. And the digital marketing situation that we are now in the digital marketing situation that we are now in has created really new challenges with companies using social media, influencers, targeted ads to reach parents directly.

And what we need is stricter regulations, monitoring and enforcement to ensure breastfeeding remains the norm and that we protect infant health. And I just want to share in the next slide one of the case studies that we have in the world.

We have completed. We conducted a research project in Armenia and in Portugal. And we use one of the tools that we have developed in WHO to capture some of the online marketing practices and to monitor the exposure of women and mothers to these digital marketing of breast milk substitutes.

And you can see on the screen here, hopefully quite clearly, that the results from Armenia are really quite alarming. In a single day, a mother, or woman may receive up to 28 adverts per day through different social media channels promoting a type of breast milk substitute.

And this is really what we are up against. The landscape of breast milk substitute marketing is evolving rapidly. New digital platforms are becoming the primary battleground for influencing parental feeding decisions.

And so this research is really critical to understand the the tactics used by formula milk companies that are relying heavily on targeting advertising and AI driven content. We need the ongoing research, we need stronger enforcement and collective action to fight back against this growing influence.

And of course, staying informed is one of the first steps in protecting, promoting and supporting breastfeeding and infant health. Thank you, I'll end my presentation here, and I'm happy to take any questions.

Thank you very much, Claire, for this brilliant presentation. And I would say your last words, staying informed is very important. I would like to thank you very much for including in your presentation various challenges or topics such as childhood obesity, as well as highlighting the international code of marketing of breast milk substitutes.

And we all know this. Yeah, marketing and advertisements can can really be a challenge. Actually, I would could I please ask for the iPad. I wanted to share with you. Because one of the goals, as you mentioned, is that you have to be a challenge.

And one of the goals, as you mentioned, was this goal of exclusive breastfeeding to have it up to 50%. And as now it's about 16 in Denmark, 50% when the child is six months. So I was just curious about that.

And don't know if if there was a couple of questions because the recommendations the WHO recommendations and the WHO recommendations are similar, but also different in some situations. But could you elaborate a little bit just on this with the you have already touched upon it, but how can we reach this goal of having 50% of full breastfeeding at six? months? Thank you.

This is this is a very important question. I think we see because of the data that we have, we see the initiation is often very high. However, looking we're looking at what the reasons are as to why breastfeeding rates drop between that sort of four to six months.

And we're fortunate enough to have had a number of experts come and come and speak to us on this topic. And the WHO recommendations are obviously based on the evidence that it's important to continue exclusive breastfeeding up until the six month period.

However, many parents are looking at what's developmentally appropriate for their children. Some of the recommendations around adding complementary foods are, you know, children have to fit a certain criteria, like be able to sit upright, etc.

And often, anecdotally, the case is that parents are quite keen to move from exclusive, you know, to move to that next step, which is adding, you know, complementary foods. And what we want to see, and I think this is a really important role for all of us is just emphasizing those messages around ensuring that we continue to breastfeed exclusively for us, you know, as long as, as a parent chooses, and the benefits to the child and to the mother of, of, of, of, of, of doing so.

And, you know, trying to work with families to ensure that it's not a case of just moving from one milestone to the next. There's, you know, all of the health benefits of, and, you know, a lot of evidence around why it is that we recommend that we exclusively breastfeed till that six month mark.

And I think that's the important role of particularly like healthcare workers in the communities and in hospitals, anywhere where, you know, anywhere where, you know, parents have access, because the alternative is we're being bombarded by messages from the formula milk companies, which are telling us actually, you need to move to this stage of milk, and this is better, the marketing is so strong, that we are often convinced.

And as parents, and I speak for myself, you know, it's a delicate time, you are, I often felt quite, you know, sleep deprived, and you're being, you're showing all these different messages, which are telling you something quite contrary to what, and it looks quite attractive, contrary to what we know is the best evidence and what the healthcare professionals are recommending.

Thank you very much, Claire. Thank you for the presentation. And thank you for this answering this last question. Thank you, thank you very much.