The risk of COVID-19 infection from breastfeeding is negligible and has never been documented, the World Health Organization (WHO) said on Tuesday, in a call for greater support for the practice.
“WHO has been very clear in its recommendations to say absolutely breastfeeding should continue,” said Dr. Laurence Grummer-Strawn, head of the World Health Organization’s Food and Nutrition Action in Health Systems unit. “We have never documented, anywhere around the world, any (COVID-19) transmission through breastmilk.”
Exclusive breastfeeding for six months has many benefits for the infant and mother which far outweigh any risk from the new coronavirus pandemic, according to WHO.
These advantages include the fact that breastmilk – including milk which is expressed – provides lifesaving antibodies that protect babies against many childhood illnesses.
This is only one of the reasons why new mothers should initiate “skin-to-skin contact” and “room-in” with their babies quickly, as “the risks of transmission of the COVID-19 virus from a COVID-positive mother to her baby seem to be extremely low”, added Dr. Grummer-Strawn.
Having tested the breastmilk of “many” mothers around the world in a variety of studies, the WHO official explained that although a few samples had contained the virus, “when they followed up to see whether the virus was actually viable and could be infective, they could not find any actual infective virus”.
Underscoring the WHO’s longstanding support for using mother’s milk over substitutes, Dr. Grummer-Strawn also warned that the pandemic had weakened essential breastfeeding support usually provided to families with newborns.
COVID ‘undermining essential support’
“The interruption of services has been tremendous around the world providing the kind of support mothers normally would get with breastfeeding,” Dr. Grummer-Strawn told journalists.
“Oftentimes, the health services that would provide maternal child health have been diverted to take care of the COVID response; sometimes families do not feel comfortable in going into the health services, because they’re afraid that they might get COVID and so they don’t come for the routine kinds of support.”
According to the WHO, “about 820,000 children’s lives are lost every year because of a lack of breastfeeding”, Dr. Grummer-Strawn continued, in reference to deaths among under-fives. “Economically, there are losses of about $300 billion a year in economic productivity, lost because of a lack of breastfeeding,” he added.
Numerous good things come from breastfeeding – for the child and their mother in developing and industrialized countries – WHO has long maintained.
It has insisted that “it is not safer to give infant formula milk”, together with UN Children’s Fund (UNICEF) and the International Baby Food Action Network (IBFAN).
Benefits for baby and mother
The three organizations have united in their call to Governments to protect and promote women’s access to skilled breastfeeding counselling, for World Breastfeeding Week 2020 (1-7 August).
“Breastfeeding provides benefits during the time of breastfeeding, and those that are most recognised are protection against diarrhoea, which is one of the top causes of mortality in low-income countries, protection against respiratory infections, against obesity – childhood obesity later on – as children get older, protection against leukaemia,” said Dr. Grummer-Strawn.
Breastfeeding also protects the mother against breast cancer, ovarian cancer, Type 2 diabetes later on, the WHO official said, “so there are benefits for both the mother and the baby, and when we added these up it comes out to about 820,000 lives around the world, even in high-income countries”.
In addition to the pandemic, breastfeeding is under pressure from what WHO and UNICEF have described as harmful promotion of breast-milk substitutes.
Countries could do more to protect parents from misleading information, the UN agencies believe. “We continue to be very concerned about the practices of the formula industries, both the big multinational corporations as well as in many countries there are local manufacturers of breastmilk substitutes that are trying to get mothers to get on to their products,” said Dr. Grummer-Strawn. “They use a number of tricks, sometimes it’s not as blatant advertising as it once was, because they know that they can get caught.”
According to WHO, of 194 countries analysed, 136 have legal measures related to the International Code of Marketing of Breast-milk Substitutes and subsequent resolutions adopted by the World Health Assembly (known as the Code).
Tricks of the trade
However, only 79 countries prohibit the promotion of breast-milk substitutes in health facilities, and only 51 have provisions that prohibit the distribution of free or low-cost supplies within the health care system, WHO said in a report published in May.
Only 19 countries have prohibited the sponsorship of scientific and health professional association meetings by manufacturers of breast-milk substitutes, which include infant formula, follow-up formula, and growing up milks marketed for use by infants and children up to 36-months old, the UN health agency study found.
WHO and UNICEF recommend that babies be fed nothing but breast milk for their first six months, after which they should continue breastfeeding – as well as eating other nutritious and safe foods – until at least two years old.
“The aggressive marketing of breast-milk substitutes, especially through health professionals that parents trust for nutrition and health advice, is a major barrier to improving newborn and child health worldwide,” said Dr. Francesco Branca, Director of WHO’s Department of Nutrition and Food Safety. “Health care systems must act to boost parent’s confidence in breastfeeding without industry influence so that children don’t miss out on its lifesaving benefits.”
WHO approves Chinese COVID-19 vaccine for emergency use
A COVID-19 vaccine produced in China has been given the green light for global rollout, potentially paving the way for its use in underserved countries, the World Health Organization (WHO) announced on Friday.
The UN agency has approved the Sinopharm vaccine for emergency use, which is a prerequisite for inclusion in the global vaccine solidarity initiative, COVAX.
The vaccine is easy to store, making it suitable for locations with limited resources, and proved 79 per cent effective in clinical trials.
“The addition of this vaccine has the potential to rapidly accelerate COVID-19 vaccine access for countries seeking to protect health workers and populations at risk”, said Dr Mariângela Simão, WHO Assistant-Director General for Access to Health Products.
“We urge the manufacturer to participate in the COVAX Facility and contribute to the goal of more equitable vaccine distribution.”
A vaccine first
The Sinopharm vaccine is produced by Beijing Bio-Institute of Biological Products Co Ltd, a subsidiary of China National Biotec Group (CNBG).
It is the first vaccine to carry a vaccine vial monitor. The vials have a small sticker that changes colour as the vaccine is exposed to heat, so health workers know whether it can be safely used.
The vaccine is recommended for adults 18 and older, with a two-dose schedule spaced over a period of three to four weeks.
Although few people over 60 participated in the clinical trials, WHO did not recommend an upper age limit for use as data suggests the vaccine is likely to have a protective effect in older persons.
Safely expediting vaccines
WHO emergency use listing (EUL) allows countries to expedite their own regulatory approval to import and administer COVID-19 vaccines.
The EUL process assesses the suitability of new medicines, vaccines and diagnostics during public health emergencies.
The goal is to make them available as rapidly as possible, while maintaining strict criteria of safety, efficacy and quality.
The Sinopharm vaccine is the sixth to receive the EUL approval. The others are by Pfizer/BioNTech, Astrazeneca-SK Bio, Serum Institute of India, Janssen (Johnson & Johnson) and Moderna.
Risky business: COVID-19 and safety at work
The numbers of home workers around the world have been swelled by the COVID-19 pandemic, putting a fresh focus on the need for employers to ensure that their employees are working in a safe environment. On the World Day for Safety and Health at Work, we look at some of the ways the UN is helping employers and governments to keep people safe, wherever they work.
The world of work has been upended by COVID-19, and the effects are likely to be long-lasting. Before the pandemic, there were some 260 million home-based workers (not including domestic or care workers). The International Labour Organisation (ILO) estimates that figure could have doubled, with as many as one in three workers remote working in North America and Europe, and one in six in sub-Saharan Africa.
The rollout of vaccines, mainly in the developed world, has increased the possibilities of a return to the workplace, but many companies and workers have signalled a wish to retain a degree of home working, after seeing some of the benefits. For employers, these include minimising the risk of contagion and potentially spending less on expensive office space whilst staff no longer have to spend commuting to and from the workplace.
‘If you’re losing your mind, I’m right there with you’
However, whilst some are enjoying baking bread or taking a stroll during a conference call, and using the commuting time to indulge in new pursuits, others have been craving a return to a more structured work-life routine.
“I tell myself daily that I am grateful to have a job with understanding supervisors and colleagues. But all of it is hard. If you’re also a working mum losing her mind daily, know that I’m right there with you,” says Paulina, a New York-based teleworker.
“I have chaired meetings with a laptop and headphones on one side of a tiny, New York City kitchen while cooking lunch and having a screaming toddler wrapped around my ankles. While all of this is cute once or maybe twice, regular screams of children in the background can only be tolerated for so long. I should know, because I passed that line sometime in July.”
Stories such as this explain why a recent study by the International Labour Organisation (ILO) found that 41 per cent of people who worked from home considered themselves highly stressed, compared to 25 per cent of those who worked on-site.
“The most effective way to eliminate the risk of contagion in a work context is, for those who can do it, teleworking, says Joaquim Nunes, head of occupational health and safety at the ILO, “But we still need to pay attention to the physical and mental well-being of workers”.
As teleworking is likely to remain an important factor in many people’s jobs, Mr. Nunes says that work-related policies will have to be updated to reflect the new reality.
“There’s a good chance that the rise of teleworking during the COVID-19 pandemic will permanently change how we live and work. Many governments have realised this, and are taking a fresh look at the rights of employees working from home. For example, companies should ensure that workers do not feel isolated, whilst giving them the right to disconnect, rather than being online 24 hours a day”.
In Chile, a law adopted early in March 2020 goes some way to addressing some of these concerns. The legislation recognizes the right of remote workers to disconnect for at least 12 continuous hours in a 24-hour period. In addition, employers cannot require workers to respond to communications on rest days or holidays.
A healthy home?
Beyond the question of comfort and mental health, is one of physical safety. It is often said that most accidents happen at home, so, if this is where much of the working week is spent, should employers be responsible for making sure apartments aren’t death traps?
“For now, there are no easy answers when it comes to ensuring a suitable home office environment”, says Mr. Nunes. “However, we can say that the same principles that apply to other workplaces apply to teleworkers, in that employers have a general duty of care, as reasonably practicable. Employers can’t control the workplace when staff are working from home, but they can provide ergonomic equipment to workers, such as suitable chairs, and help them to assess their own risks and to learn about how to maintain healthy lifestyles.”
Teleworking is also challenging for enforcement agencies, as usually inspectors do not have free access to the private spaces. One solution to ensure compliance with legislation could be virtual inspections, which are already taking place in Nordic countries on a voluntary basis. “These involve labour inspectors video calling a worker at home, and being shown their work chair, desk, and lighting setup”, explains Mr. Nunes. “These inspections can serve as a way to monitor the home workplace and provide advice, but also raise understandable privacy concerns”.
Whilst the new teleworkers and their employers grappled with their new reality, a large part of the global workforce had no choice but to go to a physical place of work. The difficulties faced by health care workers were widely reported, but employees in several other industries had to brave the trip to the workplace – sometimes on crowded trains and buses – and, often, interact with other people, at considerable risk to their health.
In the US, these fears led to collective action by workers at Whole Foods, a grocery subsidiary of Amazon. On March 31, 2020, in response to seeing their colleagues testing positive with COVID-19, workers decided to call in sick, and demand sick leave, free coronavirus testing and hazard pay. This was followed in April by work stoppages at some of America’s biggest companies, including Walmart, Target and FedEx.
Whilst early advice on protection and prevention focused on measures such as hand washing, the wearing of masks and gloves, and physical distancing, the ILO quickly realised that more needed to be done to address work-related issues.
“In the workplace, you have to think about more than just the individual worker: the whole environment needs to be protected’, explains Mr. Nunes. “One example that many of us will have come across is in shops and supermarkets, where it is now common to see PVC separators between cashiers and customers. Work surfaces are also being cleaned much more frequently, but this raises other concerns that need to be addressed, such as the potential for skin complaints or respiratory problems caused by the chemicals in cleaning products.”
Whilst areas such as healthcare and retail have been grappling with these issues for several months, other parts of the economy could soon be opening up. In several countries, plans are being made to allow gatherings of large numbers of people to take place, in venues such as concert halls and cinemas, and, heading into summer in the northern hemisphere, the range of permitted tourist activities looks set to expand.
However, for this to take place, and for economies to safely open, governments and employers, in collaboration with workers, will need to make sure that workers in these, and all other industries, are safe at their workplaces, and confident they will not be exposed to unnecessary risks, particularly those related to COVID-19.
Biotechnologies: Commission seeks open debate on New Genomic Techniques
European Commission published, at the request of the Council, a study on New Genomic Techniques (NGTs). The study shows that NGTs, which are techniques to alter the genome of an organism, have the potential to contribute to a more sustainable food system as part of the objectives of the European Green Deal and the Farm to Fork Strategy.
At the same time, the study finds that the current GMO legislation, adopted in 2001, is not fit for purpose for these innovative technologies. The Commission will now start a wide and open consultation process to discuss the design of a new legal framework for these biotechnologies.
Commissioner for Health and Food Safety, Stella Kyriakides, said: “The study we publish today concludes that New Genomic Techniques can promote the sustainability of agricultural production, in line with the objectives of our Farm to Fork Strategy. With the safety of consumers and the environment as the guiding principle, now is the moment to have an open dialogue with citizens, Member States and the European Parliament to jointly decide the way forward for the use of these biotechnologies in the EU.”
NGTs developing rapidly in many parts of the world
NGTs, which can be defined as all techniques to alter the genome of an organism developed after 2001 (when the EU’s legislation on GMOs was adopted), have rapidly developed over the last two decades in many parts of the world, with some applications already on the market of some EU trade partners.
The main findings of the study are:
- NGT products have the potential to contribute to sustainable food systems with plants more resistant to diseases, environmental conditions and climate change effects. Moreover, the products can benefit from higher nutritional qualities such as healthier fatty acid content, and reduced need of agricultural inputs such as pesticides;
- By contributing to the EU’s objectives of innovation and sustainability of food systems, as well as a more competitive economy, NGTs can have benefits for many sectors of our societies;
- At the same time, the study also analysed concerns associated with NGT products and their current and future applications. Concerns included the possible safety and environmental impact, for example, on biodiversity, the coexistence with organic and GM-free agriculture, as well as labelling;
- NGTs are a very diverse set of techniques and can achieve different results, with some plant products produced by NGTs being as safe as conventionally bred plants for human and animal health and for the environment;
- The study finds that there are strong indications that the current 2001 GMO legislation is not fit for purpose for some NGTs and their products, and that it needs adaptation to scientific and technological progress.
The study will be discussed with EU ministers at the Agriculture and Fisheries Council in May. The Commission will also discuss its findings with the European Parliament and all interested stakeholders.
In the coming months, an impact assessment, including a public consultation, will be carried out to explore policy options concerning the regulation of plants derived from certain NGTs.
The study was prepared following a request from the Council of the European Union which, on 8 November 2019, asked the Commission to carry out “a study in light of the Court of Justice’s judgment in Case C-528/16 regarding the status of novel genomic techniques under Union law.”
The study was conducted by the Commission and informed by expert opinions and contributions from Member States’ competent authorities and EU-level stakeholders via targeted consultations.
A wide range of participants was involved in the consultation, which preceded the preparation of the report. All contributions are published.
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