Breast Is Always the Best – DOH
Owing to the
successful advertising and promotion of breastmilk substitutes intended
for infants and young children, 98.6 percent of Filipino infants are
formula-fed with cow’s milk. At six to seven months of age less than two
percent of Filipino infants are exclusively breastfed.
By Maria G. Salamat
Bulatlat
MAMA’S BEST. A
multitude of nursing mothers gathered in Manila in May.
FILE PHOTO |
When Tina, a
first-time mother, was awkwardly practicing her newborn to suck at her
breast without much success, three roving resident doctors ordered her to
get milk from the hospital nursery instead. They argued that the day-old
baby was crying because he’s dissatisfied with her milk.
Despite Tina’s
grogginess—she just woke up from a drugged sleep after delivering her
baby—she asked the doctors if that milk they want her to give her baby was
breastmilk. No, the doctors said, surprised she even asked. They berated
her for letting her baby cry when there’s milk in the nursery. It happened
in a “child-friendly” hospital that advertises support for breastfeeding.
|
Tina persisted in
breastfeeding her son. She had done her homework while pregnant, she knew
her son needed little milk so far, but this little amount was exactly what
they both needed at the time. She to heal faster and the child to get
stronger. But the doctors had got to her. She felt guilty thinking she’s
making her baby work harder; she felt inadequate and doubtful of
breastfeeding.
Fortunately, her
husband and ob-gyne (obstetrician-gynecologist) arrived to reassure and
support her. Had she followed the resident doctors’ orders, it would have
been disastrous for her milk production—her body must first register a
demand before the milk supply comes out, and only a baby’s suckling can do
that.
Milk Code
Now that the
Department of Health (DOH) has finally signed an implementing rules and
regulations for the country’s 20-year old Milk Code, a controversy has
openly raged between the DOH and advocates of breastfeeding on one hand,
and the milk companies on the other hand.
What happened in
Tina’s case was actually a violation of the country’s Milk Code, but it
was nothing new and just one among the many that had been documented.
The Milk Code has
existed for a “frustrating” 20 years, according to the DOH. The main
producers of infant formula and other breastmilk substitutes have
repeatedly violated it.
The milk companies
are specially chafing at the new implementing rules’ section 11 which
states that “No advertising, promotions, sponsorships, or marketing
materials and activities for breastmilk substitutes intended for infants
and young children from 0-24 months or beyond, shall be allowed, because
they tend to convey or give subliminal messages or impressions that
undermine breastmilk and/or exaggerate breastmilk substitutes,
replacements, or supplements, and other related products within the scope
of this Code.”
Breastfeeding
advocates tasted initial victory when the Supreme Court denied last week
the milk companies’ petition for a temporary restraining order of the new
implementing rules and regulations of the Milk Code. DOH Undersecretary
Alex Padilla said the Supreme Court’s quick and decisive response
vindicated the efforts of the advocates of breastfeeding.
But ushering in a
revitalized era of breastfeeding in the Philippines has still a long way
to go. By now the breastfeeding culture in the Philippines has tragically
diminished, said the non-governmental organization Children for
Breastfeeding, Inc. Much needs to be done to revive breastfeeding. The
most crucial is for breastfeeding to get massive support and information
drive.
Tragic statistics
Owing to the
successful advertising and promotion of breastmilk substitutes intended
for infants and young children, 98.6 percent of Filipino infants are
formula-fed with cow’s milk. At six to seven months of age less than two
percent of Filipino infants are exclusively breastfed. (Source: National
Demographic and Health Survey)
Cow’s milk infant
formula is the best-selling consumer product in the Philippines, said Rep.
Anna York P. Bondoc, a doctor and author of a bill for breastfeeding and
for strengthening the country’s Milk Code. Formula-feeding costs a minimum
of P2,000 a month per infant. To save on costs, some families over-dilute
the formula or use other kinds of milk, leading to malnutrition, illnesses
and death. Last year alone, 82,000 Filipino children under five years old
died— 16,000 of these deaths can be traced to formula-feeding, said the
WHO.
But whether infant
formulas are used properly or not, there’s no substitute whatsoever for
breastmilk for humans, according to Unicef studies. Aside from lacking
antibodies and immune factors that are present in breastmilk, infant
formula is not sterile or safe. In fact, 22 infant formula products had
been recalled between 1982 and 1994, seven of which were classified as
“potentially life threatening.” Source: US Food and Drug Administration)
Filipino advocates of
breastfeeding even charged that some milk companies are dumping defective
or inferior milk products into the Philippines.
From these alarming
statistics, Rep. Bondoc said the failure to promote breastfeeding is now a
“public health emergency.”
Like battling
Goliath
Dr. Elvira
Henares-Esguerra, 50, has been breastfeeding her son for five years now.
Since she began breastfeeding she also started to promote it actively with
other advocates. Though they met high-profile positive results such as the
Guinness World Record of Simultaneous Breastfeeding (Manila’s 3,541 last
May shattered the Berkley, California record of 1,130 in 2002) and the
breastfeeding stations in SM malls,
Dr. Elvira’s
five-year experience at advancing breastfeeding caused her to liken the
advocacy to David battling Goliath. She lamented the milk companies’
unabashed use of huge resources and clout in frustrating the projects of
breastfeeding advocates and dishing out false and misleading info on both
breastmilk and infant formula.
Hilarion M. Henares
Jr., presidential consultant on national affairs and Dr. Elvira’s father,
disclosed that milk companies have threatened newspapers they’ll withdraw
advertisements if they print the truth on infant formula and breastmilk.
But perhaps even the
DOH’s 20-year frustration in implementing the Milk Code would sound like
an understatement to the two great Filipino women who will be awarded in
Malacanang this month for their pioneering role in advancing indigenous
foodstuff and breastfeeding.
In 1949, Manuela
Garcia Maramba, public health nutritionist, opposed the Unicef’s proposal
to import milk into the Philippines as part of the country’s nutrition
program. She asked then: “Why let the Filipinos get used to milk which
will be forever imported because the Philippines will never be a milk
producing country?” Instead she encouraged Filipinos to eat indigenous
foods that are just as good or even better sources of nutrients than
imported milk. In a speech in Tokyo, she said “Unicef should not force
countries to adopt western experiences; instead Unicef should adapt their
policies to the culture of the countries they operate in.”
In 1975, Dr.
Natividad N. Relucio Clavano, pediatrician, started to become the world’s
foremost breastfeeding advocate. Her “baby-friendly hospital initiative,”
pioneered in Baguio General Hospital, was replicated in 192 countries. She
banned infant formula milk from the maternity ward and enforced a regime
of “rooming-in” of the infant. In 1978 she brought the result of her
10,000-baby study (which shows that total elimination of baby milk formula
bottles and teats from the maternity wards resulted in a dramatic
reduction of infant mortality by 95%) to a hearing of a US Senate
Subcommittee chaired by Senator Ted Kennedy. Her study was said to have
galvanized world breastfeeding advocates into action.
Sen. Kennedy himself
joined the crusade against the milk companies and publicly demanded that
the World Health Organization do something about it. Three years later the
WHO/Unicef passed the International Code on the Marketing of Breastmilk
Substitutes and Other Related Products. Five years later in 1986, Corazon
Aquino signed into law Executive Order 51, the National Milk Code. But
rampant violations by the milk companies frustrated the aim of the Milk
Code to encourage breastfeeding. So now, 20 years later, the Revised
Implementing Rules and Regulations (IRR) on the EO 51 was signed.
However, even Dr.
Elvira Henares-Esguerra says it is wistful thinking to imagine the milk
companies will just swallow the ban quietly. After all, some P3.1 billion
of infant formula is imported by the Philippines each year, and it is sold
at seven times the import cost, or P21.5 billion. [Source: IRR, DOH]
So, breastfeeding
advocates have slated activities for breastfeeding and are calling for
support from Filipino families. To make breastfeeding more
practicable, they’re urging the passage of laws that will provide
lactation support programs in places of work for instance.
They’re also honoring
the two great pioneers of indigenous foodstuff and breastfeeding, Maramba
and Clavano; this week they will light candles in Makati, with the help of
Mayor Binay and the Boy Scout of the Philippines, for the 16,000 infants
who died due to formula-feeding, and, among others, they’re urging people
to sign a petition in support of the IRR to urge President Arroyo to
approve it in its entirety. Bulatlat
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