Breast of the bunch
How UNICEF Philippines is upholding children’s right to be healthy by supporting breastfeeding mothers
Seven breastfeeding mothers sit in a circle outside a rural health centre in Vinzons, Camarines Norte province. “I breastfeed my baby because I want him free of sickness,” says Joanna, who has come to the counselling group with her first baby. “It’s affordable, nutritious and easy to prepare,” adds a mother of two, nodding in agreement.
UNICEF’s work is based on upholding children’s rights, including the right to be healthy. Research has shown that exclusive breastfeeding for the first six months of a child’s life is the best way to ensure their future health and development.
According to the World Health Organization, breast milk gives babies all the nutrients they need for the first six months of life and helps protect them from disease, including gastro-intestinal infections, childhood diabetes, eczema, obesity and asthma. It also reduces the mother’s risk of getting ovarian or breast cancer later in life.
However, in the Philippines, many mothers spend hard-earned cash buying formula milk instead of breastfeeding, putting their babies’ health – and sometimes their lives – at risk. In 2003, the National Health and Demographic Survey found that only 16 per cent of infants in the Philippines were exclusively breastfed, with signs that the culture of breastfeeding was in decline. This is largely due to misconceptions and the aggressive marketing of formula by milk companies.
“Nine out of ten mothers in this area breastfeed,” Herminia Icatlo, the rural health midwife at the Vinzons breastfeeding group, says. “But working mothers often mix feed, so their babies don’t get the best milk all the time. Sometimes they don’t prepare the bottle properly or use contaminated water, so the baby gets diarrhoea.”
There are currently around 200 breastfeeding counselling groups in Camarines Norte. “We teach mothers how to breastfeed and tell them about nutrition and protecting their baby’s health.” Herminia says. The groups also tackle some of the myths and misinformation around breastfeeding, such as that it’s painful or that breastfeeding mothers lose their figures more quickly. In fact, breastfeeding need not be painful if you learn how to do it properly and it actually helps mothers lose the eight gained during pregnancy.
Making the case
On the advocacy side, UNICEF supported the Department of Health in its Supreme Court case against formula milk companies over the implementing rules and regulations of the Philippine Milk Code, which tightened the rules for advertising breast milk substitutes. “That received impressive global attention, including a documentary called Formula for Disaster,” Elham Monsef, Nutrition Specialist at UNICEF Philippines says. “It brought the issue back to people’s attention.”
“It has unfortunately become engrained in people’s minds that if you want to do good for your child you should be giving them infant formula and that if you’re giving breast milk then you must be poor,” Elham continues. “The formula companies are using very high profile personalities within the entertainment industry to promote their products and messages.”
In one such advert, a young girl is shown playing the violin in front of an orchestra in a huge auditorium, with everyone standing up and applauding. “The advert implies that this child has become brilliant because she had infant formula,” Elham says. “Then you see the face of a young lady in the slums and she has this look of bliss as if to say: ‘if only I could afford to do the same for my child’.”
Perhaps the biggest danger is that mothers feel pressured to buy something and those who can’t afford formula end up buying cheaper powdered milk, which is not designed for infants. “This damages the lining of the baby’s stomach, causing bleeding and diarrhoea, which can be fatal,” Elham says. “It’s particularly worrying in emergency situations, like after the recent typhoons and flooding, where children are already at risk of disease and malnutrition.”
Another key challenge is the high proportion of mothers in the Philippines who work. Maternity leave is typically just two to three months and when women return to work, they often feel that they cannot continue breastfeeding and that the only alternative is to use infant formula.
“There’s a lack of awareness about expressing and storing breast milk,” Elham explains. “Mothers need support from their employer to provide a breastfeeding room, a fridge or even just a small private area where they can express their milk. They can then store it to feed their babies the next day.”
UNICEF’s breastfeeding programme is focused on creating supportive communities and environments to allow mothers to breastfeed, through one-to-one counselling and support. It’s an approach that is already bringing real change for mothers and their babies, as the members of the Vinzons breastfeeding counselling group can attest.
Mercedes Juan, Nutritionist at Camarines Norte Provincial Health Office, says the support from UNICEF has been invaluable. “UNICEF has funded infant and young child feeding training for municipal health workers across the province,” she says. “These workers then train the others who couldn’t go to the training. Our aim is to have a trained health officer, nurse and doctor in every municipality.” The training focuses on how to counsel mothers, listening to their concerns and helping them find their own solutions, rather than telling them what to do.
Twenty years ago, the world made a set of promises to all children when it adopted the UN Convention on the Rights of the Child (CRC). While great progress has been made since then, children’s rights are still being denied and much remains to be done. In the Philippines, the ongoing battle to educate the public about the benefits of breastfeeding is one way in which we can help uphold children’s right to be healthy.
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