31 August 2005
It has been eight months since I raised the alarm on declining
breastfeeding rates in the Philippines. Fortunately, my message
did not go unnoticed.
Since then, President
Gloria Macapagal-Arroyo and Health Secretary Francisco Duque
have launched World Breastfeeding Week and the National Policy
and Plan of Action on Infant and Young Child Feeding in Malacañang,
while the National Anti-Poverty Commission has recognized
breastfeeding as a strategy to ensure food security for infants
up to six months and to reduce poverty.
The Liga ng Barangay
has made a commitment to promote and protect breastfeeding
at community level, and the Philippine Pediatric Society has
been earnestly thinking of ways to wean itself off commercial
sponsorships from infant formula manufacturers.
While these are
positive developments, we need to do much more to revive the
breastfeeding culture in the Philippines. The most urgent
actions we must take are:
Seriously implement the Mother- and Baby-Friendly Hospital
Initiative (MBFHI) which is a global UNICEF and WHO campaign
to support mothers in breastfeeding.
To become certified as Mother- and Baby-Friendly, maternity
facilities need to show that they are fully implementing the
10 steps to successful breastfeeding. These include among
others, giving the infant to the mother to breastfeed within
the first hour of birth, the establishment of breastfeeding
support groups and referring mothers to them on discharge
from the hospital to ensure exclusive breastfeeding up to
six months and continued breastfeeding up to two years and
beyond. Sadly, only half of the infants that are born in health
facilities in the Philippines are given to their mothers to
breastfeed within an hour, and only 16 per cent of infants
from 0 to 6 months old are being exclusively breastfed. Recently,
DOH re-launched MBFHI in Cebu City to show its commitment
to supporting breastfeeding in health facilities.
Sign and put into effect the revised Implementing Rules and
Regulations of EO51 or the Philippine Code of Marketing of
The existing IRR are too lax and full of loop holes while
the capacity of concerned agencies to monitor code violations
and compliance has been inadequate. This results in the penetration
of the health system by infant formula manufacturers down
to the level of midwives in the remotest barangays. This must
stop. Towards this aim, a Code monitoring team composed of
Government and non-governmental organizations was trained
with support from UNICEF and IBFAN, Penang, Malaysia, to look
into all violations and compliance with the Code by both the
milk companies and the health sector.
Fast-track the amendment of EO 51 to tighten its provisions
using the Model law as reference.
Strengthening of the Code can be done by;
- covering not
only infant formula but all milk products for infants and
young children up to the age two or three;
any sponsorship and/or partnership between the public health
and nutrition sectors at all levels and the milk manufacturers
and distributors of products covered by the law and the
- banning the
advertisement and marketing of milk products for the 0-
to 2- or 3-year-old children;
- banning all
sponsorships and promotional activities of infant formula
manufacturers and distributors in all health facilities
and contact with pregnant women or mothers;
- banning labels
with pictures of babies and text idealizing the use of milk
- providing stronger
sanctions to violators of the Code.
Inform every parent and potential parent, male and female,
that breastfeeding is the natural and ideal means of feeding
an infant, and that all other milks are inadequate and potentially
harmful substitutes to mothers’ milk.
We should make it clear that breastmilk is sufficient to provide
the food requirements of infants up to six months and that
the more the infants suckles the more milk the mother produces.
We now require tremendous resources to undo the massive misinformation
and misconceptions that the public – including health
professionals – have been inculcated with all these
years. The Makati City League of Barangays recently passed
an ordinance to re-orient its health workers and organize
mothers’ support groups.
Support working mothers in their choice to breastfeed.
Breastfeeding should not be incompatible with women's work.
Davao City, for example, has passed a resolution to support
breastfeeding women who work, beginning with providing breastfeeding
and nursing stations in the workplace for breastfeeding mothers
in both public and private offices and the different representatives
of partner companies in Davao city, such as Shoemart Davao,
have pledged their support to breastfeeding in the workplace.
In addition, the
Trade Union Congress of the Philippines will lead a study
in various work places to assess current practices, with a
view to crafting strategies to enable working women to provide
breastmilk to their babies.
I trust that we
can continue to count on the support of media in these endeavours.
If 44 children, all under five years old, died in a bus accident,
it would make headline news. That is the same number of children
who die every day because they are not breastfed.
Country Representative to the Philippines
United Nations Children’s Fund (UNICEF)
Ayala Avenue, Makati City
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