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Letter to the Editor
UNICEF cites urgent actions to revive breastfeeding culture in the Philippines

© UNICEF Philippines/2005
The Philippine government has to seriously implement the Mother- and Baby-Friendly Hospital Initiative to support and encourage mothers to breastfeedm


31 August 2005

Dear Editor,

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:

1. 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.

2. Sign and put into effect the revised Implementing Rules and Regulations of EO51 or the Philippine Code of Marketing of Breastmilk Substitutes.
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.

3. 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;
  • prohibiting 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 Code;
  • 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 formula; and,
  • providing stronger sanctions to violators of the Code.

4. 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.

5. 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.

Yours truly,

Dr. Nicholas Alipui
Country Representative to the Philippines
United Nations Children’s Fund (UNICEF)
RCBC Plaza
Ayala Avenue, Makati City

# # #
For further information or to arrange interviews, please contact:

Dale Rutstein
UNICEF Manila, 901 0177 or 0917 866 4969,
Alexis Rodrigo
UNICEF Manila, 901 0173 or 0917 858 9447,

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