Making breast-feeding a righ

Making breast-feeding a righ

By Maria Endah Hulupi

JAKARTA (JP): After giving birth to a healthy baby at a
hospital in East Jakarta, Wati (not her real name) was
immediately deprived of her right to breast-feed by the
hospital's nursing staff.

At feeding hours, Wati was told that she was too weak an was
not allowed to leave her third-floor room to go to the infant
ward on the ground floor to breast-feed her baby. Meanwhile, the
nurses refused to take the baby to her room.

The hospital staff assured her that her baby was being
properly fed with formula milk, however, to her surprise, she
found that her baby was incredibly weak and had lost 300 grams of
body weight due to diarrhea.

Indah Suksmaningsih, an activist with the Indonesian Consumers
Foundation (YLKI), said that Wati's case is just one of several
types of violations against mothers' rights to breast-feed their
babies, which are mainly committed in general hospitals and
maternity hospitals.

There is no official data but Lukman, a staff member at the
University of Indonesia's School of Public Health, estimated that
the country's annual birth rate is six million. With two million
of those babies being born in the general hospitals and maternity
hospitals, those facilities are a captive market for formula milk
producers.

Indah revealed that violations within hospitals have shifted
from hospitals facilitating the provision of gift packs
containing formula milk products to new mothers, to manufacturers
encouraging health practitioners to prescribe formula milk for
new mothers.

All are done in exchange for funding or medical equipment, she
said.

"We'd like to stress that it is the mothers' right to breast-
feed their babies," Indah said on the sidelines of a seminar on
the marketing of breast milk substitutes, held by the foundation.

Aside from the financial and practical advantages of breast-
feeding, breast milk is highly nutritious and helps strengthen a
baby's immune system. It also ensures healthy physical and
psychological development as it is proven that physical contact
during breast-feeding is a natural way to establish bonding.

While stating that the foundation is facing difficulties in
educating the public on these benefits, Indah also pointed out
that breast milk substitute manufacturers adopted various tactics
to sell their products through practitioners and other marketing
initiatives.

"Control should be applied here because it is difficult to
educate people about the importance of breast-feeding while the
producers bombard the public with various creative promotional
activities," she said, stressing that sanctions should be imposed
against those found violating regulations governing the marketing
of milk substitutes.

The most deplorable thing is, Indah said, that the Food and
Drug Control Board (BPOM) fails to enforce the regulations, as
stipulated by Ministerial Decree No. 237/1997.

However, Indah explained that the decree contains loopholes
that were often exploited for the interests of manufacturers,
which often breach the WHO/UNICEF International Code on marketing
breast milk substitutes. The code underlines that "there is
nothing that equals breast-feeding in providing proper
nourishment for infants".

Separately, Tien Gartini of the Directorate of Food Safety
Evaluation with BPOM admitted that there have been violations by
manufacturers in the promotion and sale of their products.

"The transgressions include giving free samples of formula
milk, sponsoring events or activities in exchange for product
promotion, or they relate to product discounts and
advertisements," she said.

However, she declined to elaborate on the actions taken by the
agency for such violations.

Juanto Rasjidgandha, vice president of the Indonesian Baby
Food Manufacturers' Association (APMB), which groups 14 local and
international manufacturers, said that its members have to
properly inform the public through pediatricians about breast
milk substitutes.

"We are not allowed to educate the public directly but we have
to educate pediatricians, as practitioners in the field, on the
benefits and the importance of breast milk substitutes," he said,
adding that if any violations were found, the association could
issue warnings and revoke the manufacturers' association
membership.

National Board of the Indonesian Society of Pediatricians
president Jose Batubara explained that breast milk substitutes
are needed for babies with certain health problems, those
refusing their mothers' breast milk, or babies whose mothers were
unable to breast feed them due to any of a number of reasons,
such as inadequate breast milk production or other health
problems.

He urged BPOM to be more active in monitoring violations and
misleading product information often shown in ads and promotional
activities.

"This is important because some parents are loyal to a brand
because the ads describe it as penetrating the brain to ensure
smart children," he said.

In an effort to protect mother's rights to breast-feed, Jose
said the government should provide a private place in offices for
working mothers to pump their milk and store it before it is sent
home or they return home.

"Mothers are only given three months of maternity leave, but
this way will ensure that their babies are exclusively fed with
breast milk until their fourth month," he added, while stating
that to fulfill babies' daily nutritional requirements, infants
should be breast-fed and given weaning food until they reach two
years old.