Utami campaigns for breast is best for baby

Utami campaigns for breast is best for baby

Ratih Sayidun & Santi W.E. Soekanto, Contributors/Jakarta

Many readers of parenting magazines here know of pediatrician Dr.
Utami Roesli. And thanks to her tireless campaign for exclusive
breast-feeding, more people have realized the superiority of
breast-milk over infant formulas.

When she started out a decade ago, however, quite a number of
people wondered out loud, "Why the fuss? Women have been breast-
feeding for centuries, guided only by instinct and reflexes, and
the human race has yet to be wiped out. So there's nothing to it,
right?"

Wrong, according to Utami, who is the founder and chairperson
of the Indonesian Breast-feeding Center and heads the Pediatric
Department of Saint Carolus Hospital in Central Jakarta.

So important is breast-feeding that it ultimately influences
human resource development and a country's poverty rate, she
argued, citing research that shows that breast-fed babies are
physically stronger and a lot smarter than bottle-fed babies.

"Breast-feeding is the first step Indonesia can take to
produce quality human resources," she said in a recent interview
with The Jakarta Post.

She cited research showing that formula-fed babies are
hospitalized 16 times more often than breast-fed babies, and
another study in the United States that estimated breast-feeding
saves a family approximately Rp 100 million in formula prices,
medical and health-care costs.

"Think what this country could do with Rp 100 million per
family. It can mean better education opportunities for so many
people."

But breast-feeding is a natural urge and any mother would by
instinct simply nurse their babies when the time comes, right?

Wrong again, said Utami. Countless women have tried to escape
breast-feeding by using a host of excuses, including the fear
that it would ruin the shape of their breasts.

In fact, Utami said, breast-feeding is a scientific discipline
in its own right that, which although quite novel, must be
studied by pediatricians and physicians to disseminate the
correct information.

She pointed out that there were many obstacles a nursing
mother had to overcome before she could successfully breast-feed
and ensure the optimum physical and psychological benefits are
gained. She acknowledged that sometimes "women need training to
breast-feed in the right way".

She said the world, too, had just begun to understand the
concept and taken the positive action of campaigning for
exclusive breast-feeding with the World Health Organization (WHO)
and UNICEF's Innocenti Declaration in Italy in 1990.

So novel is the concept in the medical school tradition, Utami
said, that many physicians and pediatricians in Indonesia have
yet to take up the campaign.

The concept of exclusive breast-feeding may seem simple --
that mothers give only breast-milk to their babies for six months
before introducing some solid food while keeping up breast-
feeding up until two years to age -- but support from various
quarters is needed before it can be implemented.

Hospitals and maternity clinics, for instance, must first
encourage rooming-in of the newly born baby with their mother so
they can instantly start nursing. Remember, however, that most
hospitals and clinics here still whisk infants away to separate
rooms and wait until the mothers are able to sit up and nurse.

Infants must not first be given formulas just because the
mother is not yet able to sit up after labor. But even among
health workers there still exists the old midwife's tale that the
first, yellowish drops of breast-milk right after labor -- known
as colostrum -- are "dirty" and often thrown away, while in fact
they actually contain the best nutrients and help the infant form
antibodies.

She cited a 1990 study, published in the British medical
journal Lancet, involving 72 mothers who immediately after birth
had their newborns placed on top of their bellies -- 20 minutes
afterward the infants began to crawl toward the mothers' nipples
and began nursing within 50 minutes without any assistance.

"It's like my kitten," Utami said. "My cat licked it all over
and within seconds the kitten began to nurse."

Utami said newborn babies should be left to start breast-
feeding for up to 10 hours before doctors or nurses take them
away to be bathed.

In Indonesia, where 99 percent of babies in natural birth are
whisked away by the nurses to be bathed, weighed and then
separated from their mothers for hours, some 50 percent of the
infants' natural ability to nurse is lost.

"Worse still, babies who are born through caesarean or with
the help of medication, almost completely lose their ability to
nurse."

Even so, why does Utami expend so much energy campaigning for
exclusive breast-feeding?

"Because this is what I call an investment for the world and
the hereafter," she said. "God has entrusted our children to us.
We give them the best so they can be the best for the world."

Utami hopes that Indonesia will one day be like Australia or
even famously progressive Sweden when it comes to breast-feeding.

"Australia has a very high rate of exclusive breast-feeding
because, in addition to four months of maternity leave, the
government also provides leave of up to four weeks for a father
to help support the mother breast-feed."

Utami envied the support that the Swedish government gives to
new parents, whereby both parents are entitled to up to a year of
paid leave while receiving 80 percent of their salaries.

"No wonder their children often have higher IQs," Utami said,
noting the dozens of studies on a father's role in ensuring
better breast-feeding, hence the developed countries' paternal
leave policy.

"Indonesian fathers would benefit from training on the
subject. Breast-feeding is not only a matter between a mother and
baby, but one that involves the father. The fathers need to learn
not only about changing diapers but also burping babies and
giving them infant massages that would ultimately encourage the
best breast-feeding experience."

In Indonesian cities, babies are introduced to formula too
soon, while in the villages babies are given solids too soon so
they lose interest in nursing.

In Lombok, West Nusa Tenggara, for instance, newborns are
often given dublak, rice or bananas that are chewed by adults
beforehand -- a practice that often leads to disease.

Together with colleagues and friends, Utami established the
breast-feeding center last year. It now provides training for
lactation counselors based on the modules introduced by the WHO.

Utami graduated from the school of medicine from Padjajaran
University, Bandung, in 1972, and studied pediatrics, graduating
a year later from the same university. She received her
neonatology training from Saint Radbour Hospital, Nijmegen, the
Netherlands, in 1987, and earned an MBA from the City University
of Manila in 1994.

Utami comes from a long family tradition of doctors, her own
mother being a pediatrician, while her two siblings also became
doctors. Her brother, Harry Roesli, is a noted musician.
Interestingly, her two children, Andi and Reza, have refused to
follow in her footsteps and chosen to pursue business
administration instead.