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.