Friday, August 22, 2014

Do the Math, Aim High for Breastfeeding

"Welcome to the Milk Mama Diaries Carnival (August). For this month, we write about the World Breastfeeding Week 2014 - Breastfeeding: A Winning Goal for Life and share how breastfeeding can help the Philippines achieve the 8 Millennium Development Goals developed by the government and the United Nations. Participants will share their thoughts, experiences, hopes and suggestions on the topic.  Please scroll down to the end of the post to see the list of carnival entries.

I will admit to being stumped as to what to write for my chosen Millennium Development Goals (Achieve Universal Primary Education and Develop a Global Partnership for Development). After all, what else do I say that I have not said before?

But since I have adopted the "Do the Math" mantra whenever I try to inspire moms to stick to and commit to breastfeeding, I guess I will  adopt the same here.

First, let's have a quick look at the following pertinent breastfeeding statistics:
1,738,100 babies are born in the country yearly
Only 34% of these babies end up being exclusively breastfed for the first 6 months (around 278, 000 babies)
18.75 - infant mortality rate for every 1,000 births (that is at least 32,000 babies 1 year below)
16,000 children between 1-5 years old die every year from illnesses traced to formula-feeding or directly-addressed by breastfeeding

It is actually very good that infant mortality rate in our country has been steadily declining. And looking at these numbers, we can say that just more push from the right institutions and it can be further reduced dramatically. That is where breastfeeding will come in.

Just another 10% more moms to exclusively breastfeed can buy them lactation amenorrhea, protection from getting pregnant again and contributing to next year's population. A steady increase like this can mean that ten years down the line, the government can be at a perfect position to actually provide better primary public education because population growth was curbed somehow (or at least, it did not boom as exponentially).

Add to this the possibility that a family with an infant who breastfed exclusively can channel their abundant/ just enough/meager funds to food for the entire family as well as education for the older children.

Let us not even quibble with rates and percentages. Let us just say that if 1,000 more families will exclusively breastfeed this year, there may be 1,000 less babies next year... and 1,000 more babies next year who will be better fed.

For us middle-class and the rich, with happy problems like which food to introduce first and whether we are able to offer enough variation, this does not seem impressive. But try living their life... Tell me if it's still easy. Try living from hand to mouth. Try losing a child to diseases like diarrhea (Go Erceflora!) and infections (Amoxycillin anyone?). Try having kids with stunted growth who cannot process what they should be able to by the time they are of school age, putting further stress on an already struggling education system. Try imagining how burdensome that could be to a family if a child will be unable to learn or contribute. Try imagining struggling to feed and raise a child only to lose that child before it turns 5 years old... and repeat the same every few years or so.

From a middle-class point of view, consider how kids of can afford parents start school at the average age of 3. This means that from that point on, that child will be bringing home viruses and germs he caught in school. Now, imagine that there will be 1,000 less toddlers/preschoolers who will get sick this year from a certain flu strain because they are still being breastfed. They won't get sick because their mom's milk will give them the antibodies. That means no medicine intake or hospitalization for a few days. That means Mommy doesn't have to go absent from work for a few days. No stress on the finances or on everybody's schedule. That will mean not missing school for a few days so there is less tension about missed lessons. Now, what if these one thousand kids  get spared twice in a year? Thrice? This great possibility is attainable if only a mother will commit to breastfeeding in the first 1,000 days of a child's life.  #BF1st1000days

Wouldn't you agree that if you look at things this way, it becomes easier to see why our government should make this a priority?

Where does global partnership come in?

Well, 1,000 more kids breastfed means 1,000 less that institutions like WHO and UNICEF will be worrying about because it is 1,000 less children requiring aid.

1,000 more breastfed kids mean 1,000 less to make provisions for in times of emergencies and calamities.

1,000 more breastfed kids would mean  at least one set of 1,000 days not missed by working moms to deliver services locally and internationally. Aren't you curious just how much that would mean for commerce and trade?

1,000 more breastfed kids will mean millions of savings from out-patient treatment due to respiratory diseases.

If policies like "Wednesdays off  for baby's first year" (an additional 44 days of maternity leave) can be enacted, we might be looking at more than 1,000!

And 1,000 babies exclusively breastfed has the potential of bringing about 192,000 less cans in dump sites (the environmental cost by those who can afford). Indeed, why don't we tell formula-feeders that when they do so, they are wasting water and blocking drainages?

Oh, and 1,000 less children dying will mean around P33M savings from funeral costs, FYI. These costs affect the national budget, the implementation of plans, the approval of loans and aids and the ability to pay off such loans. These savings can in turn be channeled to feeding and educating more children, right?

Breastfeeding is truly a gift. It is basically free and yet it can save money and lives, regardless of demographic. Which is why I hope you will scroll down to read the rest of the entries for this blog carnival. Read and share each one if you can, let us get more mommies to commit to breastfeeding in the first 1000 days. We may not meet our MDG targets next year but still, any small step in the right direction :)


Here are many thoughts and reasons why we should all advocate for mothers to breastfeed for the first 1,000 days of life #BF1st1000days

Jenny shares experiencing the One Asia Breastfeeding Forum

Mec insists to do the Math and breastfeed!

Ams, The Passionate Mom says Breastfeed for a Better Future

Pat says breastfeeding saves money and the planet

Cheryl, the Multi-Tasking Mama, tackles maternal health as addressed by breastfeeding

2011 CNN Hero Ibu Robin highlights gentle births and breasfeeding, even in disaster zones

Felyn stresses that Healthy Moms = Healthy Babies

Monique reminds us that there are second chances in breastfeeding

Normi relates how breastfeeding gave her strength and purpose

Nats thanks Dr. Jack Newman for showing how breastfeeding can be a win-win situation

Em believes breastfeeding is a solution to societal problems

Marge shares what breastfeeding has taught them

Kaity was empowered financially and as a woman through breastfeeding

Madel relates her breastfeeding saga

Jen of Next9 reminds us to do our research and share what we know

Celerhina Aubrey vows to work on one mother at a time

Grace wants to put an end to stories of toasted coffee and similar stuff over breast milk

Diane shares how she prevailed when things did not go according to plan

Hazel appreciates mommy support groups

Roan combines two passions, breastfeeding and architecture

Queenie tackled breastfeeding as the best choice for the environment as well and breastfeeding myths and poverty

Rosa shares how the picture she thought of was realized

Sally believes breastfeeding benefits mankind and our planet Earth

Floraine reminds us that breastfeeding helps combat diseases

Crislyn was happy to realize that she improved her own health by breastfeeding

Armi reminds us how breastfeeding during emergencies is crucial

Arvi tells us how breastfeeding made her look at her body a different way

Clarice elaborates on how breastfeeding saves lives and the planet

Giane reminds us that women empowerment can begin by seeing breastfeeding as more than a feeding issue

Liza thought she was only breastfeeding for her child

Thursday, August 7, 2014

Breastfeeding and the First 1,000 Days #BF1st1000days

My biggest takeaway from the first day of the 2nd Breastfeeding Congress was the role breastfeeding plays in the first 1,000 days.

First 1,000 Days is a partnership among key players worldwide concerned with maternal and child nutrition. Basically, the belief (backed by numerous studies) is that the first one thousand days of a child’s life is the period that decides the health and wealth of the world. From pre-conception care to the first two years of life, how a child is nourished will influence his long-term health, ability to learn and performance in all aspects of society. Breastfeeding, having the largest impact on child mortality of all preventive intervention, is thus something that all nations have to promote, support and protect.

Unfortunately, milk companies are trying to jump on the 1,000 days bandwagon to squash all the efforts the UNICEF and WHO (as well as other concerned agencies) have been putting in for this breastfeeding campaign and confuse consumers yet again. Or maybe I mean dupe consumers. Nestle and Danone have officially hijacked the initiative and launched/registered sites bearing the 1,000 days catch phrase. It definitely isn’t the first time that milk companies will twist something from the breastfeeding camp (golden bow, “best start”, etc). You can download Breaking the Rules 2014 and see for yourself other violations these companies have been committing worldwide.

It is in this regard that breastfeeders, breastfeeding advocates and breastfeeding supporters are now being called to express support for breastfeeding. Let us use our social media accounts. Let us post breastfeeding photos, breastfeeding quotes, reflections on your journey/testimonies as a breastfeeder and use the hashtag #BF1st1000days.

Perhaps, in this way, these milk companies won’t even think of bringing their ludicrous underhandedness in the Philippines.

Having breastfeeding in mind while pregnant helps mothers mentally prepare themselves and the people around them to breastfeed. Breastfeeding in the first two years of life (and beyond) complemented by healthy eating habits after baby turns six months reduces risks for chronic diseases for both mother and child. Breastfeed for the first one thousand days. Let your posts all contain #BF1st1000days

Friday, August 1, 2014

Truths Behind Rejection of Formula Donations During and After Emergency Situations

(I wrote this article last 22 November 2013 with the hope that some bigger syndication will publish it... wellm they didn't so I am claiming it back for my blog. This was a reaction to all the debate going on about formula donations post-Yolanda, one that even reached international forums)

Babies and children are top priority when disaster strikes. When natural calamities end up displacing hundreds of people, one of the first calls to go out or be offered is formula milk donations.

Two weeks ago, the Visayan region of the Philippines was hit by what is touted to be the strongest typhoon ever recorded in human history. The storm surge that came along with it killed thousands and leveled several areas, stripping people of their homes, schools, churches and hospitals. Hundreds of thousands of people scattered over several provinces are left without food and shelter and yet, why are formula donations being banned by the government?

There are several inter-related truths that provide rationale for this particular policy:

1. Most mothers start out breastfeeding their children. Based on experience over several strong typhoons, most that end up in evacuation centers are either breastfed and mix-fed. Few babies below the age of six months are completely formula dependent. Thus, the need for formula donations is not high and one the government can certainly address.

2. Studies show that 50% of formula fed babies run the risk of requiring hospital treatment in emergency situations, mostly due to ill-prepared formula that will be inevitable in shelters where clean water, sterile equipment and a steady supply of the formula are hard to come by. Usually, evacuees are deluged with donations in the first few days but are left wanting in the weeks, maybe even months, to come. The reality is that mothers sometimes end up preparing formula using rain or portalet water or diluting it so much that it causes water intoxication in their babies. Most people have not made the connection that formula is called precisely that because it has to be prepared a certain way for it to be beneficial.

3. Getting mix-feeding mothers to relactate, new mothers to exclusively breastfeed, and parents to wean their toddlers/preschoolers off formula/bottle feeding reduces the risks posed by ill-prepared formula. The simple act of giving milk using cups instead of feeding bottles or getting toddlers eating more solids are more practical and sustainable strategies in emergency situations.

4. There is a system in place that allows formula fed babies to get formula at evacuation centers and temporary shelters. These babies are neither forgotten nor allowed to die. Hopefully, those identified to have no other option but formula will also be monitored. However, when more mothers exclusively breastfeed, the few formula-dependent babies left can be better provided for with age-appropriate milk and other resources and information necessary to ensure safe formulation.

5. Resources are a challenge post-calamity, even if a family does not end up in an evacuation center. Communication lines may be down for a while. Water pipes busted. Supplies like gas or milk may be out of stock. In tent cities, clean water is often scarce and a family might not be able to get enough to wash and sterilize feeding bottles, what more have enough to prepare formula with. Congestion may also increase the level of humidity, expediting milk spoilage.

6. There is no wisdom in providing hundreds of cans of milk, or including a box of milk per prepacked baby kit to all families in an evacuation center since formula has to be age-appropriate and only babies under age 1 truly rely on milk as their main source of nourishment. Unfortunately, if formula is given to a breastfeeding family, they will use it, even if they were already breastfeeding successfully. If powdered milk is given to each family, they will use it, even if they were not milk drinkers previously. Such has been the indoctrination  of some societies, like ours, that people actually think formula is a safer, better food for their baby. For some, it is even a status symbol.

7. For the same price per can, private citizens or organizations could be providing one to three days worth of food and water to families in calamity zones and temporary shelters. The percentage of infants is always very low (and again, most that stay in evacuation centers are breastfed to some degree) so it is more practical to channel funds to feeding all members of a family, instead of just one, or providing them with shelter, clothes, medicines, etc. It also makes no sense for centers to be flooded with free formula while families struggle to get drinking water, cook their food or clothe themselves.

8. Returning to their homes or relocation may be a long time coming for evacuees which will pose challenges for the parents and the government to sustain formula feeding. At best, the average Filipino family can barely sustain the cost of formula for a whole year. Imagine how much worse it would be for families left with nothing and no clear prospects for the future.

9. Thanks to a growing number of breastfeeding advocates, the Milk Code is being observed better and better in the Philippines. Unfortunately, this has not stopped milk companies from offering free milk through hospitals and clinics. Milk companies are also known to freely distribute samples by the can in schools, conferences and the like. This surely suggests that should the government not have the budget to purchase formula for the few babies per center that need it, our leaders can still appeal to these companies to provide the milk because they can afford to give them freely. Private citizens and organizations, out of concern for babies, need not spend for them at all.  Unfortunately though, milk companies in the country seem to have a problem with donating unbranded cans to the Department of Health (per Milk Code stipulation) as well as taking on the task, even if they can afford it, of providing free milk indefinitely for evacuees that need it.

10. Formula feeding eats up resources in already compromised living arrangements. It eats up gas and water that could be used for cooking. It requires soap (or salt). It is a monthly expense. It takes up space and requires light (as proven by a mom who mistakenly used gasoline in preparing her baby's milk, accidentally killing her child). And because formula feeding increases risks for certain diseases (diarrhea, ear infection, allergies) that living in a shelter compounds, there will also be medical costs and it may even cost lives. Add to this again the burden of spending so much to provide for one member of the family while leaving the others malnourished and it becomes a vicious cycle of health issues.

11. Donations are hard to manage, track and properly distribute in our country over an average typhoon, what more a catastrophe that wiped out entire areas. Pre-packaged baby kits with a formula in each bag will have to be repacked, otherwise other babies will be put at risk. All formula cans would have to come with the necessary accessories, otherwise, it will put babies at risk. Prevention by banning formula donations reduces logistics nightmares, public health issues and loss of lives for the government.

12. 16,000 children age five and below are estimated to die every year in the country from diseases that are linked to formula feeding. This number will surely rise when measures are not taken to control formula feeding (especially in cases when babies are beyond age 1) and closely monitor formula distribution in shelters.

13. The ban on milk donations is not about breastfeeding being superior to formula feeding. It is about the greater good in a time of chaos and limited resources. Breastfeeding and formula feeding are also not just feeding issues, but during war and calamities, both become bigger public health issues.

14. The people who will be left in evacuation centers are the truly marginalized ones, without family or friends who can take them in. Post-Yolanda, we are looking at thousands of families. Not only will they be short of funds (which will challenge again the sustainability of formula feeding), they will have limited options. Some of these families also have multiple children of varying ages where it becomes all the more critical that fewer or none will be reliant on powdered milk for sustenance and nutrition. This references to the growing trend of milk-dependent toddlers/preschoolers when eating solids is most beneficial for them.

15. The difference with calls for breast milk donations and milk letting drives is that the breastfeeding groups behind these ensure that donated breast milk is not compromised (cold chain project) as opposed to the usual unmonitored distribution of formula without the necessary paraphernalia and information. Donated breast milk is also pasteurized and given through the use of cups, which makes it safer than formula. Perhaps, because breast milk donation is very personal in nature, its advocates take more care in making sure nothing gets wasted, as opposed to a general donation of formula wherein cans might be left under the heat of the sun or water used in formulation might be dirty. Donor milk is also not distributed indiscriminately because the goal is always to ensure safe and sustainable feeding so its recipients usually are moms in the process of relactation or babies who have been separated from their mothers.

The government and concerned agencies are just looking out for these children and their families for the short and long-term. The international standards are rigid because it has been proven time and again in emergency situations all over the world that indiscriminate formula donations just create problems and cost lives.

Now, people who really want to help these babies can send cash donations instead to trusted agencies or send food, care and emergency shelter kits for their families. Let us relieve the parents of some of their immediate worries and burdens, so that they can care for their children better. And may these truths reassure everyone that this stance the Philippine government has taken is a good one.