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Breastfeeding: The booby trap
One of the good things my mother did in her life was to breastfeed me
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ne of the good things my mother did in her life was to breastfeed me. It made me a pretty tough cookie physically: It gave me good teeth, a sturdy immune system which protected me against illnesses and allergies, and made me smart to boot!
So, when I gave birth to my son Aditya in 1975 in Bonn, Germany (because of my parents’ diplomatic posting), naturally I wanted to breastfeed him. However, when he made it out into the world, he had bluish extremities and big bluish patch on his lower back. The doctors decided to put him in a Kinderklinik (baby clinic) for two weeks, for observation.
They made me sign a letter of consent — which I signed, being the naïve, stupid 21-year-old I was then, and gave me pills to stop the flow of breast milk. I believed in the competence of these men in white coats, and they were German to boot. Jawohl, Herr Doktor!
As it turned out, both conditions were harmless: Adit’s Avatar-blue extremities were just peripheral cyanosis, due to inadequate circulation (it’s somewhat cramped in the womb, after all), and his blue back was the Mongolian blue spot, a congenital birthmark common to Asian babies which fades with age.
When I think about it now, my heart aches. Despite the fact that Adit developed into a pretty healthy 1.96 meter adult man, I deeply regret not having breastfed him.
I would be more assertive now in protecting my right to breastfeed; the long collusion between formula companies and hospitals worldwide is now public knowledge. Not surprising, when annual sales of formula milk worldwide are US$11 billion (in 2002), formula companies will protect their turf — and profits — tooth and claw.
At the moment, a draft government regulation (RPP) is being prepared for the implementation of Health Law No. 36 which was passed last year. Article 128 of the law stipulates that “every baby has the right to receive exclusive mother’s milk from the time of birth for six months, unless there is a contrary medical indication”. The law states also that anyone intentionally trying to prevent a mother from breastfeeding, could face a fine of Rp 100 million (about US$11,200) or a year in the slammer. Certainly looks like the government means business, doesn’t it?
The law is aimed at doctors, hospitals, clinics and perhaps husbands (who might be afraid that lactating might cause his lovely wife’s breasts to sag), who prevent the mother from breastfeeding.
This is the first time that there have been sanctions for preventing or sabotaging a woman from breastfeeding in the form of a full-fledged law.
Back in 1997 there was a Health Ministry Decree which prohibited hospitals from becoming a “market” for formula milk; despite this, many hospitals still do it anyway through a soft-sell approach (giving out formula “gift packages”), by “terror” tactics (that breast milk is not enough), usurpation (feeding the baby formula unbeknownst to the mother), lies (that formula is better), or outright pressure.
In hospitals, “Breast is Best” posters jostle with infant formula ads. Guess which gets heeded and which is ignored?
Because of the aggressive tactics of the formula companies worldwide, as far back as 1981 the World Health Organization issued an International Code for the Marketing of Breast Milk Substitutes (http://massbreastfeeding.org/formula/intcode.html).
In 2004, the Indonesian government adopted the 1981 WHO code into a ministerial decree from the Health Ministry, which contained 10 points to successful breastfeeding. Like the 1997 decree, it had no sanctions.
Despite knowing in principle that “Breast is Best”, I was still pretty stunned when I read the amazing list of advantages of breastfeeding, not just for the baby, but also for the mother (see www.breastfeeding.com).
Breastfeeding can even reduce the incidence of multiple sclerosis for the baby and cancer for the mother. I wonder if not breastfeeding left me susceptible to the breast cancer that struck me in 1997?
The most commonly known advantage for mothers is that breastfeeding delays the return of fertility.
This can lead to birth spacing and smaller family sizes, good in a populous country like Indonesia.
Last but not least, the economic savings are mind-boggling, not just from the high cost of the formula milk, but also in medical expenses because breastfed children are healthier.
A study in the US showed that the country could save millions of dollars and prevent 1,000 deaths per year if mothers breastfed exclusively for the first six months.
So the advantages are obvious, glaring even, but in the field this is matched by the mafia-like maneuvers of the formula companies.
This is akin to subversion, because in developing countries poverty, poor sanitation, lack of clean water, and insufficient education actually produce malnutrition, diarrhea and death with formula instead of the promised glowing health. Murder by milk? Who would have imagined!
Let’s hope the new law with the stiff penalties that it imposes will have better “luck”. But more than penalties, awareness is key. NGOs such as the Indonesian Breastfeeding Centre headed by Dr. Utami Roesli (www.usaid.gov/our_work/global_health/home/News/women/mch_roesli.html), who was also behind the drafting of the new law, have been working tirelessly to do this, and much more.
Given the weakness of law enforcement in Indonesia and the (monetary) strength of the formula companies, hopefully the growing mother’s milk movement can prevent this new law from becoming just another “booby trap”.
The writer (www.juliasuryakusuma.com) is the author of Julia’s Jihad.
