Why is breastfeeding under threat?
Novita Gemalasari Liman and Ronald Ariyanto Wiradirnata
The Jakarta Post
World Breastfeeding Week is held from Aug. 1 to 7. Almost all mothers can breastfeed, but this natural act seems to be a difficult task for societies. Globally, only four out of 10 infants are now exclusively breastfed and only about 60 percent of children receive complementary foods timely.
Indonesia's exclusive breastfeeding rate has varied from year to year. To date, only 42 percent of Indonesian children are exclusively breastfed. As a result, more than 36.4 percent of Indonesian children under the age of 5 are chronically malnourished and experience stunted growth. The lack of exclusive breastfeeding also contributes to the 29 percent mortality rate of children under 5 in Indonesia.
Breastfeeding together with the appropriate complementary feeding is and has always been the key recommendation of the World Health Organization (WHO). Newborns need breastmilk for healthy growth and development.
Proper feeding will protect them against malnutrition and various infectious diseases and would save the lives of 800,000 children annually. Also, breastfeeding mothers heal faster after giving birth, have lower risk of breast and ovarian cancer, diabetes and depression.
However, one in three Indonesian women of reproductive age suffers from malnutrition. Most are poor and aren't aware of the need for a healthy and balanced diet to produce high-quality breastmilk. We have the duty to equip mothers with correct and complete information so they can choose what is best for them, their babies and families.Integrated health services posts (Posyandu) provide information, education and communication (IEC) on breastfeeding issues. But many more women need to make use of Posyandu facilities. Its public outreach should be increased to encourage breastfeeding.
Despite more women giving birth in health facilities, mothers who perform early initiation of breastfeeding in Indonesia were last recorded at 34.5 percent. Health care providers, with active support from family members, help make breastfeeding the first routine activity in the first hour after delivery.
Breastfeeding can be challenging, especially for working mothers, who, according to the International Labour Organization (ILO), comprised nearly half of Indonesia's workforce in 2013. Of these, 32.6 percent chose to stop breastfeeding to continue working and provide prelacteal food (food other than breastmilk) to their infants. This is due to limited time, less support and the availability of facilities for breastfeeding in the workplace.
The World Breastfeeding Week 2015 pays special attention to working mothers. This year, the World Alliance for Breastfeeding Action (WABA) emerged with a global strategy to support women in integrating breastfeeding and work. It is not necessary for a mother to stay home to exclusively breastfeed for six months. WABA demands companies from all over the countries to give opportunity, place and endorsement for breastfeeding mothers. We have designated areas for smoking and we should now consider designated breastfeeding areas.
Accordingly, WHO has created standard policies to achieve global exclusive breastfeeding targets in 2025. One of them is to recommend a mandatory six months paid maternity leave. This way, the company builds trust by showing it values its female employees. And practically, it helps reduce absenteeism of mothers missing work to look after sick children.
Increased use of infant formulas plays a role in decreased practice of exclusive breastfeeding. In line with the WHO's International Code of Marketing of Breastmilk Substitutes, the government has actually banned the promotion of infant formulas that may interfere with the protection and promotion of breastfeeding.
Even so, the level of public demand for substitutes remains high. What's important is that no breastmilk substitute can replace the unique health advantages of breastmilk. We all have the opportunity to protect, promote and support breastfeeding. By promoting breastfeeding and proper feeding, we will be improving the health and saving the lives of children for their best possible start in life.
Novita Gemalasari Liman is a physician in Barru, South Sulawesi, and a research associate at Suharlim Foundation. Ronald Ariyanto Wiradirnata is a physician in Maros, South Sulawesi.
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