JP/R. Berto Wedhatama

This week, the world is commemorating World Breastfeeding Week, which aims to boost exclusive breast-feeding rates and increase awareness of mothers all over the world. In celebration of the event, we have compiled interviews with experts and the Indonesia Breastfeeding Mothers Association (AIMI) to describe the practices of baby-friendly hospitals:

Rooming-in

Healthy babies should stay close to their mothers to ensure that the mothers can exclusively breast-feed the babies, thus, hospitals that are highly committed to breast-feeding success would remove the traditional baby room and let the newborn sleep next to its mother, unless the newborn or the mother needed medical treatment after birth.

'€œThere'€™s no female mammal on earth who separates her newborn from herself,'€ Utami Roesli, a pediatrician with St. Carolus Hospital in Central Jakarta said.

Some hospitals also provide baby rooms but let mothers who opt for a rooming-in facility keep her baby close to her.

No sponsorship

Hospitals which support exclusive breast-feeding should never display promotional paraphernalia of infant formula in any form.

Nia Umar of AIMI said that promotional tools for such products did not only appear as direct advertisements, but could exist in the forms of baby health record books or vaccination schedules, for instance.

'€œInfant formula is needed in special cases so we are not against the product per se, but we are against the way the product is promoted, which is often very subtle and brainwashing,'€ she said.

Despite the prohibition of such advertising in the 2009 Health Law, many hospitals still accept sponsorship from infant formulas and advertise or hand out promotional items to mothers.

Certified experts

Hospitals which support exclusive breast-feeding will have certified experts, preferably those acknowledged by the International Board of Lactation Consultant Examiners, Inc., who are known as International Board Certified Lactation Consultants (IBCLC). An IBCLC is a health-care professional who specializes in the clinical management of breast-feeding.

According to AIMI, there are only about 30 IBCLCs across Indonesia.

'€œAn IBCLC has undergone a series of tests, which are open only once a year. Most IBCLCs in Indonesia are doctors,'€ Nia said.

Lactation clinic

There are dozens of hospital in the Greater Jakarta area which have already established lactation clinics as part of their commitment to endorsing exclusive breast-feeding.

However, because the movement to return to exclusive breast-feeding is still relatively new, many lactation consultants are not adequately knowledgeable, thus sometimes derailing a mother'€™s efforts to breast-feed her baby.

Utami said that not all lactation consultants had comprehensive knowledge on steps to ensure exclusive breast-feeding, such as early breast-feeding initiation (IMD), let alone practicing it properly.

'€œFor instance, not all counselors understand that the key to successful IMD is not to breast-feed the newborn immediately after birth, but to allow the baby to have skin-to-skin contact with the mother for at least an hour or more. Even when the baby manages to find the nipple within less than an hour, if they remove the baby immediately by then, it cannot be considered successful,'€ she said.

JP/Jerry Adiguna

No bottle policy

Giving bottles with artificial nipples to young, breast-feeding babies often leads to nipple confusion, resulting in babies refusing to breast-feed because they have difficulty latching on or suckling.

'€œBaby-friendly hospitals would never provide bottles with artificial nipples to newborn babies, let alone infant formula, after birth,'€ Nia said.

Pro-breast-feeding hospitals would provide a small cup or spoon to feed the mother'€™s expressed breast milk to the baby in the event that the baby still could not latch properly or had other feeding problems.