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hen her first child was born at a private hospital in Malang, Nuansa Putri, a 34-year-old civil servant, immediately believed the pediatrician’s statement that baby formula would make her son, Dean, grow strong and healthy.

The midwife who took care of Dean told Nuansa that if she did not immediately produce breast milk, her son would go hungry and lose weight.

The midwife offered Nuansa a famous brand of formula, saying it was an imported product with a quality similar to breast milk. The new mother trusted the midwife’s words and let her son drink it.

“My son became used to drinking formula from a bottle and didn’t want to breast-feed from me anymore,” she said, adding that it was a tough situation to endure.

Nuansa is one of many mothers who did not breast-feed exclusively because the government has failed to monitor producers and distributors of infant formula that aggressively market their products to new mothers.

Many such cases have occurred, forcing the government to create a new regulation to address the problem.

In 2014, the Health Ministry issued a ministerial regulation on imposing administrative sanctions for health personnel, healthcare facility operators, as well as producers and distributors of infant formula.

“As stated in the law, administrative sanctions could be given to them,” Didik Budiyanto, head of data and information management at the Health Ministry, said on Wednesday.

The ministry could impose administrative sanctions in the form of verbal warnings, written warnings and permit revocation, he said.

Mothers who felt like they had been duped could report incidents using the Halo Kemkes contact numbers listed on the Health Ministry’s website or through the Lapor! application, he added.

Despite the fact that the law was imposed in April 2014, there are still reports of mothers who feel they were tricked into purchasing formula for their babies, said Indonesian Breastfeeding Mothers Association (AIMI) coordinator Amanda Tasya.

“Usually mothers report to AIMI, then AIMI will send a letter to the Health Ministry and they will then give a warning to the producers [of infant formula],” she said.

However, she admitted that it was hard to find evidence of violations. Many mothers also did not follow up on their reports.

In October 2014, shortly after the law was enacted, Endah Trisnawati, a 32-year-old banker, was encouraged not to breast-feed her son directly after giving birth at a private hospital in Ciputat, South Tangerang.

The nurse told Endah that if her son waited for breast milk, he would get cold because his body could not yet adjust to room temperature.

“Actually, I know that a baby can stand without drinking breast milk for up to five days, but the nurse said she was afraid that the baby would get cold. So I said yes,” Endah told The Jakarta Post over the phone.

The government’s lack of monitoring has caused the rampant promotion and advertising of infant formula and milk for growing children, which continue to be a problem in Indonesia where half of the 5 million babies born each year do not fully benefit from breast-feeding, a recent report from UNICEF Indonesia stated.

Despite a high number of women (96 percent) breast-feeding their children at some point, only 42 percent of infants aged under six months are exclusively breast-fed. By the time they reach their second birthday, only 55 percent are still given breast milk.

Desy Saputra, a member of AIMI’s communications division, underscored the importance of breast-feeding, saying breast milk was the ideal food for infants and helped to protect against many childhood illnesses. Breast-feeding also helps mothers to bond with their children.

“When a mother breast-feeds, she faces her baby directly so she can talk to the child and they can interact,” she said.

“Formula is unnecessary if mothers follow the golden standard,” said AIMI deputy chairman Nia Umar.

She referred to the golden standard of infant feeding, which describes the steps that a mother can take for her newborn baby.

First, a baby should be given breast milk immediately after birth, by putting the baby on the mother’s chest to allow skin-to-skin contact. Second, the mother should exclusively breast-feed the baby for six months if possible. After that, the mother should begin giving the baby solids as a complementary food to the breast milk. Last, breast milk can be given until a baby reaches 2 years old. (win)