Ethics on promoting milk substitutes

REVIVING the breastfeeding culture is facing rough challenges owing to the aggressive advertising of processed milk products for infants. While there are medical factors that prevents women from breastfeeding such as being HIV positive, using certain drugs or having a baby with galactosemia (an inability to process a component of breastmilk), the most common reasons not to breastfeed varies.

A previous study conducted by the World Health Organization (WHO) notes that Filipino mothers spend P21.5 billion each year on milk substitutes. It is not just that some families consider it “sosyal” to be able to buy canned milk for their child, it also stems from the lack of education and weak enforcement of law. Many tend to give up nursing well before the recommended time frame. This means that no other liquids, not even water, should be given to children under six months old.

But old practices are hard to change. Even if it means that lives would be saved and the health and development of children would greatly improve if they continue to breastfed up to two years and beyond. Health workers have continuously conducted health classes and house to house information session with couples and mothers, to emphasize the benefit of exclusive breastfeeding. Substantial resources were also invested to improve their capacity as frontline workers.

Public health advocacy requires the commitment of different sectors, as well as the strong political will to enforce the law. One of the challenges in sustaining breastfeeding is the period when a mother returns to work. Many working women face difficulties with the risk of income loss after giving birth. Employers need to support women’s right to breastfeed during work hours. After all, providing space and time for mothers to continue breastfeeding could increase productivity and lower healthcare costs.

Another important part of creating a supportive environment for breastfeeding is to continually review and assess the implementation of the policy and legal framework to ensure that it is still in line with the globally agreed codes of conduct to regulate the marketing of breastmilk substitutes such as infant formula, and the global strategies on infant and young child feeding as endorsed by the World Health Assembly.

The strong legislative and policy framework in the Philippines is being recognized as one of the best in the world, protecting every Filipino mother’s right to breastfeed. The Milk Code or Executive Order 51in 1986 ensures that breastfeeding is protected and women are given clear information on the benefits of breastfeeding without undue influence of infant formula companies.

Have we failed in its implementation? What could still be done to counter the incessant promotion of milk formula? How will governments in the ASEAN position itself in the current international assembly to review the nutritional guidelines in every country?

The unethical marketing of breastmilk substitutes has a negative impact on breastfeeding rates and could have a disastrous effect on the substantial gains that have been put in place for the protection of children. The Codex meeting is an important event that should bring forth the demand of the public not only for transparency but also for governments in the ASEAN to firm up their stand on exclusive breastfeeding. When milk companies target low

and middle- income countries as their prey to promote their products, its people should defend their right to health.

On December 4, the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) started its review of both categories of follow-up formula, one for older infants aged 6 to 12 months and one for young children 12 to 36 months or often called as growing up milk.

Whatever standards that could be developed by Codex often serve as basis for national legislation but, the strong lobby of multi-national milk companies endangers the the health of infants and young children.

Parents and caregivers can only fulfill their roles with appropriate information on optimal infant and young child feeding practices. If the marketing of milk products is on a fast pace, done in a repetitive manner and with full investment, who would take on the public interest to be fully educated on the benefit of exclusive breastfeeding?

Opportunities abound to protect the rights of women to breastfed and for children to be protected. Email comments to roledan@gmail.com