QUEZON CITY (PIA) – A critical gathering in Quezon City sought to reinforce the unparalleled importance of breastfeeding for both mothers and their children. The Milk Code Forum, held on August 2, 2024, was a clarion call to action, a forceful reminder of the irreplaceable bond and lifelong health benefits that breastfeeding provides.
As the nation celebrated National Breastfeeding Month, the event brought together a diverse array of stakeholders – from government officials and public health experts to lactation consultants and passionate advocates – all united in their mission to protect, promote, and support optimal infant and young child feeding practices.
At the heart of the forum was a sobering reality: in a country where formula milk marketing has reached staggering heights, the precious act of breastfeeding – an innate, natural process that has nourished humanity for millennia – is increasingly under threat.
“Each formula milk purchase represents a missed opportunity to nurture the unique bond and health benefits that breastfeeding provides,” declared Dr. Aurora Gloria I. Libadia, Chair of the Mother-Baby Friendly Initiative (MBFHI) Committee. “Breastfeeding is not just about feeding a child; it’s about establishing a profound connection that has lifelong implications.”
The data speaks volumes. In the Philippines alone, formula milk marketing reached a staggering $480 million (P27.76 billion) over a five-year period, while the global market for breastmilk substitutes hit $45.8 billion (P2.649 trillion) in sales in 2019. This sobering reality underscores the immense influence of formula marketing on feeding decisions made by mothers.
“Aggressive advertising and the occasional lack of emphasis on breastfeeding’s benefits by some healthcare professionals can sway feeding decisions, ultimately impacting the health and well-being of infants and young children,” Dr. Libadia explained.
The forum, organized by the Department of Health – Center for Health Development CaLaBaRZon, aimed to strengthen the enforcement of Executive Order No. 51, series of 1986 (EO 51, s. 1986), known as the “National Code of Marketing of Breastmilk Substitutes, Breastmilk Supplements, and Related Products.” This landmark legislation, enacted over three decades ago, sought to protect and promote breastfeeding as the optimal choice for infant and young child feeding.
Yet, as the years have passed, the relentless marketing campaigns of formula milk companies have continued to chip away at the progress made. It is a battle fought on multiple fronts, as the influence of these aggressive promotional tactics seeps into the very fabric of society – from hospital policies to the advice given by healthcare professionals.
“One of the predictors of stunting and wasting is sub-optimal breastfeeding and improper complementary feeding,” explained Luz B. Tagunicar, RND, MPH, Supervising Health Program Officer of the Oral Health and Nutrition Care Division – Disease Prevention and Control Bureau. “Because this is the first food of a child and any breastfed child is a food-secured child.”
The Milk Code Forum, therefore, served as a rallying cry, a gathering of minds and hearts united in their determination to reinforce the vital role of breastfeeding in the lives of mothers and their children.
Forging unbreakable bonds
At the heart of the forum’s discussions was the profound impact of breastfeeding on the mother-child relationship. Dr. Libadia’s opening remarks underscored the deep, irreplaceable connection that is fostered through this natural process.
“The skin-to-skin contact, the exchange of hormones, and the emotional intimacy created during breastfeeding are truly irreplaceable,” she emphasized. “These elements are not just about feeding a child; they are about establishing a bond that shapes the child’s physical, emotional, and social development for years to come.”
Indeed, the benefits of breastfeeding extend far beyond the nutritional value of breastmilk itself. The act of breastfeeding triggers the release of oxytocin, a hormone that not only facilitates milk production but also promotes feelings of love, trust, and bonding between the mother and child.
Experts said breastfeeding is a unique experience that allows a mother to nurture her child in the most fundamental way
While the skin-to-skin contact, the eye contact, the soothing rhythm of the feeding, they further said, that these all contribute to the development of a deep, unbreakable bond that lasts a lifetime.
This bond, forged through the intimate act of breastfeeding, has far-reaching implications for the child’s physical, emotional, and cognitive development. Studies have consistently shown that breastfed infants exhibit higher rates of cognitive and language development, as well as improved social-emotional skills and behavior.
“The benefits of breastfeeding are not just limited to the child’s physical health,” explained Dr. Libadia. “They extend into the realms of mental and social well-being, laying the foundation for a child’s future success and fulfillment.”
Ms. Tagunicar during her discussion of the Milk Code in a community setting. (Contributed photo)
Combating the influence of formula marketing
Despite the overwhelming evidence supporting the importance of breastfeeding, the marketing tactics employed by formula milk companies continue to pose a formidable challenge.
“Aggressive advertising and the occasional lack of emphasis on breastfeeding’s benefits by some healthcare professionals can sway feeding decisions, ultimately impacting the health and well-being of infants and young children,” Dr. Libadia lamented.
The forum participants delved deep into the strategies used by formula milk companies to erode the public’s trust in breastfeeding. From eye-catching billboards and social media influencer campaigns to the subtle undermining of breastfeeding’s value within healthcare settings, the arsenal of these corporations is far-reaching and insidious.
Public health advocates, meanwhile, said that formula milk companies have long understood the power of marketing and have been investing heavily in creating an image of their products as modern, convenient, and scientifically superior to breastmilk – a narrative that can be incredibly persuasive, especially to new mothers who are already grappling with the challenges of parenthood.
This relentless promotion of formula milk has had tangible consequences on breastfeeding rates in the Philippines. According to the 2021 National Demographic and Health Survey, only 24 percent of infants under six months were exclusively breastfed, a significant decline from the 2017 figure of 28 percent.
“The drop in exclusive breastfeeding rates is deeply concerning,” said Dr. Libadia. “It underscores the urgent need to strengthen the enforcement of the Milk Code and empower mothers to make informed decisions that prioritize the unique bond and lifelong benefits of breastfeeding.”
Shining a light on the Milk Code
The Philippine Milk Code of 1986 (EO 51, s. 1986) was enacted as a response to the alarming decline in breastfeeding rates and the aggressive marketing tactics of formula milk companies. This landmark legislation sought to regulate the promotion and distribution of breastmilk substitutes, breastmilk supplements, and related products.
At the Milk Code Forum, participants delved into the core tenets of this legislation and explored the challenges in ensuring its effective implementation.
“The Milk Code is a comprehensive framework that seeks to protect, promote, and support optimal infant and young child feeding practices,” explained Luz B. Tagunicar. “It establishes guidelines for the marketing and distribution of breastmilk substitutes, as well as the provision of accurate, unbiased information to mothers and healthcare professionals.”
One of the key provisions of the Milk Code is the prohibition of direct-to-consumer advertising of formula milk products. It also restricts the promotion of these products within healthcare facilities, including the distribution of free samples and the display of promotional materials.
“The Milk Code recognizes the vulnerability of new mothers and the power of marketing to sway their feeding decisions,” said Dr. Libadia. “By restricting the promotion of formula milk, the legislation aims to create an environment that empowers mothers to choose breastfeeding as the optimal choice for their children.”
However, the forum participants acknowledged that the implementation of the Milk Code has faced significant challenges over the years. The relentless efforts of formula milk companies to circumvent the legislation, coupled with the occasional lack of enforcement by regulatory authorities, have undermined its effectiveness.
Strengthening the Milk Code through multisectoral collaboration
To address these challenges, the Milk Code Forum emphasized the need for a renewed, coordinated effort to strengthen the implementation of the legislation. This would require the participation and commitment of a diverse array of stakeholders, from government agencies and healthcare providers to civil society organizations and the private sector.
“Protecting and promoting breastfeeding is not the responsibility of a single entity,” said Dr. Libadia. “It requires the collective efforts of all sectors of society – a true multisectoral collaboration that can overcome the formidable obstacles posed by formula milk marketing.”
One key initiative discussed at the forum was the revitalization of the National Intersectoral Committee on the Milk Code (NICMC), a multi-agency body tasked with overseeing the implementation of EO 51, s. 1986. By empowering this committee and ensuring its effective coordination, the forum participants believed that significant progress could be made in safeguarding breastfeeding practices.
Participants said that the NICMC has the potential to be a powerful driver of change, but it needs to be given the resources, authority, and political will to fulfill its mandate. This means strengthening the committee’s monitoring and enforcement capabilities, as well as enhancing the collaboration between government agencies, the private sector, and civil society organizations.
The forum also highlighted the crucial role of healthcare professionals in promoting and supporting breastfeeding. Participants stressed the need to provide comprehensive training and education to doctors, nurses, and other medical personnel, ensuring that they are equipped with the knowledge and skills to effectively counsel and support mothers throughout their breastfeeding journeys.
Healthcare providers are often the first point of contact for new mothers, and their advice can have a significant impact on feeding decisions. They must empower these professionals to champion breastfeeding as the optimal choice, and to provide mothers with the practical, emotional, and technical support they need to succeed.
Investing in breastfeeding-friendly environments
Beyond the enforcement of the Milk Code and the education of healthcare providers, the forum participants recognized the need to create breastfeeding-friendly environments that support mothers throughout their breastfeeding journeys.
“Breastfeeding shouldn’t be a struggle; it should be a natural, empowering experience for mothers,” said Dr. Libadia. “To achieve this, we must address the social, cultural, and infrastructural barriers that often make it difficult for women to breastfeed.” (GLDG/PIA-NCR)
