Sunday, August 5, 2007

Idol ng Breastfeeding

Last week, I met the Philippines’ first-ever “idol of breastfeeding”, Tessa Prieto-Valdez. Tessa is a fashion designer, columnist and socialite known for her flamboyant outfits. She also comes from the wealthy Prieto clan, who controls one of the largest newspapers in the Philippines, the Philippine Daily Inquirer. I was surprised that Tessa is quite diminutive, even smaller than me, that her first-born is 20 years old, and that she has quite a sense of humor. She said, “I never imagined that my small breasts would ever take center stage!”

It may seem strange that the Philippines would need to have a breastfeeding “idol”. But having breastfed two children and currently breastfeeding my 11-month-old baby, I can see the wisdom in it. Breastfeeding is no longer commonplace, and media only shows bottle-feeding as the normal way to feed a baby.

I owe some of my breastfeeding success to mothers who have modelled breastfeeding for me. I would like to dedicate this post to them, my very own breastfeeding idols:

Victoria, my sister. Vicky became a mother when she was only 20 years old and I was 15. Being the last-born child, I thought babies were alien beings, but through Vicky’s motherhood, I first fell in love with babies. Vicky produced copious amounts of breastmilk. She leaked through diapers, towels and anything else that she placed on her chest. I didn’t know it then, but this image was a powerful one for me. You see, Vicky and I are similarly endowed (that is to say, not well-endowed), and her nursing experience planted the idea in my subconscious that I, too, could produce a lot of milk.

Melen, former Executive Director of the Council for the Welfare of Children. Years before I even thought of marriage and motherhood, I attended meetings with Melen. In a few of them, Melen brought her baby and nursed her right then and there, in front of everybody, without apology, without a thought. Melen’s example showed me many things: that working women could breastfeed; that breastfeeding is something to be proud of; and, most importantly, that babies and their Moms should stay together as much as possible.

May and Mian, my UNICEF colleagues. When my fiancĂ© and I were attending our pre-marital seminars at the City Hall, we saw a poster of a breastfeeding mother and child. It was May and her baby. May, who had four babies in four years, always gushed about having babies naturally and breastfeeding them. Mian also had natural childbirths and, in fact, was the one who introduced me to my ob-gyne when I was looking for someone who would let me give birth without drugs. Mian brought her babies to office outings, meetings and official trips even to Southern Philippines. May and Mian taught me that breastfeeding was one of the best things about motherhood, and that we could combine breastfeeding with our work in UNICEF. If there’s a will, there’s a way.

As a breastfeeding Mom, and one who works, I feel a responsibility to show off my breastfeeding. I nurse in public – at the mall, in Church, at work, on the street. I declare a little too loudly to the building security that the big black bag I am carrying is not a laptop but a “breast pump”. It’s important for other women to see breastfeeding as natural, enjoyable and doable even for a working Mom.

One of the best compliments I’ve ever received was when Yas, a woman I work with in the UNICEF-assisted media advocacy project, said about me, “she’s my breastfeeding model!”

Wednesday, August 1, 2007

Measuring Breastfeeding

In celebration of World Breastfeeding Week, the Pharmaceutical and Healthcare Association of the Philippines (PHAP) has published an ad expressing its support for breastfeeding. However, PHAP still refuses to recognize that breastfeeding rates are indeed on the decline, particularly exclusive breastfeeding in the first six months. The ad states that: the Philippines has a "commendable" 87% breastfeeding rate, 54% of mothers start breastfeeding within one hour of birth; 92% of 6-month-olds are breastfed at least 6 months in a 24-hour period, and over 30% of mothers breastfeed up to 23 months.

Do these numbers really add up to a rosy picture of breastfeeding in the Philippines?

Last month, UNICEF developed a little matrix for journalists, entitled, "Measuring Breastfeeding." It can be easy to look at a piece of breastfeeding statistic and, without knowing what the number really means, conclude that breastfeeding rates are high in the Philippines. Hopefully, this matrix will help set the record straight:

If one uses "ever breastfed" and "exclusively breastfed, below 6 months", one would conclude that: the majority of women breastfeed and one-third of all babies are exclusively breastfed. However, considering the recommendation by WHO and UNICEF for optimal breastfeeding, these numbers are virtually useless.

WHO and UNICEF recommend exclusive breastfeeding for the first six months. After this, breastfeeding should continue along with the feeding of nutritious complementary foods.

Therefore, it is not very useful to know that 86.5% of women have ever breastfed. This counts even those women who breastfed only once for even one minute or a few seconds!

The second statistic is not much help, either. It counts all babies, from 0 to six months old, who are being exclusively breastfed. This includes those who are being exclusively breastfed at one month of age, but who will no longer be so the next month. Therefore, it gives no indication of the total length of exclusive breastfeeding.

So the indicator that we use -- and it isn't perfect either -- is "exclusively breastfed, 4-5 months". This is a count of all babies who are 4-5 months old and being exclusively breastfed. It doesn't include those who go up to six months of exclusive breastfeeding, but it's the best that we've got. This number is small, merely 16.1%, and we can safely assume that the percentage of infants who do reach exclusively breastfeeding up to six months would be even lower.

The median duration of exclusive breastfeeding is even more dismal. Half of all infants in the Philippines are exclusively breastfed for less than 0.8 month or 24.8 days.

These last two indicators make it clear: very few babies in the Philippines are being exclusively breastfed for six months. And there lies the problem.

Note: All statistics are from the 2003 National Demographic and Health Survey.