Tuesday, September 25, 2007

A neonatologist tells why to breastfeed

Dr. Mianne Silvestre, a neonatologist who practices in Philippine General Hospital and St. Luke's Medical Center, sent us an abstract of lectures she delivers about the benefits of breastfeeding. Unlike the medical doctors I posted about earlier, Dr. Silvestre is very knowledgeable about breastfeeding and gives real support to mothers and their babies. As a neonatologist, she cares for pre-term babies with many health complications and problems. Yet Dr. Silvestre is able to support both mother and child to have a successful breastfeeding relationship. She has a video wherein she is assisting a newborn delivered via cesarean to latch on to its mother. More doctors should be like Dr. Silvestre!

You can read Dr. Silvestre's paper by downloading it here:

Dr. Silvestre says that, according to evidence, "what occurs in breastfeeding is not just a mere transfer of nutrients and antibodies but a complex relaying of immunologic memory and interaction." She further gives evidence for the following recommended practices:

Why early latching on:

  • Colostrum colonizes the newborn's digestive system with good bacteria, which protects against infection

Why exclusive breastfeeding:

  • Even small amounts of infant formula or solids disturbs the optimal colonization of a newborn's intestines
  • Each mother produces breastmilk with antibodies against bacteria in her environment. Therefore, baby is protected from disease-causing bacteria to which it is exposed. Infant formula cannot do this. "Breastfeeding works its wonders even in the harshest, dirtiest, most economically deprived of environments," Dr. Silvestre says.

Why exclusive breastfeeding for six months and up to two years or beyond:

  • Because breastfeeding continues to protect children from infections and death due to infections long after the first year of life.
  • In a two-year study of 9,942 children in Cebu City, children who were not breastfed in the first six months of life had an 8- to 10-fold higher risk of dying from diarrhoea. According to the WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality, babies who were not breastfed have a six-fold greater risk of dying from infection in the first two months of life.
  • As published in The Lancet, the Bellagio Child Survival Study Group estimates that exclusive breastfeeding for six months can reduce underfive deaths by 13%.

Dr. Silvestre concludes, "indisputably, breastfeeding is the single most cost-effective intervention for saving child lives."

Friday, September 21, 2007

On the importance of fathers

Got this email from Ines Fernandez, Executive Director of Arugaan and founder of Save Babies Coalition. Ines is one of the foremost breastfeeding advocates in the Philippines. WABA awarded her earlier this year -- but that's for another post. Here's Ines' email:

Happier to share with you that the Father Support Summit "Fathering the Mother" will be held on Sept. 23 on Sunday at 1-4pm at the University of the Philippines Small Scale Industry - UPSSI in Diliman, Quezon City.

Kindly join us and actively participate. We need your sharing of your insights and experiences for the next new fathers to be. Help them in their fathering journey with your stories as map guide. Make them successful with their breastfeeding mothers and babies. Let us no longer contribute to the hefty 22 billion milk sales yearly and not be part of the guilt for seeing Filipino babies asthmatic as a consequence of not breastfeeding.

Please invite your friends: male or female, youth,young professionals, single or married, young at heart who still wish to have babies, age does not matter, after all they have women in the family who will be the nurturers of the next generation. Men support is very crucial for prepared participatory birthing and breastfeeding.

It is a free interactive forum " Fathers Support Summit" come September 23.

Hopeful and thankful to see you, your family and friends.

Sincerely, Innes

below is the invitation and program.

We would like to invite you to participate with us at the forthcoming Father Support Summit titled " Fathering the Mother". It will be an interactive sharing of insights and experiences on the role of men as partners in parenting, understanding pregnancy, involvement in birthing, facilitating successful breastfeeding and nurturing care.

Below is the program:


1:00 -1:15 Registration
1:15-1:30 Welcome and Introduction
1:30-1:45 Sharing from an active partner in birthing
1:45-2:00 Video show
2:00-2:15 Overcoming Difficulties in the world of pregnancy and birthing
2:15-2: 30 Facing the challlenges in infant feeding choices
2:30-2:45 Consequences of choices: life stories
2:45-3:00 Shared Parenting: Ups and Down and Way Forward
3:00-3:15 Snacks
3:15-3:30 Open Forum
3:30-3:45 Suggestions: Action Plan
3:45-4:00 Summit Series for October: "Mothering the Father"

What: " Fathering the Mother" Father Support Summit 1

When: September 23, 2007 Sunday 1-4 PM

Venue location: Virata Hall, 1st Floor Theater, University of the Philippines Small Scale Industry -UPSSI

(turn left road as you enter UP before the Oblation (statue) UPSSI is beside Bonifacio Hall/Solair

This gathering "Father Support Summit" is a free interactive forum. Kindly join us and be an active partner in this new undertaking for new young fathers to be and for those who want to be involved in their fathering role as partners in life.

Looking forward to see you and your spouse, friends and families including young men,wise men, young at heart.


Ma. Ines Av. Fernandez and Jonathan Adam Roxas
Executive Director Focal Point
Father Support Summit

Thursday, September 13, 2007

Wrong again, Doc!

I don't like telling people that their medical doctor was wrong, or gave them bad advice. After all, I am no medical doctor; I'm not even a nurse or midwife or lactation consultant. I am merely a mother who breastfed two children and is currently breastfeeding a toddler. And I am a passionate breastfeeding advocate (lactivist?) in both my personal and professional life in UNICEF.

But sometimes, I simply have to state a fact: a medical doctor, trained for years in human anatomy, diseases and their treatment, has erred yet again in counseling a mother in the most natural act of breastfeeding.

Just recently, a working mother of a two-month-old was apologetically explaining to me why she was mixed-feeding her baby. She never had enough milk, she says. "Oh, and something happened when my baby was a newborn," she recalls, "My baby had diarrhea. She had a bowel movement after almost every feeding, up to six times a day! So my doctor told me to put her on 'tummy rest'."

"What do you mean, 'tummy rest'?" I had never heard the term before.

The mother explains, "Oh, I stopped breastfeeding for 24 hours. Instead, I gave my baby infant formula."

As you can expect, I could not help myself: "Your doctor was wrong!"

Tummy rest? It was tummy "stress", I protest! Nothing is easier for the baby's tummy to digest than breastmilk (assuming the mother is not eating anything that the baby is allergic to). So instead of giving her baby's tummy a rest, she put her under more stress. "Besides," I say, "your baby was not having diarrhea. It's perfectly normal for a breastfed baby, especially a newborn, to have a bowel movement after each feeding."

The sad part is, this is not the first time I have heard of medical doctors and nurses giving wrong advice to a breastfeeding mom. Here are some other instances I can recall:

  • When my second baby was 7 months old, a doctor told me I had to stop breastfeeding because he was going to put me on antibiotics. I asked if he couldn't give me a safe medicine for a lactating mother. Nope, he claimed, and even showed me the entry in PIMS where it says that the medicine wasn't safe for breastfeeding women. "Besides," he said, "at 7 months your baby is only breastfeeding for emotional reasons." Near tears, I consulted an expert in WHO who reassured me that I could continue breastfeeding even while on medication. In fact, the very same medicines prescribed to me are sometimes prescribed to babies, in pediatric formulation, of course.

  • One colleague was told by her doctor to stop breastfeeding because she had colds and a fever. "Or else you'll pass the virus on to your child," the doctor warned.

  • A new mother was told by nurses to give her baby glucose water, while her breastmilk hadn't yet come in. Fortunately, this first-time mother had read enough breastfeeding books before childbirth to stand her ground and say, "No, thank you, I'm breastfeeding my baby!"

  • Another first-time mother, who was having trouble latching her baby on, was advised by hospital staff to pump her milk instead. Today, this mother is a master pumper, pumping enough breastmilk for both her son and a niece. But directly breastfeeding her baby remains a challenge.

Last June, I had the priviledge of meeting Dr. Audrey Naylor, physician and CEO of Wellstart International. Dr. Naylor said that in all her years of training in some of the most prestigious Ivy League universities in the States, she did not learn about breastfeeding at all. Thus, Dr. Naylor founded Wellstart "to advance the knowledge, skills, and ability of health care providers regarding the promotion, protection, and support of optimal infant and maternal health and nutrition from conception through the completion of weaning."

Doctors and other health care providers need to be part of the overall solution to the decline of breastfeeding in the Philippines. Mothers, fathers and other family members regard doctors highly and follow their advice. When doctors give the wrong advice, breastfeeding may be interrupted or come to an end altogether. The consequences are not to be taken lightly. A baby's sustenance in the first years of life has long-term effects that persist into adulthood. And we cannot turn back the hands of time to undo the harm that was done in infancy.

Our babies will never be this age again.