Role model

It has often been described as a baby factory, with newly-delivered mothers lying head to toe in shared beds because, as in most government hospitals, there is simply no space—or resources—to spare.

But these days, Dr. Jose Fabella Memorial Hospital in Santa Cruz, Manila, goes by another name, an honorific bestowed by the World Health Organization no less: role model, for its essential newborn care programs more popularly known as “Unang Yakap (First Embrace).”

Dr. Howard Lawrence Sobel, regional coordinator for the WHO-Western Pacific Region Office’s Reproductive, Maternity, Newborn, Child and Adolescent Health, said Unang Yakap has been replicated in seven countries in the region which had the highest infant deaths: Cambodia, China, Laos, Mongolia, Papua New Guinea, the Solomon Islands and Vietnam.

As in Fabella Hospital, a decline in infant mortality was recorded after these countries embraced Unang Yakap protocol, which consists of breastfeeding, human milk banking and Kangaroo Mother Care (this last involving skin-to-skin contact between mother and child, as the infant is swaddled close to its mother’s heart for additional warmth, physical and emotional reassurance, as well as constant and easier access to breastfeeding).

Unang Yakap’s recent press launch also featured Kangaroo Mother Care—this time among fathers who grinned proudly, if a bit bashfully, as they cuddled their babies to their bare chest, the instant bonding evident. The message couldn’t have been delivered more strongly and beautifully: The support of fathers is also crucial for healthier, happier babies—and mothers.

Indeed, mothers need all the support they can get to sustain breastfeeding, which is not exactly a Hallmark experience as it is occasionally fraught with pain and discomfort, as well as unrealistic expectations and social pressure that aren’t helped any by the misinformation peddled by picture-perfect infant formula ads.

How many young mothers unwittingly discard the initial yellowish discharge from their breasts, not knowing that it is the antibodies-laden colostrum that infants need to build up immunity? How many equate breast size with capacity to produce breast milk and satisfy their babies’ hunger? How many think that fat babies are ideal, never mind that these mostly bottle-fed infants are gorging on the added sugar in infant formula? Without access to relevant information, few women are aware of the child-spacing benefit also to be derived from breastfeeding, with a gap of up to two years between kids if the mother breastfeeds exclusively.

Women anxious about regaining their shape after childbirth must know as well that breastfeeding increases the release of the hormone oxytocin, which helps the uterus regain its size faster, and leads to easier weight loss.

Fabella’s breastfeeding protocol is definitely targeted to its indigent clientele, mothers who might find infant formula too expensive and thus dilute it, which could lead to their babies being undernourished. Then too, how many of these mothers have regular access to clean water, bottles, rubber nipples and the fuel to sterilize them? The costly and time-consuming ritual involved in bottle-feeding makes breastfeeding a more economical, time-saving and accessible choice among nursing mothers. (About the only contraindication against breast milk is when the mother is HIV-positive or is undergoing chemotherapy for cancer, since the toxins might be transferred to the infant.)

The Philippines has recognized the importance of breastfeeding enough to enact Republic Act No. 10028 in March 2010. One if its provisions mandates companies to have private rooms where mothers can have a total of 40 minutes for breastfeeding, and urges malls and other public places to have nursing rooms for the same purpose.

All forward-looking steps, to be sure, but matched equally by efforts from milk companies to get around the law and convince mothers to shift to their products. There are milk commercials that now market infant formula as “follow-on milk” or “suitable for babies six months and older,” incidentally the age when babies can be weaned from milk to solid food. Then there’s the “Yolanda” disaster when milk companies donated infant formula to nursing mothers in the devastated areas—a gesture found to be in violation of the 1986 Philippine Milk Code, which prohibits donations, promotions, sponsorships, sampling and similar marketing gimmicks that may discourage breastfeeding.

While mothers embrace the Unang Yakap campaign, they must also keep an eye out for efforts to present the alternative as the easier, more modern, and—thanks to movie stars as endorsers—more glamorous choice.