The Indonesian government officially commemorated World Breastfeeding Week on Monday (20/08), hosted by the Ministry of Health.
World Breastfeeding Week is celebrated globally in the first week of August every year.
In Indonesia, it is usually observed for the entire month of August through several breastfeeding campaigns. This year, the Ministry of Health launched an advertising campaigning to promote breastfeeding of children from birth up to 2 years of age. The advert was broadcast on several television channels nationally from the end of July until mid-August.
This advert is in line with this year's theme, "Breastfeeding: Foundation for Life," in recognition of the importance of breastfeeding to a baby's future. It also reflects a recommendation by the World Health Organization (WHO) and United Nations Children's Fund (Unicef) to advocate for the protection, promotion and support of breastfeeding.
However, running a national advert or setting up an annual commemoration event may not be enough to translate the spirit of World Breastfeeding Week into action, so we need a more effective policy to meaningfully protect, promote and support breastfeeding.
Costs and Benefits
Findings from decades of research show the critical roles that breastmilk plays in providing the essential nutrients a baby needs, in addition to hormones and antibodies that protect a newborn against infectious disease. Breastfeeding from the earliest hour of life is a safeguard against newborn deaths.
A comprehensive 2016 study by Cesar G. Victoria and colleagues, published in the Lancet Journal, found that breastfeeding could prevent the deaths of 20,000 women from breast cancer and more than 820,000 children under the age of 5 around the globe annually. In Indonesia, a lack of optimal breastfeeding was found to result in the death of more than 5,000 children and 2,000 mothers annually.
In addition, the available cost analysis studies show that breastfeeding saves health care costs. One of these is a 2018 study by Adiatma Y. M. Siregar and colleagues, published in the International Breastfeeding Journal, which estimates that in Indonesia, breastfeeding also saves Rp 1.7 trillion ($118 million) annually in reduced health care costs.
Moreover, the government is currently working hard to reduce the incidence of stunting, a growth disruption mainly caused by inadequate nutrition in infants and young children. National data shows that one in three, or around 9 million young children are stunted. Unfortunately, stunted children are most at risk of being overweight or obese.
In fact, the evidence illustrates that breastfeeding is one of the most effective ways to prevent and reduce stunting. Breastmilk contains all the nutrients a baby needs, which helps prevent malnourishment if provided until 2 years of age, according to the WHO and Unicef recommendation. In addition, one of the benefits of optimal breastfeeding is a reduction in the risk that children will become overweight. Therefore, breastfeeding is indeed the foundation of life, because it is critical for child survival and is an opportunity for children to grow and develop to their full potential.
Notwithstanding these clear benefits, many Indonesian babies are missing out. The latest National Basic Health Research found that only about 42 percent of children less than 6 months of age are exclusively breastfed but no data is available for continued breastfeeding of up to 2 years. There are many reasons millions of Indonesian mothers are unable to start and continue breastfeeding successfully. One major problem is a lack of adequate breastfeeding support.
Another serious challenge for establishing optimal breastfeeding nationally is the inappropriate marketing of baby formula both in the health care system and in the general public, including on the internet and social media. Such marketing practices have been shown to contribute to breastfeeding cessation by influencing mothers' belief that formula is equally healthy, safe and just as nutritious as breastmilk, despite a lack of scientific evidence.
Formula Targets Mothers
Moreover, formula marketing has also been found to target mothers who fail to breastfeed or who think they do not have enough milk by evoking their anxieties about breastfeeding and reinforcing a perception that breastfeeding recommendations are unattainable. Evidence shows that mothers are more likely to initiate and continue breastfeeding longer when formula supplementation is not offered.
The formula marketing tactics severely undermine mothers' rights to make informed decisions on infant feeding choice, including the decision to introduce formula. Such predatory marketing practices are detrimental to child and maternal health.
We need a new political will to support and protect breastfeeding up to two years of life to help our future generations of Indonesians benefit from the lifesaving benefits of breastfeeding.
Therefore, it is now time for the government to use the month of August as a moment to strengthen our national policies to end the inappropriate marketing of formulas and foods for infants and young children to improve breastfeeding practices.
Irma Hidayana is a doctoral candidate at the Health and Behavior Department, Columbia University.