Experts Call for More Oversight of Breast Milk Substitutes

Cecelia Marshall / Khmer Times No Comments Share:
Breastfeeding practices
Breastfeeding practices are shown on a billboard outside the National Maternal and Child Health Center. (KT Photo: Chor Sokunthea)

PHNOM PENH (Khmer Times) –  Breastfeeding rates among urban women are at a low, and artificial breast milk usage is growing, according to a recent report by the Cambodia Demographic Health Survey. 
Many experts believe that it comes down to the increased availability of surrogates and bigger advertising budgets. “Breastfeeding is one of the most cost-effective interventions to improve health and prevent illness in early childhood,” the report stated. “However developing countries see a growing trend in the use of breast-milk substitutes.”
Currently 113 breast milk substitutes are sold in Cambodia. But many have neither the correct labeling nor follow marketing guidelines set by the World Health Organization (WHO). A code established by WHO provides a framework that prohibits formula companies from using flashy logos and ads that can misinform women.
“In order to oversee the implementation addressing the marketing of breast milk substitute we have to develop an oversight board,” said Mary Chea, deputy manager of the National Nutrition Program (NNP), a state initiative to improve the nutritional status of Cambodian women and children.
In Cambodia, two-thirds of the children are breastfed within the first hour. Another 86% of infants are breastfed the next day. But it is often difficult to continue this practice, Ms. Chea said.
Factors that lead women to turn to substitutes vary, she explained. Some women see it as a status symbol, others may find it easier, and others believe their breast milk is unsuitable.
Oum Ponika, 28, having given birth to her son at Calmette Hospital, said she fed him with formula because she did not produce enough milk. Doctors and nurses told her to breastfeed as much as possible, and now she is doing a mix of both. 
Her greatest fear is not doing the best thing for her child, and when she returns to work she must choose between formula and breast milk. 
“I’m confused right now which one to do,” said Ms. Ponika. “I’m afraid that my milk isn’t good enough for him.”
It is the uncertainty that many mothers have over the quantity or quality of their breast milk that gives formula marketers a way in, said Bindi Borg, a breastfeeding counselor. 
Even before opening a box of formula, the mix may be contaminated, she cautioned. There have been numerous recalls within the past 10 years, not to mention contamination that comes from unsanitary water and bottles. 
“You are piling risk upon risk upon risk,” she said.
“Breastfeeding is the biological norm,” Ms. Borg stated. “The biological norm will give you normal nutrition… normal development both physically and intellectually… and normal health.”
International research has shown that children who are breastfed will have higher IQ’s, their mouths will develop better, and they get less ear infections. Children who are not breastfed are 14 times more likely to die early.
Breastfeeding is also beneficial to mothers, said Borg.  
“Breastfeeding can inhibit obesity, diabetes, ovarian, and breast cancer,” she said. “So women who are having babies but don’t breastfeed are not getting the protective benefit.”
NNP’s Ms. Chea stressed the importance on educating midwives on these benefits.
“We have to train the midwives to make sure that they understand [the benefits of breast milk] clearly as well as medical doctors,” she said. “When they graduate, they must know.”

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