Saturday, January 3, 2015

Building a breastfeeding friendly society

By To-wen Tseng. Originally posted on San Diego County Breastfeeding Coalition's blog.

During a recent business trip to Taiwan, I was surprised by what I saw: There are nursing rooms literary everywhere I went. Nursing rooms can be found in government buildings, in shopping malls, in libraries, even in metro stations.

I was surprised because this is not the Taiwan that I remembered. I was born and raised in 1980’s Taiwan. My mom did not breastfeed. When I was growing up I had never seen anyone breastfeed. As a child, I thought all the babies were born to be bottle fed.

And this is not my personal experience. This is a collective memory of all the Taiwanese people in my age. Actually, according to the Taiwanese government, infant formula marketing in Taiwan reached its peak in 1980. In 1989, only 5.8% newborns in Taiwan were breastfed.

Now the generation that was not breastfed, that has never seen anyone breastfeed as a child, grew up and became new parents of the next generation. Surprisingly, most of them choose to breastfeed. Currently in Taiwan, 72% newborns under 1 month old are exclusively breastfed; 45.6% infants under 6 month old are exclusively breastfed.

What happened in Taiwan during the past 30 years is amazing. The 5.8% low breastfeeding rate in 1989 shocked the Taiwanese government and medical professionals. Later in 1992, the government adopted “International Code of Marketing of Breast-milk Substitute” and decided to ban infant formula TV commercial and infant formula promotion in hospitals. But the breastfeeding rate did not go up.

Then in 1998, Taiwanese government started to promote Baby-Friendly Hospital Initiative, requiring all the hospitals to train its health care staff in the skills necessary to implement breastfeeding policy, helping mothers initiate breastfeeding within one hour of birth, and allowing mothers and infants to remain together 24 hours a day. Taiwanese breastfeeding rate went up after this policy.

On the other side of Taiwan Strait, it’s totally a different story in Mainland China. Back in 1998, more than 67% newborns in Mainland China were breastfed, but the current number is 27%. In 16 years, the breastfeeding rate in China dropped by 40%. China has became the world’s largest infant formula consuming country. Each year, Chinese parents spent $11.3 billion on infant formula. More and more Chinese mothers give up breastfeeding to formula feeding.

The “Breast is Best” poster can be found everywhere in all the hospitals China, but infant formula manufacturers can also freely promote their product anywhere in all the hospitals in China. While health care staff telling mothers “breastfed babies are the healthiest,” formula manufacturers tell mothers “breastfeeding is only for those who cannot afford infant formula.”

Baby-Friendly Hospital Initiative is not promoted in mainland China. Women’s right to nurse in public and pump at work is not protected by Chinese law.

The 2008 Chinese milk scandal did not change the situation any. According to a CCTV survey, more than 70% of Chinese parents lost confidence in Chinese-produced infant formula, but they did not switch to breastfeeding. Instead, they rushed to Hong Kong to purchase U.S.-produced infant formula. The situation got so bad that Hong Kong government passed a restriction order, requiring each mainlanders can only carry two cans of infant formula when leaving Hong Kong. Now Chinese parents are buying up infant milk everywhere they can get it, outside of China. And that has led to baby formula shortages in at least a half-dozen countries, from Netherlands to New Zealand.

The lesson from China and Taiwan is that, simply telling mothers “breast is best” is not enough to encourage mothers to breastfeed. Mothers need a real breastfeeding-friendly environment to comfortably nurse their babies, from a baby-friendly hospital to a baby-friendly public.

A nursing room in Taiwan Immigration Office.

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