By June Tsai
Melamine contaminated products have sickened thousands of infants in mainland China and left several dead. These tragic deaths and the fear of feeding children toxic products have raised Taiwanese mothers' interest in breastfeeding.
Hospitals in Taipei reported a 30-percent surge in the number of expectant mothers registering to their breastfeeding classes since the melamine scare. Mothers who had just weaned their babies also came to seek advice on how to start breastfeeding again.
According to a survey made by Taiwan's Bureau of Health Promotion in 2004, only 30 percent of new moms started exclusive breastfeeding. This compared to over 70 percent in the United States and 99 percent in Norway. The survey also showed this number fell to 13 percent six months after delivery. Even the rate of mothers feeding children under six months old with a mix of breast milk and formula milk was stunningly low: 20 percent only. This means up to 80 percent of young children in Taiwan relied on infant formula. No wonder any news about tainted formula would trigger panic among parents.
Local groups made urgent calls to renew support for breastfeeding and to provide public facilities to this end. The Breastfeeding Association of Taiwan stated Sept. 20 there had been several occasions in recent years when international companies, such as Nestle in 2004, were forced to recall batches of tainted infant formula. Companies may take prompt measures to ensure safety and health agencies may multiply food checks, but in the end, "breastfeeding is still the best option with regard to immunity protection, nutrition and better mother-baby relationship."
Despite long-time efforts of related government agencies such as the BHP and nonprofit organizations in promoting breastfeeding and encourage social support, the lack of facilities has prevented many new moms from breastfeeding.
In addition to the present regulation on maternity leave which allows pregnant women to take eight weeks of paid leave around delivery time, the Gender Equality in Employment Act amended in April 2007 stipulates an unpaid parental leave up to two years. Yet women are still concerned about losing their jobs or being bullied if they decide to take parental leave.
In addition, both the gender equality law and Labor Standard Act stipulate that a female worker is allowed to breastfeed her baby twice a day, each time for 30 minutes, until it is one year old, and that this shall be deemed as working time. However, because of the lack of breastfeeding rooms at the workplace, the laws could remain just words. "The lack of public facilities is one of the biggest deterrents," said Chen Chao-huei, president of Taiwan Academy of Breastfeeding, citing the BHP's 2004 survey that showed there were less than 1,000 nursing rooms available in public buildings throughout Taiwan.
"The workplace could show support simply by implementing the law," said Chen Yi-chun, director of the Breastfeeding Association.
While 29 percent of the mothers responding to a survey conducted by the BHP in August said they were deterred from breastfeeding by the lack of adequate public facilities, 19 percent revealed their mothers-in-law influenced them, and 10 percent held their neighbors and bosses responsible. Moreover, 57 percent of respondents said their husbands were their biggest support.
"These results show that everyone around a new mother can affect her decision about breastfeeding," Chen Chao-huei said.
She also pointed to the unrestrained advertisement for infant formula in the country. The power of advertisement is such that many people are convinced that human milk is less nutritious than formula milk.
Just in June this year, for example, professionals had to dispute a local media report about tests that concluded formula milk had a higher content of iron than breast milk. "Breast milk contains less iron than formula, yet it is far better absorbed," Chen Chao-huei said. Experts estimate that 50 to 70 percent of the iron in human milk is absorbed compared to only 4 to 10 percent in formula.
Because of this low absorption rate, iron is added into formula to ensure babies absorb enough iron, Chen Yi-chun explained. While the extra iron is metabolized, the process strains needlessly the babies' kidneys, she warned.
Taiwan Academy of Breastfeeding recommended a proper distribution of information concerning infant formulas since some companies tend to advertise beyond the measures specified in the "International Code of Marketing of Breast-milk Substitutes" promulgated by World Health Organization in 1981. A majority of women complained about marketing personnel contacting them, even though the Code specifically stipulates they should not seek direct or indirect contact with pregnant women or mothers of infants and young children. The organization said government agencies should be responsible for implementing the Code in Taiwan.
The Breastfeeding Association cited the WHO's 1990 "Innocenti Declaration." This document stated that as a global goal for optimal maternal and child health and nutrition, mothers should be able to practice exclusive breastfeeding for the first six months of a child's life, and that children should continue to be breastfed up to two years old or beyond, with gradual introduction of age-appropriate complementary foods.
To achieve this goal, the association reminded the responsibility should not fall only upon mothers. "Everyone, including health care and education professionals, can and should help create an appropriate environment of awareness and support to encourage mothers to breastfeed."
This article appears in Taiwan Journal Oct. 16, 2008.
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