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Infant Formula Costs Burden Poor Filipinos


Health experts say use of infant formula instead of breastfeeding is impoverishing already poor Filipino families and contributes to the death of 16,000 children a year.

The average income of a poor Filipino family is about 7,000 pesos a month, or $125, and the World Health Organization says one fourth of that is spent on infant formula.

Doctor Jean Marc Olive, WHO country representative for the Philippines, says more than $375 million is spent on infant formula, and the economic impact is staggering. "Breast milk is free," he said. "They could use this money in improving the nutrition status, buying better food for their offspring, paying for education, so this has a very important impact on poverty."

The health impact is even more compelling. According to WHO estimates, about 16,000 infants die each year because of problems related to formula.

The biggest issue is the lack of antibodies in formula.

Doctor Howard Sobel, a WHO childcare specialist, says this vital protection from sickness for children is carried in breast milk. "The first immunization a child receives is breast milk. It is full of mommy's antibodies," he said. "And that protection is there in many ways ... and one of them is that a child who is not breast fed, a child who is formula fed, is almost four times as likely to die of pneumonia as a child who is fully breast fed."

Formula, which is less nutritious than breast milk, also can be contaminated by bad water or poor handling.

Why don't mothers in the Philippines breastfeed? WHO doctors say they are the victims of misinformation and misconceptions, including a belief that they cannot produce enough milk.

But the overwhelming factor, says Doctor Olive, is the access the milk industry has to health facilities and communities to promote milk substitutes.

Milk companies hang posters in hospitals, give gifts to women who have just given birth and even sponsor motherhood classes at community health centers. Dr. Olive says the industry suggests that bottle-fed children are smarter than those who are breast fed. But nothing is further from the truth he says - breast-fed children score higher in intelligence tests.

There also are incentives for health workers and doctors to promote milk-formula, such as trips for doctors, electric fans for local health workers and free T-shirts, a form of advertising. When others people see the shirts they are told they can get one if they collect wrappers from formula cans.

Doctor Olive says promotion and advertising are allowed under what is called the Philippine Milk Code. Only one other country allows this under its milk code - Nicaragua.

The WHO has been working with the government to change the way the milk code is implemented, and Doctor Olive says the revisions should be completed by the end of the month.

In conjunction with this, the WHO is commencing a program to promote breast-feeding friendly health facilities in one thousand local administrative districts. The WHO says this is just a start to its efforts to get women nationwide back to breastfeeding.