A nurse helps a new mother breastfeed.
It is uncommon to see children above the age of two being breastfed. But two-and-half year-old Thanapat Piemnoree enjoys being breastfed.
“I will breastfeed him until he wants to stop,” said Wijitar Meesawad, his 33-year-old mother. Wijitar works at a hospital and usually pumps and stores her breast milk for the boy to drink during the day. When she returns home in the late afternoon, she breastfeeds him again.
“What I like the most about breastfeeding is the feeling of bonding. He loves to be around me.”
Every Mother’s Day, which is on Friday this year, the subject of breastfeeding and its benefits return. How one feeds one’s child is a matter of choice, though statistics show that only 12.3% of mothers in Thailand breastfeed their infants in the first six months — that figure accounts is among the lowest in the world and is the lowest in Southeast Asia.
Statistics also show that mothers who give birth in public hospitals tend to have a higher rate of breastfeeding than those giving birth in private hospitals. Mothers in Bangkok have the lowest percentage of breastfeeding in the country.
The importance of breastfeeding
“Breast milk is not only for feeding a child, but it also builds the baby’s immune system too,” said Dr Tanakorn Saranyapinyo, director of Wihan Daeng Hospital. He also adds that the oxytosin hormone released by the infant’s suckling is important to the process of mother-child bonding.
The World Health Organization (WHO) and Unicef recommend that mothers should start breastfeeding within the first hour of their babies’ lives and keep doing it exclusively for the first six months. They also recommend women breastfeed their children for at least two years and supplement breast milk with other nutritious foods starting in the sixth month.
Napat Phisanbut, Unicef Thailand’s communication development officer, added that breastfeeding is a key to sustainable development.
Earlier this year, the Lancet Medical Journal published an article stating that continuous breastfeeding increases a child’s IQ threefold or fourfold. Another long-term study, conducted in Brazil with 2,000 test subjects, has also shown that those raised with breast milk have a much higher IQ than those who are not breastfed.
Dr Sutheera Uerpairojkit, a paediatrician and infant expert at BNH Hospital, added that breast milk contains DHA, which supports brain development and protects neurological function so it’s good for children until the age of seven, as by then the brain is fully developed.
Dr Tanakorn added that breast milk also benefits the mother as it prevents postpartum haemorrhaging and reduces breast and ovarian cancer.
Breastfeeding also has an economic advantage, since it there is no cost involved compared to powdered milk, which can cost a few 1,000 baht a month.
Breastfeeding in Thailand
Despite the low percentage of breastfeeding in Thailand, there is an attempt to encourage mothers to adopt the practice. Wihan Daeng district in Saraburi is one of the areas that actively promotes this issue.
Wijitar Meesawad with her son, Thanapat Piemnoree, who enjoys being breastfed. Photos courtesy of UNICEF
At the district hospital run by Dr Tanakorn, the process of encouraging mothers to breastfeed starts from when expectant mothers enter antenatal care. The mother’s breasts are inspected and if they show any problematic signs in secreting milk, the hospital can attend to it in time. Throughout the pregnancy, a mother is required to join the parental school twice. On delivery day, nurses are in charge of advising mothers to start breastfeeding almost immediately.
The hospital sets aside a room for mothers to breastfeed or those who need power-pumping. “Miss Breastfeed” is a lactation consultant who is on standby to offer mothers advice through the hospital’s hotline.
At Wihan Daeng, attempts to promote breastfeeding aren’t only confined to the hospital but directed at the entire community. Volunteer staff are deployed to survey pregnant women and urge expectant mothers to join antenatal care. Once they have given birth, volunteers revisit them to ensure that they have no problem with breastfeeding.
This year, 49% of new mothers in Wihan Daeng breastfed their infants, a significant rise from 33% in 2015.
“The surge in breastfeeding is because mothers are now better informed of the importance of breastfeeding and any doubts on it have been clarified,” said Nucharin Jareonpol, a nurse at Wihan Daeng Hospital.
There are several negative beliefs about breastfeeding, such as a perception that some mothers don’t produce enough breast milk due to the size of their breasts. But clinically if they have been correctly stimulated, 95% can lactate regardless of breast size. On the other hand, if the breasts haven’t been stimulated, they can dry out quickly.
The marketing of breast milk substitutes
Last month, Instagram posts with the #glainommae (“similar to breast milk”) caused a buzz. It was an advertising campaign that implied the benefits of milk substitutes were similar to mother’s milk. On television, milk products are known for putting out advertisements depicting smart kids to convince parents in picking a premium powdered milk brand.
“The nutrients in other substitutes cannot be compared with what there is in breast milk,” said Dr Sutheera of BNH Hospital. “There are more than 200 nutrients in breast milk, which is best for an infant’s needs. The synthetic ones are not the same as in nature. Kids will also be at risk from diarrhoea if the water mixed with the powder is not clean enough.”
Even the Ministry of Public Health has issued an announcement on the International Code of Marketing of Breast Milk Substitutes following the code of the World Health Assembly, but it has never really brought it into practise. However, Thailand is now in the process of enacting a law to curb inappropriate marketing of breast milk substitutes.
“In the beginning, breastfeeding was not as convenient as compared to powdered milk, but I believe that if hospital staff can explain the benefits of breast milk and the drawbacks of not having breast milk, chances are they will find the best solution,” said Dr Sutheera.
Another reason why powdered milk is successfully sold in the country is because of the support of some hospital staff, continued Dr Sutheera.
Sairoong Noi-In, 36, who gave birth at a private hospital said a sample of powdered milk was given to her at the hospital. Sairoong’s daughter did not take to the powdered milk, so she ended up breastfeeding her for the first six months. To this day, Yanakorn Sichin, her two-year-old youngest daughter, is still being breastfed in addition to being fed other food.
“I found that my daughter hardly got sick compared to her older siblings, who weren’t breastfed as long as she was. She also has good development. I can also save a lot of money. If I raised her with powdered milk I would have to spend thousands on it. But with my youngest one, I can save this money for her education in the future.”
This source first appeared on Bangkok Post Lifestyle.