Babies and children are top priority when disaster strikes.
When natural calamities end up displacing hundreds of people, one of the first
calls to go out or be offered is formula milk donations.
Two weeks ago, the Visayan region of the Philippines was hit
by what is touted to be the strongest typhoon ever recorded in human history.
The storm surge that came along with it killed thousands and leveled several
areas, stripping people of their homes, schools, churches and hospitals.
Hundreds of thousands of people scattered over several provinces are left
without food and shelter and yet, why are formula donations being banned by the
government?
There are several inter-related truths that provide
rationale for this particular policy:
1. Most mothers start out breastfeeding their children.
Based on experience over several strong typhoons, most that end up in evacuation
centers are either breastfed and mix-fed. Few babies below the age of six
months are completely formula dependent. Thus, the need for formula donations
is not high and one the government can certainly address.
2. Studies show that 50% of formula fed babies run the risk
of requiring hospital treatment in emergency situations, mostly due to
ill-prepared formula that will be inevitable in shelters where clean water,
sterile equipment and a steady supply of the formula are hard to come by.
Usually, evacuees are deluged with donations in the first few days but are left
wanting in the weeks, maybe even months, to come. The reality is that mothers
sometimes end up preparing formula using rain or portalet water or diluting it
so much that it causes water intoxication in their babies. Most people have not
made the connection that formula is called precisely that because it has to be
prepared a certain way for it to be beneficial.
3. Getting mix-feeding mothers to relactate, new mothers to
exclusively breastfeed, and parents to wean their toddlers/preschoolers off
formula/bottle feeding reduces the risks posed by ill-prepared formula. The
simple act of giving milk using cups instead of feeding bottles or getting
toddlers eating more solids are more practical and sustainable strategies in
emergency situations.
4. There is a system in place that allows formula fed babies
to get formula at evacuation centers and temporary shelters. These babies are
neither forgotten nor allowed to die. Hopefully, those identified to have no
other option but formula will also be monitored. However, when more mothers
exclusively breastfeed, the few formula-dependent babies left can be better
provided for with age-appropriate milk and other resources and information
necessary to ensure safe formulation.
5. Resources are a challenge post-calamity, even if a family
does not end up in an evacuation center. Communication lines may be down for a
while. Water pipes busted. Supplies like gas or milk may be out of stock. In
tent cities, clean water is often scarce and a family might not be able to get
enough to wash and sterilize feeding bottles, what more have enough to prepare
formula with. Congestion may also increase the level of humidity, expediting
milk spoilage.
6. There is no wisdom in providing hundreds of cans of milk,
or including a box of milk per prepacked baby kit to all families in an
evacuation center since formula has to be age-appropriate and only babies under
age 1 truly rely on milk as their main source of nourishment. Unfortunately, if
formula is given to a breastfeeding family, they will use it, even if they were
already breastfeeding successfully. If powdered milk is given to each family,
they will use it, even if they were not milk drinkers previously. Such has been
the indoctrination of some societies,
like ours, that people actually think formula is a safer, better food for their
baby. For some, it is even a status symbol.
7. For the same price per can, private citizens or organizations
could be providing one to three days worth of food and water to families in
calamity zones and temporary shelters. The percentage of infants is always very
low (and again, most that stay in evacuation centers are breastfed to some
degree) so it is more practical to channel funds to feeding all members of a
family, instead of just one, or providing them with shelter, clothes,
medicines, etc. It also makes no sense for centers to be flooded with free
formula while families struggle to get drinking water, cook their food or
clothe themselves.
8. Returning to their homes or relocation may be a long time
coming for evacuees which will pose challenges for the parents and the
government to sustain formula feeding. At best, the average Filipino family can
barely sustain the cost of formula for a whole year. Imagine how much worse it
would be for families left with nothing and no clear prospects for the future.
9. Thanks to a growing number of breastfeeding advocates,
the Milk Code is being observed better and better in the Philippines.
Unfortunately, this has not stopped milk companies from offering free milk
through hospitals and clinics. Milk companies are also known to freely
distribute samples by the can in schools, conferences and the like. This surely
suggests that should the government not have the budget to purchase formula for
the few babies per center that need it, our leaders can still appeal to these
companies to provide the milk because they can afford to give them freely.
Private citizens and organizations, out of concern for babies, need not spend
for them at all. Unfortunately though,
milk companies in the country seem to have a problem with donating unbranded
cans to the Department of Health (per Milk Code stipulation) as well as taking
on the task, even if they can afford it, of providing free milk indefinitely
for evacuees that need it.
10. Formula feeding eats up resources in already compromised
living arrangements. It eats up gas and water that could be used for cooking.
It requires soap (or salt). It is a monthly expense. It takes up space and
requires light (as proven by a mom who mistakenly used gasoline in preparing
her baby's milk, accidentally killing her child). And because formula feeding
increases risks for certain diseases (diarrhea, ear infection, allergies) that
living in a shelter compounds, there will also be medical costs and it may even
cost lives. Add to this again the burden of spending so much to provide for one
member of the family while leaving the others malnourished and it becomes a
vicious cycle of health issues.
11. Donations are hard to manage, track and properly
distribute in our country over an average typhoon, what more a catastrophe that
wiped out entire areas. Pre-packaged baby kits with a formula in each bag will
have to be repacked, otherwise other babies will be put at risk. All formula
cans would have to come with the necessary accessories, otherwise, it will put
babies at risk. Prevention by banning formula donations reduces logistics
nightmares, public health issues and loss of lives for the government.
12. 16,000 children age five and below are estimated to die
every year in the country from diseases that are linked to formula feeding.
This number will surely rise when measures are not taken to control formula
feeding (especially in cases when babies are beyond age 1) and closely monitor
formula distribution in shelters.
13. The ban on milk donations is not about breastfeeding
being superior to formula feeding. It is about the greater good in a time of
chaos and limited resources. Breastfeeding and formula feeding are also not
just feeding issues, but during war and calamities, both become bigger public
health issues.
14. The people who will be left in evacuation centers are
the truly marginalized ones, without family or friends who can take them in.
Post-Yolanda, we are looking at thousands of families. Not only will they be
short of funds (which will challenge again the sustainability of formula
feeding), they will have limited options. Some of these families also have
multiple children of varying ages where it becomes all the more critical that
fewer or none will be reliant on powdered milk for sustenance and nutrition.
This references to the growing trend of milk-dependent toddlers/preschoolers when
eating solids is most beneficial for them.
15. The difference with calls for breast milk donations and
milk letting drives is that the breastfeeding groups behind these ensure that
donated breast milk is not compromised (cold chain project) as opposed to the
usual unmonitored distribution of formula without the necessary paraphernalia
and information. Donated breast milk is also pasteurized and given through the
use of cups, which makes it safer than formula. Perhaps, because breast milk
donation is very personal in nature, its advocates take more care in making
sure nothing gets wasted, as opposed to a general donation of formula wherein
cans might be left under the heat of the sun or water used in formulation might
be dirty. Donor milk is also not distributed indiscriminately because the goal
is always to ensure safe and sustainable feeding so its recipients usually are
moms in the process of relactation or babies who have been separated from their
mothers.
The government and concerned agencies are just looking out
for these children and their families for the short and long-term. The
international standards are rigid because it has been proven time and again in
emergency situations all over the world that indiscriminate formula donations
just create problems and cost lives.
Now, people who really want to help these babies can send
cash donations instead to trusted agencies or send food, care and emergency
shelter kits for their families. Let us relieve the parents of some of their
immediate worries and burdens, so that they can care for their children better.
And may these truths reassure everyone that this stance the Philippine
government has taken is a good one.
Needless to say... I am looking forward to Play Pilipinas (