Plummeting breastfeeding rates in East Asia “alarming” -expert

Posted on 3 May 2012


03 May 2012 12:29
Source: alertnet // Thin Lei Win

A baby sleep in a hammock inside a temporary house built after the 2004 Tsunami at Lok Kruet village, in Aceh Besar April 16, 2012. REUTERS/Beawiharta

By Thin Lei Win

BANGKOK (AlertNet) – Faced with plummeting rates of breastfeeding – a “natural vaccine” – East Asia must ensure workplace policies support the practice and must clamp down on the marketing of infant formulas, says a UNICEF expert.

Exclusive breastfeeding – meaning no other liquids are fed for the first six months of a baby’s life – significantly reduces national health costs and helps prevent malnutrition, UNICEF, the United Nations’ children agency, says.

However, as few as 5 percent of all Thai mothers breastfeed exclusively, while in Vietnam and China the rates are 10 percent and 28 percent, respectively, UNICEF says. The rate across East Asia and the Pacific in 2009 was below 30 percent, according to the World Bank.

“It’s alarming because we know there’s nothing that can replace breast milk for child survival, growth and development,” France Begin, UNICEF’s nutrition advisor for East Asia and the Pacific, told AlertNet.

The fact that more women in the region are entering the workforce without sufficient support for mothers, and “aggressive marketing of infant formula in the region,” were behind the low exclusive breastfeeding rates, UNICEF recently said in a statement.

Diarrhoea and respiratory infection, common illnesses among infants in East Asia, are the main causes behind infant mortality in the region, she said. Infant mortality stands at 19 deaths per 1,000 live births there, according to UNICEF.

“Exclusive breastfeeding really has the potential to prevent those diseases because it increases the immunity of the child,” with breast milk acting like a natural vaccine, she added.


Emerging markets make up 73 percent of the $30 billion global infant nutrition market.

“Another alarming thing is that for many infant formula companies, the East Asia market is of great potential for them,” Begin said.

“They have immense marketing strategies so unless the countries are better equipped with (the International Code of Marketing of Breast-Milk Substitutes) and enforce it, we risk seeing a further decline in the breastfeeding rates,” she added.

“You … have companies promoting formula milk saying it’s as good as breast milk and it would give your child a good future.”

The code does not prohibit the sale of formulas, but prevents them being marketed on billboards and posters, prevents providing free samples in hospitals and health facilities and donating formula milk during natural disasters and emergencies.

Countries in East Asia have adopted the code but in various forms. It is enforced quite strictly in the Philippines but is only voluntary in Thailand.

Government enforcement as well as support from companies is essential, Begin said.

“It’s not a battle one can win if companies don’t step forward to respect that and comply,” she said.

“Some poor families may decide to spend a lot of money buying (formula milk) because they think it’s better and the high class does it,” Begin said. “And they may do it by spending less money on other important things like education or healthcare.”


Workplace policies often don’t support the practice of breastfeeding.

In China, many mothers migrate from rural to urban areas to find jobs and find it difficult to continue breastfeeding unless there is maternity leave of up to six months or a place at work to do so, Begin said.

Begin points to Vietnam, which has had impressive economic growth in the past decade, as a role model.

“The government is considering right now to see what they can do more to protect the children … and contemplating the possibility of having maternity leave (of) up to 6 months and this would boost the rate of exclusive breastfeeding to a certain extent,” she said.

She said the extension of maternity leave to one year increased breastfeeding rates significantly in Canada and Norway.

And there are other bright spots. Cambodia’s exclusive breastfeeding rates jumped from 12 percent between 1995 and 2003 to 74 percent in the 2006-2010 period.

This was due to education on the matter and strong community support for breastfeeding mothers, Begin said.