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Tuesday, March 29, 2011

Signed IRR for RA10028 - a setback!

One year after Republic Act No. 10028 or the Expanded Breastfeeding Promotion Act of 2009 was signed in to law, the Implementing Rules and Regulations have been signed! But there was a major change made in the signed IRR. During the Breastfeeding TSEK launch, advocates from various groups talked about writing a letter to speed up the issuance of the IRR. Then we received information that the IRR was to be signed shortly, pending a single change to be made. Early this week, I received a copy of the IRR with advocates highlighting the major changes - which was deemed as a setback to the cause.


Under Republic Act No. 10028, the minimum requirements for the provision of lactation rooms are as follows:
Sec. 11. Establishment of Lactation Stations. - It is hereby mandated that all health and non-health facilities, establishments or institutions shall establish lactation stations. The lactation stations shall be adequately provided with the necessary equipment and facilities, such as: lavatory for hand-washing, unless there is an easily-accessible lavatory nearby; refrigeration or appropriate cooling facilities for storing expressed breastmilk; electrical outlets for breast pumps; a small table; comfortable seats; and other items, the standards of which shall be defined by the Department of Health. The lactation station shall not be located in the toilet.

In addition, all health and non-health facilities, establishments or institutions shall take strict measures to prevent any direct or indirect form of promotion, marketing, and/or sales of infant formula and/or breastmilk substitutes within the lactation stations, or in any event or circumstances which may be conducive to the same.
Apart from the said minimum requirements, all health and non-health facilities, establishments or institutions may provide other suitable facilities or services within the lactation station, all of which, upon due substantiation, shall be considered eligible for purposes of Section 14 of this Act.
However, in the Implementing Rules and Regulations, the minimum requirements established by the law (which the IRR are supposed to implement and explain ONLY) were amended!
Section 10. Minimum Requirements in the Establishment of Lactation Stations. - It is hereby mandated that all health and non-health facilities, establishments or institutions, which have at least 100 women of reproductive age working in the establishment or institution, including public places, shall establish lactation stations. Lactation stations shall be accessible to the breastfeeding women. It shall be adequately provided with the necessary equipment and facilities, such as lavatory for hand-washing, unless there is an easily accessible lavatory nearby; refrigeration or appropriate cooling facilities for storing expressed breast milk; a small table; comfortable seats where the mother can hand expressed and eventually electrical outlets for breast pumps; and other items, the standards of which shall be defined by the Department of Health. The lactation station shall be clean, well ventilated, comfortable and free from contaminants and hazardous substances, and shall ensure privacy for the women to express their milk and/or in appropriate cases, breastfeed their child. In no case, however, shall the lactation station be located in the toilet.
The IRR now included a minimum requirement of 100 women of reproductive age working in the establishment or institution for lactation stations to be established! This is such a high requirement! In my own institution, we are almost 4000 employees, with only about 600 women of reproductive age. That's about 15-20% ratio - so to have 100 women of reproductive age, a company must have about 500 employees! I have a copy of the first draft of the IRR and this minimum requirement was not included. I was also informed that this was a highly contentious issue during the IRR preparations and discussion and was eventually struck down for being discriminatory to women.

In the US Patient Protection and Affordable Care Act, the minimum requirement is 50 employees (employees - male and female and not just women of reproductive age)! Plus for companies/institutions with less than 50 employees, exemptions are granted only if it can be proven that the establishment of a lactation station would be an undue hardship, taking in to account each specific employer in comparison to the size, financial resources, nature and structure of the employer's business.

I can't help but think about the "discrimination issue" in light of a recent study I read last week, entitled "Spoiled Milk: An Experimental Examination of Bias Against Mothers Who Breastfeed". Findings are as follows:
Results showed the breastfeeding confederate was rated significantly less competent in general, in math and work specifically, and was less likely to be hired compared to all other conditions, except for the sexualized breast condition. Importantly, the breastfeeding mother emphasis and the sexualized breast emphasis resulted in equally negative evaluations. Results suggest that although breastfeeding may be economical and healthy, the social cost is potentially great.
This study was done in the US, but in light of the "100 women of reproductive age requirement", the discrimination issue against women is becoming more and more possible. Unlike the US law - where the minimum number of 100 employees (whether male or female, whether old or young) is the basis, in the Philippines, an employer will definitely think twice about hiring a WOMAN of a certain age. I hope Secretary Ona will re-think and take out this minimum number of women employees requirement.

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