The Story of Milk

I was finally able to get and upload Judy's powerpoint presentation on the story of milk. Judy wrote the story line while the art and animation is by Sam Leon. Watch and share!

Story Of Milk

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What I Learned From The Milk Code Forum

Last Saturday, I was happy to have attended the Milk Code Forum organized by Arugaan, in cooperation with UP WinLaw and UP Volunteers for Children. It was a packed day, with several speakers. The coordinator/facilitator was Nanay Ines of Arugaan and she had the entire room decorated with various breastfeeding posters.

The forum started with a brief welcome by Unicef's Elham Monsef. She focused on the theme of this year's World Breastfeeding Week and discussed how the promotion of formula during emergencies displaced the breastfeeding moms. She also emphasized that in times of calamities, formula donations should not be given directly to breastfeeding moms, but rather be coursed through the Department of Health who will then determine whether a certain mom really needs it or whether giving her this formula will just curtail her breastfeeding relationship. Elham stressed the need to strengthen the 3 pillars of breastfeeding - protect, support and promote; and rued the loss of the culture of breastfeeding in the Philippines.

The forum participants were also lucky to hear Dr. Anthony Calibo's discussion. Dr. Anthony Calibo is the Philippine Medical Tourism Manager of the Office of the Undersecretary for Special Concerns, Department of Health. Dr. Calibo is also a practicing pediatrician and is connected with St. Luke's Medical Center. He discussed his experience as a medical student (on how breastfeeding is superficially discussed) and as young resident, who was bombarded by marketing strategies of big milk companies, in hopes that he will be swayed to support them. Dr. Cabilo emphasized that breastfeeding information should be given even by the ob-gynes and believed that pediatricians have a role in prenatal care (e.g. if only to advise the mothers about breastfeeding and rooming-in). He wrote a research paper on the top things that ob-gynes discuss with their patients and sadly, breastfeeding is not included in the list. It is really a sickness of the medical practice - to rely on milk companies/big pharmaceutical companies to support medical conventions - and thus be susceptible to marketing gimmicks or strategies thrown back to the doctors.

Part 2

Formula Milk for Toddlers

For older babies, even if extended breastfeeding is considered to be beneficial, the milk companies attempt to manipulate consumers that by giving their children formula milk, they are getting something better. If you notice, all of the formula milk ads are targeted towards toddlers and preschoolers. In the US, the American Academy of Pediatricians recommends whole cow's milk for children beyond one and not formula. However, in the Philippines, we have formula milk for almost everyone!
Dr. Francesca Tatad-To,* respected pediatrician-neonatologist AND breastfeeding advocate shares her thoughts on this matter. Please note that this post is for informational purposes only and this is no substitute for medical advice given after an actual examination by a board certified doctor of your particular case.

Formula is unnecessary in children who are older than 1. At this age, children are expected to have a full/complete diet which may or may not include full cream fresh milk.
Fresh milk is the standard dairy recommendation for children older than 1 who are no longer breastfed, and the American Academy of Pediatrics actually recommends low-fat milk for ALL children (Except malnourished ones) older than 2.

As infant formula was originally designed to be a breastmilk replacement/alternative, children who have weaned naturally and no longer require breastmilk should not require formula either.

In most countries, formula sold is really only for babies 1 and below. It is only in countries like ours where the commercial demand is strong that formula manufacturers take advantage and try to create an even bigger demand through marketing, etc.

The average toddler formula is higher in calories than full cream fresh milk and this is not a good thing. These extra calories are usually from sugar and fat, not from any added 'special nutrients'. In fact, toddler and preschool formula is often the culprit in young children who are obese and who have poor diets. The typical caloric requirement for a toddler is 1000-1200 kcal/day and the majority of this should be coming from solid food. The recommended limit for dairy/milk intake for children older than 1 is 16-24 oz or 2-3 cups a day only. This means that a toddler taking 3 cups of milk a day will already consume 40-50% of his calories in milk, leaving 50% for food. Giving your child toddler formula almost always ensures that he/she will get more fat, sugar and calories than he/she needs.

Also, it is common for children who exceed the recommended milk intake to develop iron-deficiency anemia. This is because cow milk protein causes a little bit of bleeding in the gut and larger amounts of milk translates to bigger blood loss. Many parents don't know this but this is a common concern of well-trained pediatricians and is found in all our medical textbooks.

There is a lot more information available in books and online. If you look at the recommended Food Pyramid for children, you will see that there is no recommendation for formula here either.

Indeed, a lot of research has shown that formula (actually milk for that matter) is unnecessary in children who are older than 1. In fact, even Dr. Sears believes that milk is not necessary and experts generally believe that milk is just an easy and convenient source of calcium, protein, fats, vitamin D (if fortified).
Hopefully, Filipino moms will realize that we do not really need to purchase those formula milk to make our children healthy or smart. To be honest, being "panatag" (secure) is just an excuse to be lazy and not attempt to teach or encourage your child to have a healthy diet. As Dr. Zeka pointed out, there is no recommendation for formula in the Food Pyramid.


Furthermore, just because Nido claims to have less sugar (70g) doesn't mean it is better than the other brands or than regular milk for that matter. The 70g sugar is still extra sugar that your child will do without if you choose to give him regular milk or other foods to provide whatever "nutrients" s/he is supposed to get from Nido.
Whether or not you decide to include milk in your family's diet is your choice. But again, really, FORMULA MILK IS NOT NECESSARY. It is really high time for Filipino consumers to be educated and bust those formula milk myths.

*Dr. A.M. Francesca Tatad-To specializes in pediatrics and newborn medicine. She also serves as medical consultant to L.A.T.C.H.
*The opinion that toddler formulas are unnecessary is also shared by this American doctor.

Part I of this Post is here.

So called nutrition for Toddlers

Do toddlers still need to be given formula milk?! (a.k.a Breastmilk v. Formula)

Recently, the issue of the hazards of cow's milk (including formula) cropped up in my peer counselor group and another local mother's group I'm part of. One of the moms was worried about the effects of formula milk (or hormonized cow's milk, as she calls it) that her daughter was taking. Her pediatrician had patients who were menstruating at 4 and 7 years old - and the pediatrician thought it was because of the milk they were taking (the mom required the child to take 8 glasses to make up for the low food intake). Meanwhile, another mom (who continued to breastfeeding her 18 month old baby - yay! :D) was worried that her toddler was not getting all the required vitamins and minerals - she had been bombarded with the commercials for formula milk (and we have plenty!! DHA? ARA? +7 IQ points?).

During the Milk Code Forum I attended last Saturday, one of the presenters, Judy, had a terrific presentation on the story of milk. She emphasized that because of the great demand for milk, dairy farmers are doing everything to boost their cows' milk production - by adding hormones which for sure eventually ends up in the milk that we drink. Judy also shared that even if companies say that they've tested the milk for contaminants and did not find any, there are other contaminants not being tested or detected! There are about 60 or more chemicals/medicines injected into cows but only the presence of 6 (in the end-milk product) is being tested. And this is only for the regular milk! Formula milk undergoes more processing for it to be converted into milk "suitable" for babies. To mimic breast milk, milk companies then add synthetic DHA and ARA (from cultured algae, etc.) to the powdered milk. The formula milk is exposed to more contamination risks (BPA, melamine, salmonella, etc.) during the processing, canning and preparation process. No wonder our generation's hormones are totally whacked out - with menstruation even starting at age 4!!!
In my response to the breastfeeding toddler's mom, I shared how milk companies earn P42B from Filipino consumers which is why they spend P1B in marketing their products. I got those figures during the Milk Code Forum from Nanay Ines of Arugaan. Obviously, each milk company wants to get the biggest chunk of that P42B pie - which is why they are aggressively (and unethically) marketing their products.
With the passage of the Milk Code's revised rules and regulations, milk companies recognized that they can no longer actively market products targeted for babies below 1 year old, to preserve their "good image". The superiority of breast milk of formula has been settled and established. Detailed comparisons are available here and here. There is even a downloadable brochure of stacked blocks which show how far away formula milk is from breast milk, particularly in terms of nutritional content. So, they directed their attention to older babies.

To be continued... Part 2.

Unicef on WBW 2009 - Breastfeeding a crucial priority for child survival in emergencies

UNICEF joined the World Alliance for Breastfeeding Action in commemorating World Breastfeeding Week, 1-7 August 2009, through the release of this video which underscores the vital importance of breastfeeding during emergencies.

You can read UNICEF's press release here. Two things struck me most in that press release.

"Globally, only 38 percent of infants under the age of six months are exclusively breastfed".
The Philippines' 2008 National Demographic and Health Survey (NDHS) has just been recently publicly released and I am sad to read that the Philippine statistics are even lower than the global rates. Although the headline states that 50% of Filipina moms breastfeed, this number refers to babies at 1-2 months. According to our Secretary of Health Francisco Duque III, "the 50 percent breastfeeding rate in 2008 was down from 53 percent in 2003; the same study showed 34 percent of infants below six months are being exclusively breastfed." Actually, the 34% rate refers to babies at 2-3 months. I was able to obtain a copy of of the 2008 NDHS survey and the results are more dismal. At 4-5 months, only 22.6% are exclusively breastfeeding, despite the UNICEF's (and other experts') position that breastfeeding provides the best food for a baby’s first six months of life.

"More damaging is the common donor impulse to send infant formula or breast milk substitutes to disaster zones"
When I was single and not breastfeeding Naima, I was guilty of this same practice. Actually, even during the early months of breastfeeding Naima, I was likewise guilty of propagating the formula culture. I had cans and cans of formula leftover since I was already making enough milk for Naima. My mom's secretary had a baby two months older than Naima and was think of weaning at 6 months. I did encourage her to continue breastfeeding, but I guess my encouragement was not enough and what was even more damaging was that as I eventually sent her all my cans and bottles of formula.
In hindsight, I should have thrown out all those formula instead of giving them away. This is also the reason why I don't advice new moms to buy even just a small can of formula "for reserve" or for "just in case". With the Filipino trait of being frugal/thrifty, you will certainly be tempted to use the formula or give it away.