Q&A: Dr. Marini S. Tabon-Esguerra calls for breastfeeding support, education
IN celebration of the National Breastfeeding Awareness Month this August, Sun.Star Weekend had a one-on-one with a certified breastfeeding specialist, Dr. Marini S. Tabon-Esguerra. A mother of two, Marini’s interest in breastfeeding started when she has trouble breastfeeding her own kids. “I started studying it for my own knowledge, but I quickly realized the need to make information and support about breastfeeding accessible and widely available,” she shared.
Here’s what Dr. Marini has to say on her advocacy on breastfeeding.
Why should moms breastfeed their children? What are its benefits for the child and the mother?
Dr. Marini: Human milk is the natural food for human babies, but breastfeeding is not just about nutrition. It is one of the most important factors that ensure the survival of our species throughout evolution. If a species is not able to provide good nutrition to its young, how will the subsequent generations grow up to contribute to society?
There are no benefits to human milk consumption, only risks due to not being breastfed (Linda Smith, IBCLC). A non-breastfed child has a higher risk to suffer from gastroenteritis, pneumonia, allergies, asthma, speech delay, malocclusion (teeth not fitting nicely in the mouth), obesity, leukemia, breast cancer… the list goes on and on. The health of the child’s immune system may be compromised.
The economic burden of the cost of treating these diseases is unexplored in the Philippines. In each household that consumes artificial milk for babies (milk formula), how much is spent to buy the milk formula, its safe preparation (powdered milk is not sterile), healthcare costs, wages lost due to absences from work to take care of a sick child and buy medicine, hospitalization, lowered IQ that may lead to suboptimal academic performance, etc.? For premature and sick babies, how much is lost when human milk cannot be provided? In centers where pasteurized human milk can be provided for preterm and sick babies, there is a lower number of days of hospitalization and lower number of complications.
Breastfeeding families, especially those who do the Kangaroo Mother Care (KMC) or baby wear, also benefit in the psychosocial aspect. A child who is closely bonded to his or her mother no only has earlier development of language and social skills but also has a lower risk of abandonment, child abuse or neglect. The baby has an increased chance of survival because of a closely bonded family unit — a unit with psychosocial support in the face of the stress of daily life.
Breastfeeding mother also have a decreased risk of post partum hemorrhage, osteoporosis, breast cancer, maternal depression and diabetes. They also have improved child spacing. Discoveries are made each day on breastfeeding medicine. It has existed to nourish our species for thousands of year and now we are rediscovering it. That’s why I believe that breastfeeding medicine should be part of the curriculum of all health professionals’ training, especially doctors, nurses, midwives and nutritionists. The ramifications of not being able to breastfeed spell a lifetime of risks for both the mother and the baby. Not breastfeeding also negatively affects the environment — that is, the cost and waste in the production of artificial milk, paraphernalia to administer the artificial milk and finding safe water areas especially in disaster-prone areas.
Happily, interest and support for breastfeeding in many organizations and groups has been steadily growing. A sustainable system of providing breastfeeding support needs to be developed at the community level and education of the healthcare providers is of paramount importance.
Can you give us tips on breastfeeding?
Education is key! Pregnant moms and their families should arm themselves with good information by attending a breastfeeding or mother’s class. The most important things to learn are good positioning and attachment and the qualities of colostrum. At around an hour after being born, the baby will naturally crawl to the mother’s breast and breastfeed all by himself. He will then be able to get the immunoglobulin rich colostrum that will serve as his first immunization. This is called Unang Yakap. When I do breastfeeding classes, the mom always get teary eyed when they watch the video. There should be non-separation of mom and baby from the moment of birth. The moms should set the stage for the baby to breastfeed every time the baby shows hunger signs. Do not wait for the baby to cry before feeding! Imagine being so hungry that you’re driven to tears! The baby should breastfeed for as long and as frequent as he or she can — unli-latch!
Why do you think some people don’t like moms who breastfeed in public?
In the course of evolution, our species has been conditioned to see breasts as a sign of good health and being able to feed the young — this ensures the survival of the species and is seen as attractive. Other signs of good health and ability to care for the young are healthy hair and skin, good teeth, etc. This concept has evolved into thinking of the breasts in a sexual manner. Sadly, many have forgotten the breast’s evolutionary purpose which is to feed the baby human and more are reluctant to admit that the function of the breast is to produce breast milk and to deliver it to the mammalian baby. Other mammals haven’t forgotten, though.
Breastfeeding is the natural way to feed babies and whatever kind of mammal. Human baby is to human milk. Cow baby is to cow’s milk. Goat baby is to goat’s milk. Even whales and dolphins breastfeed their young too! If a mom is unable to directly breastfeed her baby, she should be assisted in expressing her breast milk and giving it to her baby by some other way.
For example, by using a spoon to trickle feed or drip-drop feeding or through a breastfeeding supplementer to allow physiologic feeding by cup feeding or spoon feeding – not bottle feeding because it may cause nipple confusion. The next options in order are pasteurized human milk from a donor and the last is the artificial baby milk or milk formula.
What are the common reasons why moms stop breastfeeding their babies?
One of the most common reasons why some moms stop breastfeeding is returning to work. Republic Act 10028 mandates that breastfeeding moms are entitled to 40 minutes breastfeeding break for an eight-hour work day.
This is in addition to their lunch break. All public places, workplaces included, should have breastfeeding stations. Moms can easily store their milk in a bucket filled with ice to bring home for their baby to use the next day. Breast milk can be stored in a clean covered container in the refrigerator for three days, longer in the freezer.
What piece of advice would you give to new moms out there?
Arm yourself with knowledge! You already have all the parts needed to breastfeed: breast + baby. Support is important — it takes a village to breastfeed. Identify your support group: fathers, lolas, titas, sisters, etc. Know that you are not alone. Somewhere out there, someone is laughing, crying and stressing out like you. Someone is also marveling at the little newborn wonder and the strength of a mother’s love just like you. Ask for help.