(2 of 2)
Macapagal-Arroyo is not the first Philippine president to come out in support of breastfeeding. In 1986 President Corazon Aquino signed into law Executive Order 51, the National Milk Code designed to implement the objectives of the WHO's 1981 International Code of Marketing of Breast-milk Substitutes, which bans virtually all forms of advertising and marketing of infant formula, as well as forbidding milk-company representatives from contacting pregnant women and mothers, or distributing gifts to health workers. In its annual meeting in 1974, the WHO determined that breastfeeding was in decline around the world, and soon after drafted the Code as a non legally binding framework within which countries can enact their own national laws.
The International Baby Food Network (IBFAN) regularly publishes its "State of the Code by Country," classifying nations by their compliance. The Philippines gets the organization's highest rating, having "implemented most of the Code and subsequent World Health Assembly resolutions by means of a comprehensive law, decree or other legally enforceable measure." India and Sri Lanka also top the list. Developed countries Hong Kong, Japan, Singapore and Taiwan come in low, having only instituted a few voluntary provisions, and the U.S. is in the words of IBFAN founder Annelies Allain "at the bottom of the pile." Its position in the lowest category 9 indicates that the country has taken no action to implement laws that would protect breastfeeding or restrict the marketing practices of the formula-milk companies.
Part of the challenge of implementing pro-breastfeeding legislation, in the developing world, has been the amount of resources and the determination needed to see the process through. In August this year Vietnam's Health Ministry announced the discovery of dozens of violations of the country's formula labeling rules. In its latest Breaking the Rules, Stretching the Rules report from 2007, IBFAN documents over 3,000 Code violations, committed by 12 companies in 67 countries, and collected since 2004.
In reality, after the signing of the Philippines' own National Milk Code, "the implementation was spotty, irregular, not done consistently," says Health Undersecretary Alexander Padilla. Held up by legal complaints from milk companies who saw the code as an unlawful affront to their industry, the domestic law went through 12 drafts over 19 years. "We went through public hearings, consultations; we even tried to process the complaints of the milk companies until when we couldn't agree on anything anymore, they brought the case to the Supreme Court," says Padilla. The milk companies' efforts finally lost the case when the Supreme Court declared on October 9, 2007: "The framers of the constitution were well aware that trade must be subjected to some form of regulation for the public good. Public interest must be upheld over business interests."
Asked how breastfeeding advocates in other nations can follow her country's example, Henares-Esguerra has this advice: "Promotion, protection, and support. You have to do all three together you can't do one without the other." As the synchronized breastfeeding participants and nursing mothers around the world know, the right to breastfeed is something worth fighting for.