Jakarta, IO – Mother’s milk is the optimal food for babies. This is why the WHO has declared the first week of August each year as World Nursing Week. In Indonesia, the importance of supplying mother’s milk for the first thousand days of life is being championed in the effort to intervene against stunting.
According to the Indonesian Nutrition Status Survey (SSGI), the coverage of exclusive mother’s milk for babies 0-5 months old has stagnated within the past two years, with a coverage rate of 52.1% in 2021 growing to a mere 52.2% coverage in 2022. On the contrary, the Early Nursing Initiative (ENI) rose significantly from 47.4% in 2021 to 58.1% in 2022.
Meanwhile, the Ministry of Health found that in the first quarter of 2023, only seven provinces have achieved the target of 75% exclusive mother’s milk supply for babies: Aceh Darussalam, SCR of Jakarta, West Sumatera, Jambi, Bali, Lampung, and Special Region of Yogyakarta.
“Indonesia is working hard to lower stunting rate among children, currently at 21.6%, to 14% by 2024. We need to solidify stunting-prevention interventions before birth, and the transition into other foods after having exclusive mother’s milk for 24 months. These first thousand days are a crucial period of child growth, and we need to make use of it properly to prevent stunting,” stated dr. Endang Sumiwi, MPH, a member of the Ministry of Health’s Directorate General of Public Health, in the “World Nursing Week 2023” online press briefing held on Tuesday (8/8/2023).
“Actually, 18.5% of babies are born stunted. However, the stunting rate decreased to 11.7% among babies 0-5 months, rising back to 13.7% among babies 6-11 months old, and continued to increase to 22.4% among children 12-23 months old. In other words, the stunting rate rises significantly among babies 6-11 months old to 12-23 months old.”
An important thing to note is the 18.5% prevalence of stunting among newborn babies, which means that nutrition intervention for teenaged girls and pregnant mothers is necessary. Only 52.2% of all babies 0-5 months old are exclusively given mother’s milk in our country. With a 1.6 times spike in the prevalence of stunting during transition period (below the age of 24 months), babies require mother’s milk supplements rich in animal proteins.
“There are four principles in the feeding of babies and children: First, ENI, which will determine the success of the supplying of mother’s milk in the future. Second, the supplying of exclusive mother’s milk up to 6 months, without adding anything, even plain water. Third, the supplying of mother’s milk supplement foods from local ingredient family foods that have undergone chopping and pulverizing, that is the same as what the adults in the house eat. Fourth, continued supply of mother’s milk until the child is about two years old,” she stated.
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There have been numerous studies performed concerning the benefits of mother’s milk. Most of them confirm that this food protects babies from multiple types of infection, contains specific nutrients for the development of babies’ brains and eyes, and prevents uncommunicable diseases from appearing in the babies as they grow older.
Exclusive breastfeeding prevents unnecessary deaths. When compared to their peers who are exclusively breastfed, infants 0-5 months of age living in low and middle-income countries receiving: no breastmilk are 14.4x more likely to die; breastmilk with animal milk/formula/food are 2.8x more likely to die; breastmilk with water-based liquids is 1.5x more likely to die. In Indonesia, this saves the lives of 5,377 children each month, and saves up to Rp 3 trillion in medical costs, by preventing the onset of illnesses like pneumonia and diarrhea among children.
As for the mother, nursing her babies improves the quality of life for her and her baby, while strengthening the bonds between them. Even though it is very beneficial for both mothers and babies, 45% of female workers stop nursing their babies once they get back to work.
“When we look at the pattern of exclusive mother’s milk supply in Indonesia in 2017, we notice the drop in nursing in the third month after the three-month maternity leave ends. According to Statistics Indonesia, 52.74 million (38.98%) of female workers will get pregnant and give birth. We want these children to get the best nutrient for their survival, growth, and development – and that means feeding them mother’s milk. We need to support working mothers, so that they can exclusively provide mother’s milk to their babies until they are at least 16 months old.”
Finally, dr. Endang declares that mothers do not need supplements to increase their milk production, as long as they nurse their babies sufficiently frequently. “When a woman is nursing, her brain will order her body to generate cytosine and prolactin, which produces and issues the milk out of her body. All mothers can produce milk, as long as they notice the pattern of the baby’s sucking and their position of projecting. Give milk to the babies anytime – there is no need to stick to specific hours. What matters is that mother’s hydration needs are satisfied – she needs to drink up to 16 glasses of plain water a day,” she concluded.
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Separately, dr. Karina Widowati, MPH, UNICEF Representation for Indonesia, declared in the “Nursing Support for Working Mothers” webinar organized by the PW Fatayat NU of Central Java on Monday (7/8/2023), reiterating that a supply of mother’s milk helps to reduce mental problems among children and teens, especially when they are nursed properly as babies. “Challenges to nursing in Indonesia include the massive gap between policies or regulations concerning BMS (mother’s milk substitute products) marketing codes in the market, and less-than-optimal support for nursing mothers in the workplace. We need to solidify regulations concerning nursing protection, such as maternity leave and flexibility in selecting the time for such leave; the provision of a dedicated space for lactation; and time flexibility for when the mother nurses,” she said.
Then dr. Karina went on to declare that the provision of nursing rooms, sufficient rest time to nurse, and the policy of 14-18 weeks’ paid leave are important, low-cost steps that will improve the level of nursing, work productivity, and retention of nursing mothers. (est)