The Age
July 9, 2007 - 11:24AM

The debate over whether new mothers should breast-feed entered the top Philippine court recently, with health officials claiming that aggressive advertising has many women believing that formula is better than their own milk.

With breast-feeding rates declining across Asia - just 35 per cent of mothers breast-feed exclusively for their baby's first six months - the Philippine Health Department last year proposed regulations to strengthen its national milk code.

The goal was to make it harder for formula companies to target parents of children under the age of two with advertising of products that claim to foster smarter, stronger babies. The earlier regulations banned companies from promoting products for infants younger than one year old.

"We have seen a dramatic decrease of our breast-feeding rates. We have seen an increase of the profits and sale of infant formula companies," Health Department Undersecretary Alexander Padilla said.

The Pharmaceutical and Healthcare Association of the Philippines has sued the government agency, arguing only Congress has the power to change regulations.

The Supreme Court initially backed the Health Department, but on appeal, it ordered a temporary halt to the stiffer rules, which also call for stricter labelling that would include warnings that formula could be harmful if contaminated and companies could face sanctions if they do not comply.

In June, both sides presented further arguments. PHAP attorney Felicitas Aquino-Arroyo told the justices that the new regulations were unconstitutional because the department had acted beyond its authority.

She said US-based milk companies Wyeth, Mead Johnson Nutritionals and Abbott Laboratories along with British-based GlaxoSmithKline, all represented by the association, stand to lose about $US208 million ($A248.55 million) if the stricter rules are enforced because they will be forced to change labels and destroy milk products already in circulation.

She argued the advertising ban also deprives women of a right to information that would allow them to freely choose whether to use formula or not.

"PHAP and the milk companies have been painted to look like corporate ogre, motivated by nothing more than corporate profits," she said after the court adjourned. "That is not the issue in this case. We are not battling breast-feeding."

About a dozen Filipina mothers lined up outside the court to protest against formula, which they say harms children. They bared their chests, which had been brightly spray-painted with slogans like "God's milk is life" and "Greedy milk companies."

The row has prompted the Washington-based US Chamber of Commerce to intervene. Its chief sent a letter to Philippine President Gloria Macapagal Arroyo urging her to re-examine the Health Department's plan or risk the country's "reputation as a stable and viable destination for investment."

Attorney Agnes Devanadera, representing the health department, argued that exceptions would be made to the ban for ads that a department committee says do not undermine breast-feeding or idealise breast milk substitutes.

"It is a matter of explaining to our people, for those who have forgotten, that there is no substitute for breast milk," she told the justices. "We are not prohibiting the sale of milk substitutes, but we are prohibiting the advertisements."

The World Health Organisation recommends mothers nurse exclusively for the first six months and continue providing breast milk along with complementary foods until age of two. Research has shown that babies given breast milk develop fewer respiratory and intestinal diseases, and those given formula have a greater chance of developing asthma or allergies later in life, along with obesity. WHO estimates up to 1.45 million children die annually in poor countries because of low breast-feeding rates.

Exclusive breast-feeding rates during the first four to five months have dipped from 20 per cent in 1998 to 16 per cent in 2003 in the Philippines, where more women with disposable income are working full time and juggling busy lifestyles like many women in the West.

But unlike mothers in the United States and the European Union, who are moving more toward breast-feeding in the first few months, many in rapidly developing Asian countries are abandoning the practice.

Thailand has the region's lowest exclusive breast-feeding rate during the first six months, with only 5.4 per cent of mothers nursing. Vietnam's rate has fallen from 29 per cent in 1998 to 15 per cent in 2002, while Indonesia dropped from 42 per cent in 1997 to 40 percent in 2002.