Political Will

Expressed Commitment Theme

Senator Pia Cayetano is an example of a breastfeeding champion who has used her position in the national government to protect, promote, and support Philippine women’s right to breastfeed.
She is the youngest woman elected Senator in the history of the Philippines and is a member of a prominent political family, both her brother and father are/were Senators, another brother is an ex-city councilor and the third is a former Barangay Chairman (local government unit) and a current congressional representative. She defines herself as “a staunch breastfeeding advocate” and is well known for her pursuit of women and children's rights. She has over 387,000 likes on her Facebook page and 529,000 followers on Twitter (both figures continually rise), where she regularly updates about breastfeeding-related legislative issues and her charity “Pinay in Action”, which is dedicated to improving the lives of Filipino girls and women through empowering activities such as all-women sporting events, fitness clinics, and inspirational talks and seminars on women’s health, anti-violence against women and breastfeeding.

Senator Cayetano has given numerous speeches in support of protecting, promoting, and supporting Philippine women’s right to breastfeed.  Most speeches centered on women’s rights for breastfeeding protection during emergencies or humanitarian disasters, breastfeeding in the workplace, and paid maternity leave. 

Breastfeeding protection during emergencies or humanitarian disasters

In 2011, Senator Cayetano raised awareness for the need for maternal protections in the event of an emergency or humanitarian disaster. She cautioned against the distribution of breast milk substitutes in disaster situations and the need for local government units and relief workers to be responsive to needs of nursing mothers who take shelter in evacuation centers. “Nursing mothers must be encouraged to breastfeed while staying in relief centers and even after they return to their homes when the risk has subsided. This is to ensure that their children will continue to receive proper nutrition and protection against disease outbreaks from nutrients that could only be supplied by mother’s milk,” she said, adding “Our evacuation centers and relief efforts must be gender-responsive and ready to care for the particular needs of women and children since they are among the most vulnerable whenever disaster strikes and communities at risk are forced to evacuate.” This is a critical issue for the country because roughly 20 typhoons hit the Philippines every year. (Reference #2).

Breastfeeding protection and breastfeeding in the workplace

The Philippines celebrate World Breastfeeding Month every August.  Ahead of World Breastfeeding Month, Senator Cayetano's regularly delivered speeches to the Philippine Senate to garner attention for breastfeeding issues. Her speeches have addressed World Breastfeeding Week themes and highlighted the country’s achievements as well as identified country challenges in protecting, promoting and supporting breastfeeding. She has spoken about the role of the government in guaranteeing adequate and responsive legislation that bans the advertisement, promotion, and sponsorship or marketing of infant formula.  She has called upon the Department of Health to look into illegal practices that were still occurring despite stringent breastmilk substitution legislation.  She has focused on the protection and support for breastfeeding mothers by asking the Government and employers to ensure compliance with the Republic Act 10024 (Expanded Breastfeeding Promotion Act of 2009).  She has outlined upcoming activities, highlighted other prominent breastfeeding advocates, including other senators, and launched the Senate’s first breastfeeding /lactation room (Reference #1, 3,4,5,6).

Paid Maternity Leave

In 2015, Senator Cayetano proposed a bill to extend maternity leave in the Philippines to 100 days. (Reference #6, 7) On two occasions, while introducing her Expanded Maternity Leave Bill to the Senate, Senator Cayetano expressed public commitment to breastfeeding. She took the opportunity during these two speeches to promote the benefits of breastfeeding, highlighting the scientific evidence to support the argument that longer maternity leave leads to increased breastfeeding rates, which in turn leads to better health outcomes for mothers and children.  She used the UNICEF/Alive & Thrive policy statement on Maternity Leave (Reference # 10) as part of her evidence base for legislative action. She also invited her colleagues to visit the photo exhibition outside the Senate chamber featuring breastfeeding mothers, most of whom were government staff, including the Senator’s own Chief of Staff, Deputy Chief of Staff, personal assistant, and other members of staff.

Media attention

Senator Cayetano’s efforts garnered extensive media attention. She was interviewed in the media several times about her proposed Expanded Maternity Leave Bill. One news headline highlighting the passing of the 100 Days of Maternity Leave bill in the Philippine Senate on January 2016 stated “Senator Pia Cayetano, chairperson of the Senate Committee on Women, Children, Family Relations and Gender Equality and sponsor of Senate Bill No. 2982, said the current allowable maternity leave is less than the 98-day minimum requirement of the International Labor Organization (ILO).” This article also highlighted that the bill states that private sector workers will not receive less than two thirds of their normal wage. (Reference # 8)

Senator Cayetano’s commitment to improving maternal/child health and nutrition in the Philippines was captured in a UNICEF Philippines press release about the legislative advocacy forum UNICEF hosted at the Philippine Senate, specifically on maternal/child health and nutrition.  Senators Pia Cayetano and others were present to support the agenda. (Reference #9) Sen Juan Edgardo Angara stated, “We will pursue strong legislation to ensure growth and development to their full potentials. This is a very meaningful window for both houses of Congress to pass important legislation supporting this advocacy, because maternal and child nutrition and health touch on issues of social justice and inequality.” The Department of Health, National Nutrition Council, Department of Social Welfare and Development; and NGOs World Vision, Save the Children and International Care Ministries were all present.  A similar forum at the House of Representatives took place just after the Senate one.  These forums were organized by the Philippine Legislators’ Committee on Population and Development (PLCPD), which Cayetano and Angara chaired and vice-chaired respectively.

References:

  1. Official Website of Philippine Senator Pia S. Cayetano. (2010). Give breastfeeding moms a (lactation) break! February 17, 2016
  2. Breastfeeding in Evacuation Centers. (2011).
  3. Official Website of Philippine Senator Pia S. Cayetano. (2013). Let's Embrace a Breastfeeding Culture. February 17, 2016
  4. Official Website of Philippine Senator Pia S. Cayetano. (2014). Breastfeeding- A Winning Goal for Life. February 17, 2016
  5. Official Website of Philippine Senator Pia S. Cayetano. (2014). Breastfeeding A Security Issue.  
  6. Official Website of Philippine Senator Pia S. Cayetano. (2015). Breastfeeding and Work, Let's Make It Work! 17 February, 2016
  7. Official Website of Philippine Senator Pia S. Cayetano. (2015). Extend Maternity Leave to 100 days. February 17, 2016
  8. Official Website of Philippine Senator Pia S. Cayetano. (2016). Senate OKs 100 Days Maternity Leave Bill.   February 17, 2016
  9. UNICEF. (2015). UNICEF launches child nutrition advocacy with Senate, House [Press release].
  10. UNICEF, Alive & Thrive. (2013). Maternity Leave: All Asia-Pacific Countries can Implement Six Month Paid Maternity Leave.

In 2011, First Lady Michelle Obama launched a breastfeeding campaign to support nursing mothers. The campaign recognizes the health benefits of breastfeeding and identifies its association with lowering the risks of childhood obesity, which coincides with Mrs. Obama’s “Let’s Move!” initiative.  Mrs. Obama said that early intervention, including breastfeeding, was key in preventing obesity. She cited needing more breastfeeding education, specifically for women in predominately black communities, according to Mrs. Obama, “40% of [black] babies never get breastfed at all.” She also has pushed for more hospitals to be certified as “Baby Friendly” and more flexible workplace rules for breastfeeding. Mrs. Obama has been very open about breastfeeding her own children and this is generally recognized to be the first person in the US with the First Lady's stature or power that has embraced breastfeeding so publicly.
           
References:

  1. Toby Harnden, Liza Meckler. (2011). Michelle Obama urges women to breastfeed. The Telegraph.
  2. http://www.unicef.org.uk/BabyFriendly/News-and-Research/News/Michelle-Obama-calls-for-more-support-for-breastfeeding-as-part-of-anti-obesity-campaign/

The Brazil MOH established an initiative to implement special rooms to support breastfeeding.  The Breastfeeding Support’s room is a space within companies where women can express her milk. This milk is kept in a freezer at a controlled temperature until the end of the day. At the end of the day, the woman can take her milk home to be offered to the child or she can donate it to a Human Milk Bank. 

Reference:

  1. Brazil Ministry of Health, National Health Surveillance Agency. (2015). Guide for deployment rooms to support breastfeeding for working women.

During 2013, the Midland District Health Boards Shares Service Agency (HealthShare) commissioned the New Zealand Institute of Rural Health to carry out the ‘Midland Region Rural Maternity Services Consumer Engagement Study’.  District Health Boards (DHBs) are responsible for providing or funding the provision of health services in their district.  HealthShare, a cooperative partnership between five DHBs (out of 20 DHBs countrywide), commissioned the study to identify areas where improvements could be made to ensure rural women had equitable access to Midland’s maternity services.  The study looked specifically at the experiences of Maori women, assessing whether there were maternity workforce issues, and understanding the relationship between primary care/general practice and maternity services.

The study recommended the need for a mobile phone app for pregnancy and birth which should be provided free to newly pregnant women. The Midland Maternity Action Group (MMAG), a clinical network within HealthShare who led regional activity on delivery of maternity services including implementation of maternity actions, undertook the development of a breastfeeding app. The primary objective of the Breastfed NZ app was to find a more consumer friendly way to support the work of Baby Friendly Hospital Initiative (BFHI) and the Ten Steps to Successful Breastfeeding (The Ten Steps). 

The resulting app, BreastfedNZ, is a free source of breastfeeding help, information and support.  It covers a multitude of topics - benefits of breastfeeding, learning how to, common problems, support, effects of drugs, going back to work and weaning.  The purpose of this app is to provide simple ‘in the moment’ support and information to help women and their babies, especially those in rural areas, alongside their partners and support networks, achieve their breastfeeding goals from birth to weaning.  It is written in a" conversational" style to make it more personal for the reader and it includes personal stories and photos from mothers throughout their breastfeeding journey, as well as links to other networks and organizations for further information. 
                       
The app was launched in August 2015 and as of April 2016, the app had been downloaded 4000 times.

References:

  1. Ministry of Health, New Zealand. (2014). District Health Boards.  
  2. Midland Maternity Action Group. (2015). BreastfedNZ.  

The Texas Department of Health developed a free app, the Health Care Providers Guide to Breastfeeding, to serve as a clinical resource guide on breastfeeding for health care workers including physicians, nurses, and dietitians.  It was developed as part of the Ten Steps to Successful Breastfeeding initiative and was peer reviewed by experts in lactation and maternal and child health.  The app offers evidence-based protocols and recommendations on lactation assessment, drug interactions and treatment of common maternal and infant conditions, however some of the resources are specific to Texas.  There is no internet access needed except where an external link is provided.  This app is available from the App Store and Google Play.

Reference:

  1. Texas Department of State Health Services, Nutrition Services Section. (2015). The Health Care Provider's Guide to Breastfeeding.  

As mentioned in benchmark PWG1, Senator Cayetano of the Philippines is an example of a breastfeeding champion who has used her position in the national government to protect, promote, and support women’s right to breastfeed. She was the principal author of the Expanded Breastfeeding Promotion Act, which allows for paid breaks for mothers to express and store their milk and requires employers to designate private areas, with refrigerated storage facilities and other amenities, for this purpose.  She also sponsored: a) the Expanded Maternity Leave Bill, developed by the Senate Committee on Women, of whom she is Chair; b) a bill to ensure there is one midwife in every health station per 5,000 people, in order to help the Philippines reach its Millennium Development Goal of improving maternal and neonatal health outcomes, c) a resolution asking the legislature to launch an inquiry into Milk Code violations and d) succeeded in getting “gender provisions’ into the ‘Philippine Disaster Risk Reduction and Management Act of 2010’, which sets out the implementation of a program to train humanitarian aid workers and other sectors involved in disaster work about how to support breastfeeding before and during a disaster or emergency.

References:

  1. Sixteenth Congress of the Republic of the Philippines. (2013). An Act Mandating the Appointment of One Midwife For Each Barangay, and For Other Purposes
  2. Senator Pia Cayetano. (2013). A Resolution Directing the Senate Committee On Health and Demography to Conduct an Inquiry, In Aid of Legislation, On The Implementation Of Executive Order No. 51, Otherwise Known as the National Code Of Marketing Of Breastmilk Substitutes, Breastmilk Supplements and Other Related Products, Republic Act No. 7600, Otherwise Known as the Rooming-In and Breastfeeding Act Of 1992 And Republic Act No. 10028, Otherwise Known as the Expanded Breastfeeding Promotion Act Of 2009.
  3. Breastfeeding in Evacuation Centers. (2011).