The Indonesian government has taken an important step in protecting the practice of exclusive breastfeeding with the issuance of Government Regulation (PP) Number 28 Year 2024.
On 11 August 2024, the Director of Nutrition and Maternal and Child Health, dr. Lovely Daisy, MKM, announced that this regulation prohibits the promotion of formula milk, which is stipulated in Article 33, as part of efforts to increase the success of exclusive breastfeeding in Indonesia. The regulation adopts the International Code of Marketing of Breast-milk Substitutes that has been introduced by the World Health Organisation (WHO) since 1981.
Ban on Formula Milk Promotion
This step was taken following reports that revealed violations of the code. These include inappropriate labelling, promotion in health facilities, and health workers’ involvement in promoting formula milk products. Cross-promotion between products was also a concern. Dr Daisy emphasised that stricter supervision and strict sanctions are necessary to ensure compliance with these regulations.
Multiple violations of the formula milk marketing code of conduct have been an important basis for this new government order. Since 1981, the WHO has issued an International Code prohibiting inappropriate promotion of breastmilk substitutes. However, its implementation in many countries, including Indonesia, remains challenging.
This regulation also requires the enforcement of sanctions for violators and further supervision of deviant formula milk promotion practices.
Long-term Health Benefits of Exclusive Breastfeeding
Exclusive breastfeeding is one of the most essential health interventions in improving a child’s overall well-being. Breast milk contains various bioactive substances that provide basic nutrients and important components that support the development of the immune, neurological and metabolic systems.
One key element differentiating breast milk from infant formula is its immunological components. Immunoglobulin A (IgA), which is present in large amounts in breast milk, serves as the baby’s first line of defence against pathogens in the environment. IgA works by coating the mucosal surfaces in the infant’s digestive tract. Therefore, it prevents bacteria and viruses from attaching and penetrating into the body’s tissues. In addition to IgA, breast milk also contains lactoferrin. Lactoferrin is a protein that inhibits bacterial growth by binding to iron needed by microorganisms to multiply. The role of these immunological components is crucial in reducing the incidence of respiratory tract infections, diarrhoea and ear infections in exclusively breastfed infants compared to formula-fed infants.
The Role of Breastmilk in Neurological Development
Breast milk is also rich in essential fatty acids, especially docosahexaenoic acid (DHA) and arachidonic acid (ARA), which are important components in forming nerve cell membranes. DHA and ARA are found in large amounts in the brain and retina. They are critical for cognitive and visual development. Studies show that breastfed babies have better cognitive development, including improved learning ability and memory, compared to non-breastfed babies. This link between breast milk and neurological development further emphasises the importance of exclusive breastfeeding in early life.
Mechanism of Metabolic Disease Prevention
In the context of metabolic disease prevention, breast milk plays an important role in regulating infants’ energy metabolism and appetite through the various hormones and growth factors it contains. The hormone leptin plays a role in regulating appetite and energy balance, preventing obesity later in life. In addition, components such as adiponectin, also present in breast milk, help improve insulin sensitivity and reduce the risk of type 2 diabetes. These long-term effects are largely related to the influence of breast milk on the composition of the infant’s gut microbiota. This plays a key role in metabolic regulation and inflammatory response.
The Impact of Breastfeeding on Maternal Health
Not only does breastfeeding benefit the baby, but it also provides several health benefits to the mother. Breastfeeding helps lower the risk of breast and ovarian cancer, which has been documented in numerous epidemiological studies. Breastfeeding induces lactational amenorrhoea, which reduces the mother’s estrogen exposure, thereby lowering the risk of breast cancer. Research has also shown that longer breastfeeding is associated with a reduced risk of osteoporosis in menopause. This is because calcium lost during breastfeeding is replaced after the lactation period ends. In addition, breastfeeding helps mothers regain pre-pregnancy weight faster through increased calorie burning during milk production.
Health Education on Breastfeeding and its Impact
Education on the importance of exclusive breastfeeding should be a priority in maternal and child health services. Through regulations such as PP 28 Year 2024, the government not only protects breastfeeding practices from unnecessary interventions from the infant formula industry but also ensures that true and accurate information about the benefits of breastfeeding is delivered to the public. Health workers play an important role in supporting mothers to exclusively breastfeed by providing appropriate guidance and resisting the promotion of breastmilk substitutes that can undermine a mother’s confidence in breastfeeding.
Have a pressing question for a doctor? Medical Channel Asia has launched a community forum page where you can get questions answered by a medical specialist. Visit the community forum here.
