Artificial “Life Formula”: Georgian Mothers without the Right to Choose
Georgian mothers refuse to breastfeed their newborn babies and opt for bottle feeding. The authorities acknowledge that due to outdated legislature and ineffective control mechanisms it is impossible to regulate the breastfeeding of newborns. And, the businesses have taken advantage of the situation. Sofia Tetradze tried to find out how artificial formula managed to overcome the maternal instinct.
“On the first day, they wanted to take my baby and give him formula milk. I refused,”- this is how Ekaterina Pogorelova recalls her first day as a mother. Two years ago, in Gagua Clinic, no one told her about the benefits of breastfeeding.
Although there is no official date available, a small survey we conducted while preparing this material showed that Ekaterina is not the only one who had encountered such a problem. The women we interviewed complain that no one from medical staff encouragement them to breastfeed their babies.
“My friend, who is a pediatrician, brought me the booklets of World Health Organisation on complementary feeding. She convinced me that I had enough milk and formula was not needed. Earlier, a pediatrician from Iashvili Clinic checked the baby and without going into details, recommended me to switch to formula milk. She said that the whole America was feeding the babies with formula and that is was okay. I did not listen to her. We continued extensive breastfeeding up to six months,” told us another mother, Nata Bregvadze.
Everyone agreed on the benefits of breastfeeding long time ago. But practice shows that in most cases the medical personnel in Georgian medical facilities not only ignore the existing recommendations on breastfeeding, but often agitate in favor of artificial formula.
“Theoretically, we, the doctors know about the benefits of breastfeeding, but in practice it is not encouraged or recommended. Many women in postnatal period are prescribed artificial baby formulas. There are situations when a child may need formula, but not regularly. Statistics show that a lot of newborns who were discharged from maternity hospitals were fed with formulas there,” said Nana Rurua, director of the Babymed pediatric clinic.
Statistically, only less than 1% of mothers are unable to breastfeed due to lack of milk. All the rest are potentially ready and able to satisfy their newborns’ nutritional needs.
“The doctors regularly underestimate our experience with breastfeeding. My gynecologist told me that there was no benefit from breastfeeding and moreover it was harmful for baby boys, because the female hormones penetrate into their body through mother’s milk,” a woman told us.
By some tacit collusion, Georgian maternity hospitals in most cases disregard the National Clinical Practice Guidelines which clearly define the regulations for managing breastfeeding in hospitals. According to the document, the medical staff is obliged to regularly develop their skills and attend seminars, timely inform women in postnatal stage about the benefits of breastfeeding, help them during the first two hours after giving birth, and show the correct position for breastfeeding, give recommendations for maintaining lactation and encourage women to long-term breastfeeding.
According to guidelines, it is not allowed to give formula to newborn baby without sound medical evidence. It is also not allowed to offer dummies and bottles to babies who are exclusively breastfed. Pediatrician Nana Rurua names several reasons for given circumstances:
“Firstly, it is unprofessionalism of medical personnel. Secondly, many believe that formula feeding is easier than breastfeeding. And the third factor, which I do not want to believe, is the commercial interests on some medical personnel in light of ineffective control means. ”
However, the problems that many mothers encounter cannot be explained only by unprofessionalism of doctors. The head of the pediatric department at Gagua Clinic Nino Kamkamadze can briefly describe the benefits of breastfeeding and explain in details the effects of breast milk on babies. The main problem, as she believes, is the lack of public awareness on postnatal development of babies and almost complete unwillingness to receive knowledge in this area.
“It is impossible to convince a woman in two days to choose breastfeeding if she is unable to understand the difference between formula and breast milk. I personally organized a series of lectures on postnatal development of children. And you know how many people attended it? Only two families. And both were from European countries,” Kamkamadze said.
Certified neonatal nurse Dalila Melkonyan from Alemeda Center in San Francisco believes that due to insufficient knowledge Georgian mothers become more susceptible to influences from medical staff, who might be driven by certain business interests and advise mothers to switch from breastfeeding to formula milk of specific producers.
According to survey conducted by Georgian Ministry of Health in 2016, almost 71% of women began to breastfeed their babies after giving birth. The number of breast-feeding initiated in the first eight hours after giving the birth was 19.8%. And only 2.5% of mothers decided to feed their children within 24 hours after giving birth.
However, there are no available data on how long mothers feed their infants. Pediatricians say that the number of babies who are exclusively breastfed for over three months is very low. But, the World Health Organization recommends breastfeeding for at least six months.
The Georgian Ministry of Health responded to IWPR request with one paragraph, in which the agency acknowledged the existence of the problem.
“In the first 10 years (after the adoption of the Law on the Protection and Protection of Breastfeeding in 1999 – author’s note), intensive work was carried out to raise public awareness about breastfeeding. The trainings were conducted for medical staff, where they were taught practical skills in this area. Unfortunately, neither then nor now, there were no normative acts adopted that would help to monitor the situation. The law itself needs to be revised and upgraded. Consequently, it is necessary to develop the relevant legal base. All the questions you raised are put on the agenda.”
The ministry also added that while working on the issue a draft decree has been prepared. It provided for the formation of working subgroup under the coordinating council on maternal and child health issues. But, the decree has not been approved yet.
Meanwhile, the lack of proper information campaigns and encouragement from medical professionals stimulates the demand for so-called doulas (doula – is a trained companion during pregnancy and childbirth – author’s comment) and breastfeeding consultants. Ekaterina Mariposa, who is a founder of the Association of Professional Doula, said that the women in Georgia have to literally fight for the right to independently feed their babies.
“Take a rest! There is no milk on the first day anyway, so we feed your baby! This is what they tell women in maternity hospitals and immediately give babies bottles with formulas. The newborns are even unable to try colostrum, which precedes milk. It’s easy to suck a bottle, and once a baby is given formula it often gives up breastfeeding. “
Dalila Melkonyan , who occasionally attends childbirths in Tbilisi hospitals as invited specialist, believes that hiding information about the benefits of breastfeeding is not only unethical, but also contradicts the fundamental rights of women.
“No one has the right to give your baby formula without your permission, no one has the right to tell you that your body is unable to do something. Women should know that this is a violation of their fundamental rights. ”
But not everyone can afford a professional doula. Prices for experienced consultants significantly vary in different markets. In most countries, the bills go up to hundreds of US dollars. However, doulas are quite open to negotiating the price. Due to insufficient information, there is little trust in this practice. The main customers of Georgian doulas are women from Western countries who are already familiar with this service.
Georgian women, meanwhile, rarely question the expertise of physicians encouraging physically healthy and able women to give up breastfeeding.
“It shall be prohibited to carry out any advertising of artificial baby food products, except for complementary food,” – says Article 7 of the law of Georgia on Protection and Promotion of Breastfeeding and Consumption of Artificial Food. The law is quite outdated, but still existing.
Apparently, this is not a priority issue for the government. Meanwhile, the couples, who amid the social problems decide to have a baby, are forced to allot a substantial sum in their family budgets for expensive artificial formulas, on which their children become dependent from the first days of their life.
* The content of this publication /article does not reflect the official position of Conflict, Stability and Security Fund (CSSF), United Nations Development Fund for Women (UNIFEM) or Institute for War and Peace Reporting (IWPR). Responsibility for the information and opinions expressed in the material lies entirely with the author (s) of the publication.