Mother's milk

Breast milk is widely accepted as the most nutritious and cheapest food a mother can give to her newborn baby. But what happens if mothers are unable to provide it?

Bussarawan Teerawichitchainan

Malee is a young mother of two. Economic pressure pushed the construction worker back to work as soon as her youngest daughter was three weeks old. Her strenuous job robbed her of all her time and all the breast milk she could have been giving to her baby during her critical period of development.

The uneducated mother fed the baby sweetened condensed milk which was the only kind of dairy product she could afford.

Now her daughter is three years old and suffers from malnutrition. She is much smaller than her peers and has learning difficulties.

The story of Malee and her daughter is sad. But it is a tragedy that has befallen many Thai infants in recent years.

"If the girl received substitute powdered milk, her life could have been different," said Boonlom Khansaksalarn, a social worker at the Holt Sahathai Foundation.

Apart from babies born to families with financial difficulties, babies of many unwed and HIV-positive mothers also face a similar situation, she said.

According to the social worker, the problem is critical at the moment as the country's economy is nosediving while the prices of imported commodities, like powdered milk, are skyrocketing.

Jinda is a young mother with Aids. She breastfed her daughter even though she knew the baby could contract HIV from it.

She said she had no choice as she was too poor to afford powdered milk. Now the girl is three years old and falls ill constantly. It is highly likely that she will be HIV positive.

"Forget about powdered milk. Many families don't even have enough money to buy food," Jinda said.

In recent years, various government departments have had a policy of providing powdered milk to children born to HIV-positive mothers. However, budget cutbacks now mean a shortage of powdered milk available to these mothers. This is confirmed by recent news that hospitals could be allowed to receive donations of milk formula from manufacturers to cope with the shortfall. However, there are concerns that these babies run the risk of being used as "guinea pigs" to test new milk formulas if the programme goes ahead.

Cutbacks are affecting almost every sector concerning children.

"Each year we can help only a small number of children and parents who want powdered milk. The budget has been set for years and it doesn't cover the increasing number of needy people," said an official of a community health centre in Bangkok who asked not to be named.

The centre can offer each infant only 1 to 2 kg of powdered milk a month. But a normal baby needs up to 3.6 kg a month, she explained.

To cope with the shortfall, it refers cases to non-governmental organisations.

The Holt Sahathai Foundation was among the first children's organisation to have an official fund to buy powdered milk.

According to social worker Boonlom, the foundation has provided powdered milk for needy mothers since its establishment in 1976. But it was not until 1994 when the problem became worse that its "Powdered Milk Fund" was officially set up. So far, it has helped over 3,400 children.

"For years we have worked with downtrodden families and unmarried mothers. Financial problems threaten the good nutrition children should receive," she said.

Many parents turned to cheap sweetened condensed milk or rice soup with sugar added. Even today when knowledge of infant nutrition is more widespread, many parents still do this if they cannot buy powdered milk for their babies.

For the foundation, helping these parents does not mean giving them powdered milk free of charge. They sell it at a price affordable to the parents.

"This can range from 5 baht per bottle to 30 or 40 baht. We do this because our aim is not only to solve the short-term problem of making sure their infants have proper milk to drink. We aim to rehabilitate their family and their life," said Boonlom, who is head of the foundation's family rehabilitation programme.

To pay even as small a sum as a few baht is to show responsibility towards their children. Social workers will decide how much the mothers should pay depending on their family income.

"Most of the people who come to us are females. They may be mothers or grandmothers. Most of them are the wives of unskilled labourers or workers themselves," Boonlom said.

According to the foundation's regulations, they provide powdered milk from when the baby is born until they are 18 months old.

"Children of one year and a half can get nutrition from other kinds of food apart from milk. Anyway, the period can be extended on a case-by-case basis," she explained.

They have to do this in order to cover as many babies as possible on their limited budget.

The foundation also has support groups and rehabilitation programmes for mothers who seek help.

"They come to our foundation twice a month to receive the milk. When they come, we have a one-hour discussion group for mothers. The topics we discuss range from how to raise a baby and how to manage the family budget to moral issues and social problems they are facing," the social worker said.

The things taught can be as mundane as how to clean milk bottles or as abstract as the process of contraception.

Take Nuthong Suwan, a 24-year-old mother of two. She admits that she gets a lot of support from the group.

She was having a nervous breakdown after the birth of her second child who had heart disease, bowel deformity and voice cord paralysis.

"It was a sudden shock. My neighbours told me that the child could not live long. My husband's salary of only 4,500 baht was not enough for the treatment," she said.

In the first few months, her son, "Bank" stayed at the hospital more often than he was at home. This caused her breast milk to dry up. She had no money for her son's operation, let alone for powdered milk. She and her husband had no relatives in Bangkok who they could turn to.

"I was very desperate then. Fortunately, I was introduced to the foundation. The moral support from the social workers there help me a lot," she said.

With the foundation's help, Nuthong can buy powdered milk for her son at a cheap price instead of the retail price of over 800 baht a month. They also referred her son to Rajvithi Hospital where he received medical treatment.

Now Bank is 10 months old and has undergone a bowel operation. He is getting better although his physical and mental development still lags behind other babies his age. His mother pays close attention to him.

"I wish he will become a normal child one day. I will never lose hope in him again," the Si Sa Ket native said.

Not many underprivileged mothers are as lucky as Nuthong. In such an economic crisis as Thailand is currently experiencing, the Powdered Milk Fund is also having a hard time. They are facing a milk price hike and a huge increase in the number of babies needing help.

"In 1997 alone, the average price of powdered milk increased three times. Early last year, the average price was 47 baht, then 65, and finally 75 baht a bottle. As the baht is still volatile, it seems that the price could go higher," said Boonlom.

The soaring price of powdered milk means that the foundation's annual expenses now total over one million baht compared to 800,000 baht in previous years.

According to statistics provided by the social worker, the number of babies receiving support from the fund reached 300 last year.

Boonlom accepts that this year they will experience greater difficulties.

"Despite all the problems we are facing, I don't think we can stop helping these mothers and babies," she said. "Every child has the right to grow properly. If their parents fail in this task, we as a society need to help."

To make a donation to the Powdered Milk Fund, contact the Holt Sahathai Foundation at 850/33 Sukhumvit 71, Bangkok 10110. Call 381-8834-6 or fax 381-8837. You can deposit money into saving account number 063-2-07716-5 at Thai Farmers Bank, North Nana branch.

Other organisations providing powdered milk for needy mothers and babies include:

Foundation for Slum Child Care, 100/771-775, Klong Toey Block 6, At-narong Road, Klong Toey, Bangkok 10110. Call 249-4589 or fax 249-5956.

Foundation for Children (Baan Taan Tawan), 666 Charoen Nakhon Road, Klong San, Bangkok 10600. Call 438-9331-2 or 438-0353-4.

Dulnimit Foundation. Call 381-7595.

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