Maternal love transcends all boundaries -- including distance.
Kulthida Methanuchit calls herself a "long-distance mum". Every day, she pumps her breast milk at home and at her office in Khon Kaen, so she can have it delivered by air to her seven-month-old baby in Bangkok.
Ms Kulthida, 31, said that she and her husband are committed to feeding their first daughter breast milk despite their domestic situation. "Whenever we have to go back to Khon Kaen to work, she stays in Bangkok with our parents," she said. To overcome the distance, Ms Kulthida -- at the recommendation of her doctor -- opted to join a free, breast-milk delivery service.
"Each day, I extract my breast milk and store it in the freezer. On pick-up day, I wrap the bottles in newspaper and pack them into a polystyrene box filled with ice packs," she said.
"My breast milk is then sent from Khon Kaen by air to Bangkok every two or three days. The flight takes about an hour, and my parents in Bangkok collect the milk at the airport."
Ms Kulthida said that despite low levels of lactation, she has managed to send her breast milk to Bangkok 42 times so far.
"I almost gave up because I was producing so little breast milk, but I overcame my doubts and soldiered on," she said.
Ensuring a continuous supply of breast milk for her daughter is a way of making up for her frequent absence.
"I feel happy when I do it because I'd do anything for her," she said.
Another beneficiary is Mana Nammanee, 35, who uses the courier service to feed his five-month-old daughter with his wife's breast milk.
"My wife works in Bangkok. She pumps and freezes her breast milk every day so she can have it delivered to Khon Kaen every two weeks," he said.
"We are committed to our decision, because breast milk is not only more nutritious than powdered milk but is also cheaper."
Mr Mana said the decision to feed their daughter exclusively with breast milk for six months was initially opposed by his parents.
"At first they were worried that the milk would go bad during delivery, plus they were accustomed to supplementing their children's diet with semi-solid food, such as rice or banana puree." he said.
"They changed their minds after seeing how our daughter is growing."
The breast milk delivery service is provided free of charge for families in Khon Kaen, Roi Et, Mahasakhum and Kalasin. The service, which kicked off at the start of this year, is a collaboration between the Regional Health Promotion Centre 7 Khon Kaen, Thai AirAsia, and several local transport service providers.
To help support the cause, The United Nations Children's Fund (Unicef) has also launched a nationwide campaign to promote breast feeding in the first 1,000 days of a child's life.
LACK OF AWARENESS
Dr Amporn Benjaponpitak, the deputy director-general of the Department of Health, says breast milk is a mother's greatest gift to her child.
"Not only is it a rich source of nutrients, the act of breastfeeding also creates a lifelong bond between mother and child," she said.
"Unfortunately, a lot of mothers miss out on this opportunity due to distance, and sometimes also ignorance."
Although the breast milk delivery service can be very helpful to working mothers, Dr Amporn insisted there is no replacement for direct breastfeeding because it helps foster a strong mother-child relationship.
"The precious bond is formed when a mother touches and looks at her baby while breastfeeding," she said.
"Furthermore, breast milk contains antibodies which are crucial for the development of the child's immune system. Freezing the milk prior to delivery degrades these antibodies."
As such, Dr Amporn urges new families to choose direct breastfeeding over baby food and formulas.
"We don't want them to take precedence over breast milk," she said.
"Remember in the past, when infants were fed with condensed milk?"
According to a 2016 report by Unicef Thailand and the National Statistical Office (NSO), about 40% of Thai babies are breastfed within one hour of birth. Around 23% are exclusively breastfed for six months, and 13% are breastfed for two years.
The Public Health Ministry is aiming to double the number of babies that are exclusively breastfed for six months by 2025.
Anongluk Srisaenpang, a registered nurse at the lactation clinic of Khon Kaen's Regional Health Promotion Centre 7, offers advice for successful breastfeeding.
"A mother should breastfeed her baby within an hour of birth because it helps stimulate lactation. The infant should be nursed immediately when its mouth and face start inching towards the mother's breast. Each breast should be completely drained to encourage further lactation," she told the Bangkok Post.
Ms Anongluk said that many mothers give up on breastfeeding when they develop painful symptoms from mastitis.
"Mastitis happens when a milk duct gets blocked and inflamed," she said. "To prevent mastitis, the mother must continuously change her breastfeeding position so the baby can drain all of her milk ducts."
"Breastfeeding requires a lot of commitment," she added.
"It is more difficult than bottle feeding, but is definitely more rewarding."
CONTRIBUTING FACTORS
Breastfeeding rates in Thailand remain low because of a number of contributing factors, which include hospitals' post-partum policy and the influence of the baby-formula industry.
Dr Chompoonut Topochai of the Department of Health is concerned about hospitals that do not implement a rooming-in practice -- wherein a newborn baby is kept in the same room as the mother.
"This is a serious error, as rooming-in encourages breastfeeding within an hour of birth," she said. "It helps to stimulate the mother's instinct to lactate. Separation can effectively switch off this impulse."
Dr Chompoonut said that both state and private hospitals have been known to ignore the practice.
"While most state hospitals in the provinces have been instructed to implement the policy, there are others -- such as hospitals attached to medical schools -- that take away the newborn baby to be cared for separately after birth," she said.
"Top-tier private hospitals are more likely to encourage mothers to stay with their newborns, but unfortunately the rest often don't."
Dr Chompoonut said that the practice of separating mothers from their babies stems from a different approach to post-partum care.
"Many paediatricians believe that if a baby is kept with the mother right after birth, then the mother won't have enough time to rest and recuperate," she said.
"This is made worse by the fact that many baby-formula makers often sponsor hospitals to hand out their products."
Dr Chompoonut went on to say that bottle feeding should be discouraged as it inhibits the baby's natural instincts.
"Each method requires a different set of skills," she said. "Once accustomed to drinking milk from bottles, infants are less likely to suckle from their mothers."
DANGER OF EXCESS
Addressing the craze sparked by mums posting photos of themselves breast-pumping, Dr Chompoonut warned that unnecessary pumping can also have its dangers.
"Mothers should only pump their breast milk when they are unable to feed their children directly," she said.
"Working mums are advised to do it only in the afternoon, to ensure there is an adequate supply of breast milk to feed their children once they get home."
Dr Chompoonut also said that working mothers should wait for about a month after delivery before they start pumping and storing breast milk.
"Rushing into it may cause their bodies to hyperlactate, which can lead to painful mastitis," she said.
She also urged parents to be cautious about breast milk-sharing drives.
"While it is generous of some mothers to donate their surplus breast milk, we have to remember that breast milk, like blood, contains living cells," said Dr Chompoonut.
"It must be disinfected before it is distributed."
