Let’s Talk About Breastfeeding!

3D, whenever we hear the word, surely we’ll be imagining seeing a movie with a special pair of glasses to see the motion pictures appear as if they’re right in front of us. An extraordinary sensation, that’s what we get after we see a 3D-movie. That’s exactly what the atmosphere like in the World Breastfeeding Week theme this year, Talk to me! Breastfeeding a 3D-experience


Mention the breastfeeding word, I bet the only thing pop up in our head is either a mother is breastfeeding her baby, or a mother who is busy having her pregnancy controlled at the doctor’s office then delivering the baby which follows by breastfeeding the baby, at the end the weaning process. Or we are thinking of a mother who always brings her baby to a health facility for immunization and checking the baby’s growth. Or imagining mothers who share experiences and problems in breastfeeding their babies. The main actor for the breastfeeding activity is the dynamic duo, the mom and the baby

But have we noticed? The couple needs supports from the people around them to achieve the success in breastfeeding.

The mother knows there are a lot of benefits in breastfeeding, for the baby and for herself. The mother also has the ability to breastfeed exclusively and continues for the next two years. However, is it enough? Knowing and wanting sometimes isn’t necessarily capable enough yet.

‘Isn’t capable enough yet’ because as the baby cries, the mother being judged not being able to calm the baby for the amount of breastfeeding milk isn’t enough yet. ‘Isn’t capable enough yet’ because the mother is being given a milk package by health officer as she comes back from the hospital. ‘Isn’t capable enough yet’ because the mother isn’t allowed to squeeze at work more than at break-time, lunches and a mother feels awkward to squeeze in public space.

Mom and baby need supports from all sides, starting from dad and other family members, colleagues at office, surroundings neighborhood and public places, the health officers in the health facilities, the government and its policies, for the success of breastfeeding.

There are ways required to breach boundaries, cross generations, sectors, gender, and culture to be able to share experiences and knowledge so it can spread like a breeze.

KomunikASI. That is the word to complete the fun adventure of 3D breastfeeding. Protect, promote and support the breastfeeding movement through breastfeeding communication (komunikASI). The fast way is to send across the breastfeeding information through the time and space limit. So easy with the instant technology nowadays such as Mailing-list, Facebook, Twitter, and BlackBerry messengers (BBM). Undeniable, Twitter makes it easy to spread the breastfeeding information.  BBM speeds up the search for solution and challenge in breastfeeding. These methods make KomunikASI easy


Let’s discuss these one at a time, Cross Generation and Culture


I remember my trip to Faroe Island, an autonomic country from Denmark. My team and I was taken to an elementary school to see how breastfeeding and how they feed the baby. The breastfeeding period has become the integrated part of the life cycle (same thing with pregnancy, delivering babies, growth and development). Breastfeeding becomes part of the series of health program which applied in the school. The subject is so familiar that children at this age talk about the importance of being breastfed and breastfeeding.


If you open the official website from the World Breastfeeding Week, http://worldbreastfeedingweek.org/, you will see lots of photos capturing the facilitators/instructors’ activities sharing about breastfeeding to young humans. Last October in the Global Breastfeeding Forum in Malaysia, Katherine Houng, a college/university student talked about how youth role in communicating breastfeeding (komunikASi). Last but not least, last April, the AIMI Chairman, Mrs Mia Sutanto, launched her first book titled, “Mom, what does little baby brother/sister eat?” which dedicated to very young children to give preliminary understanding  of a baby being breastfed.



Cross sectors and Genders


I will only take one of the examples. Does the three Ministries Decision Letter (SKB 3 Menteri) ring a bell? Let me refresh the letter, it mentions about the giving of breastfeeding milk during office hour at working place. That the three ministries : Ministry of Women and Child Protection, Ministry of Labors and Transmigration and Ministry of Health care about the working mothers who are still breastfeeding. This Letter focuses on two things; the giving of opportunity for working moms to breastfeeding dan/or squeeze breast for milk during office hour; and provide the space or a corner to squeeze for milk and/or breastfeeding. Each Ministry has duty and responsibility so that the breastfeeding information is being communicated (komunikASi) properly.


The wish is every person, every sector, every generation and every culture will be able to communicate (komunikASi) breastfeeding.  Whatever crossed your mind about giving support, promote and protect breastfeeding, just go for it! Even if it’s out of your league

Relactation to Those Who Wish to Swift from Formula to Breastfeeding

published in Tabloid Nakita – 622/March 2011 edition


Basically, we, the breastfeeding advocates are not the victims of polemic presence of bacteria E. Sakazakii in infant formula. With or without the news about this bacteria, we continue with our campaign: to support, promote and protect breastfeeding in Indonesia. Nevertheless, I must admit, this is a moment to remind the community on the importance of breastfeeding, and to return giving breastmilk.

Reason for not using breastmilk substitute:


  1. The formula milk ingredients. The formula milk comes from cow milk in which the composition has been altered similar to breastfeed milk. Unfortunately, the formula milk has been added un-natural composition which does not exist in cow milk such as DHA, AA, sfingomielin, lactofferin, etc. The cow milk composition is very limited compares to breastfeed milk and it doesn’t change according to baby’s needs.


  1. Bottles and nipples rubber. These tools contain of a kind of plastics that have to be hygienic and clean at all times. Therefore, these tools must be sterilized. To sterilize the bottles and nipples rubber, it requires some sort of fuels and water. Moreover, the use of nipples rubber causes confusion to the nipples itself (the condition in which babies are difficult to attach to their moms’ nipples while they are breastfeeding their babies directly). In addition, there will be possible early teeth dysfunctional.


  1. Sanitation and access to water. In order to make formulated milk there has the need to use clean and boiled water. For your knowledge, only less than 50% of Jakarta people have access to water pipe and 90% of these water has been contaminated by coli bacteria (according to BPS 2006)


  1. Nature and pollution. Bottles and nipples rubber need plastics, glass and silicon in the process which are all requires some recycling work. In the making they also need factories, distributions and packaging which cause pollution issues.


  1. The consumption illustration of this formulated milk on a baby requires a minimum of 7 cans per month at Rp. 60.000 per can. This means a mother has to prepare at least Rp.420.000,- per month. It leaves us to a question, what happen to the unfortunate poor people when they have to buy formulated milk?


Basically, we, the supporters for the breastfeeding movement aren’t the victims of this polemic, whether this news appear or not, we will continue stick to our campaign: to support, promote and protects the breastfeeding in Indonesia.


However, I must admit that this is one of the precise moment to re-invite people and jog their memory on how important the breastfeeding process to their children


What does this mean?


If a mother has an infant aged 0-2 years, she is able to perform relactation. A relactation is a practice of a mother returning to breastfeeding her baby directly from her breasts after a certain period of time she hasn’t perform any breastfeeding or partially breastfeed (combine breastfeed with food or drink other than breastfeed milk) for a reason.


Relactation can be started with a strong will to return to breastfeeding again. Mothers may take their husbands along and their other family members, perhaps the closest people to support mothers in performing relactation. The younger the baby the easier relactation can be done and work.


Relactation steps:

  1. Stop all uses of nipples rubber and bottles, give milk or other food by using a glass or spoon of your own, so the baby forgets about the nipples rubber and wants to sip from mommy.


  1. Increase physical skin contact between the mother and the baby. This skin contact may cause the lactation hormone to work as it is designed to fit the baby’s mouth in order to sip the nipples. Another uses is to be able to smell mother’s scent and tight a closer bond to the mother.


  1. When the baby starts to breastfeed directly from the mother, prepare an NGT hose or pipette to drop / channel the liquid into the container. Place the container in a higher spot than the mother’s breast. This container may contain cow milk or formulated milk which is being consumed by the baby at the time. Put the tip of the hose into the container fills with liquid, while on the other end is attached on the breast, right near the nipples. We do this stage so that when the baby closing in to the mother in a breastfeed position will not get frustrated with the amount of the breastfeed milk is still very little. This process also can lure the production of the milk as the baby’s sippimg may accelerate the hormone to work.


  1. Adjust the position and placement when breastfeeding. Find the right and comfortable position for the mother and the baby. If the baby feeling uncomfortable with the position (usually because he isn’t used to being breastfed) then spend time to get closer longer. Always communicate with the baby, engage a small talk about the lactation process that need to get through together.


  1. Ask someone for a favor to hold the cow milk container so that it goes through smoothly. If you are using a pipette, other can help by dropping the liquid right on top of the nipple. Make sure the drop doesn’t stop so the baby don’t get frustrated again. When no one is aroung, then hang the container around the mother’s neck, or just place it on the table.


  1. If the baby has been having other liquid than breastfed milk, for instance formulated milk, then use this milk as liquid in the relactation container. Little by little, reduce the amount of the formulated milk with breastfeeding milk, as the stimulation made by the baby to mom,  the breast will produce more milk and ready to pump.


  1. Pumping the breastfeeding milk. Producing milk from breast can stimulate the lactation hormone to start engaging again and increase the milk supply. Pumping the milk can be done after breastfeeding the baby directly (not before). Pumping can also be done by hand or pump tool


  1. Prepare the amount of time and high level of patience in doing the relactation process as this process can be measured by time frame. It all depends on the intention and effort made by each individual.


  1. Contact the Lactation Counselor nearby whenever mothers need practical assistance in applying the re-breastfeeding steps.


Then, for children above 2 years old, the breastfeeding will no longer be needed by thourough consideration that the children are old enough to eat the home-made meal with nutrional-balanced pattern.


Many people come up to me and ask whether or not they should be given milk? Milk is one of the protein, in which we can get from food such as soybeans, tofu, eggs etc.


Let’s think of the long term solution from this formulated milk contained bacteria. It’s not too late to return to breastfeeding milk, let’s save the future of the nation’s generation.


*from various sources

Kasih ASI? Tanya Saya!

Kemarin seorang teman berikan testimoni bahwa Pin ‘Kasih ASI? Tanya Saya’ (KATS) yang dipakainya membawa keberuntungan. Orang-orang sekitarnya menjadi tergerak bertanya tentang ASI karena melihat pin tersemai dikerah bajunya.

Ternyata tantangan tersendiri dalam membuat suatu alat kampanye, memerlukan waktu dan kreativitas tinggi. Ingin rasanya berbagi dibalik pembuatan kampanye Kasih ASI? Tanya Saya karena ini tidak sekedar kata-kata (baca: tagline) namun makna yang tersimpan. Berikut penjelasannya agar menjadi pembelajaran bersama.

Warnanya yang mencolok, perpaduan antara hitam dan oranye membuat menarik untuk dilirik. Pemilihan warna kontras didasari untuk tidak menggunakan warna-warna lembut khas produk ibu & bayi, seperti pink dan biru muda.

Tagline ‘Kasih ASI? Tanya Saya’ pun terkesan menantang siapapun yang melihatnya. Menantang untuk mencari tahu lebih jauh tentang hal yang awalnya agak canggung untuk ditanyakan karena bersifat pribadi. Kata ‘kasih’ digunakan karena mengandung  2 arti, memberi dan cinta. Dua arti tersebut menggambarkan proses menyusui yang memberi cinta tiada henti.

Logo ditengah, pasangan breastfeeding dyad – ibu dan bayi, sementara lingkaran berarti lingkungan yang mendukung menyusui mulai dari ayah, keluarga, kantor, petugas Kesehatan, dan Masyarakat. Dalam pembuatannya, logo ini mengalami beberapa kali perubahan dan pengetesan di Masyarakat.

Pin ‘Kasih ASI? Tanya Saya’ diciptakan* tahun 2007 sebagai tanda pengenal para konselor laktasi terlatih. Hal ini dilakukan agar masyarakat mulai bertanya tentang menyusui, dengan begitu konselor laktasi dapat memulai memberikan informasi relevan dan mencoba menggali permasalahan menyusui si ibu. Tanda pengenal ini juga berguna menandai seseorang  (baca: konselor laktasi) sebagai sumber informasi terpercaya dalam memberikan informasi tentang manajemen laktasi yang tepat dan lengkap.

Bertanya belumlah menjadi budaya orang-orang kita, khususnya menanyakan hal yang sekiranya sesuatu yang dianggap natural seperti menyusui. Jika seorang ibu merasa ASInya kurang, si ibu kerap berpikir, hal ini juga terjadi pada saudaranya, rekan kerjanya, tetangganya, dan tidak menganggap ini suatu permasalahan.

Dalam dunia menyusui, merasa-ASI-kurang merupakan akibat dari sebab yang beragam. Bisa saja karena posisi dan pelekatan saat menyusui yang kurang tepat, atau karena bayi yang kerap menangis dan ibu langsung mengasosiasikannya dengan jumlah ASI yang kurang, dan masih banyak lagi. Jika tidak segera ditangani atau dicari penyebabnya, maka akan berujung pada percaya diri ibu yang menurun, intensitas menyusui yang berkurang, dan gawatnya, beralih kepada cairan selain ASI.

Disinilah peran dari Konselor Laktasi yang dapat membantu ibu mencari penyebab dan inti masalah agar bersama mendapat solusi. Konselor Laktasi terlatih juga diharapkan dapat memberikan informasi yang relevan dan bantuan praktis yang dibutuhkan si ibu dengan cara konseling dan tanpa menghakimi atas apapun yang telah dan/atau yang sedang ibu lakukan. Kami akan duduk sama tinggi, berbagi, berdiskusi, dan berada disisi untuk berikan dukungan.

“Attributes of the peer counsellors included their friendliness, being women and giving support in a familiar and relaxed way” (Jolly Nankunda, 2009)

Jadi, bagi para Konselor Laktasi: gunakanlah kemanapun pergi, biarkan orang-orang sekitar melihatnya, menaruhnya dalam ingatan, memilah pertanyaan apa yang hendak ditanyakan, karena dikemudian hari tidak jarang anda akan mendapatkan orang mulai bertanya. Dan dengan begitu, sedikit demi sedikit budaya malu bertanya pun lenyap.

Bagi para ibu dan anggota Masyarakat lain: jika menemukan orang dengan pin KATS silahkan jangan segan untuk bertanya karena anda bertemu orang yang tepat yaitu Konselor Laktasi yang terlatih menjawab kekhawatiran anda dalam menyusui atau apapun yang berhubungan dengan manajemen laktasi.


*dalam kampanye Kasih ASI Tanya Saya, pin diciptakan bersamaan dengan poster, spot radio dan jingle.

Photo: Siti Mulyanni

Photo : Mercy Corps Indonesia

Relaktasi Bagi Yang Ingin Beralih Dari Susu Formula ke ASI

dimuat di Tabloid Nakita edisi Maret 2011 no. 622

Miris mendengar berita akhir-akhir ini dimana banyak ibu yang diwawancara mengatakan jika produk susu yang ia berikan kepada anaknya termasuk dalam produk susu formula yang berbakteri, maka dengan mudahnya mereka menimpali “ya saya cari merek lain yang tidak berbakteri, abis mau bagaimana?!”

Pertanyaannya, apakah kita bisa pastikan susu formula pengganti yang ibu berikan betul-betul aman dari bakteri sakazaki atau risiko lain? Bukankah tanpa isu berbakteri pun, susu formula sudah memiliki daftar panjang risiko tersebut? (lihat tulisan “Alasan Medis untuk Tidak Menggunakan Pengganti ASI di http://aimi-asi.org/2011/02/alasan-medis-pengganti-asi/)

Agar tidak terperangkap pada solusi jangka pendek tersebut (baca: mengganti dengan merek lain), mari kita lihat apa saja risiko lain dari penggunaan susu formula.

Selain terdapat serentetan alasan medis untuk tidak menggunakan pengganti ASI, masih banyak juga kerugian-kerugian lain dilihat dari faktor  kandungan susu formula, perlengkapan (baca: botol dan dot), sanitasi, alam, dan ekonomi.

  1. Kandungan susu formula. Susu formula berasal dari susu sapi yang komposisinya diubah menyerupai ASI. Susu formula saat ini sudah ditambahkan komposisi yang tidak secara alami terdapat pada susu sapi, misalnya DHA, AA, sfingomielin, lactofferin, dsb. Kandungan susu sapi sangat terbatas dibanding ASI. Dan komposisinya tidak berubah sesuai kebutuhan bayi.
  2. Botol dan dot. Botol dan dot terdiri dari plastik jenis tertentu yang harus selalu bersih dan higienis. Oleh karenanya, botol dan dot perlu disterilkan. Untuk mensterilkan botol dan dot diperlukan bahan bakar dan air. Ditambah lagi, penggunaan dot menyebabkan bingung puting (kondisi dimana bayi sulit melekat pada payudara ibu saat menyusui langsung) dan kerusakan dini pada gigi.
  3. Sanitasi dan akses ke air. Dalam membuat susu formula diharuskan menggunakan air bersih yang dididihkan. Untuk diketahui saja, kurang dari 50% penduduk jakarta punya akses ke air pipa, 90% air sumur dangkal terkontaminasi bakteri coli (menurut BPS 2006)
  4. Alam dan polusi. Botol dan dot memerlukan plastik, kaca, karet, dan silicon yang semuanya tidak dapat didaur ulang. Juga memerlukan pabrik, distribusi, pengepakan yang menimbulkan masalah polusi.
  5. Ekonomi. Ilustrasi perhitungan Konsumsi susu formula pada seorang bayi memerlukan minimal 7 kaleng/bulan @ Rp 60.000.  Berarti untuk seorang bayi dikeluarkan minimal Rp 420.000. bagaimana nasib orang yang miskin jika harus membeli susu formula?

Pada dasarnya, kami para pendukung gerakan menyusui bukanlah korban dari polemik ini, karena ada atau tidak berita seperti ini, kami tetap dengan kampanye kami: mendukung, mempromosikan dan melindungi pemberian ASI di Indonesia.

Namun harus saya akui, ini menjadi salah satu momen yang tepat untuk kembali mengajak masyarakat akan pentingnya menyusui, dan mengingatkan untuk kembali ke ASI.

Apa maksudnya?

Jika seorang ibu yang memiliki anak usia 0 – 2 tahun, dapat melakukan relaktasi. Relaktasi adalah suatu praktek kembali menyusui bayi langsung ke payudara setelah dalam kurun waktu tertentu tidak menyusui atau menyusui secara parsial (mencampur pemberian ASI dengan  makanan/minuman selain ASI) karena alasan tertentu. Relaktasi dapat dilakukan dengan diawali niat yang kuat untuk kembali menyusui. Ajak suami dan anggota keluarga serta orang-orang terdekat untuk mendukung ibu melakukan relaktasi. Semakin muda usia bayi, semakin mudah relaktasi dikerjakan dan berhasil.

Tahapan relaktasi:

  1. Hentikan total penggunaan dot dan botol, berikan susu atau makanan lain dengan menggunakan gelas atau sendok, agar bayi dapat lupa pada dotnya, dan mau menghisap ibu.
  2. Persering kontak kulit antara ibu dan bayi. Guna dari kontak kulit ini agar hormon laktasi  dirangsang oleh hisapan mulut bayi. Kegunaan lain, dapat mencium bau ibunya dan mengakrabkan diri dengan si ibu.
  3. Bila bayi sudah mau menetek langsung, siapkan selang NGT atau pipet untuk meneteskan / mengalirkan cairan yang ada dalam wadah. Letakkan wadah pada tempat yg lebih tinggi dari badan (baca: payudara) ibu. Wadah bisa berisi ASI perah (ASIP) atau susu formula yang sedang dikonsumsi bayi saat itu. Ujung selang dimasukkan kedalam wadah berisi cairan, sementara ujung satu lagi dilekatkan di payudara, tepat didekat puting. Tahapan ini dilakukan agar ketika bayi menempel pada badan ibu dalam posisi menyusui, tidak akan frustasi dengan jumlah ASI yang masih sedikit. Ini dilakukan untuk memancing produksi, karena hisapan bayi dapat merangsang hormon bekerja.
  4. Perbaiki posisi dan pelekatan  saat menyusui bayi. Cari posisi yang tepat dan nyaman untuk ibu dan bayi. JIka bayi merasa tidak nyaman dengan posisi (biasanya karena tidak terbiasa disusui) maka, sediakan waktu untuk berdekatan lebih lama. Selalu berkomunikasilah dengan bayi, ajak bicara tentang proses relaktasi yang harus dilalui bersama.
  5. Minta bantuan orang lain untuk memegang wadah berisi ASIP/cairan lain tersebut supaya jalannya lancar selama melintasi selang. Jika menggunakan pipet, orang itu dapat membantu meneteskan cairan tepat diatas puting. Pastikan tetesan itu tidak berhenti, agar bayi tidak kembali frustasi. Jika disekitar tidak ada orang, maka gantunglah wadah disekitar leher ibu, atau letakkan wadah di meja.
  6. Jika selama ini anak mendapatkan cairan selain ASI, susu formula misalnya, gunakan susu formula tersebut sebagai cairan dalam wadah relaktasi. Secara perlahan kurangi dan diganti dengan ASI perah, karena seiring stimulasi yang dilakukan oleh bayi ibu, ASI pun berproduksi dan dapat diperah.
  7. Memerah ASI. Mengeluarkan ASI dari payudara dapat menstimulasi hormon laktasi untuk mulai kerja kembali dan meningkatkan persediaan ASI. Memerah ASI dilakukan setelah menyusui bayi secara langsung (bukan sebelum). Memerah dapat dilakukan dengan tangan atau pompa.
  8. Siapkan waktu dan kesabaran yang tinggi dalam menjalani proses relaktasi karena proses ini tidak bisa diukur jangka waktunya. Semua tergantung niat dan usaha masing-masing individu.
  9. Kontak Konselor Laktasi terdekat jika dirasa memerlukan bantuan praktis dalam menerapkan langkah-langkah kembali menyusui ini.

Lalu untuk anak yang lebih dari 2 tahun, sekiranya diumur sekian anak sudah cukup besar untuk memakan makanan yang ada di rumah, tentu dengan pola nutrisi berimbang.

Banyak yang bertanya pada saya. Jadi apakah perlu diberi susu? Susu merupakan salah satu jenis protein, dimana protein bisa kita dapatkan dari makanan seperti tempe, tahu, telur dan sebagainya.

Mari kita berpikir jangka panjang dalam mencari penyelesaian dari polemik susu formula yang berbakteri ini. Yuk, tidak ada kata terlambat untuk kembali ke ASI, selamatkan generasi masa depan bangsa.

Konselor LaktASI: Sebuah Panggilan Hati

Tidak ada yang menyuruh saya untuk menyusui. Tidak ada yang mengajarkan saya menyusui. Tidak banyak yang memberikan dukungan ketika saya menyusui. Ketiga hal itu lah yang malah menjadi pendorong diri untuk menyusui. Modalnya, cari literatur, artikel, feature apapun tentang menyusui. Dari situ saya tahu apa itu pemberian ASI eksklusif, kenapa harus 6 bulan, dan kenapa tidak perlu susu tambahan. Entah dorongan dari mana yang sangat kuat, saya menjadi sangat percaya diri untuk memberikan ASI, dan tekad itu pula lah yang membuat saya berhasil menjadikan Muhammad Rafa Ibnusina sarjana ASI eksklusif dan diteruskan sampai 2,5 tahun.

Kala itu di tahun 2003 belum ada milis tentang pemberian ASI, apalagi organisasi pendukung gerakan menyusui. Maka berlatar belakang pengalaman pribadi, saya mencoba untuk berbagi dengan keluarga dan teman-teman dekat. Semakin sering saya berbagi, semakin banyak pula yang merasakan keindahan manfaat menyusui. Lalu saya melihat suatu iklan di majalah tentang pelatihan menjadi konselor laktasi, saat itu tahun 2005, dan saya bekerja sebagai penyiar radio di Jakarta. Dengan mengikuti pelatihan selama 40 jam bersama Sentra Laktasi Indonesia itulah saya menjadi konselor laktasi. Disitu pula saya bertemu pertama kali dengan dr. utami Roesli.

Menjadi konselor laktasi (KL) membuat saya semakin PD berbagi pengalaman dan pengetahuan dengan cara pendekatan konseling kepada orang-orang disekitar saya. Semenjak itu pula hari-hari saya diisi dengan kegiatan bertemakan ASI. Mulai dari memberikan konseling, menjadi panitia perayaan Pekan ASI Sedunia mulai tahun 2006, dan membuat acara-acara seminar. Tahun 2007, dalam proses pencarian dana untuk salah satu acara seminar tersebut, saya bertemu dengan sebuah LSM internasional dan tidak disangka kemudian saya direkrut menjadi staf karena latar belakang saya seorang Konselor Laktasi. Tidak pernah terlintas dipikiran saya, dengan bekal pelatihan 40 jam menjadi KL, saya bisa diterima di suatu LSM yang memiliki program Kesehatan ibu dan anak tersebut. Sekedar info, saya tamatan non medis, yaitu fakultas sastra Inggris. Dan awalnya, alasan saya mengikuti pelatihan menjadi KL hanya untuk memperkaya pengetahuan saya dalam hal ASI/menyusui.

Sejak awal tahun 2007 saya menjadi staf komunikasi sebuah program menyusui pada LSM Internasional, yaitu Mercy Corps Indonesia. Disitu pula semua hal tentang menjalankan manajemen program menyusui saya pelajari secara professional. Dalam waktu yang hampir bersamaan, ketika semangat luar biasa membara karena memulai suatu pekerjaan yang berasal dari hati, saya menemukan sebuah organisasi ibu-ibu menyusui dan tanpa berpikir panjang segera bergabung. Ternyata mereka baru saja mengukuhkan sebuah Asosiasi khusus untuk ibu-ibu menyusui. Karena baru saja terbentuk, saya pun diajak untuk menjadi salah satu pendirinya. Saya merasa beruntung dan terhormat sekali bisa menjadi bagian dari Asosiasi Ibu Menyusui Indonesia, yang biasa disebut AIMI.

Selama bekerja di Mercy Corps Indonesia dari tahun 2007 sampai awal 2010 saya terlibat penuh sebuah program yang bertujuan menciptakan sebuah lingkungan yang mendukung menyusui. Bergandengan tangan dengan pemerintah, petugas kesehatan dan masyarakat dalam mengkampanyekan praktek menyusui. Pengalaman yang membuka jejaring luas, pengalaman yang mengajarkan berpikir holistik, dan yang terpenting pengalaman di lapangan dimana saya bertemu langsung dengan ibu-ibu di bilangan Jakarta Utara yang hidup diambang garis kemiskinan dan tidak mampu membeli susu formula. Memberikan susu formula merupakan tekanan dari orang-orang sekitar, petugas kesehatan, dan lingkungan. Karena itulah kasus diare dan malnutrisi sering ditemui di lapangan. Dari situ saya belajar, jika saja program menyusui ini bisa merasuk ke jiwa masyarakat, tidak hanya ibu tetapi juga para penentu kebijakan di struktur kepemerintahan dan petugas kesehatan, maka banyak bayi yang bisa selamat dari jeratan penyakit dan kematian.

Merasa terpanggil dalam menyuarakan pentingnya menyusui inilah, yang membuat saya ingin terus berbuat di dunia ASI Indonesia, maka saya bergabung total dengan AIMI sejak Maret 2010 sebagai Sekretaris Jenderal dan mendedikasikan hari-hari saya bersama-sama dengan pengurus AIMI lain untuk secara volunteer menjalankan tugas-tugas mulia, yaitu menjadi teman (baca: konselor), motivator, sekaligus fasilitator dalam menyebarluaskan dan menyediakan informasi tentang menyusui. Terlihat sederhana, namun pekerjaan ini sungguhlah memerlukan waktu, tenaga dan pikiran karena menanjaknya ekspektasi para orangtua (khususnya Ibu hamil dan menyusui) akan mendapatkan pengetahuan mengenai ASI. Tidak hanya itu, AIMI juga menjadi lembaga yang melakukan advokasi bagi terciptanya dukungan, pun dituntut untuk melakukan riset, pengembangan cabang-cabang daerah dan menjadi corong para konsumen Kesehatan (khususnya ibu hamil dan menyusui) kepada institusi kesehatan, pemerintah dan legislatif. AIMI menjadi organisasi lokal pertama yang didirikan-oleh dan diperuntukkan-bagi ibu-ibu menyusui. Hanya satu yang menyatukan para ibu-ibu menyusui yang menjadi motor penggerak AIMI, passion yang sama, yaitu breastfeeding.

Senang rasanya berbagi dan melihat semakin banyak ibu bersemangat memberikan ASI bagi putra putrinya. Semua itu tidak dapat saya rasakan jika tidak menjadi seorang konselor laktasi – sebuah panggilan dari hati.

10 Langkah Menuju Keberhasilan Menyusui

Sering kali kami menemui atau mendengar banyak ibu yg mengeluh, “kenapa anak saya dikasih susu formula? Kok perawat tidak meminta ijin ke saya, padahal saya ingin menyusui eksklusif?” Atau, “kenapa dokter bilang ASI saya tidak cukup untuk bayi saya?” itu hanya 2 dari sekian banyak keluh kesah ibu sesaat setelah persalinan, yang tentu membuat ibu stres dan berujung pada ketidakmampuan menyusui anaknya, khususnya sekembalinya di rumah. Tidak sedikit dari ibu-ibu yang sudah memiliki pengetahuan dan kemauan utk menyusui namun gagal menerapkan pemberian ASI eksklusif.


Ketika fasilitas kesehatan (faskes) dan petugas kesehatan (petkes) adalah pihak yg tidak mendukung pemberian ASI, maka bisa dipastikan kesulitan dan tantangan menyusui menjadi penghalang dalam memberikan ASI Ekslusif pada bayi.


siapa korbannya? tentu saja IBU dan BAYI!


Faskes dan petkes merupakan garda paling pertama dari kunci sukses menyusui. Semua diawali di tempat saat ibu melahirkan. Jika ibu tidak diberikan kesempatan untuk Inisiasi Menyusu Dini (IMD)[1] ketika persalinan,  ibu tidak diajarkan cara menyusui dengan tepat, ibu dipisahkan dari bayinya, bayi diberikan cairan selain ASI, maka bisakah faskes tersebut layak disebut rumah sakit pro-ASI?


Lagi-lagi, siapa korbannya? IBU dan BAYI!


Sejarah RSSIB

Faskes pro-ASI merupakan terminologi yang sering diucap oleh kebanyakan ibu belakangan ini untuk menggantikan apa yang dahulu kita kenal dengan Rumah Sakit Sayang Bayi (RSSB).

Program RSSB diperkenalkan secara Nasional pada tahun 1991 dengan perlombaan implementasi 10 Langkah Menuju Keberhasilan Menyusui (10 LMKM), berupa pengembangan instrument pedoman dan penilaian, training assessor pusat dan daerah, penilaian diri sendiri, penilaian bersama internasional assessor, penilaian tingkat pusat, penilaian tingkat provinsi, reward tingkat pusat, maka dihasilkanlah 340 RSSB di seluruh propinsi. Kemudian di tahun 1992 dikeluarkanlah Kriteria Global Breastfeeding Friendly Hospital Initiative (BFHI). Pada tahun 1999 dilakukan survey akreditasi RSSB di DKI Jakarta dan hasilnya tinggal 25% faskes yang menerapkan 10 LMKM. Pada tahun 2000, terjadi integrasi dari RSSB menjadi Rumah Sakit Sayang Ibu Bayi (RSSIB). Hal ini tidak disambut antusias oleh para pihak pelayanan Kesehatan, di tahun 2003, revitalisasi RSSB hanya terjadi di beberapa propinsi saja. Maka pada tahun 2006 dikeluarkanlah versi revisi dan terkini dari Kriteria Global RSSB.[2]


Di Indonesia,10 Langkah Menuju Keberhasilan Menyusui ini didukung oleh 10 dasar-dasar hukum yang antara lain:

  1. Kepmenkes no 450 th 2004 tentang Pemberian ASI Eksklusif
  2. Surat Edaran Dirjen Yanmedik no YM003351465 th 2005 tentang Revitalisasi RSSIB
  3. Surat Edaran Dirjen Yanmedik no MM0003352219 th 2007 tentang Pelaksanaan IMD
  4. SKB 48/Men.PP, 27/Menakertrans, 1177/Menkes th 2008 tentang perlindungan dan dukungan pekerja perempuan menyusui selama waktu bekerja
  5. Kepmenkes no 203 th 2008 tentang Pokja Nasional Metoda Kanguru
  6. Kepmenkes np 603 th 2008 tentang RS Sayang Ibu Bayi
  7. Kepmenkes no 237 th 1997 tentang Pemasaran Pengganti ASI
  8. PerMen Negara Pemberdayaan Perempuan dan Perlindungan Anak No 03 th 2010 tentang Penerapan 10 Langkah Menuju Keberhasilan Menyusui
  9. Undang-Undang no 36 th 2009 tentang Kesehatan
  10. Peraturan Pemerintah tentang Pemberian ASI Eksklusif (dalam proses pembahasan)


Perayaan Pekan ASI Sedunia

Setiap tanggal 1-7 Agustus, dunia merayakan Pekan ASI Sedunia atau World Breastfeeding Week (WBW). WBW merupakan perayaan menyusui tahunan yang dirayakan di minggu pertama bulan Agustus. Seluruh dunia, para pendukung menyusui merayakan, berdemonstrasi, mengadakan konferensi atau acara. Hal ini dilakukan agar meningkatkan kesadaran masyarakat dan dukungan akan praktek menyusui. Tahun 1992, World Alliance Breastfeeding Action (WABA)[3] mengkoordinasikan perayaan ini untuk pertama kalinya untuk mempromosikan bahwa menyusui adalah yang terbaik bagi ibu, bayi dan bumi, dan yang terpenting, untuk memberikan pengertian pada dunia bahwa begitu besarnya pengaruh yang selama ini diberikan oleh perusahaan-perusahaan susu formula.  Perayaan WBW tiap tahun memiliki tema berbeda. Hal ini dilakukan untuk menyatukan seluruh ibu menyusui di dunia. Tahun 2010 diangkat tema “Menyusui: Sepuluh Langkah Menuju Sayang Bayi,” dengan slogan “Sayang Bayi, Beri ASI”[4] yaitu terjemahan dari “Breastfeeding: Just Ten Step! The Baby Friendly Way”[5]. Penerapan 10 Langkah Menuju Keberhasilan Menyusui (10 LMKM) sangat penting dalam meningkatkan cakupan pemberian ASI.


Sejarah 10 Langkah Menuju Keberhasilan Menyusui

Pada tahun 1989, UNICEF bersama WHO memperkenalkan Sepuluh Langkah Keberhasilan Menyusui dengan mengeluarkan sebuah Pernyataan Bersama mengenai “Perlindungan, Promosi, dan Dukungan Menyusui: Peran Khusus Fasilitas Pelayanan Kesehatan Ibu”. Tahun 1990 Deklarasi Innocenti menghimbau dunia agar mendukung pelaksanaan Sepuluh Langkah di semua fasilitas Kesehatan yang memberikan pelayanan Kesehatan ibu. Tahun ini Pekan ASI Sedunia memperingati ulang tahun ke 20 Deklarasi Innoceti, sayangnya hanya 20.000 fasilitas persalinan atau sekitar 28% dari seluruh rumah bersalin di seluruh dunia yang telah sepenuhnya menerapkan Sepuluh Langkah dan telah disertifikasi oleh Baby Friendly Hospital Initiative, di Indonesia dikenal sebagai Rumah Sakit sayang Ibu dan Bayi.


Apa saja 10 Langkah Menuju Keberhasilan Menyusui yang selayaknya menjadi standar tiap Pelayanan Kesehatan dan Pemberi Pelayanan Kesehatan agar terwujud Fasilitas yang Sayang Ibu Bayi?

  1. Mempunyai kebijakan tertulis tentang pemberian ASI
  2. Memberikan pelatihan bagi petugas
  3. Menjelaskan manfaat menyusui yang benar
  4. Melaksanakan Inisiasi Menyusu Dini
  5. Menunjukkan teknik menyusui yang benar
  6. Tidak memberikan Makanan dan atau minuman selain ASI
  7. Melaksanakan rawat gabung
  8. Membantu ibu menyusui sesering mungkin dan semau bayi
  9. Tidak memberikan dot dan atau kempeng
  10. Membina Kelompok Pendukung ASI[6]


Dengan demikian, mengajak semua orangtua dan calon orangtua untuk meminta hak nya mendapat pelayanan diatas. Caranya dengan mencari (yang kita sering sebut shopping) faskes dan tenakes yang menerapkan 10 Langkah. Bahwa ibu dapat meminta 10 hak-haknya:

  1. untuk dijelaskan manfaat menyusui
  2. untuk diajarkan cara menyusui yang tepat
  3. untuk mendapatkan pelayanan Inisiasi Menyusu Dini ketika persalinan
  4. untuk tidak memberikan asupan apapun selain ASI kepada bayi baru lahir
  5. untuk bayi tidak ditempatkan terpisah dari ibunya
  6. untuk mendukung ibu memberikan ASI kapanpun
  7. untuk tidak memberikan dot atau kempeng
  8. untuk Petugas Kesehatan tidak memberikan bingkisan yang berasal dari produsen susu formula
  9. untuk Fasilitas Kesehatan tidak menempelkan logo produsen susu formula pada poster, leaflet, banner, box bayi, selimut, dan semua material ibu dan bayi
  10. untuk dibina atau dirujuk kepada kelompok pendukung ibu menyusui


Semoga perayaan Pekan ASI Sedunia tahun 2010 yang dirayakan oleh Indonesia selama bulan Agustus ini dapat menjadi ajang memperkuat dan meningkatkan pelayanan Kesehatan agar tidak lagi jatuh lebih banyak korban Ibu dan Bayi!


Selamat merayakan bulan ASI Nasional!


[1] IMD – Inisiasi Menyusu Dini adl memberikan kesempatan pada bayi baru lahir untuk mencari payudara dan sumber kehidupannya sesaat setelah dilahirkan dan dibiarkan minimal 1 jam. Segala tahapan IMD 1 jam tersebut berguna utk ibu dan bayi

[2] Makalah Dr. Dien Sanyoto Besar, SpA, IBCLC Ketua BKPPASI pada Worskhop Pekan ASI Sedunia Kemenkes, 27 Juli 2010

[3] http://www.waba.org.my/

[4] Buku Pedoman Pekan ASI Sedunia (PAS) tahun 2010 kerjasama Kementerian Kesehatan RI, UNICEF, WHO

[5] http://worldbreastfeedingweek.org/

[6] Pedoman PAS th 2010 Kemenkes/UNICEF/WHO

Little Changes Does Matter

I have seen great men. One of them is Nyoman Suartanu. He – for some reason – has put big interest in breastfeeding. He is willing to do what common male not choose to do: becoming breastfeeding counselor. This is – of course – way beyond his task as a chief of public health section in North Jakarta District Health Office. As government person who work closely with Healthy Start Project since 1,5 years ago, he supports the SOS project – competition on Ten Steps to Successful Breastfeeding for Health Facilities in North Jakarta. The seriousness showed clearly not only when he assessed these health facilities, but also when he escorted SOS Project Winners to Faroe Islands.

He felt so blessed to be part of this visit as he got so much lessons of life. “I can see that in Faroe Islands, life is so peaceful that people appreciate nature as the teacher of life” as he told me on the journey back to Jakarta. Our visit to Faroe Islands was in the middle of cold weather, nevertheless, Nyoman saw that its people still do whatever they have to do. “They go along with the rhythm, don’t mind the weather!”


Moreover, he said,


“I have witnessed that Faroe Islands’ Officials are the one who serve its people. That fact leads me to provide better service to community in North Jakarta. This experience was such a reminder. I am hoping that all the representatives of winning health facilities could implement  what they have been doing in compliance with the Ten Steps, and could get lots of lesson learn from Faroe Islands’ experience to keep trying to make the best efforts for healthier citizens.”


I met him again at his office not too long ago and I saw changes. He served his guesses with offering drinks and prepared it himself, he came early to the office only to greet his colleagues – scenes that rarely seen in a leader.


He did not leave his heart in Faroe Islands, but he brought back his heart – that has been sharpened there, to be shared to others in his country.

Fine Friendly Faroe

I was there — at a breastfeeding workshop last Wednesday — sitting in the back row, observing the six people on stage as they presented each and every step they had taken to be champions. These six people are representatives of health clinics in North Jakarta who, earlier this year, won a competition about breastfeeding awareness and practices. In this workshop, each representative gave presentations on how they achieved success in the Ten Steps to Successful Breastfeeding at their health facilities.

Their auras were pouring out into the whole room. Their eyes were glowing. Their words were full of spirit. And as they spoke, driven by their hearts — let me tell you, they were amazing!
All six representatives from the winning health facilities, Indonesian government health officials and Mr. Jørgen Niclasen, Faroe Islands’ Minister of Public Affairs, proudly showing certificates of accomplishment. Photo: Irma Sitompul/Mercy Corps

It all started when the Faroe Islands Government implemented a project called Setuju Oentoek Sepuluh (SOS) — which, translated from Bahasa Indonesia means “Agree for the Ten,” referring to the Ten Steps to Successful Breastfeeding. With help from Mercy Corps’ Healthy Start Program and the North Jakarta Health Office, the SOS Project was implemented in 67 health facilities, hospitals, puskesmas (government health centers that include midwives), maternity clinics and midwifery stations. These health facilities joined the SOS competition to promote the Ten Steps to Successful Breastfeeding in the pilot area, North Jakarta.

Out of these 67 entrants, six health facilities were chosen as the most compliant after six months of assessments. These six delegations got the chance to receive an exposure study trip to health facilities and training institutions in the Faroe Islands —a reward that they’d never imagined! I was fortunate enough to accompany them.

Faroe Islands, an island country with a population of not more than 50,000 people, was just outstanding. The 7,400-mile flight from Jakarta really paid off, with beautiful panoramas of green hills, hundreds of waterfalls and the ocean laid in front of us. The enthusiasm grew bigger when we finally met the warm, friendly people of Faroe. Ávirkan nummar eitt! (This is Faroese for “Impression Number One.”)

Our team, which consisted of six representatives from the leading health facilities, four government leaders and four Mercy Corps Healthy Start staff, were all covered with winter coats. It was 4 degrees Celsius and not even winter. For those of us from Indonesia, that was the most freezing experience of a lifetime, yet exciting!

“I am glad I have prepared two coats and two pairs of boots to protect me from the cold!” whispered my colleague Yogiana, from Puskesmas Tugu Utara District, on the day we landed.

But cold did not stop the spirit even a bit. It was like we were entering an amusement park, wanting to try all the rides. We visited government hospitals, clinics, community centers and even houses where Faroese mommies had just delivered babies.

We listened.


And learned.

“All the health systems here are integrated. Here, all health services are free,” Barbara á Tjaldrafløtti, our host, mentioned.

The Faroe Islands’ Minister of Foreign Affairs, Mr. Jørgen Niclasen, was the one who greeted us on our first night in Faroe. It was such a pleasure and an honored moment. Ávirkan nummar tvey! (“Impression Number Two”)

“I am fully aware that being here must be cold for all of you, do not blame on the weather, but blame on the clothes,” he smiled. He made us smile. That really broke the ice for the 14 awkward, don’t-know-how-to-act Indonesians who were visiting Faroe Islands for the first time!
An old town in Faroe Islands. They still maintain the traditional culture, growing grass on the rooftops. Photo: Farahdiba Tenrilemba Jafar/Mercy Corps

While eating the very special dishes of Faroe, delicious lamb chops and fine fish, I saw how two different worlds melted together because of our similarities. Both Faroe Islands and Indonesia are formed of islands, which makes the character very similar: friendly, family-oriented and religious. I found Faroe Islands simply unique. Unique because they keep their tradition and mix it with modernity. Unique because it’s nearly impossible for trees to grow and unique because they grow grass on the rooftops instead. Ávirkan nummar trý! (“Impression Number Three”)

The experience will always stick in our minds and hearts. The experience where togetherness is important, where love has to be shared, where appreciation is held high, where responsibility is highly respected, where efforts are highly valued.

“I’ve seen with my own eyes how they appreciate their beautiful nature as they worship their God. I’ve learned how they revere life as their basic ground of living,” said Nyoman Suartanu, one of team members from the North Jakarta Government, over and over again as he was really emotionally moved.

And so — as witnessed by us — there were six agents of change, standing at the podium, their commitments was being transferred. The three memorable days they spent visiting Føroya were being disseminated to other health facilities, government and key community members that are willing to change. These champions were communicating change to give preventative services to their communities, change to be supportive for breastfeeding and change to be compliant with the Ten Steps to Successful Breastfeeding.


can be read also here


Ask Me, and I Will Follow You Down

How do you recognize a midwife who’s already trained to be a breastfeeding counselor? And who do you ask about breastfeeding if you go to puskesmas, local health facilities around Indonesia?

Those two questions became apparent when Mercy Corps’ Healthy Start Program had already trained several midwives as Breastfeeding Counselors. How would we differentiate them with the ones who had not been trained? After all, there are many midwives around the neighborhoods and villages where we work, and not all of them have been trained.
A press conference, held jointly by Mercy Corps and the North Jakarta government, launches the “Kasih ASI? Tanya Saya!” poster and badge campaign to support the Healthy Start Program, raising awareness of proper breastfeeding. Photo: Elpido Soplantila/Mercy Corps

So last year, with the help of a graphic designer and communication consultant, we invented a badge that can be pinned on every Breastfeeding Counselor’s shirt. Designing and making the badge took more than a year, just to make sure that everything was right. We took lots of steps along the way.

First, we had to match the objective of the badge-making with the design. The objective of the badge is to be the sign of a trained Breastfeeding Counselor. It is to recognize their existence and importance in the community. It communicates that, now, there is a trust person who can answer all questions about breastfeeding for mothers.

Second, the design. The logo and tagline needed to be catchy enough to grab people’s attention. The combination of color was also an important aspect. I conducted several focus group discussions just to measure accuracy and perceived meaning of the logo and design. We wanted the badge to capture the image of bonding between a mother and her baby, as well as support from the mother’s environment, such as family, counselor and health provider, and government.

Third, the tagline presented another challenge. Our aim of making the badge was to make people start asking while they see or read the words “Kasih ASI? Tanya Saya!” In English, this means “Breastfeeding? Ask me!”

We are fully aware that the challenges of breastfeeding cannot be countered with just a badge. These challenges need specific and tailored answers for the questions, problems and situations of each mother. But we hope that this badge will make people start asking these trusted Breastfeeding Counselors about breastfeeding.

Today, the badge has become the true sign of every Breastfeeding Counselor and Motivator. They wear it with pride and honored.

“People recognize me as the woman on the train who’s received training as a Breastfeeding Counselor,” said Ibu Ita, who always rides the train to get where she needs to go in Jakarta. As a member of the Midwives’ Association who received training through Mercy Corps, mothers now recognize her as someone who knows a lot about breastfeeding and is willing to answer any kind of question about breastfeeding.

“People started asking me, ‘what is that badge that you are wearing? And what’s the meaning?’” another midwife told me.
Ibu Tatiek Fauzi Bowo, the wife of Jakarta’s Governor, wears a Breastfeeding Counselor’s badge in support of Mercy Corps’ Healthy Start Program. Photo: Julisa Tambunan/Mercy Corps

Even if people don’t know the meaning of the badge, at least they are questioning about it. That’s also the purpose of the badge, to make people start to wonder about it. Once the Breastfeeding Counselor realizes that people are staring at the badge, then they can start talking about their work. Interesting, eh?

On a few occasions, we’ve even pinned the badge to Ibu Tatiek Fauzi Bowo, the wife of Jakarta’s Governor. Two years ago, she became an ambassador for Breastfeeding Counselors in Jakarta. We also pinned the badge to Jack Newman, a breastfeeding expert from Canada who came to Jakarta to give seminars in celebration of World Breastfeeding Week 2009. He wore it with pride every day during his time at Jakarta.

If they lose the badge, the Breastfeeding Counselors immediately ask for a new one. Because now, they would feel empty without the badge on the right side of their uniform.

There are 239 Breastfeeding Counselors spread throughout Jakarta, as well as 458 breastfeeding motivators in North Jakarta, who have been trained by Mercy Corps’ Healthy Start Program and its partners.

“We are ready to answer anything about breastfeeding, here is the proof!” said many motivators and counselors, pointing to their badges, when I met them during World Breastfeeding Week, which took place last month. It was the first event that gathered all the counselors and motivators in Jakarta.

Let’s hope that the more people see the badge, the more questions they’ll ask.

posted also here

Being a Lactation Counselor: A Dedication to Your Proffesion

Ibu Lilis Ratnasari, a private midwife, received a 40-hour training in lactation counseling through the World Health Organization (WHO) and UNICEF about a year ago. More recently, she shared her experience at the first Jakarta Counselor Forum, which was conducted by Mercy Corps in cooperation with the North Jakarta Government.

Her enthusiastic gestures filled the 14th floor of the North Jakarta Mayor’s office, as she began to tell not only of her achievements but also about her challenges as a Lactation Counselor.

After she trained to be lactation counselor, Ibu Lilis says she never forgets to remind every mother she meets to breastfeed. Not only that, she has made time to give counseling to each of them, in order to make the mothers around her confident in breastfeeding.

“I realize my neighborhood has not given full support to breastfeeding practices yet, but at least I am doing my part as counselor, which is to give counseling one by one to every mother that comes to my clinic,” she said.
Ibu Lilis (with microphone), a Mercy Corps-supported midwife and lactation counselor, talks about the challenges of her job at a recent forum. Photo: Farahdiba Tenrilemba Jafar/Mercy Corps

So naturally Ibu Lilis, 33, who opened a clinic called “Sunter Jaya Baru” in Jakarta’s Tanjung Periok neighborhood a month ago, was sad to see one of her patients drowned in a lack of confidence in breastfeeding.

“I told her everything about early initiation (for breastfeeding) while she still pregnant. She‘s the smartest patient I’ve ever met. She was so confident to give her child breastmilk and willing to do the six months’ exclusive breastfeeding once she delivered. I never thought she would give up just like that,” Ibu Lilis explained.

But more challenges were presented with the 25th patient that came to her clinic. This patient’s baby’s body temperature got higher on his second day of life.

“I convinced the mother to keep breastfeeding, that would make the temperature go down. But the grandmother was worried, then pushed me to give formula instead,” Ibu Lilis said.

After the mother’s family pushed to switch the newborn baby to formula, Ibu Lilis suggested that the mother go to a pediatrician at the nearest hospital to check on the baby and give another opinion. As a lactation counselor, she never wants to give formula, ever. The clinic where she works does not even have any correlation with a formula company, as she learned from her last experience working at Maternity Hospital, which had a contract with a big formula company.

“I learned from the training that we can not have any collaboration with formula company. It’s against the code that I’ve now taken,” Ibu Lilis explained.

Through committed women like Ibu Lilis, Mercy Corps’ Healthy Start Program is trying to touch mothers willing to change the behavior and commit to a healthier beginning for their infants. Together with the Midwives Association and North Jakarta District Health Office, Healthy Start is not only conducting training for health providers and government staff, but also training for community volunteers to become Lactation Motivators and run Mother Support Groups in some of Jakarta’s poorest neighborhoods. Last but not least, the program also fights for policy changes to create a more supportive environment for breastfeeding.

“I feel so blessed for being able to join the training,” Ibu Lilis said. “I got the networking that I’ve been waiting for, including connections with pediatricians. It makes my work easier. It was also easier for me to get the legal authorization to open myprivate midwife practice. I will pass this breastfeeding knowledge to everyone I know for the rest of my life.”

read also here