System failed Baby River

The current epidemic has placed a heavy burden on the health sector and government at all levels in responding to a disease (COVID-19) that today makes it the fourth-most common cause of illnesses (after respiratory ailments and hypertension), a mere seven months after it appeared. The mortality rate due to the virus seems low at over 6,000, but it is most likely 10 times that, since deaths are usually reported late and underreported – if not validated by a positive PCR (Polymerase chain reaction) test.

All of the above are directly caused by the current contagion, but there is also an indirect cost to consider, as the medical journal Lancet predicted in June this year that in the Philippines the impact on maternal death and child death under 5 years of age could result in an additional 1,500 mothers and 29,000 children dead in a year if the pandemic persists.

Clearly, the death of Baby River Nasino this October 9 was indirectly caused by the pandemic. And she did not deserve to be a victim of the way we respond to COVID-19.

As a statistic, Baby River now joins more than 4,000 infants who die every year in Manila (according to the Department of Health’s Field Health Service Information System of 2018) and 21,019 nationwide. In this country, infants die at a rate ten times higher than most Filipinos up to the age of 55. That is the reason globally, a country’s infant mortality rate is considered a mirror of a country’s health system, and the manner it treats its most vulnerable citizens.

Our legal system has treated Baby River and mom Reina Mae Nasino in a conduct that flies against the prolonged and exemplary actions that this country has taken to protect mothers and babies like the two.

Health laws and guidelines in this country consider the mother-infant dyad worthy of protection, not to keep them apart so exclusive breastfeeding up to six months can be guaranteed. The court separated Mother Reina from Baby River at six weeks, and kept them apart when Baby River fell ill of illnesses common to infants who are not breastfed.

Have our judges forgotten the following laws and decisions by the Supreme Court aimed at supporting breastfeeding?

Executive Order No. 51: The National Code of Marketing of Breastmilk Substitutes, Breastmilk Supplement and Other Related Products. The aim of the Code is to contribute to the provision of safe and adequate nutrition for infants by the protection and promotion of breastfeeding issued by former president Corazon C. Aquino in 1987 during the Revolutionary Period.

Republic Act (R.A.) 7600: The Rooming-In and Breast-feeding Act of 1992. The State adopts rooming-in as a national policy to encourage, protect and support the practice of breastfeeding.

The Expanded Maternity Leave under R.A. No. 11210 is an act increasing the maternity leave period to one hundred and five (105) days for female workers with pay, and an option to extend for an additional thirty (30) days without pay. This also grants extension of fifteen (15) days for solo mothers, and for other purposes.

Pursuant to R.A. 10028: The Expanded Breastfeeding Promotion Act of 2009, August of every year is Breastfeeding Awareness Month.

The signing of the Department of Health’s Administrative Order 2009-0025 on December 1, 2009 institutionalizes policies and guidelines for government and private health facilities to adopt the essential newborn care protocol.

R.A. 11148: “Kalusugan at Nutrisyon ng Mag-nanay” Act scales up the national and local health and nutrition programs through a strengthened integrated strategy for maternal, neonatal, child health and nutrition in the first 1,000 days of life, appropriating funds therefor and for other purposes.

Pharmaceutical and Healthcare Association of the Philippines/Health Secretary Francisco T. Duque III, Supreme Court Decision. The Department of Health issued the Revised Implementing Rules and Regulations (RIRR) which was supposed to take effect on July 7, 2006. It is a petition for certiorari under Rule 65 of the Rules of Court, which sought to nullify the RIRR of the “Milk Code,” assailing that the RIRR was going beyond the provisions of the said code, thereby amending and expanding coverage of the said law.

(The Philippines ratified the International Convention on the Rights of the Child. Article 24 of said instrument provides that state parties should take appropriate measures to diminish infant and child mortality, and ensure that all segments of society, especially parents and children, are informed of the advantages of breastfeeding.)

These actions by the country have made us an exemplar in protecting and promoting breastfeeding worldwide. How can our judges fail our most vulnerable mothers and infants?

National security cannot justify the legal system’s failure to protect Baby River. – Juan Antonio Perez III, MD, MPH, Public health worker, Commission on Population and Development and advocate for breastfeeding