"IT MUST be stated for the record that the Milk Industry is in full support of the Milk Code and the government's breastfeeding campaign, " said the Pharmaceutical and Health Care Association of the Philippines (PHAP) in the petition it filed with the Supreme Court on June 28, seeking to prevent the implementation of the Code's revised rules. (View petition, in pdf files, 1, 2, 3, and 4.)

"In fact," said the group, "it has poured its own resources to supplement the meager P1 million fund allotted by the government for the said campaign. However, even as the Industry concedes the need to put more teeth in the Milk Code to further its effectiveness, the same must be done legally by means of legislative action, and not by mere issuance of administrative rules and regulation."

PHAP head Leo Wassmer Jr. declined PCIJ's request for an interview. In its petition, though, the PHAP, whose members include U.S.-based transnationals Abbott Laboratories, Wyeth Philippines, and Mead Johnson, said the revised rules' premise that breastfeeding substitutes are hazardous to health and that there is no substitute or replacement for breast milk is "fundamentally flawed."

"The impetus of the Milk Code was precisely to regulate the proper use of breastmilk substitutes, in recognition of the fact that in certain instances breastfeeding is not appropriate or possible," it said.

The PHAP repeated these arguments in its motion for reconsideration. It also quoted a position paper from the Department of Trade and Industry (DTI) that said the revised rules, if enacted, would be "an infringement of the fundamental right of consumers to information and freedom of choice," and result in the "damage of the infant formula sub-sector which employs a substantial number of Filipino employees."

The PHAP estimates that displaced employees would reach 1,500. It says the proposed changes may cost its members to lose some P9.96 billion in all, including a P3.5-billion tab that would come from the "destruction of existing non-compliant inventory, withdrawal and destruction of trade stock due to non-compliant labels, and write-off of existing and pre-ordered packaging materials including, among others, tin, cartons cans, tin plates, plastic caps, labels."

"But we are not asking the milk companies to destroy their products," says Padilla. "The (revised rules cover) advertising, and promotional materials. If at all, what they will be changing are the labels. Not the products themselves."

The revised rules in part ban the advertising, promotion, sponsorships, or marketing materials and activities for breast milk substitutes intended for infants and young children up to 24 months. Among the strictest prohibition perhaps is an "absolute" ban on "all health and nutritional claims for products within scope of the Code," including "any phrase or words that connote to increase emotional, intellectual abilities of the infant and young child."

The rules even disallow the use of pictures of babies and children with their mothers, fathers, siblings, grandparents, other relatives or caregivers in any advertisements for infant formula and breast milk supplements — as these would tend to "idealize" their use.

"OF COURSE they didn't want to diminish their market, " harrumphs Health Secretary Duque, who says he is not surprised that milk manufacturers are putting up a fierce fight. "They don't want their bottom lines affected." (Read a transcript of PCIJ's interview with Duque.)

He confirms reports that officials of the U.S. Embassy and U.S. State Department talked to him, as well as to Trade Secretary Peter Favila about the changes in the rules. "They wanted the old provisions of the law, that they be reflected as is in the implementing rules and regulations," Duque recalls. "We could not agree. Those were the very loopholes that existed and allowed them to go around the (rules)."

Responding by e-mail to the PCIJ's query about the matter, U.S. Embassy Information Officer Matt Lussenhop wrote: "The U.S. believes that infant health is very important and that breast-feeding should be the first choice for infant nutrition. We support the broadest possible availability of information and educational materials regarding infant health."

"At the same time, " he continued, "this is an important issue that concerns a number of interested parties including private industry. We encourage the government of the Philippines to make regulatory decisions and rulings in a transparent manner that incorporate the concerns and views of all interested parties, including private industry, as an important principle in developing sound public policies." (View a transcript of PCIJ's communication with Lussenhop.)

But breastfeeding advocates say the milk companies and their supporters are simply too preoccupied with protecting, well, a cash cow. The DOH estimates the Philippine market of breast-milk substitutes is worth P21 billion ($400 million) annually. Padilla cites BFAD figures that show that in the last five years alone, there have been some 139 infant-formula products introduced in the Philippine market.

"The Philippines market is something (the milk companies) care for," says WHO's Iellamo. "Their interest is here." He says Cambodia recently went through a similar process of legislating the regulation of breast-milk substitutes — "with very little resistance" from the milk industry. Iellamo notes that in contrast to the Philippines' high birth rates, Cambodia sees only 300,000 newborns every year. Official statistics show that each year, some 2.5 million babies are born in the Philippines.

AC Nielsen Media Research says that the total advertising expenditures for powdered milk products in the Philippines was around P2.3 billion in the first half of this year alone. Milk-product advertising ranked sixth in AC Nielsen's top ten ad big spenders. Nielsen executive director Jay Bautista told BusinessWorld recently, "These products cater to the biggest segment of our population. About 23 percent of our total population (82 million) are nine years old and below."

Yet it's not as if the efforts of breastfeeding advocates have been for naught. Reenalee Imperial, for one, is such a believer in breastfeeding that she did not let her infant son Joaqui's inability to suckle stop her from giving him her milk. She would express and store it until it was time to feed Joaqui, who had a congenital heart ailment. The boy got his mother's milk through a tube.

But the increasing pressures of a fast-paced lifestyle in a deteriorating economy seem to be pushing more mothers, especially those who work outside the home, toward milk formulas instead. Some do start their babies on breast milk, but then switch to formulas once they return to work. In all probability, a mother who commutes to work would find it difficult to lug around a breast pump, sterilized bottles, and a mini cooler (to keep the expressed milk fresh).

Some mothers also get frustrated when they cannot express as much milk as their babies seem to need. Breastfeeding can be painful for some women as well. Discouraged, they give up on the practice early.