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Healthier babies in Jakarta's poorest neighborhoods

Indonesia, March 7, 2012

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  • More than a quarter of children in Indonesia are malnourished, due in part to a widespread misconception that formula is better than breastfeeding. Photo: Cassandra Nelson/Mercy Corps

Did you know that a father holding his infant on his shoulder at the end of the day may be the best way to soothe a cranky child? The baby is often comforted by the father’s heartbeat and his calm demeanor, which relieves a tired and stressed mother after a long day of infant care.

When the group motivator shared this tip at one of Mercy Corps’ Mothers Support Groups in West Jakarta, Indonesia, all 14 women sitting in the room nodded their heads and vowed to practice with their husbands. The motivator explained that this is a healthy way to allow the father to bond with his baby when he comes home in the evening, and give the mother a break.

As part of Mercy Corps’ Hati Kami (“our hearts”) project, these Mothers Support Groups (MSGs) allow women to gather and share stories, ask questions and learn new skills mindful of both their and their babies’ health and wellbeing. During the hour, the women, with their infants in their laps, listened attentively, started lively discussions, and often unabashedly breastfed where they are sitting. It was a clear demonstration of the groups’ success teaching women the value and acceptability of breastfeeding in a culture that has deemed it taboo in the face of strong advertising and lobbying from formula companies.

Mothers Support Groups are just one part of the Hati Kami project, which focuses on helping new mothers among Jakarta's poorest residents. The four-year initiative is a continuation of the successful Healthy Start program that Mercy Corps implemented in North Jakarta, which increased the rates of breastfeeding immediately after birth from 17.9% to 64.9%.

Despite the growing awareness among Indonesian policy and decision makers about the critical health benefits of exclusive breastfeeding during an infant’s first six months of life and beyond, the practice has continued to decline in Indonesia over the past five years. In West Jakarta, the Hati Kami target area, only 27% of newborns were breastfed within the first hour after birth, which is lower than the rate in Jakarta Province at 33.1% and Indonesia at 29.3%. New mothers continue to be misinformed that formula is better than breastfeeding by health providers on contract with formula companies, and once home, they often find it hard to continue breastfeeding in the face of generational pressure from grandmothers.

Hati Kami is working to expand the knowledge about breastfeeding benefits from families and local midwives to hospitals and legislators. The program also targets women’s nutrition before and during pregnancy to address more underlying causes of infant illness, malnutrition and death. But at its heart are the MSGs, which support mothers in their day-to-day breastfeeding and care of their infants.

Forty-five mentors, who are midwives and community health volunteers, have trained 205 Mothers Support Group motivators — pregnant women and breastfeeding mothers who lead the discussions — and oversee the groups, which are active in more than 36 West Jakarta neighborhoods. Residents here often come from rural areas in search of work and live in informal settlements with substandard housing, infrastructure and health services. Each group links its 10-15 members with health resources and new knowledge to better care for their children.

On this particular day, after talk of their husbands died down, the women began discussing how their mothers-in-law encourage the tradition of wrapping a wide cloth around their babies’ middles to help shape their stomachs. The motivator pointed out that this practice may result in indigestion and cause babies to cry for long periods of time due to the prolonged discomfort. This simple peer support model encourages the mothers to make small, yet significant changes like this at home. Smiling and cradling their infants, the mothers looked empowered and pleased to have yet another technique to keep their children calm, happy and healthy.