Alarmed by a string of toxic infant milk powder scandals, Beijing native Ms Zhang Shuang was determined to breastfeed her son when he was born nine months ago .
"Unlike with breast milk, you can't be sure of the source of formula milk and how it's processed," the housewife told The Straits Times.
She said she opted for breast milk as it is the one chance for babies to get the best nutrition.
But Ms Zhang, 29, is part of a minority group of mothers in China, where many infants are fed - sometimes entirely - with baby formula in their first six months. Breastfeeding rates here have plummeted to among the lowest in the world, prompting the country's top health authority to step up a drive encouraging more women to breastfeed.
In 2013, only about 28 per cent of Chinese women breastfed their babies through the World Health Organisation's recommended period of six months, a drastic decline from 67 per cent in 1998, said the National Health and Family Planning Commission. According to the United Nations Children's Fund, the figure is even bleaker in cities at only 16 per cent, significantly lower than the global average of 38 per cent.
China is trying to revive breastfeeding in a bid to further reduce the infant mortality rate, which dropped to 9.5 per 1,000 in 2013 from 29.2 in 2002, and promote the health of both mother and child - and, in turn, maximise the potential of China's economy.
A string of safety scares over formula milk has given the cause a boost. In 2008, for instance, an adulterated milk powder incident left six babies dead.
Experts say breastfeeding rates in China began to drop in the 1970s with the introduction of baby formula - a market that is now worth US$21 billion (S$29 billion), according to a Bloomberg report. Aggressive marketing of milk powder led many to think it was more nutritious than breast milk, even though the latter is often cited as the best source of nutrition for newborns as it raises their immunity, they add.
Dr Robert Scherpbier, chief of health and nutrition at Unicef China, said curbing the country's rampant marketing of breast milk substitutes (BMS) is essential to a successful breastfeeding strategy. "China's market for BMS has grown 13-fold since 2005.
Neighbouring India has not experienced such exponential growth due to enforced government restrictions on BMS marketing," he noted.
But cultural factors and economic trends also have a part to play.
A post-natal confinement period that shifts the burden of feeding away from mothers, a high rate of Caesarean births, scarce nursing facilities at work, and the prevalence of mothers who migrate from their villages to cities for work, leaving newborns behind, also negatively affect breastfeeding rates.
China wants to raise breastfeeding rates to 50 per cent by 2020.
For a start, the government's new advertising rules that take effect next month will forbid makers of milk powder from claiming that their products can "replace a mother's milk, fully or partially".
China has also issued policies to ensure maternity leave for female workers and has asked companies to set up nursing rooms so mothers can express milk for their babies.
Dr Dai Yaohua of Capital Institute of Paediatrics said the initiatives are getting results. At the Beijing hospital where she works, the breastfeeding rate for babies delivered there rose to over 90 per cent. "We've seen improvements across China as the government has made promoting breastfeeding a priority.
Mothers and health professionals are more aware of its benefits now," she said.
This article was first published on Aug 13, 2015.
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