Raising babies

PINOY KASI

Raising babies
By Michael Tan

Inquirer

Last updated 02:07am (Mla time) 11/17/2006

Published on Page A15 of the November 17, 2006 issue of the Philippine Daily Inquirer

THE booklet was lying in a corner of the antique store, but it caught my eye because it had photographs of babies on the cover. Inside the booklet were babies from all over the country, from Aparri, Cagayan to Jolo, Sulu, interspersed with pictures of tourist spots such as Manila's old Congress building, Palawan's underground river and the bamboo pipe organ in Las Piñas. There was no date of publication, but I suspect it was before World War II. What was so intriguing was that the entire booklet was clearly promotional material, each page of the baby photographs accompanied by a caption: "Reared on 'Milkmaid' Sweetened Condensed Milk." The babies were cuddly but I realized, too, that many of them had "moon faces." They looked well fed but some were actually suffering from edema ("manas" in Filipino), induced by all the sugar in their condensed milk. Yet that moon face was, and still is to some extent, the standard for a healthy baby. I bought the booklet right away, seeing how useful it would be for lectures with health professionals, a reminder that our concepts of health change all the time and are often shaped by commercial interests. Today, condensed milk remains popular among urban poor communities for infant and child feeding and, together with improperly prepared infant formula as well as junk foods, put many Filipino children's lives in jeopardy. Those raising children are often bewildered by the barrage of publications and, lately, films, claiming to give expert advice on childrearing. From parenting experience, I've learned to be extremely critical about these materials, but it also helps to recognize that even "scientific" childrearing can sometimes be faulty, sometimes biased by vested interests. ColonialismLast year, the journal American Anthropologist published an article by Bonnie McElhinny with a kilometric title: "'Kissing a Baby is Not at All Good for Him': Infant Mortality, Medicine and Colonial Modernity in the US-Occupied Philippines." It described the American colonial administrators' attempts to change childrearing practices in their new colony. The Americans had good reason to be concerned, given that we had one of the highest infant mortality rates in the world. McElhinny says that at the turn of the century, about 40 percent of babies born each year died before the age of one. It's hard to have accurate figures, but there can be no doubt the death rates were extremely high, posing formidable challenges to both Filipino and American physicians. Not surprisingly, they tended to blame "ignorance," especially among the poor, as the cause of these deaths. In 1921, the colonial government organized the First National Conference on Infant Mortality and Public Health, which produced a list of 40 "superstitions" associated with childrearing. The campaign to eradicate these "superstitions" extended into public education materials and "mothercraft" classes. Quite a few of the "superstitions" that were identified related to religious practices, which the physicians felt would spread disease. They were apparently horrified at the practice of mothers kissing religious statues and the children. Even baptism of babies, some physicians felt, meant "unnecessary exposure" of infants. The public health administrators also tried to discourage what they thought was excessive indulgence in child-rearing practices. The title of McElhinny's article came from advice in a manual about kissing babies, with one physician conceding that if parents needed to kiss their infants, it should only be on the cheek. One manual said that feeding on demand (which we still do) would "predispose the baby to diseases of the digestive system" and "make him nervous and spoiled." The manual also discouraged "rocking the baby, lulling him to sleep, and dancing him up and down." Sleeping with babies was also discouraged. The 1921 conference proceedings had a photograph of Filipino adults and children sleeping together, with this advice: "Human beings are not cattle and should not herd as such." HabitsMany of the "superstitions" about childrearing are still around, but I've learned to be more critical in assessing whether these practices are harmful or not. Our practice of having babies sleep at our side may actually have protective effect. I've never ceased to be amazed at how parents will suddenly wake up in the middle of the night sensing something's wrong even without the infant crying out. The triggers can be a slight fever or fever, irregular breathing, or quite simply, hunger. Check the bookstores these days and you'll find entire books on toilet training, all with different advice. The most rigid is to have children sit until they do it, but I am also familiar with anthropological literature claiming that societies with such rigid toilet training also tend to have "anal" people, meaning terribly obsessive-compulsive. In the end, I chose to stick to our local practice, which is to go with the pace of the child, who will eventually ask to use the toilet, often because they want to imitate older people. Science and medicine are affected by the times. Several historians and anthropologists note how, in the early 20th century, American child-rearing practices began to replicate policies in industrial factories, with an emphasis on time schedules and developing correct "habits." We see that in this piece of advice from a Filipino doctor during the American colonial period: "Do not put the little one to the breast every time it cries. Fifteen to twenty minutes should be the limit for every nursing period." Even taking children to fiestas was frowned upon because it meant children sleeping late. The advice was to develop "regular hours" for the children as early as possible. In effect, childrearing became part of the attempt to "tame" and "civilize" the Filipino, creating a new "native" who was more conscious about such civilized concerns as cleanliness and time schedules. Alas, today we still have problems with sanitation and punctuality. At least, the infant mortality rate in the Philippines has dropped to about 30 per 1,000 live births, but I wouldn't credit it to the "anti-superstition" campaigns. More important were the immunizations, access to safe water supplies and, most of all, a general improvement in living standards. But that current infant mortality rate still means several thousand deaths each year. I worry that we will continue to lose babies not so much because of traditional beliefs than because of modern superstitions. Someday, historians will look back at our advertisements for bottle-feeding formulas, filled with claims of brighter, healthier children and the ads pushing all kinds of junk foods for children, again showing happy toddlers at play. They will question these modern "superstitions" and wonder why we were so easily deceived, even as we paid dearly in terms of young lives lost.