Breastfeeding in the Philippines: Hoffman Study Promoted by Doctors on +7IQ points is Misleading & Inaccurate

This entry is a continuation of PR Companies and the Milk Formula Manufacturers (Part 2)

I still remember my son tugging at my sleeve “Mom, did you do that to me?”

He led me to the room where Maan, his former caregiver was breastfeeding her son.

“Of course, I breastfed you.” I hugged my boy.

“Are you sure mom? Breastfeeding is good for babies.”

My son didn’t seem to believe me. Too bad I didn’t have photos of our breastfeeding moments. I pointed out the cross stitching projects in the kitchen .

I explained “When I breastfed you, I did cross stitch projects because it took you an hour to feed.” He seemed satisfied with my answer but the next day, he nagged me with the same question. Memories like these often make me nostalgic. I will never forget his words.

breastfeeding mom
Breastfeeding Lauren at 5 months old

Though I am 51 years old now, with adult children and way past my breastfeeding days…my passion is now transformed into saving the lives of future babies of poor mothers.

A good friend wrote last year on Breastfeeding, breast-baring, before Supreme Court with staggering statistics:

Marketing by milk formula companies has become increasingly aggressive. The number of women who breastfeed their infants has gone down dramatically in just a few years, while the sales and profits of the companies have risen. The irony, in the words of Sen. Edgardo Angara, author of the Rooming-In and Breastfeeding Act of 1992, is that each year we import $400 million in milk formula, but spend P536 million to bury 15,000 bottle-fed babies, and another P3.5 billion to treat infant malnutrition and diarrhea. We needlessly fritter away our foreign exchange reserves. We forget nature’s first form of immunization, enabling the infant to fight serious infection. We forgo the benefits of birth spacing as a form of natural birth control.

I know most of you can easily discern the merits of breastfeeding versus bottle-feeding. My concern lies on mothers who think bottle-feeding is far more superior than breastfeeding.

Formula for Disaster

Watch this youtube video on an eye-opening documentary that reveals how the marketing of powdered milk has caused fewer mothers to breastfeed in the Philippines. The milk companies’ formula for profits is a formula for disaster.

Part 2 | Part 3 | Part 4 | Part 5

Yes, these Milk Companies are getting so aggressive that they have a renewed promotional campaign tagged as ask their doctor about the Hoffman study and how you can give your child +7IQ points, a copy of which was sent to my house for my review. Click image below.

The PR Company of a Milk Manufacturer also showed me research studies by prominent doctors and scientists.

PR Strategy based on Inaccurate Studies

I have problems with the Dr. Dennis R Hoffman (Phd) study on Recent Evidence that Dietary Supply of DHA and ARA in Early Infancy Leads to Possible Trends in IQ of 4-Year Olds. Allow me to show you some highlights.

1. The basis of the increase of 7 IQ points is this 2000 study called A Randomized Controlled Trial of Early Dietary Supply of Long-chain Polyunsaturated Fatty Acids and Mental Development in Term Infants You can Download the Study here (170 KB PDF file)

The study only dealt with a sample of 79 infants who were fed DHA and ARA supplementation of infant formula within 5 days of age. Only 58 infants completed the protocol until they were 18 months of age.

2. Another is the 2006 study on Visual Acuity and Cognitive Outcomes of 4 years of Age in a double-blind, randomized trial of long-chain polyunsaturated Fatty-acid-supplemented Infant Formula from the same group of scientists.

Only 52 infants were available for testing at 4 years of age. A breast fed group composed of 40 healthy infants provided the “gold standard” for comparison with formula-fed groups.

3. The advertorial shown to me by the PR Company was careful not to mention that another comparison group was the breastfed babies and that the DHA supplemented children had lower Verbal IQ scores than the breastfed kids after 4 years.

4. The PR company did not show me the largest scientifically designed study of breastfeeding ever conducted which concludes that breastfeeding raises children’s IQs and improves their academic performance by Kramer MS et. al. released on May 6, 2008 . The study is called Breastfeeding and child cognitive development: new evidence from a large randomized trial. You can preview the Abstract here and another study on Effects of prolonged and exclusive breastfeeding on child behavior and maternal adjustment: evidence from a large, randomized trial. (88 KB PDF file)

The largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children’s cognitive development. The sample size used was 17,046 healthy breastfeeding infants, of whom 13,889 (81.5%) were followed up at age 6.5 years.

Compare that to the measly 52 infants used in the Hoffman’s study. No need to question the benefits of breastfeeding–’Res ipsa loquitor’–the thing speaks for itself.

Milk Company in Possible Violation of Philippine Code of Marketing of Breastmilk Substitutes (E.O. 51) that was signed in 1986.

What is my problem with the Promotional Strategy of Milk Companies?

1. I suspect that milk companies are going to claim that they are merely marketing milk for young children, not infants, therefore its milk product is not covered by the Milk code. Unfortunately, the Hoffman study that they are citing studied infants therefore the milk company is actually breaking the law with their claim of ‘increased IQ’ when the child drinks their supplemented milk.

2. Ever since the Milk Code was made into a law by virtue of President Cory’s Executive Order 5, milk companies have become creative by marketing cow’s milk as follow-on milk food, prenatal milk, milk for the elderly, etc. Still the same banana–all these undermine breastfeeding directly or indirectly by claiming these make our children and adults smarter and healthier.

3. Milk Company commercial ads are profoundly influential, especially with the masses. ““That’s the problem with unethical marketing practices,” Nona Castillo, one of the country’s five International Board-Certified Lactation Consultants says. ““The ads make poor mothers feel deprived because they can’t afford to buy infant formula. They will breastfeed their children because they have to, but if they get money, they will buy what is touted as a good product.” Middle- and upper-class mothers have access to books and the Internet, where they can learn the facts about infant formula and breastfeeding. But poor mothers rely mostly on the ubiquitous TV, where formula ads are aired, day and night, for information. The result is a deeply ingrained belief that expensive, imported, and artificial is better than free, ideal, and natural.

I wish TV shows for the masses like Jessica Soho or Mel and Joey will feature a story on the merits of breastfeeding. If only they did, they are helping save the lives of Filipino children.

““The sad part of the advocacy is hearing mothers say ‘I am breastfeeding because I am poor and I cannot buy this product’,” says Castillo. ““Some even resort to stealing, and when you go to groceries you see pictures of mothers who were caught stealing cans of formula milk. It’s actually painful.”

Philippine Health Practitioners and Milk Formula Manufacturers

There are some doctors who are against the penalties for physicians and any health worker who prescribes milk formula when it is not indicated. There are specific disease conditions when any milk is harmful to the baby such as a metabolic problem like galactosemia. But this is so rare, why promote cow’s milk for any and all problems that a new mother may encounter? You should have heard what these physicians said against the Milk Code—exactly the same arguments as the milk companies. Nakakahiya ang mga doktor na yan, trading our children’s (and nation’s) health for the protection of milk companies’ profits.

What can we do?

1. Continue the breastfeeding advocacy: protection, promotion, and support. ““Protection means you fight those people who are fooling us. Promotion, that you make mothers want to breastfeed. And support, because even mothers who want to breastfeed need to be supported. They don’t have models to guide them; their own mothers didn’t do it anymore. And people around them are using bottles. So even if mothers decide to breastfeed, if there is nobody to help them, they end up succumbing to social pressure.”

2. If you know any mother who has questions on breastfeeding, contact the breastfeeding clinic aside from their pediatrician or OB-gynecologist. I don’t trust some doctors and other health practitioners anymore. I heard that some members of the Philippine Pedia Society got so disturbed by the new Revised Implementing Rules and Regulations (RIRR) for EO 51 RIRR of the Milk Code— nawalan ang mga pediatricians ng sponsors for their conventions and junkets. I know not all doctors are like these though.

3. Say NO to promo enticements from PR companies who support Milk Formula Manufacturers.

World Health Organization (WHO) has estimated that 16,000 children die every year from illnesses and complications caused by improper feeding practices, including the use of infant formula.

Help us save 16,000 Filipino children’s lives every year and 1.5 million babies dying every year throughout the world, because they were not breastfed. This is a public emergency, but nobody seems to be noticing because babies cannot speak for themselves.

Left to Right: Nona D. Andaya-Castillo, Dr. Belen Lardizabal-Dofitas, and Elvira L. Henares-Esguerra during Synchronized Breastfeeding Event on August 8, 2007

Thank you to my sister, Dr. Belen Lardizabal-Dofitas, a dermatologist and breastfeeding advocate and Nona D. Andaya-Castillo and Dr. Elvira L. Henares-Esguerra, (two of the country’s five International Board-Certified Lactation Consultants) for additional materials for this entry.

For questions on Breastfeeding, contact
The Breastfeeding Clinic:
Your Partner from Pregnancy to Parenting
(Managed by two International Board Certified Lactation Consultants)
Nona D. Andaya-Castillo, IBCLC

Elvira L. Henares-Esguerra, MD, FPDS, RPh, IBCLC
Telefax: 632-889-1105
Mobile: 63-919-839-5555

Breastfeeding Websites in the Philippines

Noemi Lardizabal-Dado (1388 Posts)

You may contact Noemi (noemidado @ for speaking and consultancy services in the following areas: Parenting in the Digital Age (includes pro-active parenting on cyber-bullying and bullying) ; Social Business ; Reinventing One’s Life; and social media engagement. Our parenting workshop is called "Prep to Prime (P2P): Parenting in the Digital Age (An Un­Workshop)" P2P Un­Workshops are conducted by two golden women in their prime, Noemi and Jane, who have a century’s worth of experience between them. They are both accomplished professionals who chose to become homemakers. This 180­degree turn also put them on a different life course which includes blogging, social media engagement and citizen advocacy. They call their un­workshops Prep to Prime or P2P, for short, to emphasize the breadth of their parenting experience. They tackle different aspects and issues of parenting ­­ from managing pregnancies, prepping for the school years of children, dealing with househelp, managing the household budget, to maximizing one’s prime life and staying healthy through the senior years.

  • I’ve yet to personally encounter a pediatrician or ob-gyne that outrightly promotes milk formula feeding as better than breastfeeding. Fortunately, I’ve worked in mother-and-baby-friendly hospitals since clerkship. We’ve already been given opportunities since med schools to promote breastfeeding by giving lectures to mothers at the OPD. But sadly, I’ve also to say that I’ve heard some doctors who do promote milk formula feeding. I daresay that milk formula feeding, per se, isn’t bad. It offers an alternative to mothers, who for some reasons, cannot breast feed. But still, definitely, breast feeding is the best for babies. And it’s a duty by physicians to educate their patients about it.

    Prudences last blog post..My Top 10 Emerging Influential Blogs for 2008

  • @prudence- the law was passed in 1986 and the following year, I gave birth to Marielle and I could hear the pediatrician giving orders to feed my baby this particular brand. I was shocked. I didn’t give orders to feed my baby with formula milk

    They told me I couldn’t breastfeed Marielle because I just had Hepatitis B.

    In the few instances where the mother has an active infection (ex. HIV, Hepa, TB) or is taking dangerous medication (like radioactive stuff), this mother’s breastmilk should not be fed to the infant until the infection is treated or the medication fully out of the mother’s system. BUT, this doesn’t mean that the infant should not be fed breastmilk per se. Marielle could have still been fed breastmilk from another mother (screened for safety of course) if there was a milk bank in the hospital or if there was another willing mother who could have donated her breastmilk.

    I didn’t know that those could be done.

  • I heard of the restraining order last year. Kudos to the breastfeeding advocates who fought hard for the restraining order to be lifted.

    The problem is in the provinces where midwives are prone to corruption by these milk companies. Geesh, I wish these Milk Companies have some other form of ad campaign.

  • The milk company is trying to sell its supplemented milk food for young children here–and using studies based on infants fed with supplemented milk! Whatever way you look at it, this milk company is going to break the law once it promotes its milk food this way because its advertisement uses a study about babies drinking infant formula vs breastfed babies. Mabuti kung the clinical trial studied young children who drank supplemented milk food and then their IQs were measured after 4-6 years–but this is not the case.

  • Dina

    Thanks for this entry. I have always know the benefits of breastfeeding. What I wasn’t aware are the mortality statistics due to bottle feeding. I am angry now at these Milk Companies

  • Nerisa

    How convenient for Milk Companies to show only one side of the Hoffman Study. what will Dr. Hoffman say on this misleading advertorial? Thank you for showing the Kramer study which has a larger sample size.

  • @dina- when I wrote this entry, I discovered the death statistics by accident. I was mortified at how aggressive these Milk Companies are.

    @Nerisa- they will only show the side that will be of value to them, conveniently removing parts of the study.

  • Lorraine

    The government should ensure that Milk Code laws are strictly followed. Makonsensya naman sila.

  • RJ

    this is enlightening.. i was talking with my bestfriend the other day and we were talking about our 2-yr-old babies’ milk and all.. She told me that at one year old their American Pediatrician advised to stop giving Formula Milk to their son., and give him fresh cow’s milk twice a day., that is at lunch and before bed.. what do you think bout that? i think i have to go over again this post tomorrow when i wake up.. eyes ready to drop.. 😉

  • @RJ- the American pedia must have her reasons that I am not privy to. I trust the mother would do her research and consult with other pedias as well.

  • Breastfeeding is important moment of baby and mother. No bottle feedinf has the same nutrition like breastfeeding. I believe this is the best food for babies in their first days…Reading about your son question I think I must have the photos of my breastfeeding moment in case my children ask about it someday 🙂

  • chanesemom

    I have been breastfeeding my 3rd child for 5 months now and I have never been amazed in my life! She is the healthiest in our family because of the antibodies from my milk. I am proud to breastfeed my baby!

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  • how underhanded is that!!!

    i’m active as well in pursuing this advocacy with a group of other women. our group is called LATCH (Lactation Attachment Training Counsel Help), and we conduct workshops at Medical City every other month. 🙂 Our site’s at

    • That’s so nice that you have a group to support our moms. But in the provinces, these moms are given milk formula samples by midwives.

  • kim diaz

    ang ganda po ng entry niyo about breastfeeding marami po akong nakuhang information tungkol sa research namin… ito po yung napili kong topic sa research kasi pareho po tayong sumusuporta sa breastfeeding…. thanks po ulit

  • rommel


    I am a strong believer of breastfeeding. I am a husband and a future father to a baby girl. My wife and I wants to have our baby bebnefit from breastfeeding until at least her 6th month of infancy. I wonder if there are online forums or a society in the Philippines that supports mother who wants to breastfeed their babies.

    Thanks and more power!