Mia Sutanto

Mia Sutanto is organizing mother-to-mother support groups that encourage mothers to opt for, and help them succeed in, breastfeeding their children in accordance with international norms endorsed by the Indonesian government. Through these groups and related advocacy activities, Mia is making important inroads in combating malnutrition—a major cause of infant and child mortality in Indonesia.

In recent decades, with rapid urbanization, increasing employment of women in formal workplaces, and the availability and promotion of substitute “infant formulas,” breastfeeding newborn infants and young children is no longer the cultural norm in Indonesia. Consequently, the nutritional status of infants and children in low- and modest-income households has significantly declined. Mia is attempting, with growing success, to combat those trends by encouraging and assisting the formation of mother-to-mother support groups that facilitate breastfeeding and by providing the groups with supporting services, including lactation counselors. Under the aegis of a volunteer-run organization that she formed in 2007, Mia is also engaged in related educational activities and in advocacy work with relevant government agencies, and with business firms employing women of childbearing age.

Mia is strongly committed to expanding her work on a national scale. She has already extended her work to three other cities in Java, in addition to Jakarta, and plans are underway to launch three additional programs; extending the reach of her organization, Asosiasi Ibu Menyusui Indonesia (AIMI; Indonesian Breastfeeding Mothers’ Association).

Every five minutes a baby dies in Indonesia, and most of these deaths are due to malnutrition. Despite the superior health and nutrition benefits of breast milk in comparison to substitute products, in Indonesia only 32 percent of babies are breastfed until the World Health Organization’s (WHO) suggested minimum of six months of age. Even fewer children continue to breastfeed until the recommended age of two. Given the lack of breastfeeding mothers, the positive benefits associated with breastfeeding, including improved mental and physical health of both mother and baby, are not widely achieved.

Two decades of government efforts to increase the percentage of breastfeeding mothers have proven mostly ineffective. New mothers are often confused about what is best for their baby, and rarely have trusted resources and support to turn to. Though lactation counselors are available, access to them is generally restricted to Jakarta, and interested mothers are often unaware that they exist. Widely held but erroneous beliefs, for example, that breast milk goes sour if the mother exerts too much energy, create additional obstacles that limit the use of breastfeeding. The misinformation means that in many respects breastfeeding is no longer considered the norm.

Worsening the problem, formula companies concerned with expanding their customer base and sales have marketed aggressively to new mothers through the use of gift packs, phone calls, and strategically-placed advertising. In many instances, disregarding international marketing codes, formula companies also develop close relations with doctors and other hospital staff members that result in their promoting infant formula as a healthy and sometimes preferable alternative to breast milk. But for impoverished women who decide to use formula, the results can be deadly; a need to stretch expensive formulas may further lead to a dilution or contamination of the product, endangering the baby’s health.

Even though some women understand the benefits of breastfeeding, they often lack a supportive environment and infrastructure. In workplaces, an absence of appropriate facilities for pumping and storing breast milk can make it infeasible for women to continue to breastfeed when returning to their jobs.

In 2007 Mia established her Jakarta-based volunteer-run organization, AIMI, and launched Indonesia’s first mother-to-mother support groups to promote peer exchange of information, and encourage women to continue breastfeeding in the face of obstacles. In just five years, the support groups have been augmented by additional activities that encourage sustained breastfeeding in Indonesia, including widespread community education and advocacy work.

The mother-to-mother support groups help new mothers learn to breastfeed by connecting them with volunteers who provide one-on-one counseling via email, telephone, or personal visits. Initial hospital visits also help negate any pressure a woman may encounter to formula feed. New mothers who participate in the mother-to-mother support groups often become active in the AIMI community, adding to the organization’s volunteer and support base.

Building upon the foundation of support groups, AIMI has developed additional offerings, including classes targeted at parents and expectant parents. These classes provide guidance for addressing and overcoming the most common problems in breastfeeding. Charging a modest fee to participants who can afford to pay, AIMI is able to open these classes free of charge to lower income participants.

Mia is also working to create an infrastructure in workplaces that encourages breastfeeding. In partnership with several companies, Mia and AIMI travel to offices for discussions with employers and employees about the importance of breastfeeding and of continuing the practice after mothers return to the workplace, offering advice about setting up mothers’ rooms onsite. Partnering with corporate social responsibility divisions, AIMI leverages corporate networks to increase breastfeeding awareness across the community. AIMI is particularly cautious about creating these partnerships, insisting thorough background research be completed first. Companies participating in activities counter-productive to breastfeeding promotion are banned from partnering with AIMI.

AIMI’s legal advocacy division partners with other advocacy groups, encouraging breastfeeding-favorable government legislation throughout Indonesia, and other Asian countries. Recently, AIMI hosted a conference with seventeen participating countries, resulting in a declaration titled “A call for an end to all baby food promotions.” AIMI has also met with important government audiences, including the Indonesian parliament. AIMI is an active member of the Indonesian Breastfeeding Advocacy Coalition and is helping to monitor draft government regulations to ensure they support exclusive breastfeeding, and that “sponsored” messages from the breastfeeding formula industry do not appear. To do this, AIMI and the Indonesian Breastfeeding Advocacy Coalition must be one step ahead of the Department of Health, and the formula industry, as loopholes have frequently been added in the past to give advantages to the formula companies. While playing a role in drafting regulations, AIMI is also setting up systems to monitor violations of the WHO’s marketing code, including unethical advertising at health facilities, through health workers, and electronic and print ads.

Complementing advocacy work with the government and organizations employing substantial numbers of women, AIMI is also engaged in several efforts focusing on changing perceptions about breastfeeding in the broader community. As part of those efforts, Mia has published two books including the children’s book, Mommy, What do Babies Eat? which AIMI both sells and gives away as part of their campaigns. Through AIMI’s work, synchronized breastfeeding events have been broadcast on TV stations across the nation, and Indonesia’s First Lady is considered one of the national icons in the promotion of greater breastfeeding. AIMI actively engages with the media to disseminate accurate information more broadly.

In 2010, AIMI developed a unique approach by designing a breastfeeding curriculum for delivery through religious channels. AIMI mobilized Islamic clergy to participate in the breastfeeding workshops, highlighting twenty-two verses of the Quran that relate directly or indirectly to breastfeeding. AIMI supplements these religious verses with technical information about breastfeeding. AIMI plans to expand this outreach to other religious groups, in addition to disseminating information to schools, universities, and neighborhood communities.

Mia has also creatively modified UNICEF’s “Seven Contacts Program,” designed for healthcare providers to help mothers sustain breastfeeding, to meet Indonesia’s specific needs. Instead of offering the services through hospitals, AIMI’s lactation counselors ensure seven contacts are made through a combination of educational courses, hospital, and home visits. The program is designed on the premise that all women can breastfeed successfully if given a strong support network. Thus, an expectant mother would have two prenatal contacts with a breastfeeding counselor, another contact on the day she gives birth, and four additional contacts during the child’s infancy. This program also elevates the professional status of lactation counselors, in hopes of capturing the interest of a greater number of Indonesian women.

With three branches currently opened and demand for more, AIMI is ambitiously working to open branches in all of Indonesia’s thirty-three provinces. AIMI also plans to provide regional support to Indonesian mothers living in other Asian countries, such as Malaysia and Singapore. To complement their geographic spread, AIMI is developing a strong online presence through social media, and is creating a database of all available resources at AIMI-asi.org.

Born in Jakarta in 1974, Mia spent much of her childhood in Manchester while her father completed postgraduate work. From her working parents, she learned the values of patience, listening, and perseverance. A natural leader, Mia was elected head of the Student Union during junior high, and was an active participant in theater during high school.

In 1992 Mia studied public law, and during her studies she completed an internship with a law firm. Immediately after graduation, she launched a firm of her own. In 2002, after five years in business, she sold the company and moved to the Netherlands to complete a master’s degree in international business law at Leiden University.

When Mia became pregnant at 30, she was determined to breastfeed, and her husband was very supportive. After giving birth to her first child in 2004, Mia immediately experienced challenges associated with breastfeeding. With a jaundiced baby, hospital employees pressured Mia to formula feed her baby to avoid dehydration and weight loss. Lacking both information about successful breastfeeding and skilled assistance, Mia reluctantly agreed. While she later breastfeed, she did not do so exclusively and she only continued to breastfeed her daughter for ten months. Through this experience, Mia discovered that determination was not the only condition required for successful breastfeeding. She recognized a strong need for a support network of moms, and access to accurate information about breastfeeding.

Two years later, when Mia’s sister gave birth, Mia helped her learn to breastfeed based on her own knowledge. This experience exhilarated Mia, and encouraged her to enroll in a lactation counselor training course held by the Indonesian Breastfeeding Center in early 2007. After completing her training, she joined ASIFORBABY, the only email list targeted to breastfeeding mothers in Indonesia. At the time, the list reached just thirty mothers. Realizing that some mothers did not have access to the Internet and therefore could not benefit from the network, Mia gathered other concerned volunteers and established the Indonesian Breastfeeding Mothers’ Association, dedicated to providing support and information to all mothers.