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Xu Liang: World Breastfeeding Week: the way to promote breastfeeding by legislation

Back to March 20, 2013, a rainy Wednesday, Xu Liang came to the breast milk bank in Guangzhou Women's and Children's Medical Center, the country's first "water testing" breast milk bank, and donated 140 milliliters of breast milk. The donation has tied Xu Liang to campaigns to promote breastfeeding as she has been serving as the volunteer and legislative promoter since then.


Xu Liang, No. 001 donor of breast milk bank


Six years later, a legislative campaign to promote breastfeeding was launched in Guangzhou. In January 2019, 74 Guangzhou NPC members jointly submitted the Bill on Legislation to Promote Breastfeeding during the two sessions in Guangzhou. At the end of May, the bill was formally introduced into the legislative process. On July 31, Guangzhou Breastfeeding Promotion Regulations (Draft Amendment Proposal) (hereinafter referred to as Draft Amendment Proposal) passed the first trial, and the second trial is planned for September.

However, whether it is the most effective way to protect and support breastfeeding through legislation and how to legislate breastfeeding by local people's congresses for the first time remain controversial.


In March 2013, the breast milk bank of Guangzhou Women's and Children's Medical Center was put into trial operation by Liu Xihong, director of Guangzhou Women's and Children's Medical Center. A few years ago, during her study tour in the United States, Liu Xihong found that the operation of breast milk banks were as mature as that of blood banks there. After returning to China, she made a strong case that a breast milk bank shall be set up in the hospital to provide breast milk free of charge to critically ill children such as premature babies.

After the site was chosen and equipment were put in place, the breast milk bank of Guangzhou Women's and Children's Medical Center opened in a low-key manner. But after a few days, no one came to donate breast milk. Liu Xihong was anxious about this and went to each ward and encouraged seven or eight people to donate breast milk, but no one was willing to donate and she was even kicked out.


A breastfeeding mother came the breast milk bank of Guangzhou Women's and Children's Medical Center to donate breast milk with volunteers taking care of her baby.


Xu Liang's arrival marveled Liu Xihong. Xu Liang, who gave birth to a baby when she was 39, is a staunch supporter of breastfeeding. Knowing that breast milk can help the sick baby recover, Xu Liang immediately decided to donate and became the No. 001 donor of breast milk bank of Guangzhou Women's and Children's Medical Center. Liu Xihong and Xu Liang therefore came to know each other and formed a consensus: recruit a group of volunteers to donate breast milk. The Volunteer Breastfeeding Service Team (hereinafter referred to as the "Volunteer Breastfeeding Team") was thus created.

The breast milk bank of Guangzhou Women's and Children's Medical Center has strict requirements for milk donation volunteers: donors are healthy with no bad habits, and their babies are within 10 months of age.

As the breast milk bank features "free to donate, free to use", Xu Liang contacted Lei Jianwei (the alumni of EMP2016 Spring Class), who has been engaged in philanthropy activities for more than a decade to raise funds for the operation. With the help of Lei Jianwei and other enthusiasts, the breast milk bank soon received its first donation of RMB200,000 which is used to purchase medical breastfeeding pumps, bottles and other equipment. Lei Jianwei also gladly accepted Xu Liang's invitation to become the Chairman of Volunteer Breastfeeding Team.

Promote "Breastfeeding Flash"

Over the past six years, Xu Liang and Volunteer Breastfeeding Team have organized hundreds of philanthropy activities throughout the country, including the most influential one, "Breastfeeding Flash".


Site of activity "Breastfeeding Flash"

In August 2017, more than 70 mothers with babies were breastfeeding in Swan Lake in Changlong, Guangzhou, Huangpu River in Shanghai, and Houhai in Beijing to promote the concept of breastfeeding. The flash drive, titled "The Source of Life," was once the sixth most searched topic on Sina Weibo on the same day.

As of April this year, the breast milk bank of Guangzhou Women's and Children's Medical Center had received 1.885 million milliliter of available breast milk donated by 850 volunteers and treated 445 premature and critically ill children free of charge.

However, in recent years, the number and the growth of breast milk donations have shown a slowing trend. To this, Xu Liang said, even if the hospital and philanthropy team are doing their best to expand publicity, but the influence is still limited.

The operation of breast milk bank also faces considerable challenges. Xu introduced that the operating cost of the breast milk bank has been relatively high, donating nearly 100 yuan per set of consumables used in breast milk, and donors need about 500 yuan for physical examination. The milk bank's operating funds mainly rely on hospitals and social donations.


At the same time, there are more and more mother-and-baby room in public places and mother lodges in enterprises and institutions in Guangzhou. In 2014, Guangzhou Federation of Trade Unions launched the Guangzhou Federation of Trade Unions Three-Year Action Plan for Mother's Cabin. By December 2018, 531 mother's cabins (including 189 public places) had been built in the city.

Guangzhou love mother cabin construction is still slightly inadequate. According to the results of the breastfeeding network questionnaire survey on married women aged 20-50 commissioned by Guangzhou Women's Federation by a third party in Guangzhou: Only 3% of the employers where "the mother of breastfeeding" (working mother during the lactation period) work do not have lactation rooms.

Lady Luo, "the mother of breastfeeding", has no mother-and-baby room in her unit, but has chosen to use the barrier-free toilet for breastfeeding, which is rarely used by people. "It's very inconvenient to milk in the washroom. Sometimes you can't squeeze it for half a day, and sometimes you just pour it out." Ms. Luo said.

The construction of mother-and-baby room in public places is underway. Since October 2016, when the Guangzhou Municipal Government promulgated the Three-year Action Plan for the Construction of Maternal and Child Rooms in Public Places in Guangzhou, up to December last year, Guangzhou has completed 658 mother-and-baby rooms that meet the standards, basically covering key public places in the city. The mother-and-baby room of Guangzhou Baiyun International Airport Terminal 1 can be called "high standard". In the 96 square meters of space, there is not only an area for children to play, but also a professional nursery teacher.

The most influential way to legislate


"The best philanthropy is policy advocacy, and the most effective and influential form of policy advocacy is legislation. Breastfeeding legislation can have a lasting impact on those involved in this field in Guangzhou." Lei Jianwei, who has been a Guangzhou NPC member for 13 years, has come up with a proposal to promote breastfeeding legislation.

Since last September, Lei has led a motion research and drafting group of about 15 people. "Eight lawyers took part in the legislative research. Interestingly, three other breast milk donors were involved the whole process, whose work was also related to the legislative work, as well as contributing to the work in their spare time." Lei said.

After nearly three months of research, they put together a 786-page compilation of their findings. Finally, more than ten drafts of Guangzhou Breastfeeding Promotion Regulations (Draft) were revised before and after the draft was submitted.

Before the proposal was submitted, Lei sent the draft to nearly 20 government departments for comments through the Guangzhou Women's Federation, and 17 of them responded in writing or by telephone or text message. "We have modeled all aspects of departmental proposal legislation." Lei said the idea was to improve the quality of the rules to ensure its smooth process.


In 2016, Suzhou Municipality promulgated the Measures of Suzhou Municipality on Promoting the Construction of Breastfeeding Facilities in Public Places in the form of government regulations, which stipulates the construction of mother-and-baby room in public places. At the national level, there is no specific legislation to regulate breastfeeding, and the related content is scattered in the Law of the People's Republic of China on The Protection of Women's Rights and Interests, Law on Maternal and Infant Health Care of the People's Republic of China and so on.

Why should we promote breastfeeding through legislation? Lei believes that compared with government regulations, local regulations can enact penalty rules, and the duration of their implementation is longer than that of government regulations, thus providing better continuity.

The responsible person of Social Construction Work Committee of the Standing Committee of the Guangzhou Municipal People's Congress believes that if Guangzhou succeeds in legislating, it will be the first time in China that Guangzhou has set a precedent, reflecting the means of social governance in Guangzhou and the civilized behavior of the city.

According to Dong Guanghui, a professor at SCHOOL OF PUBLIC HEALTH, SUN YAT-SEN UNIVERSITY, the need for breastfeeding legislation is reflected in the fact that "due to the limitations of knowledge or advertising, many people think that breastfeeding is not necessary, and the right standard of publicity can be more effective to reverse this."


Avoid discussions of moral judgmental tendencies

In February, the China Development Research Foundation (CDRF) released a survey on influencing factors of breastfeeding in China, which showed that the rate of exclusive breastfeeding within six months was 29.2%. There is still a long way to go to reach the goal of 50% exclusive breastfeeding rate by 2020 as set out in China's Children's Development Program (2011-2020) and National Nutrition Plan (2017-2030).

It is necessary to raise the rate of breastfeeding, but Tao Ying, director of obstetrics and gynecology at The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University, has reservations about the legislation on breastfeeding. In her view, once legislation was in place, mandatory provisions were involved. In essence, breastfeeding is a mother's right, and raising rates requires social consensus and other supporting systems, such as maternity leave for women, adequate breastfeeding leave, and scientific popularization for feeding.

Zeng Dexiong, a Guangzhou NPC member and director of the Philosophical Institute of Guangzhou Academy of Social Science, has participated in the legislative research forum as an expert. He believes that breastfeeding legislation is to be encouraged. At the same time, we should avoid the idea that breastfeeding is ethical and non-breastfeeding immoral. "Even with all the benefits, women can still choose not to breastfeed." Zeng said.

In the process of drafting the Draft Amendment Proposal, the relevant responsible person of the Social Construction Work Committee of the Standing Committee of the Guangzhou Municipal People's Congress held that legislation would encourage and promote breastfeeding. It will provide facilities and conditions for mothers who wish to breastfeed, and will not include mandatory feeding for women who do not wish to breastfeed.

According to Liu Mei, chairman of the Guangzhou Women's Federation and member of the Standing Committee of the Guangzhou Municipal People's Congress, the consolidation of breastfeeding legislation is implemented with the help of successful legislative experience and then it is promoted and replicated and the problems that have arisen can be avoided with legislation. The promotion of legislation in the form of NPC motion reflects the needs and voices of the people, not the management needs of the executive branch, and reflects the importance and concern of Guangzhou on the topic of people's livelihood.

At present, the Draft Amendment Proposal has passed the first instance of the Standing Committee of the Guangzhou Municipal People's Congress, and the second instance will be held in September. The Draft Amendment Proposal stipulates that the Guangzhou Municipal Health Administration shall be responsible for the supervision and administration of breastfeeding promotion. In addition, the Draft Amendment Proposal stipulates that the Guangzhou Municipal People's Government shall provide necessary funds for the construction, operation and management of the breast milk bank, and that its administrator shall give certain nutritional subsidies to the donors, so as to solve the problem of difficult operation of the breast milk bank.

Zhong Jie, a Guangzhou NPC member, suggested that, on the premise of no conflict with the superior law, some systems should be created in local laws and regulations, such as setting up breastfeeding subsidies, so as to provide more protection for breastfeeding mothers and show the characteristics of local legislation.


The promotion of breastfeeding legislation made Xu excited. She said that six years ago, when Volunteer Breastfeeding Team was first established, she did not think that it would help the construction of mother-and-baby room in Guangzhou, let alone that breastfeeding could be legislated. "Breastfeeding legislation, in the final analysis, is due to the innovation and inclusiveness of the city, giving breastfeeding mothers more support and choice." Xu said. 

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