Policy and Purpose: Rooming-in and Breastfeeding
- The State adopts rooming-in as a national policy to encourage, protect, and support breastfeeding (Section 2).
- The State must create an environment where mothers’ and infants’ basic physical, emotional, and psychological needs are fulfilled through rooming-in and breastfeeding (Section 2).
- The law requires the State to protect working women by providing safe and healthful working conditions that take into account maternal functions (Section 2).
- The policy is aligned with international instruments including CEDAW, the Beijing Platform for Action and Strategic Objective, and the Convention on the Rights of the Child (Section 2).
- Section 2 declares breastfeeding’s advantages for the infant and mother, including that it is the first preventive health measure at birth, enhances mother-infant relationship, and may save the country foreign exchange.
- Section 2 states that breastmilk is the best food because it contains essential nutrients for the infant’s needs, acts as nature’s first immunization, and contains growth factors that enhance organ system maturation.
- The law directs the State to promote and encourage breastfeeding and to provide measures that give mothers opportunities to continue expressing their milk and/or breastfeeding (Section 2).
Key Definitions Under the Law
- Section 3 defines “Breastfeeding” as feeding an infant directly from the human breast.
- Section 3 defines “Breastmilk” as human milk from a mother.
- Section 3 defines “Breastmilk substitute” as any food marketed or represented as partial or total replacement of breastmilk, whether or not suitable for that purpose.
- Section 3 defines “Expressed breastmilk” as human milk extracted from the breast by hand or breast pump, fed using dropper, nasogastric tube, cup and spoon, or bottle.
- Section 3 defines “Expressing milk” as extracting human milk from the breast by hand or pump into a container.
- Section 3 defines “Infant” as a child within zero (0) to twelve (12) months of age.
- Section 3 defines “Infant formula” as breastmilk substitute formulated industrially in accordance with applicable Codex Alimentarius standards, to satisfy normal nutritional requirements up to six (6) months of age.
- Section 3 defines “Rooming-in” as placing the newborn in the same room as the mother right after delivery up to discharge to facilitate bonding and initiate breastfeeding.
- Section 3 defines “Lactation stations” as private, clean, sanitary, well-ventilated rooms or areas in the workplace or public places where nursing mothers can wash up, breastfeed or express milk comfortably, and store it afterward.
- Section 3 defines “Workplace” as work premises in private enterprises or government agencies, including subdivisions, instrumentalities, and government-owned and controlled corporations.
- Section 3 defines “Public place” as enclosed or confined areas such as schools, public transportation terminals, shopping malls, and the like.
- Section 3 defines “Nursing employee” as any female worker, regardless of employment status, breastfeeding her infant and/or young child.
- Section 3 defines “Young child” as a child from twelve (12) months and one (1) day up to thirty-six (36) months.
Coverage and Applicability Rules
- The provisions in this Chapter apply to all private enterprises and government agencies, including subdivisions and instrumentalities, and government-owned and controlled corporations (Section 4).
- Section 4 provides an exemption mechanism: health and non-health facilities, establishments, and institutions may be exempted for a renewable period of two (2) years from Section 6 when lactation stations are not feasible or necessary due to peculiar circumstances of the workplace or public place, considering among others number of women employees, physical size of the establishment, and average number of women who visit.
- Exemptions require application to, and determination by the Secretary of the Department of Labor and Employment for the private sector and the Chairperson of the Civil Service Commission for the public sector (Section 4).
- All health and non-health facilities, establishments, or institutions that are exempted yet opt to comply are entitled to the benefits provided under the Act, provided they grant employees the privilege of using the same (Section 4).
Lactation Stations, Facilities, and Prohibitions
- Section 6 mandates all health and non-health facilities, establishments, and institutions to establish lactation stations (Section 11 added).
- Section 11 requires lactation stations to be equipped with necessary equipment and facilities, including:
- lavatory for hand-washing (unless an easily accessible lavatory is nearby);
- refrigeration or appropriate cooling facilities for storing expressed breastmilk;
- electrical outlets for breast pumps;
- a small table;
- comfortable seats; and
- other items whose standards are defined by the Department of Health (Section 11).
- Section 11 requires that lactation stations shall not be located in the toilet.
- Section 11 requires strict measures to prevent any direct or indirect form of promotion, marketing, and/or sales of infant formula and/or breastmilk substitutes within lactation stations or in circumstances conducive to such promotion, marketing, and/or sales.
- Section 11 allows additional suitable facilities or services in the lactation station, and these may be eligible for Section 14 if substantiated (Section 11).
Nursing Breaks and Compensable Lactation Time
- Section 12 grants nursing employees break intervals in addition to the regular time-off for meals to breastfeed or express milk.
- Lactation intervals include the time it takes the employee to get to and from the workplace lactation station (Section 12).
- Lactation intervals are counted as compensable hours worked (Section 12).
- Section 12 authorizes the Department of Labor and Employment (DOLE) to adjust the intervals.
- Section 12 sets the minimum: intervals shall not be less than a total of forty (40) minutes for every eight (8)-hour working period.
Breastmilk Collection and Storage for Health Institutions
- Health institutions adopting rooming-in and breastfeeding must provide equipment, facilities, and supplies for breastmilk collection, storage, and utilization, with standards defined by the Department of Health (Section 10 as amended).
- Health institutions are encouraged to set up milk banks for storage of breastmilk donated by mothers and pasteurized (Section 10 as amended).
- The stored breastmilk primarily goes to children in the neonatal intensive care unit whose own mothers are seriously ill (Section 10 as amended).
Education, Training, and Public Programs
- The Department of Health, with other government agencies and professional and nongovernmental organizations, must conduct continuing information, education, re-education, and training programs for health workers on updated lactation management (Section 13).
- Information materials must be provided to all health workers involved in maternal and infant care in health institutions (Section 13).
- Health institutions and health workers must immediately and continuously teach, train, and support pregnant women and mothers during prenatal, perinatal, and postnatal consultations and/or confinements, using participatory strategies such as mothers’ clubs and breastfeeding support groups, and must distribute written information materials free of charge (Section 14).
- The Department of Health must develop and provide breastfeeding programs for working mothers, and employers are encouraged to avail of these as part of their human resource development programs (Section 14).
- The Department of Health must produce and make available relevant information and programs on maternal nutrition and proper nourishment for all city, municipal, and barangay health centers (Section 14).
- Employers are encouraged to develop breastfeeding or lactation support programs to assess needs and provide adequate lactation management information through brochures, pamphlets, and other educational materials (Section 14).
- The Department of Education, Commission on Higher Education, and Technical Education and Skills Development Authority must integrate in relevant subjects the importance, benefits, methods or techniques of breastfeeding, and changing societal attitudes toward breastfeeding, especially in medical and allied medical courses and technical vocational education (Section 15).
- August in each and every year throughout the Philippines must be known as “Breastfeeding Awareness Month” (Section 16).
- The law requires a comprehensive national public education and awareness program with objectives including:
- protecting, promoting, and supporting breastfeeding as normal, natural, and preferred;
- guaranteeing breastfeeding’s rightful place as a national health policy and nurturing value that must be enforced;
- providing information on breastfeeding benefits and superiority and the high risks and costs of bottlefeeding;
- generating awareness on full enforcement of laws, codes, policies, and programs regulating breastfeeding promotion and protecting safe and adequate nutrition, including regulating marketing of certain foods and feeding bottles, teats, and pacifiers;
- instilling recognition and support and ensuring access to comprehensive, current, culturally appropriate lactation care and services and support for breastfeeding mothers in the work force (Section 17).
- The Department of Health must lead implementation of the comprehensive national public education and awareness program through collaborative interagency and multi-sectoral efforts at all levels (Section 17).
DOH Certification and Working Mother-Baby Friendly Status
- Facilities satisfying the requirements for proper lactation stations may apply with the local Department of Health office for a “working mother-baby friendly” certification (Section 18).
- The Department of Health must promulgate guidelines to determine eligibility, including an annual Department of Health inspection to confirm continued compliance with standards (Section 18).
- The Department of Health must maintain and publish a list of “mother-baby-friendly” establishments available to the public (Section 18).
Incentives and Implementation Responsibilities
- Expenses incurred by private health and non-health facilities in complying with the Act are deductible for income tax purposes up to twice the actual amount incurred (Section 19).
- The deduction applies for the taxable period in which the expenses were incurred (Section 19).
- All health and non-health facilities, establishments, and institutions must comply with the provisions of the Act within six (6) months after its approval (Section 19).
- Private facilities must secure a “Working Mother-Baby-Friendly Certificate” from the Department of Health, and file it with the Bureau of Internal Revenue, before availing the incentive (Section 19).
- Government facilities, establishments, and institutions receive an additional appropriation equivalent to savings derived from complying with the Act, included in their budget for the next fiscal year (Section 19).
- The Department of Health is principally responsible for implementation and enforcement (Section 20).
Sanctions and Administrative Penalties
- Private non-health facilities, establishments, and institutions that unjustifiably refuse or fail to comply with Sections 6 and 7 must be fined:
- first offense: not less than PHP 50,000 but not more than PHP 200,000;
- second offense: not less than PHP 200,000 but not more than PHP 500,000;
- third offense: not less than PHP 500,000 but not more than PHP 1,000,000 and cancellation or revocation of business permits or licenses to operate (Section 21).
- Fines must take into consideration, among others, number of women employees, physical size of the establishment, and average number of women who visit (Section 21).
- The Secretary of Health is empowered to impose sanctions on health institutions for violations of the Act and rules issued thereunder, in forms including:
- reprimand or censure;
- and for repeated willful violations, suspension of the permit to operate (Section 21).
- Heads, officials, and employees of government health and non-health facilities who violate the Act face administrative penalties:
- first offense: reprimand;
- second offense: suspension for one (1) to thirty (30) days;
- third offense: dismissal;
- without prejudice to other liabilities under civil service law and rules (Section 21).
Funding, IRR Issuance, and Timing
- Government agencies, including subdivisions and instrumentalities, must use their respective budgets for gender and development or budgets for repairs, maintenance and materials acquisition to comply with Section 6 (Section 17).
- The Department of Health, as lead agency, must issue the rules and regulations needed to carry out the Act within one hundred and twenty (120) days from effectivity, in coordination with the Department of Labor and Employment, Department of Trade and Industry, Department of Justice, Department of Social Welfare and Development, Department of Education, Department of the Interior and Local Government, Civil Service Commission, Commission on Higher Education, Technical Education and Skills Development Authority, and professional and nongovernmental organizations concerned (Section 18).
Separability and Repeal Rules
- Section 19 provides separability: if any clause, sentence, paragraph, or part is declared invalid, the remainder remains in force and effect.
- Section 20 repeals or modifies all laws, presidential decrees, executive orders, rules and regulations, or parts that are inconsistent with the Act.