Roger Mathisen

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Verified

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• Master of Science (MSc, RD)
• Director Alive & Thrive East Asia Pacific at FHI 360

Evidence shows that breastfeeding has many health, human capital and future economic benefits for young children, their mothers and countries. The new Cost of Not Breastfeeding tool, based on open access data, was developed to help policy-makers and advocates have information on the estimated human and economic costs of not breastfeeding at the cou...

The Mothers' Milk Tool was developed to make more visible the economic value contributed to society by women's unpaid care work through breastfeeding infants and young children. This manuscript describes the development and display key features of the tool, and reports results for selected countries. For the development, we used five steps: (1) def...

Women’s¹ lifelong health and nutrition status is intricately related to their reproductive history, including the number and spacing of their pregnancies and births, and for how long and how intensively they breastfeed their children. In turn, women’s reproductive biology is closely linked to their social roles and situation, including regarding ec...

Policy-makers need to rethink the connections between the economy and health. The World Health Organization Council on the Economics of Health for All has called for human and planetary health and well-being to be moved to the core of decision-making to build economies for health. Doing so involves valuing and measuring what matters, more and bette...

Background Sales of commercial milk formula products (CMF) are rising rapidly. This study analysed key economic and environmental impacts CMF feeding in Indonesia, which are often overlooked in policy discussions despite their relevance. Methods We assessed the economic and environmental impacts of CMF in Indonesia in 2020 using the Mothers’ Milk...

Background Inattention to young child growth and development in a transitioning global environment can undermine the foundation of human capital and future progress. Diets that provide adequate energy and nutrients are critical for children’s physical and cognitive development from 6 to 23.9 months of age and beyond. Still, over 70% of young childr...

Islam provides strong support for infants to be breastfed, including for wet nursing where mothers are unable to breastfeed. Amongst those infants who may be in need of breastmilk from another woman are small vulnerable newborns. These infants can benefit from donor human milk from a human milk bank (HMB). However, in Islamic contexts, HMBs must be...

Timely support given to breastfeeding mothers can result in life‐saving benefits for both mothers and infants. Progress in achieving results from existing efforts to improve breastfeeding practices can be accelerated with adequate investments in effective interventions. We aimed to document expenditures incurred by three diverse programs in Banglad...

Background/Objectives: There is extensive evidence that breastfeeding saves lives, improves health, and provides value to the economy and societies worldwide. The Philippines and Viet Nam have progressive policies to enable breastfeeding, and breastfeeding rates in these countries have substantively improved. In the Philippines, exclusive breastfee...

Child nutrition has serious long‐term development implications. Evidence‐based frameworks and models are urgently needed to reduce deficits in infants and young children's diets on a large scale. Our paper reviews 32 publications and five impact evaluations of programmes in Bangladesh, Ethiopia, Nepal, Nigeria and Vietnam to identify what worked an...

Background/Objectives: There is extensive evidence that breastfeeding saves lives, improves health and provides value to the economy and societies worldwide. The Philippines and Viet Nam have progressive policies to enable breastfeeding, and breastfeeding rates in these countries have substantively improved. In the Philippines, exclusive breastfeed...

Background: Sales of commercial milk formula products (CMF) are rising rapidly. This study aims to analyse the key economic and environmental impacts CMF feeding in Indonesia. Methods: We assessed the economic and environmental impacts of CMF in Indonesia in 2020 using the Mothers’ Milk Tool (MMT), the Green Feeding Tool (GFT) and the Cost of Not B...

Background and Objectives: Donor human milk (DHM) from a human milk bank (HMB) is used to feed low-birthweight (LBW) and preterm infants when mothers cannot provide their own breastmilk. The misuse of DHM could interfere with mothers’ breastmilk and weaken breastfeeding efforts. This study aimed to identify factors behind prolonged DHM usage during...

Introduction Self-help groups (SHGs) and Support Groups (SGs) are increasingly recognized as effective mechanisms for improving maternal and young child nutrition due to their decentralized, community-based structures. While numerous studies have evaluated the outcomes and impact of SHGs and SGs on nutrition practices, there remains a gap in the li...

Breastfeeding rates in Vietnam, and globally, remain suboptimal. A major contributor to this is the aggressive marketing of commercial milk formulas (CMF), mainly through online media. The Vietnamese Government has implemented legal measures to limit CMF marketing, but these have been difficult to enforce, because of complex online environments. We...

Nutrition in early life plays a key role in shaping an infant's future health. There is limited understanding of the perspectives of Vietnamese mothers with children under 24 months of age regarding breastmilk expression, donation and use. In this cross‐sectional study, an online survey was administered through two parenting social media communitie...

Background Breastfeeding is the biological norm for feeding infants and young children. When mothers’ breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and sca...

Carbon offset frameworks like the UN Clean Development Mechanism (CDM) have largely overlooked interventions involving food, health, and care systems, including breastfeeding. The innovative Green Feeding Climate Action Tool (GFT) assesses the environmental impact of commercial milk formula (CMF) use, and advocates for breastfeeding support interve...

Background Inattention to young child growth and development in a transitioning global environment can undermine the foundation of human capital and future progress. Diets that provide adequate energy and nutrients are critical for children's physical and cognitive development from 6 to 23.9 months of age and beyond. Still, over 70% of young childr...

Breastfeeding is important for health, but until now its broader environmental and economic significance has been in the shadows. Two new resources – the Mothers’ Milk Tool and the Green Feeding Tool – switch on the light by calculating the environmental costs and economic losses of not breastfeeding. Launched by the Australian National University...

Nutrition policies are critical frameworks for tackling the triple burden of malnutrition, including undernutrition (i.e., stunting and wasting), overweight, and hidden hunger (i.e., micronutrient deficiencies). We examined (1) the alignment of recent National Nutrition Strategies and Action Plans (NNS) in Cambodia, Laos, and Vietnam with recent gl...

There is a growing recognition globally that care regarding lactation following a perinatal death needs to potentially offer the opportunity for maternal donation. This article discusses this experience and perspectives from a human milk bank (HMB) in Vietnam. This is a descriptive exploratory case study that has a long tradition in both the social...

Background The Philippines has enacted maternity protection policies, such as the 105-Day Expanded Maternity Leave Law and the Expanded Breastfeeding Promotion Act of 2009, to protect, promote, and support breastfeeding. This study aimed to review the content and implementation of maternity protection policies in the Philippines and assess their ro...

Background Donor human milk (DHM) is essential to the operation of human milk banks (HMB). This study examined characteristics and factors associated with higher volumes of DHM donation at the first HMB in Vietnam. Method Data from an online HMB monitoring system collected between February 2017 and July 2022 included demographic characteristics, c...

(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to deliver high-quality breastfeeding and early essenti...

Women’s contributions to food production and food security are often overlooked, thus perpetuating inequitable and unsustainable globalized commercial food systems. Women’s role as producers in the first-food system, breastfeeding, is largely invisible and underfunded, encouraging the production and consumption of environmentally unsustainable comm...

In 2013, Vietnam expanded its paid maternity leave from four to six months. This study evaluated whether the expansion of Vietnam's paid maternity leave policy was associated with improved long-term labour market outcomes for Vietnamese women. We used a regression discontinuity design to evaluate the impact of this policy on the probability of wome...

[This corrects the article DOI: 10.3389/fnut.2022.1049610.].

The Philippine Milk Code was enacted in 1986 to protect breastfeeding and reduce inappropriate marketing of breastmilk substitutes (BMS). The Philippine Milk Code is categorized as “substantially aligned” with the International Code of Marketing of Breast-milk Substitutes (“the Code”), but its provisions are assessed as relatively weak in prohibiti...

Introduction Recommendations for the clinical management of new mothers with suspected or confirmed COVID-19 and their infants are required. Guidance must weigh the risk posed by transmission of SARS-CoV-2 against the protection that maternal proximity and breastfeeding provide infants. Our aim was to review international COVID-19 guidance for mate...

Background In March 2020, the World Health Organization (WHO) published clinical guidance for the care of newborns of mothers with COVID-19. Weighing the available evidence on SARS-CoV-2 infection against the well-established harms of maternal-infant separation, the WHO recommended maternal-infant proximity and breastfeeding even in the presence of...

Background: Microbiological quality is one of the key safety standards in human milk bank (HMB) operations. We describe the profiles of bacteria in donor human milk (DHM) before and after the pasteurization of samples collected from breastfeeding women in the hospital and from the community in the first HMB in Vietnam. Methods: Data were collect...

Breastfeeding is essential for child survival but globally less than fifty percent of infants receive adequate breastfeeding. Gaps in breastfeeding knowledge and misinformation are widespread. Mass media aims to motivate mothers and families, encourage care-seeking, improve social norms, and counteract misleading advertising. However, the costs and...

The prevalence of early and exclusive breastfeeding in Vietnam remains sub-optimal. The objective of this study was to determine factors associated with early initiation of breastfeeding (EIBF) and exclusive breastfeeding for the first 3 days after birth (EBF3D). We conducted a population-based, cross-sectional survey of 726 mothers with children a...

The Philippines has adopted policies to protect, promote, and support breastfeeding on par with global standards, yet the impact of these policies is not well understood. This study assesses the adequacy and potential impact of breastfeeding policies, as well as the perceptions of stakeholders of their effectiveness and how to address implementatio...

Manufacturers and distributors of commercial milk formula (CMF), or breast milk substitutes (BMS), a US$ 55 billion industry,1 have a duty to their shareholders to maximise sales. Marketing increases CMF sales - but reduces breastfeeding. The health system and those who work within it have a primary obligation to preserve and improve health outcome...

Objectives To determine the content, implementation, and effectiveness of policies aimed at improving breastfeeding practices in the Philippines. Methods This study used mixed methods, including a desk review of relevant policies and documents and in-depth interviews with 100 caregivers, workers, employers, health workers, and policymakers. Resul...

Objectives To examine the uptake of Vietnam's paid maternity leave policy in terms of entitlements and awareness, perceptions, and gaps in implementation through the lens of formally employed female workers. Methods In this mixed methods study, we interviewed 494 formally employed female workers, among whom 107 were pregnant and 387 were mothers o...

Objectives To determine factors associated with breastfeeding practices around childbirth, namely early initiation of breastfeeding (EIBF) and exclusive breastfeeding for the first three days after birth (EBF3D). Methods A population-based, cross-sectional survey of 726 mothers with children aged 0–11 months in two provinces and one municipality w...

Maternity protection is a normative fundamental human right that enables women to combine their productive and reproductive roles, including breastfeeding. The aim of this study is to examine the uptake of Vietnam’s maternity protection policy in terms of entitlements and awareness, perceptions, and gaps in implementation through the lens of formal...

The influence of marketing on infant and young child feeding and health is well recognized, and an International Code was adopted by the World Health Assembly (WHA) in 1981 to reduce inappropriate marketing and protect breastfeeding. Yet the marketing and influencing continue. This scoping review systematically examined the published research evide...

Commercial milk formula for pregnant women (CMF-PW) is an expensive, ultra-processed food with a high concentration of sugar, the consumption of which may be linked to negative health outcomes. However, CMF-PWs are promoted as beneficial for pregnant women and lactating mothers as well as their children. To date, little is known about the factors a...

Background The aggressive marketing of breastmilk substitutes (BMS) reduces breastfeeding, and harms child and maternal health globally. Yet forty years after the World Health Assembly adopted the International Code of Marketing of Breast-milk Substitutes (The Code), many countries are still to fully implement its provisions into national law. Furt...

This is the protocol for a scoping review that aims to systematically explore and summarise the published evidence of violations of the International Code of Marketing of Breast-milk Substitutes (the Code) and subsequent World Health Assembly Resolutions globally. The planned scoping review will seek to identify what research has been conducted on...

Background: The promotion of breastmilk substitutes (BMS) is an important barrier to successful breastfeeding. Objective: To examine the enactment and implementation of the Code of Marketing of Breast-Milk Substitutes (the Code) in Vietnam with a focus on marketing practices by the baby food industry and perceptions of caregivers, health workers...

Background: Rates of early initiation of breastfeeding are low in Southeast Asia, despite evidence that increased initiation of early breastfeeding would lead to better long-term infant and child health and decrease inequities in long-term health and well-being. In response, a novel performance-based, baby-friendly hospital program designates hospi...

Background Poor access to healthcare facilities and consequently nutrition counseling services hinders the uptake of recommended infant and young child feeding (IYCF) practices. To address these barriers and improve IYCF practices, Alive & Thrive (A&T) initiated community support groups in remote villages across nine provinces in Vietnam. Objectiv...

Background Providing an enabling environment for breastfeeding is hampered by the inequitable implementation of paid maternity leave, primarily due to perceived or actual financial costs. To estimate the real cost of paid maternity leave requires using reliable methods. We compared methods utilized in two recent studies in Indonesia. Study A estima...

Background: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother’s own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste res...

Background: Since 1979, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight (LBW) and preterm newborns as the 'first alternative' when mothers are unable to provide their own milk. However, they have not issued an...

Breastfeeding is critical to maternal and child health and survival, and the benefits persist until later in life. Inappropriate marketing of breastmilk substitutes (BMS), feeding bottles, and teats threatens the enabling environment of breastfeeding, and exacerbates child mortality, morbidity, and malnutrition, especially in the context of COVID-1...

Background The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) an...

Objective To examine the association between the place of residence and receiving free samples and advice to feed the baby with infant formula. Design A cross-sectional study. Setting This study covered 12 counties/districts in China. Participants 5,112 mothers with infants aged 0-5.9 months. Results About 16% of the mothers received free sampl...

BACKGROUND Since 1979, the World Health Organization (WHO) and UNICEF have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight and preterm infants as the first alternative when mothers are unable to provide their own milk. Globally, there are about 700 HMBs, and the number is increasing. Concerns relat...

• When a mother’s own milk is unavailable for preterm or low birthweight infants, pasteurised donor milk protects against necrotising enterocolitis compared with formula milk • Pasteurised donor milk can also be used to supplement the mother’s own milk in order to meet an infant’s nutritional needs and can be administered in the sameways as the mot...

In low- and middle-income countries, almost three-fourths of women in the labour force lack maternity protection. In the Philippines, current laws do not guarantee paid maternity leave to workers in the informal economy. A non-contributory maternity cash transfer to informal sector workers could be used to promote social equity and economic product...

Background: Despite its well-known benefits, breastfeeding practices remain suboptimal worldwide, including in Southeast Asia. Many countries in the region have thus enacted policies, such as maternity protection and the World Health Assembly International Code of Marketing of Breast-milk Substitutes (the Code), that protect, promote, and support...

BACKGROUND Previous studies focused on the promotion of infant formula in big cities and among families of high socioeconomic status in China. OBJECTIVE To examine the association between the place of residence and receiving free samples and advice to feed the baby with infant formula. METHODS We analyzed cross-sectional data from face-to-face in...

Background: In an effort to prevent infants being infected with SARS-CoV-2, some governments, professional organisations, and health facilities are instituting policies that isolate newborns from their mothers and otherwise prevent or impede breastfeeding. Weighing of risks is necessary in policy development: Such policies are risky as was show...

We examined the association between breastfeeding practices and associated factors using cross‐sectional data from face‐to‐face interviews with 9,745 mother–child dyads in China. The study collected information on breastfeeding practices and potential associated factors at the individual, family, health facility and environmental levels in China. W...

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coor...

Background: The World Health Organization (WHO) recommends early essential newborn care (EENC) - The First Embrace - as a simple lifesaving procedure for newborns. The successful implementation of EENC at scale requires an understanding of health staff experiences, including facilitators, barriers, and local adaptations of EENC. This study aims to...

UNSTRUCTURED Design: Mixed methods (desk review, trend data analysis, quantitative and qualitative data collection). Population: In each of the 4 countries: we will conduct up to 24 in-depth interviews (IDI) with policy makers or authorities at national and provincial levels and stakeholders from the United Nations (UN), non-governmental organizati...

Opinion leader research (OLR) has been widely used in public health to identify influential persons or organizations to affect health care practice, inform policy-making processes, and help shape communication strategies. We used OLR to gather information related to barriers and possible solutions to guide strategic engagement for strengthening pol...

Background The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually (Walters et al, 2016; Siregar et al, 2018; Walters et al, 2019), the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia are informal employees, and less than 50% exclusive breastfeed. No m...

Background The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15-49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) an...

Background The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15-49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) an...

Background The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15-49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) an...

Background: Progress in gender equity can improve health at the individual and country levels. Objectives: This study’s objective was to analyze recent trends in gender equity and identify historical and contextual factors that contributed to changes in gender equity in three countries: China, Nepal, and Nicaragua. Methods: To assess gender equity...

Background: Almost half of all Indonesian children under 6 months of age were not exclusive breastfed in 2017. Optimizing maternity protection programs may result in increased breastfeeding rates. This study aims to: estimate the potential cost implications of optimizing the current paid maternity protection program, estimate budgets needed to incr...

Nutrition issues are increasingly being addressed through global partnerships and multi-sectoral initiatives. Ensuring effective governance of these initiatives is instrumental for achieving large-scale impact. The Collective Impact (CI) approach is an insightful framework that can be used to guide and assess the effectiveness of this governance. D...

https://doi.org/10.1159/000480486

Objective: To review regulations and to perform a media audit of promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes ('the Code') in South-East Asia. Design: We reviewed national regulations relating to the Code and 800 clips of editorial content, 387 advertisements and 217 Facebook posts from...

Rates of exclusive breastfeeding are slowly increasing, but remain suboptimal globally despite the health and economic benefits. This study estimates the costs of not breastfeeding across seven countries in Southeast Asia and presents a cost-benefit analysis of a modeled comprehensive breastfeeding strategy in Viet Nam, based on a large programme....

Background: In 2005, more than 90% of Vietnamese households were using adequately iodized salt, and urinary iodine concentration among women of reproductive age was in the optimal range. However, household coverage declined thereafter to 45% in 2011, and urinary iodine concentration levels indicated inadequate iodine intake. Objective: To review...

Exclusive breastfeeding in the first six mo of life is critical to child development and health. Effective from May 1, 2013, Vietnam became one of the first lower- to middle-income countries to offer 6-month paid maternity leave (6mo-PML). We analyzed data from different sources to 1) describe the process of adopting the 6mo-PML policy, 2) examine...

Background. In Vietnam, malnutrition remains a public health problem, even though much progress has been made in the last decades. The number of cases of severe acute malnutrition (SAM) is more than 200,000 per year. To accelerate the treatment of SAM, community-based treatment with ready-to-use-therapeutic foods (RUTFs) is preferred. However, a lo...