For generations, Pacific Island women sat cross-legged on the floor and fed their babies on demand.
When they faced challenges, their sisters, mothers, aunties and grandmothers stepped in to help.
But in the Pacific today, only about half of babies under six months are exclusively breastfed — and it's no surprise formula milk sales have increased.
Despite boasting higher rates of breastfeeding than other parts of the world, those rates are falling.
Reasons for this include aggressive marketing practices by formula companies, social and cultural taboos and difficulty managing work and nursing commitments.
Unsurprisingly, the region is not on track to reach a global target of at least 70 per cent exclusive breastfeeding by 2030.
'You miss out on so much'
PNG mother-of-three Melinda Kanamon had just started a new job when she fell pregnant with her second child.
Ms Kanamon was not eligible for maternity leave, so she used annual leave and sick leave to give birth and recover.
She returned to work weeks later.
"Consideration needs to be given to extend maternity leave to enable mums to fully provide for their baby, to bond with them and to exclusively breastfeed for three to four months," she said.
"At that age, they just need so much consistently and I was unable to provide that."
The full-time working mum reorganised her day to factor in an early morning feed, but eventually, her body stopped producing milk.
"The healthcare workers did advise me that it was because of the inconsistency, as well as postnatal stress," she said.
Ms Kanamon was left with no option but to exclusively bottle-feed her daughter with formula from four weeks old — it was a "costly exercise".
"In a month, we'd spend between 400 and 600 kina ($AU160-$240) on formula and that was a really big expense for us, especially with just me working. But we managed," she said.
Living in PNG's highlands, Ms Kanamon said she often felt judged by her inability to breastfeed.
"People would give me that look of disappointment when I was feeding my child with a bottle instead of breastmilk," she said.
"Not a lot of us understand the different, various reasons why working mums can't breastfeed."
Happy baby, happy worker
PNG news director Genesis Ketan wanted to exclusively breastfeed her four children, including twins, but managing work and nursing proved difficult.
Ms Ketan gave birth to her daughter in 2017 but it coincided with the country's elections, so she returned to work three weeks later.
Missing out on crucial bonding time with her baby had lasting impacts.
"I had to exclusively bottle-feed after that and I've noticed she has formed a closer relationship to her babysitter and her father than to me," she said.
"You want that bond that comes from breastfeeding your baby."
PNG is one of the last countries in the world to guarantee paid maternity leave.
Working mothers are entitled to six weeks of maternity leave, unpaid — for it to be paid, they must convert sick leave and recreation leave into maternity leave.
While Ms Ketan felt supported by her employer, who granted her leave to breastfeed her premature twin babies, she said she still faced barriers.
"It's easier if you have a vehicle so you can travel home to breastfeed during the lunchtime, or express pump milk and fill up the bottles," she said.
"But I didn't have a car at the time, so I couldn't go home and come back to work.
"Employers need to make paid time for this, or even if it is on our lunchbreak, then our employer needs to provide transport to and from our home.
"If everything at home is fine and our babies are fully fed, satisfied and happy, then we're happy workers and we're able to be more productive at the end of the day."
'Don't feel inferior'
Physician and mother Mangu Kendino's breastfeeding experience with her seven-month-old daughter has been different to Ms Kanamon and Ms Ketan's.
Under PNG's Public Services Act, female public servants are entitled to two hours of paid breastfeeding leave per day for six months.
But utilising it becomes a matter of being able to "potentially accommodate for that during the work schedule," Dr Kanamon said.
"I wake up in the morning, she wakes up after me, I breastfeed her, then I run off to work," she said.
"It's then a cycle throughout the day when I'm returning at 10am, 12pm, 2pm."
Dr Kendino said she is "in awe" of those who still accommodate for feeds, without financial support from their employer.
"If you are not exclusively breastfeeding within the six-month period, don't feel you are inferior in any way," she said.
Breastmilk 'saves children's lives'
Frances Vulivuli, a health and nutrition specialist with UNICEF in Fiji, said the "worrisome" decline in breastfeeding rates were being seen in Samoa and countries not signed up to the World Health Assembly code to promote breastfeeding.
Of the 14 Pacific Island countries supported by UNICEF Pacific, only two have taken regulatory action in line with the code — Fiji and Palau.
"In Samoa, the exclusive breastfeeding dropped from 70.3 per cent in 2014 to 51.7 per cent in 2019," she said.
"Early initiation within the first hour fell from 81.4 per cent in 2014 to 53 per cent in 2019.
Dr Vulivuli said "urgent action" must be taken to address this decline across the Pacific.
"Babies who are exclusively breastfed are 14 times less likely to die in the first six months than babies who are not breastfed," she said.
"Breastmilk saves children's lives as it provides antibodies that give babies a healthy boost and protect them against many childhood illnesses."
