How many babies need to die before they are allowed their mothers' milk?

Bob Dylan the well known singer and song writer wrote ‘Blowing in the Wind’ in 1962 a hard hitting song about war and peace and human rights during the civil rights movement in the United States. One line in that song goes like this: Yes, 'n' how many years can some people exist, Before they're allowed to be free? Another line in the same song: Yes, 'n' how many deaths will it take till he knows.

That too many people have died?

The recent scandal surrounding the U.S. administration’s attempts to derail a resolution to promote breast feeding of infants evidently in favour of infant formula manufacturers brings to mind Bob Dylan’s powerful song.

The United Nations-affiliated World Health Assembly held a meeting in May 2018 in Geneva. Delegates representing many countries had gathered to pass a resolution to promote and encourage breast feeding. The member countries expected a swift passage of the resolution. The U.S. delegation in a shocking turn of events initially pushed to remove a phrase from the draft text that would ask governments to “protect, promote and support breast-feeding”. NY Times reported that Ecuador was threatened with aid cuts and punitive trade measures if it went ahead with the resolution. President Trump has denied this in a tweet.

Russia had to intervene and the resolution promoting breast feeding passed, the U.S. also had to vote for the resolution in the face of a huge outrage on the national and international front.

The Health Advantages to Breast Feeding

In a detailed article published in the leading medical journal The Lancet in January 2016, key messages were that children who were breastfed for long periods had lower rates of respiratory, intestinal and ear infections, had higher intelligence, and fewer dental problems. Breast feeding it appears may protect children from obesity and diabetes in the future. Breast feeding may also lower risk of ovarian cancer in women. There is evidence to support lower incidence of breast cancer in women who have breastfed their infants.

The researchers in The Lancet argued that increasing breastfeeding practices to almost universal levels and for up to 2 years can prevent 823000 annual deaths of children younger than 2 years.

They also estimated that rates of breastfeeding they observed during their research period prevented 20000 annual deaths from breast cancer.

A 2016 Harvard study found that 3,340 annual premature deaths in the U.S. and $3 billion in medical costs were associated with suboptimal breastfeeding. Optimal breastfeeding is exclusive breastfeeding for six months with continued breastfeeding for one year.

Global Infant Formula Industry

The major global infant formula producing companies are the British Mead Johnson (now Reckitt Benckiser), Swiss Nestle, French Danone, and the U.S. Abbott.

In 2015, retail sales were $ 53.3 billion and are projected to increase to $ 76 billion by 2021. Abbott an American company spent 790,000 dollars on lobbying efforts in 2018. It also contributed a significant amount to Trump’s campaign during the 2017 elections.

In 1974 an organization called War on Want published The Baby Killer exposing Nestle company’s aggressive marketing measures in developing countries influencing healthcare workers and encouraging women to use infant formula rather than breastfeed.  This sparked a widespread movement to boycott Nestle in the 1970s.

In 1981 the World Health Organization (WHO) implemented an international code banning the advertisement of infant milk products as being comparable to breastmilk.  The global infant formula companies have been accused of continuing to violate the code.

Changing Markets Foundation’s new report has found that Nestlé marketed its infant milk formulas as “closest to”, “inspired by” and “following the example of” human breastmilk in several countries, which is in violation of the WHO code of 1981.

The study analyzed over 70 Nestle baby milk products in 40 countries. In South Africa, the firm used sucrose in infant milk formulas, in Brazilian and Hong Kong they reported their products were free of sucrose “for baby’s good health”.

A Guardian/Save the Children investigation published in February 2018 revealed that in some areas of the Philippines Nestlé and other companies were bribing doctors and other health care workers with free trips to conferences and other entertainments in violation of Philippine law.

Targeting the Developing World

More and more women are breastfeeding in the U.S. In 2004 ,42% of babies were being breastfed at 6 months and in 2014, 55% of babies are being breastfed. The global infant formula makers are pushing their products on the developing world where breastfeeding was previously the norm.  WHO report from 2015 showed an average of 28% babies breastfed between 2007 and 2014 globally. Aggressive advertising from infant formula companies has played an important role in China having one of the lowest rates of breastfeeding in the world. An interesting analogy is with the Big Tobacco companies which have been aggressively promoting their products in the developing countries as smoking rates have declined in the Western countries.

India enacted a legislation - Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) called IMS Act after the World Health Assembly urged member states to introduce laws on advertisements of infant foods.

“India has one of the most comprehensive laws in the world when it comes to outlawing the promotion of formula milk and infant foods for children below two years old,” said Dr. Arun Gupta, International Baby Food Action Network (IBFAN) Asia coordinator. “But 21 years since it was enacted, it is clear that the law is being blatantly violated by big corporates who are misleading mothers.”

India ranks low on breastfeeding practices based on a report by WHO and UNICEF, exclusive breastfeeding in the 1st 6 months is at 55%.

Cuba: Setting High Standards

99% of Cuban babies were delivered in hospitals or other health institutions in 2016. 57 of the country’s maternity hospitals have been UNICEF-accredited ‘Mother-And-Baby-Friendly,’ wherein a high percentage of mothers successfully breastfeed when they leave the hospital.

Conclusions

In most countries in the world women have inflexible work conditions and hours, a lack of privacy for breastfeeding, they are unable to find crèches at or near the workplace, have job insecurity, and limited maternity leave. Passing a resolution to encourage breastfeeding is only the first step, women will need structural support. And after that it is up to the individual woman to make an informed decision as to breastfeed or use an alternative for her infant.

U.S. and European imperialism have many manifestations, the most obvious being military interventions to overthrow independent governments who do not toe the line. Transnational corporations based in imperial countries, given their meager growth in North America and Europe, are aggressively focusing on developing countries at the serious detriment of peoples' health and well being. This can be defeated only by strong grassroots movements to protect public health in the short term. The bigger challenge for humanity is to defeat the underlying twin evils of capitalism and imperialism.

-- Padma