Earlier this month, the Trump administration took a stance in favor of infant formula over breastfeeding. Although the president denied it was an action against encouraging breastfeeding in a tweet, the US delegation to the United Nations affiliated World Health Assembly used its influence to try and kill a resolution that would have promoted breastmilk and restricted formula marketing. The resolution was aimed at misleading marketing tactics by formula companies, such as Nestle, as well as increasing breastfeeding around the world.

Infant formula is necessary in some cases. Statistically, this number is very low. Between 1-5% of mothers are physically unable to breastfeed. Mothers choose infant formula for a variety of reasons. I don’t believe they should be shamed for this; however, they should not be influenced by misinformed infant formula marketing tactics. 

Breastmilk is nature’s first food for infants. Infant formula is a human-made substitute. According to the 2011 US Surgeon General’s Call to Action to Support Breastfeeding:

In the United States, bottle feeding is viewed by many as the “normal” way to feed infants. Moreover, studies of mothers who are immigrants that examine the effects of acculturation have found that rates of breastfeeding decrease with each generation in the United States and that mothers perceive bottle feeding as more acceptable here than in their home countries.^79–86 Widespread exposure to substitutes for human milk, typically fed to infants via bottles, is largely responsible for the development of this social norm. After reviewing data from market research and studies conducted during 1980–2005, the U.S. Government Accountability Office (GAO) reported that advertising of formula is widespread and increasing in the United States.⁸⁷ Furthermore, the strong inverse association between the marketing of human milk substitutes and breastfeeding rates was the basis of the WHO International Code of Marketing of Breast-milk Substitutes (the Code).³⁵ The Code has been reaffirmed in several subsequent World Health Assembly resolutions. However, its provisions are not legally binding in the United States. [note]https://www.ncbi.nlm.nih.gov/books/NBK52688[/note]

The Politics of Breastfeeding

How could something as simple as encouraging mothers to breastfeed become so politicized? According to the New York Times, the US delegation actually threatened and bullied other countries to drop the breastfeeding resolution.

American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

When that failed, they turned to threats, according to diplomats and government officials who took part in the discussions. Ecuador, which had planned to introduce the measure, was the first to find itself in the cross hairs.

The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced.

The showdown over the issue was recounted by more than a dozen participants from several countries, many of whom requested anonymity because they feared retaliation from the United States.[note]https://www.nytimes.com/2018/07/08/health/world-health-breastfeeding-ecuador-trump.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news[/note]

Russia came to the rescue of breastfeeding and introduced the resolution. The Trump administration did not try their same bullying tactics on Putin.

The official message from the Department of Health and Human Services is not that the US government is anti-breastfeeding, but the intent was to protect a woman’s right to choose how to feed her baby. Newsweek reported:

Caitlin Oakley, a spokesperson for the Department of Health and Human Services, told Newsweek in an emailed statement, “Recent reporting attempts to portray the U.S. position at the recent World Health Assembly as ‘anti-breastfeeding’ are patently false. The United States has a long history of supporting mothers and breastfeeding around the world and is the largest bilateral donor of such foreign assistance programs,” the statement said. “The issues being debated, were not about whether one supports breastfeeding. The United States was fighting to protect women’s abilities to make the best choices for the nutrition of their babies.”[note]https://www.newsweek.com/us-breastfeeding-resolution-opposition-russia-objects-un-world-health-1013327[/note]

Particularly the US opposed the language of the draft resolution originally proposed by Botswana, Canada, Gambia, Georgia, Ghana, Kenya, Mexico, Mozambique, Namibia, Nepal, Pakistan, Panama, Russian Federation, Senegal, Sierra Leone, Sri Lanka, Thailand, and Zambia that said:

The US attempted to remove the language “protect, promote and support breastfeeding” from the resolution by threatening Ecuador with trade punishments and withdrawal of military aid. Other countries were likewise intimidated, except for Russia. The language remained; however, “inappropriate promotion of foods for infants and young children” was removed. [code]https://www.aol.com/article/news/2018/07/08/trump-admin-favored-corporations-in-opposing-breastfeeding-resolution-report/23477344/[/note]

Interestingly, the countries included in the original draft resolution proposal are ones that have seen the greatest adverse effects of formula companies marketing tactics. Take for example Botswana. In 2016, the country filed charges against infant formula maker Nestle for violating the country’s Marketing of Food for Infants and Young Children regulations.[note]http://www.babymilkaction.org/archives/8584[/note]

The involvement of the World Health Organization in passing resolutions against aggressive marketing infant formula marketing strategies began in 1981 after recommendations in 1979 by UNICEF and member states. This resolution stated:

Impoverished women in these countries often dilute infant formula with more water causing malnutrition. Clean, safe drinking water is also not always available. [note]https://www.nytimes.com/1981/12/06/magazine/the-controversy-over-infant-formula.html?pagewanted=all[/note][note]https://www.businessinsider.com/nestles-infant-formula-scandal-2012-6#meanwhile-in-the-third-world-women-tried-to-save-money-by-diluting-the-formula-8[/note] In fact, some experts believe it is impossible for women in developing countries to use infant formula properly. Some families spend 3/4 of their income just on formula.[note]https://www.theguardian.com/lifeandstyle/2018/feb/27/formula-milk-companies-target-poor-mothers-breastfeeding[/note]

The 1981 resolution continued to lay out specific marketing and business practices such as bonuses for the volume of infant formula sales and sales quotas should not be used. 

This 1981 non-binding regulation promoting breastfeeding and discouraging infant formula marketing tactics was passed 118-1.  The lone dissenting vote: the United States.

27 years ago the reasoning for US dissent was free speech. The New York Times explained:

The United States’s lone dissenting vote was explained, in part, by Elliott Abrams, Assistant Secretary of State for International Organization Affairs (since nominated to be the Assistant Secretary of State for Human Rights). ”Despite our governmental interest in encouragement of breast-feeding,” he said the W.H.O. recommendations for a complete ban on advertising to the general public of infant formula and the proposed restrictions on the flow of information between manufacturers and consumers ”run counter to our constitutional guarantees of free speech and freedom of information.”[note]https://www.nytimes.com/1981/12/06/magazine/the-controversy-over-infant-formula.html?pagewanted=all[/note]

The Trump administration is following in the footsteps of the Reagan administration protecting the interest of big business over women worldwide, only this time using the excuse of limiting access to formula as the reason for opposition. In fact, the Reagan government stated there was no problem with infant formula in the US, failing to act globally and ignoring studies of low-income households in big US cities.[note]https://www.nytimes.com/1981/12/06/magazine/the-controversy-over-infant-formula.html?pagewanted=all[/note]

In 2016, the Trump administration delegation also opposed the WHO provisions against infant formula marketing tactics. [note]https://lactationmatters.org/2016/06/29/protections-for-breastfeeding-at-the-69th-world-health-assembly/[/note] The Obama administration supported WHO promotion of breastfeeding. [note]https://www.nytimes.com/2018/07/08/health/world-health-breastfeeding-ecuador-trump.html[/note]

2018 Nestle still at in the Philippines

The developing world continues to be the target of infant formula predatory marketing tactics. Take for example the Philippines where Nestle has violated the law by offering “doctors, midwives and local health workers free trips to lavish conferences, meals, tickets to shows and the cinema and even gambling chips, earning their loyalty.”[note]https://www.theguardian.com/lifeandstyle/2018/feb/27/formula-milk-companies-target-poor-mothers-breastfeeding[/note]

Only 34% of Philippino mothers breastfeed exclusively the first six months of their infant’s lives.[note]https://www.theguardian.com/lifeandstyle/2018/feb/27/formula-milk-companies-target-poor-mothers-breastfeeding[/note] This compares to 55% in the United States.[note]https://www.cdc.gov/breastfeeding/resources/us-breastfeeding-rates.html[/note]

The Guardian reports on current advertising of infant formula in the Philippines:

TV advertising campaigns for follow-on milk by brands such as Bonna – which portray the “Bonna kid” as one who is smarter and succeeds in life – convinced them, they said, that bottle feeding is not only as good for the baby’s health as breast milk but will bolster their IQ and future prospects. Store displays of formula were splashed with claims such as “clinically proven to give the IQ + EQ advantage”. For mothers living in poverty, such aspirational marketing is particularly seductive.[note]https://www.theguardian.com/lifeandstyle/2018/feb/27/formula-milk-companies-target-poor-mothers-breastfeeding[/note]

It was not just the breastfeeding resolution at the recent Health Assembly the US opposed favoring business over the health of world citizens. The US also tried to block unsuccessfully a “roadmap” to provide life-saving medicines to impoverished regions. The reasoning was to protect intellectual property rights of Big Pharma.[note]https://www.snopes.com/news/2018/07/09/importance-of-breastfeeding-resolution/[/note][note]http://www.ip-watch.org/2018/05/24/wha-agrees-drafting-roadmap-access-medicines-vaccines-us-blasts-compulsory-licences/[/note]

Breastmilk is best; however, infant formula is necessary in some instances. Marketing strategies should not influence a women’s decision on how to feed her baby. 

135 countries have some law limiting infant formula marketing.[note]https://psmag.com/news/the-push-to-ban-companies-from-advertising-infant-formula[/note] Predatory marketing techniques have caused millions of infant deaths around the world. Supporting business profits over human health is disdainful and disgusting. Feeding babies should not be political. 

Image: Beeki / Pixabay