The war on breast milk

Every August, for World Breastfeeding Week, health groups highlight the benefits of breastfeeding and use the occasion to push for overall infant and maternal health.

More than 500 mothers from Albay joined “Hakab 2018” on Saturday, and more than 300 mothers breastfed their babies in Bohol for “The Big Latch.” Such activities might seem trivial, but they are radical moves in the global fight to promote breastfeeding. The word “fight” is apt; there is a long history of policymakers and infant formula companies undermining the research that breast milk is still best for infants less than 1 year old.

The timing is specially poignant. Just a few weeks ago, American delegates to the UN World Health Assembly stunned the world by threatening Ecuador, which intended to introduce a resolution on breastfeeding, with punitive aid and trade measures. The resolution called on governments to “protect, promote and support” breastfeeding and to limit the promotion and marketing of food products that included breast milk substitutes. The American delegates had started out wanting to modify this language, but, when met with resistance, resorted to threats. Ecuador acquiesced; Russia stepped in, and the United States backed down.

It was shocking to health officials, but it was really nothing new in a long line of politicians embracing the interests of the billion-dollar infant formula industry.

In a poor country like the Philippines, it would make sense if healthcare workers and indigenous families embraced breastfeeding, which is usually available, reduces infant mortality, boosts the immune system, has irreplaceable antibodies, and—as estimated by the World Health Organization—can save a family about P4,000 per month. But this is not always the case.

One recalls The Guardian/Save the Children investigation that reported earlier this year that companies in the Philippines rampantly flout the Milk Code and target mothers who can “least afford” infant formula. The Milk Code is intended to combat aggressive marketing of breast milk substitutes and protect the culture of breastfeeding. The investigation revealed flagrant violations of the Milk Code as well as its international equivalent. Representatives from various companies, for instance, were a “constant presence” in hospitals and, contrary to law, were handing out
infant nutrition pamphlets and coupons.

Media advertising has long supported campaigns showing that certain formulas will boost children’s IQ and give them a better life (the “IQ+EQ advantage” and “Promil kid” come to mind). But The Guardian also noted a “clandestine”
approach to the promotion of formulas; some of the marketing went on behind the scenes, with visits, dinners and sponsored trips for health providers.

What’s the impact on Filipino families? Many were found to be spending up to three quarters of their income on milk formula, denying themselves food and failing to pay for basic utilities. Many were also found to have been directly recommended a specific brand of milk substitute by healthcare workers, along with freebies and samples. It was also noted that only 34 percent of mothers were exclusively breastfeeding in the first six months of life—the time at which breastfeeding has the most impact.

What are we to do? Health workers clearly have a role to play, not just in education, but also in rejecting even innocuous-seeming advertising campaigns. We also need to be able to normalize breastfeeding. Social media likes breasts but doesn’t seem to like breastfeeding: celebrities who post photos of themselves doing so have been loudly criticized.

But what’s at stake is not just a woman’s intimacy, but also a culture that impacts infant and maternal health, as well as the right of women to free and informed choice. The rest is on the Department of Health, which, according to reports, launched an investigation in the wake of The Guardian/Save the Children findings. However, it has yet to make public any resolution regarding the companies that were flagged.

We don’t need new laws. We just need to be better at implementing the existing ones, and to report violations when we can.

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