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Breastfeeding: Trump administration supports industry misleading moms about breastfeeding

 


Women’s health clearly does not concern Trump. Trump has even tweeted about breastfeeding and how infant formula should be made available to the poor and malnourished, missing the whole point of breastfeeding. Trump was referring to an article published in the New York Times on Sunday, July 8th, how Trump’s officials meddled in a United Nations global health meeting in May that was set to approve a simple, uncontroversial resolution supporting breastfeeding.

According to the New York Times, the Trump administration was bowing to the interests of baby formula makers (Nestle and Abbot, among others) and going against decades of public health research demonstrating that babies who are breastfed have better health and development outcomes than babies fed formula.

It turns out that the World Health Organization’s (WHO) global health resolution was just one of a few battlefronts in Trump’s fight against policies that support breastfeeding, as the administration increasingly aligns itself with the U.S. infant formula industry.

A key policy the industry hopes to influence next is a forthcoming United Nations guideline for “follow-up” formulas or “growing-up milks,” baby formula marketed for children over 6 months of age. Infant formulas, aimed at babies younger than 6 months, are now heavily regulated in many countries. Laws around them sprung up after it came to light that millions of babies died, especially in Sub-Saharan Africa, following aggressive marketing campaigns by formula makers like Nestle and Abbot. The heavy marketing led mothers to give their babies formula powder mixed with contaminated water instead of breast milk.

Formula companies want to head off regulation through global food guidelines of these follow-up formulas which are virtually indistinguishable from their infant counterparts when it comes to their packaging and labeling. These products represent the fastest-growing category in the $70-billion baby formula market.

Lucy Sullivan, the executive director of 1,000 Days, a women and child nutrition nonprofit stated, “Because follow-up formula is promoted with labels that look similar to infant formula which is specifically formulated to meet the needs of young babies, the marketing of these products contributes to parents misusing these products, leading to potential health risks in children. We know there’s a lot of consumer confusion about how to use these [older infant formulas], and that confusion is purposeful on the part of companies ... to get around restrictions countries have implemented.”

The UN group responsible for setting the standards on how countries should regulate food products, the Codex Alimentarius, hasn’t yet decided whether follow-up formulas should be treated like infant formulas as “breastmilk substitutes.” Calling them a substitute for mother’s milk would mean heavier scrutiny and regulation something public health advocates want.

But if the United States gets its way at an upcoming November Codex meeting, where a final decision on the standard for these products is expected, they would be deemed food instead.

In other words, these older infant formulas could be the loophole through which the baby formula makers repeat their dark history of misleading moms about the benefits of baby formula and undermining breastfeeding, leading them to abandon the practice early or altogether. And they may do so with America’s help.

“In my view,” Sullivan added, “this is a public health disaster waiting to happen.”

Breastfeeding and why it’s so important for public health.

Breastfeeding is the gold standard for infant nutrition. The World Health Organization recommends that babies exclusively be breastfed (i.e., only consume their mother’s milk) for the first six months of life. After that, it suggests about another year and a half of partial breastfeeding along with baby food. So, in total, according to the WHO, babies should be breastfed for about two years.

Health organizations have long promoted more breastfeeding since science has revealed a range of health and social benefits.

Breastfeeding is basically an inoculation against sickness and death for babies. One of the undisputed health gains: breast milk helps protect against a number of illnesses, including ear, throat, and sinus infections. It also protects against pneumonia and diarrhea, which are common killers of infants globally. This is because breast milk contains many hormones, bacteria, and antibodies that aren’t found in formula and strengthen babies’ immune systems.

Research has also linked breastfeeding to higher rates of survival during the first year of life, higher intelligence, and lower rates of chronic diseases like obesity and diabetes later on.

Finally, breastfeeding seems to boost maternal health, reducing the risk of postpartum hemorrhage right after birth; and in the longer term, Type 2 diabetes and breast, uterine and ovarian cancers among mothers. If breastfeeding were near-universal, some 820,000 lives could be saved every year, a Lancet report estimated.

For all these reasons, public health institutions, including WHO and governments around the world, have been working to encourage and support moms in breastfeeding, and also counter marketing claims by food companies suggesting formulas are an equivalent substitute.

But the United States has often been a roadblock to improving global breastfeeding standards. In 1981, the WHO launched the International Code of Marketing of Breast Milk Substitutes, which is separate from the Codex but sets national standards all over the world for regulating the marketing of breastmilk substitutes and feeding bottles. The code prevents formula companies from directly targeting mothers and doctors with breast milk substitutes, and also discourages promotion of the products and health claims on packaging.

One hundred and eighteen countries voted in support of the code when it was introduced at the World Health Assembly, a World Health Organization forum where 194-member countries convene to set global health policy.

“The US was the only country that voted against the code,” said Sullivan.

Since then, the US has failed to adopt international breastfeeding standards around marketing. The U.S. is one of a tiny handful of countries around the world including Papua New Guinea and Suriname that has no national policy on paid parental leave, and that’s a key barrier keeping moms from breastfeeding as much as they’d like. And with the Affordable Care Act being eroded, mothers who breastfeed are finding less and less support.

In May, as the NY Times reported, US delegates at the World Health Assembly used aggressive tactics to try to get countries to vote against a resolution that would encourage breastfeeding, threatening them with retaliatory trade or aid sanctions. In a strange geopolitical twist, only when Russia introduced the measure did the U.S. back off.

Public health advocates and global health officials at the December meeting said the US delegation - which included representatives from Health Human Services, the Food and Drug Administration, the Department of Agriculture, the US Trade Representative’s Office argued that follow-up products are not breastmilk substitutes.

Health advocates expect the US to take a similar stance at the November 2018 meeting, where the final decision about whether follow-up products should be regulated like breast milk substitutes will be made. At that point, if the Codex committee sides with the US, the industry could avoid the tougher regulation and standards infant formula has been subject to, standards that have averted thousands of deaths around the world.

 

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