Questions on the baby formula industry and the push for breastfeeding

Breast milk is more nutritious for infants compared to manufactured baby formulas, says the World Health Organization. After decades of scientific research backing up that finding, a resolution was introduced in the United Nations, encouraging mothers to breast feed their babies. However, the United States objected.

The New York Times reported that the U.S. delegation to the UN wanted to remove language explicitly asking governments to promote breast milk, and restricting formulas shown to have negative health effects for infants. The delegation also threatened retaliation to any country attempting to introduce the measure.

Ecuador was set to introduce the non-binding resolution, but withdrew it after U.S. officials allegedly threatened the country with trade measures and less military aid. President Donald J. Trump denied the U.S. threatened Ecuador in a tweet, calling the piece “fake news.”

WikiTribune answered a few questions on this story. Help improve these answers using EDIT STORY. 

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Questions to answer

1. What are some ways to help get breast milk to babies with mothers who are unable to breastfeed?

Donated milk is the considered the “second best” choice for newborns, according to breastfeeding advocates who spoke with WikiTribune. There are a number of ways a mother can get another mother’s milk, the most reputable being “milk banks,” non-profit agencies that screen, freeze and distribute donated milk to needy mothers.

Milk banks have a rigorous screening process for donors. The breast milk is also pasteurized before it is frozen. This process is to ensure that the breast milk is safe for human baby consumption.

Milk banks also have a recurring problem with supply. The majority of the supply goes to hospitals neonatal intensive care units (NICUs) or to babies with significant health concerns.

Mothers can be deemed ineligible for a milk bank for a number of reasons. Those who don’t want to use formula sometimes turn to informal marketplaces including a number of Facebook groups, all of which are unregulated.

Dr. Naomi Bar-Yam, executive director of Mothers’ Milk Bank Northeast, does not fault mothers for getting or purchasing milk from these unregulated forums, especially if they are unable to breastfeed. She just hopes they are making an “informed choice” before they do so. A study found that 3 percent of donor mothers had diseases, including syphilis and hepatitis, which can be transmitted via their milk.

Developing countries lack the infrastructure to properly screen, freeze and distribute donated milk to needy mothers. Bar-Yam figures that’s why this option was not mentioned in the United Nations resolution promoting breastfeeding.

2. List all known and demonstrated benefits and disadvantages of both breast milk and formula feeding?

Formula feeding is generally less nutritious than breastfeeding, but there are many valid reasons why mother needs to formula feed. Mothers who are physically unable to produce milk are typically eligible for donated supply from milk banks, but not in every case. Another reason is inflexible work schedules that don’t allow them to breastfeed. This is a pronounced problem in the United States and other countries without paid family leave. So a benefit to formula feeding would be the freedom it gives the mother to leave her baby with someone else, bottle at hand.

Breast feeding has several health benefits, mainly for the child but also for the mother. The strongest scientific case for human breast milk come is the benefits for a baby’s digestive system (Nutrients). A major reason why the UN strongly recommends breastmilk in the developing world is that a strong digestive system is integral for a baby with limited access to sanitary conditions.

Studies also show that breastfeeding establishes a social bond between mother and child that extends beyond infancy, according to the American Psychological Association. Mothers also reduce their chance of breast cancer by 50 percent if they breastfeed for at least two years, according to the American Journal of Epidemiology.

There is no scientific consensus that breastfeeding improves cognitive abilities in the long-term. A study from Brown University found that breast-fed children under the age of 4, had enhanced development in certain areas of the brain. But an Ireland study, of roughly 8,000 children, found that any cognitive improvements from breastfeeding were ultimately mitigated after the age of five.

3. Does the dairy industry lobby on behalf of formula companies considering cow’s milk is in infant formula? 

More than 80 percent of infant formula is based on cow’s milk, according to USDA, bringing a strong connection between the formula lobby and the dairy lobby. Dairy is a $38 billion industry in the United States with a storied history of sleek marketing campaigns, and lobbying on the federal level. So when the White House supports formula companies, breastfeeding advocates such as Alison Stuebe are quick to suggest that the dairy lobby might have a say as well.

But after preliminary research, there is no evidence that the dairy industry directly lobbies on behalf of infant formula products, even if they have a strong incentive to do so. More reporting must is needed to answer this question.

4. What’s the connection between WIC (food assistance for low-income families) and infant formula?

Half of the formula purchased in the United States is provided through the Special Supplemental Nutrition Program for Women, Infants, and Children, known as “WIC” for short. WIC is a federal program, though each state negotiates their own WIC contracts through a bidding process that is dominated by three manufacturers: Mead Johnson, Abbott and Nestle (Wall Street Journal). 

When WIC was founded in 1970, back when formula feeding was the norm, the program did not recommend breastfeeding to new mothers. This policy changed has changed dramatically along with the rest of the country. As of now, WIC openly advocates and incentivizes breastfeeding by offering  more generous WIC packages for mothers who commit to completely breastfeeding their child.

The WIC program also offers peer counseling to help with breastfeed and offers breast pumps to mothers who need them.

There are critics who see WIC as buoying the infant formula business by acting as their main U.S. buyer (The Atlantic). The concern is that by giving formula to free to millions of Americans, consumers will become loyal to the brand even if they are no longer WIC eligible (Economist). But three breastfeeding advocates who spoke with WikiTribune said the best way to help low-income Americans breastfeed is by offering social support such as paid family leave.

(Read more on how U.S. hospitals and public agencies promote breastfeeding thanks to advocacy)

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    1. “Milking It” researched by Changing Markets. Report on nutritional shortcomings of baby formula companies, and their use of misleading advertising
    2. “Intuitive Breast-feeding” by Regine Gresens, an expert and professional breast feeding consultant, published 2016 in German.
    3. Add another…

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