Babies in the developing world who are breastfed for six months are 15 times less likely to die from diarrhoea or pneumonia than their bottle-fed counterparts.
But babies in the developed world have nothing to fear from a lack of breast milk? Wrong. In 1989, the US National Institute of Environmental Health Sciences estimated that four out of every 1,000 American babies died because they were not breastfed.
American babies, then. Not our babies, surely? Wrong, too. Our babies are the same as babies everywhere. So are our boobs. Though you wouldn’t think it from our breast-feeding statistics: We are among the worst in the developed world.
Some of our babies are dying preventable deaths because of lack of breastfeeding. The HSE’s national infant feeding survey (2008) says pre-term babies are more likely to survive if they are breastfed, and they are less likely to develop early onset diabetes, Hodgkin’s disease, and possibly leukaemia. The survey lists the advantages to babies of breastfeeding: Fewer infections of the tummy, respiratory tract, urinary tract and ears, less eczma and athsma.
Adults who were breastfed as children have less chance of developing type-2 diabetes, raised blood pressure and obesity. Mammies who breastfeed will get their figures back more quickly and have less chance of developing pre-menopausal breast cancer, ovarian cancer, and osteoporosis.
But breast milk has one terrible drawback: It can’t be sold. That’s why there has been a century-long battle to stop women breast-feeding and make them buy modified cow’s milk for their babies. The battle has been very successful. Some estimates say only one third of babies worldwide are exclusively breastfed.
That’s why the UN has been battling back, and produced a code for the marketing of infant formula in 1981, by which formula companies are meant to voluntarily abide. The preamble to the code says infant formula “should not be marketed or distributed in ways that may interfere with the protection and promotion of breastfeeding”. Article 5.1 of the code states: “There should be no advertising, or other form of promotion, to the general public of [infant formula] products within the scope of this code.”
So you understand my horror when I saw Ireland’s Pregnancy and Baby Fair — where you can receive “expert advice from Ireland’s leading professionals in midwifery and parenting” — advertised to run this weekend at the RDS in Dublin and Cork City Hall under the slogan “SMA know how”.
SMA, one of the world’s biggest infant formula milk brands, was acquired from Pfizer Nutrition in 2012 by Nestlé, the world’s biggest food company, which has been associated with aggressive marketing of infant formula in the developing world for decades.
The most notorious such case is surely that of 24-year-old Syad Aamir Raza, who got the job of his dreams in 1994, as a medical delegate with Nestlé Pakistan, making contact with health workers, arranging baby shows, and handing out free samples.
A couple of years later, he met a doctor who had just broken to parents the news that their three-month-old baby had died. He asked why the child had died and the doctor told him: “Because of people like you.”
Raza resigned and engaged in a legal battle to stop Nestlé promoting its products in Pakistan, but he failed. He received death threats and shots were fired at his house, but Nestlé did not condemn the attacks and he fled the country. A Danis Tanovic film, Tigers, which premieres next month at the Toronto Film Festival, tells a similar story.
Save the Children’s recent hard-hitting report, Superfood for Babies (2012), accuses Nestlé, in Pakistan, of recently targeting health workers with branded pads and calendars and pens, and of supplying free samples of formula, or bottles or teats, to health facilities. But it also mentions that Oxfam considers Nestlé India less aggressivethan its competitors in that country.
This story was never about Nestlé alone. Superfood for Babies shows that there is an inherent problem with the promotion of infant formula: Your competitor is breast milk.
It is the responsibility of governments to enforce the code, and Save the Children has shown that tough enforcement is the difference between steady or collapsing breastfeeding rates. In India, infant formula must have a warning across one third of the packaging, and in Iran formula is sold in plain packaging, by prescription.
Not all of the code is transposed into Irish law, but some of it is in an EU directive (2006, 141) that is policed by the Food Safety Authority. It is not technically illegal to host massive baby fairs in prestigious public venues to which you are hoping to attract thousands of pregnant women to “sit back, relax and enjoy learning about mothering” and under the banner “SMA know how”.
But it should be. Although there may be no SMA personnel or freebies at the event, the branding clearly suggests SMA as a feeding option and that is why SMA is sponsoring it. This introduces that all-important marketing tool: Doubt.
“Choice suggests that it’s between two reasonably equal alternatives and that’s not the case”, as former national breastfeeding co-ordinator Maureen Fallon said to me some years ago.
Awareness of this issue is so low that formula companies can get away with events like the Pregnancy and Baby Fair, while in the UK even the SMA Roadshow was cancelled, a branded bus offering information that plied the roads of Ireland a couple of years ago without raising an eyebrow. Awareness is so low here that listed exhibitors at the SMA Know How fair include Temple Street Children’s Hospital and Friends of the Coombe.
Worst of all, Concern Worldwide is exhibiting, seeming not to understand that it is lending legitimacy to the sponsors and that they can’t successfully promote the importance of breastfeeding in the developing world underneath an “SMA know how” banner.
There are many cultural reasons for our ignorance of breastfeeding, but surely our role, as the biggest European producer of infant formula, has been a factor for successive governments. We look at the hundreds of jobs at the infant formula plant in Askeaton, Co Limerick, and close our eyes to the fact that a large part of what it produces now goes to emerging markets in the Middle East, Africa, Latin America, and Asia. And babies die because of people like us.
Families in the dairying counties deserve to eat, but not by depriving babies in the developing world of “super-food”. Stay away from the SMA Know How Pregnancy and Baby Fair and take a first step in raising awareness.
Breast milk is nature’s miracle worker ... but it has one terrible drawback: It can’t be sold