The rationale is strong, but practices are still in flux. President Trump stepped into this health issue recently, and not for the better.
In the 1970s, concerns surfaced that mothers were not using breast milk substitutes properly. To save money, they were overdiluting, and using contaminated water. Moreover, they were bombarded with inappropriate marketing that suggested the substitutes were just as good as breast-feeding. A seminal report published in London in 1974 was titled “The Baby Killer,” and a subsequent outcry led to a boycott of Nestle, a major producer.
By 1981, the WHO took action, setting up a code for nations to follow in limiting the way breast milk substitutes could be marketed. Among other things, it barred the use of promotional ads and gifts to push the products. Since then, the code has periodically been strengthened and written into national laws. As of this year, 136 countries, of 194 WHO members, have some part of the code written into law, but the WHO found in a report in April that “too few countries have robust measures” in place.
Although the benefits of breast-feeding are widely acknowledged, the WHO says that 3 out of 5 children under 6 months are not exclusively breast-fed, and only 45 percent of children continue breast-feeding for two years. Thus, the struggle to encourage breast-feeding is hardly over. Meanwhile, the industry that manufactures substitutes is expanding and looking for new markets, especially in fast-growing economies of East Asia. (Nestle, a major player, says it supports the code.)
When the World Health Assembly, the decision-making body of the WHO, met in Geneva in May, a resolution supporting breast-feeding was expected to win easy approval. But as the New York Times reports, the U.S. delegation upended the deliberations. Acting at the behest of manufacturers, the Times says, the delegation first attempted to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding.” When that failed, according to the Times, the U.S. delegation attempted to bully Ecuador, the sponsor of the resolution, to drop it, threatening to unleash punishing trade measures and withdraw crucial military aid. Ecuador relented. Eventually, Russia sponsored the resolution.
In response, Mr. Trump called the story “fake news,” insisted the United States “strongly supports breast feeding,” and added, “We don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty.” No one is going to deny them access. But the proper policy is to encourage breast-feeding to save lives. Mr. Trump should not send a contrary message.