By Nicole Graham, Humanitas Global
This week marks the annual World Breastfeeding Week, coordinated by the World Alliance for Breastfeeding Action. The theme of the 2016 World Breastfeeding Week is dedicated to highlight how “breastfeeding is a key element in getting us to think about how to value our wellbeing from the start of life, how to respect each other and care for the world we share”.
The nutritional benefits of breastmilk are undeniable. The milk contains a near-perfect combination of nutrients, vitamins, protein and fat – all pivotal to a baby’s growth and development. It is easier to digest than breastmilk substitutes (BMSs), and has the added benefits of providing necessary antibodies babies need to fight off diseases and infections. It is also a healthy option for mothers. Breastfeeding releases the hormone oxytocin, which helps return the uterus to pre-pregnancy size and reduces bleeding. Breastfeeding also burns extra calories, and lowers risk of breast and ovarian cancers.
Despite the benefits of breastfeeding, as far back as 2000 BC, women were finding alternative methods to feed their babies. By the early 1800s, scientists and doctors were attempting to create a synthetic equal to breastmilk. Wet nurses were initially used out of necessity, but quickly developed into a symbol of status. A need for an acceptable substitute was sought after by women because they were not lactating often enough or at all, because they were working, or because the mother had passed away in childbirth and the family needed a way to feed the newborn.
Efforts to create a viable BMS were largely unsuccessful though and mothers stuck with breastfeeding or alternative forms of feeding until the mid-nineteenth century. By then, researchers began to analyze the breastmilk itself, in order to create an adequate substitute. A combination of cow’s milk, a bicarbonate of potash, wheat and malt flour became the closest imitation available. Cows were deemed the new “wet nurse for the human race”, but finding a consistent and clean source of milk became a concern during this time. These years saw higher rates of diarrhea due to contaminated milk and child mortality as a result.
The onset of the Industrial Revolution and resulting immigration boom pushed pediatricians to more seriously pursue a BMS method that would decrease infant deaths. With more women in the workforce than ever before, infants were increasingly being fed by hand, with unsanitary bottles, or with cow’s milk that was not properly preserved. In 1867, Nestlé introduced “Farine Lactée”, or “flour with milk”, the most successful BMS to date. The product is still available today.
Following its creation in 1850, the feeding bottle progressively became a more practical, clean and inexpensive option for mothers. By 1924, Pyrex had introduced a heat-resistant bottle with a wider neck, facilitating the cleaning process.
At the same time, big producers like Nestlé were introducing infant cereal and the first powdered milk option. BMS marketing campaigns increased significantly around the time of the Second World War, as women left the home to become an integral part of the workforce. Societal shifts, availability of BMSs, and marketing campaigns led to a decline in breastfeeding rates.
Nestlé, the world’s largest food manufacturer at the time, adamantly marketed their BMS products to mothers of the Global South, with catastrophic results. Many mothers, believing that BMS were more nutritious than breastfeeding, bought BMSs that they could not afford, mixed it with unclean drinking water, and excessively watered the formula down to make it last longer. The result was widespread infant death due to malnutrition and water-borne disease.
A boycott of Nestlé spread from the non-profit Counterpart International to ten different countries. The issue took the international stage in 1981 when the 34th World Health Assembly adopted the International Code of Marketing of Breast –milk Substitutes. The Code was passed with 118 votes to 1, with the United States as the sole negative vote. The Code responded to the rampant diarrhea, malnutrition and infant mortality directly linked to the emergence of BMS in developing countries. Within it, the Code acknowledges these to be critical issues, and asserts the right for every lactating mother and newborn child to access adequate nourishment as a means to attain and maintain health.
These stipulations were reinforced at the May 2016 World Health Assembly in Geneva. During the Summit, delegates adopted two resolutions on nutrition:
- Urges countries to make policy and financial commitments to improve people’s diets and calls on UN bodies to provide guidance, implement nutritional programs, and support monitoring and reporting mechanisms.
- The necessity of World Health Organization (WHO) guidance on ending harmful promotion of inappropriate infant foods and reinforcing the protection and promotion of the practice of breastfeeding.
The second regulation specifically included a stipulation that called upon health professionals to guide and interact appropriately with companies that market BMS. It urged all industries – health workers, the food industry, and the media to support these guiding measures.
Despite improvements, women today still face issues and challenges to breastfeeding. These difficulties are outlined in our blog from last year’s World Breastfeeding Week. While most mothers agree with international breastfeeding recommendations, a large percentage still deal with contemporary hurdles such as the stigma attached to breastfeeding in public.
The promotion of breastfeeding is essential to the achievement of the SDGs. Breastfeeding presents a cost-effective and critical way for mothers to deliver all essential nutrients to help a baby grow and develop. Breastfeeding also supports goals for good health and well-being, female empowerment, and sustainable partnerships. Currently, most countries are off track to meet the current breastfeeding target rates, impacting development goals as a whole. Mothers are 2.5 times more likely to engage in breastfeeding when it is supported and protected. The new WHA resolutions, efforts such as “nurse-ins” and studies such as those provided by the Lancet series are furthering the conversation for increased support and protection of breastfeeding. With continued improvements, breastfeeding can flourish as a practice and ensure the health and development of millions of infants.