It can happen here

I’ve been closely following the story of the Pakistan floods on CNN.   The horrors of the flood itself are now being replaced by the inevitable catastrophe of contaminated water.   Countless numbers of children are suffering and dying from dehydration due to gastroenteritis.   Every day I wait to hear Dr. Sanjay Gupta state the obvious: breastfeeding plays a critical role in saving lives under such circumstances.   I’m still waiting.   I also waited as I followed the Haiti earthquake story, and before that, Hurricane Katrina.   Maybe I missed it, missed somebody saying so, but I doubt it.

Why is that? After all of the natural and man-made catastrophes over the last few years, why do we still not hear more about a cost-free intervention that could save hundreds or thousands of lives?  There are a number of possible explanations:

• Preventive health measures just aren’t sexy.   In fact, they’re downright invisible.   Nobody exalts over how many children don’t die because they were breastfed.   Nobody even notices it.   But it’s the low-profile preventive health measures that have been responsible for the greatest medical care break-through’s over the last century, not the far more dramatic and eye-catching technological advances in diagnostics, pharmaceuticals, and surgery.  
• The education of health care workers continues to minimize the importance of breastfeeding.   Breastfeeding is still widely regarded as desirable but not really necessary.   And by the time it does become necessary (as, for example, in Pakistan, Haiti, or New Orleans), it’s too late… so why bother to mention it?
• More broadly, at the end of the day, our culture doesn’t really see a difference between formula-feeding and breastfeeding, such oversight being the inevitable result of the ubiquitous marketing of infant formula. 
• We still believe that “it can’t happen here.” Starvation and dehydration is a “developing nation” phenomenon.   Sure, there was Katrina, but that was an anomaly… wasn’t it?  

But it can happen here, and there is good reason to believe that it will, perhaps with a vengeance.   With global warming we can expect droughts, flooding and hurricanes to become far more frequent and far more severe.   A decaying national infrastructure may increasingly subject great segments of the population to catastrophic events, with resultant loss of access to food, water, and medicine.   Finally, the ongoing recession combined with the spiraling national deficit and calls for reductions in government spending could conceivably result in the eventual and dangerous contraction of the WIC and other social assistance programs.

Shades of Chicken Little, perhaps.   But sometimes the sky really is falling:

“ ‘He’s dyin’, I tell you! He’s starvin’ to death, I tell you…’

“She moved slowly to the corner and stood looking down at the wasted face, into the wide, frightened eyes.   Then slowly she lay down beside him.   He shook his head slowly from side to side.   Rose of Sharon loosened one side of the blanket and bared her breast.   ‘You got to,’ she said.   She squirmed closer and pulled his head close.   ‘There!’ she said.   ‘There.’”

                                                                                    – From “The Grapes of Wrath,” the story of the impoverished and starving  Okies of 1930’s America.  

It can indeed happen here.

Jerry Calnen is a pediatrician and president of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.