Breastfeeding Medicine

Physicians blogging about breastfeeding

It can happen here

with 6 comments

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.

Written by gcalnen

September 11, 2010 at 5:59 am

Posted in In the news

6 Responses

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  1. I feel your piece conveys strong negative emotions akin to a muted outrage over something that sounds like an “easy fix” to me. However, I find it arrogant and naive to propose that breastfeeding can save children after catastrophic events such as the Pakistani flood and Haitian earthquake. Haiti is flooded with discarded children who live with unclean water, a lack of food (not to mention nutrition), and overwhelmed but few caregivers daily. Add to that such an event and there is no opportunity for any saving grace outside of introducing a foreign help to the “system”, in my opinion. Additionally, children in both countries are often seen as disposable, or a hindrance – someone to be used at best. In order to save them via breastfeeding, someone would have to WANT to, at their own expense (such as african tribes rife with HIV where some women are nursing 10 or 16 children at a time in order to save them – and the eldest are starving). Given unclean water conditions that may even be impossible for a lone mother/child relationship, much less multiple children. Sure, in the US we have the luxury of making the decision to nurse or bottle feed and I’m sure IF a nursing pair survived the storm, flood, criminals, and heat then the nursing woman naturally made the the choice to continue as possible. however, in a country with little water resources, the decision is best made between walking 5.5 miles to the closest resource, or farther in the hopes that there is yet something undiscovered or less popular.

    Perhaps Dr. Gupta hasn’t suggested such a thing bc he may understand or even seen first hand the reality of what you are suggesting, complete with cultural and moral (or lack of) implications, and may understand such a suggestion as futile, naive, or irresponsible.

    As to your assertion it can happen here: certainly. I find position selling based on fear mongering always inappropriate however.


    September 11, 2010 at 7:01 am

  2. No truer words were ever spoken. As a US citizen, I sat glued to the television when Katrina and then Rita hit the Gulf coast, and felt the utter helplessness of watching families hold up newborns and infants to the cameras and cry that they had “no milk” and wondered why no one was putting these babies to breast???? I tried to mobilize forces through the American Academy of Pediatrics Section on Breastfeeding, only to find we could do nothing–the Red Cross would not let us down to the disaster site as we had not had prior disaster training; we could not get information down to the folks in the disaster (doctors, health care workers, LLL, lay people) because there was no electricity to send them information via the Internet). Those scenes are etched into my mind. This could as easily happen in any other developed part of our world—this is NOT just a US issue, as ABM is NOT just a US organization. And when these disasters occur in the less developed places in the world with less infrastructure and less access to funding—like the Indonesian tsunami, or the Pakistani floods, the results are that much more disastrous.

    I can only speak from my own perspective here in the United States with any real knowledge, but I do sit on the United States Breastfeeding Committee as the official representative of ABM. And within USBC, I am active in the Disaster Preparedness Task Force. We are working right now to gather information to set up a web page on the USBC site that will contain the best worldwide information we can find on disaster preparedness related specifically to infant and young child feeding, with concise information that can be gotten to those in the field in a timely fashion. The idea will be to enable emergency response groups to be trained BEFORE disasters strike in the support, promotion and protection of breastfeeding and its role in an emergency as a lifesaver. And being available on the Internet through the USBC website, with ABM as an active member, we will be able to disseminate this information and make a difference for future emergencies. Because as you state Jerry, we know they will keep coming. Stay tuned, I will let you know when we go live and we will link through the ABM web site as well.

    Kathie Marinelli is a neonatologist and a Board member of the Academy of Breastfeeding Medicine.


    September 11, 2010 at 9:06 am

  3. Informative blog. Thank you.


    September 11, 2010 at 12:24 pm

  4. Enjoyed reading it.


    September 11, 2010 at 12:25 pm

  5. No one makes money from advocating breastmilk/breastfeeding. If an infant is held up and mother says, “no milk, he’s starving,” lots of people will run down to the grocery store, purchase formula, and donate it (though there is no clean water to prepare it). That makes the corporations money. Asking for lactating volunteers or promoting breastfeeding does not make anyone money – it only saves lives.


    September 12, 2010 at 7:43 am

    • You are right that no one makes money when we breastfeed. As I suspect you are saying Meghan—it is sad that we advocate for something that is a billion-dollar industry and ignore that which nature provides us with, because it can’t be or isn’t effectively marketed! And all that formula piles up far from the site of the need. It can’t get in–there is no infrastructure to bring it in during time of disaster. No trucks, no roads, no fuel, no way to get to the edges of the disaster, let alone the center. And if by some miracle, the formula, the bottles, the nipples can be gotten in–there is no way to prepare it in a clean way. No clean water to mix the powder, no refrigeration to store it, no way to wash and sanitize the bottles and nipples—so the babies who might get the formula also get sick—diarrhea—and can die from that. Of course there is no medical care to deal with those complications either.

      Everyone is entitled to their own opinion. But we need to take notice of fact versus opinion. Breastfeeding is lifesaving. I will say it again. Breastfeeding is lifesaving. In the context of a man-made or a natural disaster, breastfeeding is clean, safe, nutritious, in the perfect packaging, readily available at the disaster site, at the correct temperature, stored in a safe manner. It is not only nutrition, but it also contains immune factors to infectious diseases in the environment and actually acts as an immunization and as protection against infectious diseases, which increase in the unsanitary conditions that always occur. The hormones released in the lactating mother actually help her relax—that cannot help but be a good thing in an extremely stressful situation! A mother delivering during or in the aftermath of the disaster can be helped to breastfeed that baby if disaster workers or community people know how to support breastfeeding. A mother who has delivered a baby within even months of a disaster can be helped to lactate if she initially did not, or to relactate if she stopped in the interim. And a lactating mother can feed more than one baby. Given the choice—breastfeed a baby who is not your own or watch that baby die of starvation and/or disease—what is the right thing to do?


      September 12, 2010 at 10:18 am

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