The well-being of mothers and children is not a tradeable commodity

Breastfeeding is the foundation of public health and economic development. All major medical organizations recommend 6 months of exclusive breastfeeding, followed by continued breastfeeding through the first one to two years of life and beyond.

Evidence continues to mount that disrupting optimal breastfeeding contributes to disease burden and premature death for women and children. Globally, optimal breastfeeding would prevent 823,000 child deaths each year. In the US, enabling optimal breastfeeding would prevent 721 child deaths and 2619 maternal deaths each year, as well as 600,000 ear infections, 2.6 million gastrointestinal illnesses, 5,000 cases of maternal breast cancer and more than 8,000 heart attacks.

Optimal infant feeding is also essential for economic development. Being breastfed is associated with a 3 to 4 point increase in IQ, leading to better school performance and workplace productivity. As stated by the World Bank’s Keith Hansen, “If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.”

Breastfeeding is vital and essential to protect the world’s children, the most vulnerable who cannot speak for themselves.  Given the essential role of breastfeeding in global health and wellbeing, it is imperative that every nation supports policies and programs that enable women and children to breastfeed. It is therefore deeply troubling that the United States delegation to the World Health Assembly actively undermined efforts to enable optimal breastfeeding, as reported by the New York Times.

Contrary to assertions by U.S. officials, the World Health Assembly resolution did not attempt to restrict access to infant formula; rather, the resolution called for enforcement of the International Code of Marketing of Breastmilk Substitutes.  Marketing of artificial breastmilk substitutes is a major deterrent to optimal infant feeding. The $70 billion baby food industry has long engaged in a global effort to replace breastfeeding with commercial formulas, to the detriment of global maternal and child health.

In settings where clean water is not available, infant formula is a major cause of death from diarrheal disease. These acute risks of formula-feeding become relevant in high income countries during natural disasters, or when the water supply is contaminated with heavy metals. Moreover, aggressive marketing efforts to replace breastfeeding with infant formula expose both mothers and children to morbidity and mortality.

When mother’s own milk is not available, the preferred alternative for infant feeding is donor human milk. Human milk is tailored to the physiology of human infants. Artificial breast milk substitutes should be considered the last resort.

Poverty or malnutrition is not an indication for formula feeding; rather, social policies that separate mothers from children precipitate formula feeding and worsen poverty and malnutrition. The United States is the only high income country without any provision for paid parental leave; consequently, 23% of employed women return to the workforce within 10 days of birth. The appalling absence of social policies to enable women to nurture their children undermines breastfeeding and perpetuates poverty and malnutrition.

Breastfeeding and breast milk are life sustaining, unique human physiologic events that cannot and should not compete with or have an equal with other commodities or corporate profits.  Maternal and child health is not a trade issue.

The Academy of Breastfeeding Medicine calls upon legislators and policy makers to:

1) Recognize that enabling mothers to breastfeed is fundamental to human health and must be foundational to all national and global policy;

2) Support enforcement of the WHO Code of Marketing of Breastmilk Substitutes and subsequent WHA resolutions;

3) Enact paid family and medical leave, consistent with the International Labour Organization’s standards on maternity protection;

4) Ensure that social policies and programs enable every mother to nurture her child and engage in optimal infant and young child feeding.