Putting babies before businessThe Right Reverend Simon Barrington-Ward *
For babies everywhere, the benefits of breastfeeding are undisputed. But for babies in developing nations, breastfeeding is imperative: Their very survival depends on the immune-boosting properties of mother’s milk. For them, infant formula is not just inferior; it can cause disease or even death. Poor families often over-dilute costly formula with unclean water and mix it in unclean bottles, adding to the risk. Yet, despite international pleas and a marketing code agreed to 16 years ago, manufacturers still market infant formula and other substitutes unethically around the world. It is time for them to stop.
Not all miracles stand up to scientific scrutiny, but breastmilk is one that does. It is without doubt one of the world’s greatest life-savers. The most sophisticated science has taken a long time to recognize and prove what mothers and midwives always knew—breastfeeding is best for babies and there is no substitute of equal value.
Breastmilk is a ‘live’ and incredibly complex substance, containing all the nutrients vital for nourishment, as well as growth factors believed to help in tissue development and antibodies to fend off infections. It is always at the right temperature, requires no mixing, sterilization or equipment, and is safe regardless of the quality and availability of water. Its composition changes from feeding to feeding, and even within feedings, and the amount is triggered by the mother’s hormonal response to the needs of the baby. Breastfeeding encourages bonding between mother and baby and discourages conception.
The World Health Organization and UNICEF recommend that babies be fed breastmilk only—nothing else, not even water—for about the first six months of life. Worldwide, reduction of formula feeding and improved breastfeeding practices could save an estimated 1.5 million children a year.
So why are only an estimated 44 per cent of infants in the developing world (even less in the industrialized countries) exclusively breastfed? One factor has to be the relentless promotion of breastmilk substitutes. It is no accident that breastfeeding levels are high in countries like Burundi and Rwanda, where there is little marketing.
I am now firmly persuaded that the promotion regularly practised by the infant formula companies is unethical and that it flouts the International Code of Marketing of Breast-milk Substitutes, to which they signed on. In fact, they helped draft the Code, which seeks to protect breastfeeding as “an unequalled way of providing ideal food for the healthy growth and development of infants.”
The World Health Assembly adopted the Code in 1981 as a recommendation to its member States. They in turn are urged to translate it into national legislation ensuring that breastmilk substitutes are not marketed or distributed in such a way as to interfere with the protection, promotion and support of breastfeeding.
All along, the industry has insisted that it was ‘self-monitoring’ to ensure that its members followed the Code. The International Baby Food Action Network (IBFAN), a non-governmental organization, suspected otherwise, and it doggedly set about to collect evidence. Enough violations of the Code accumulated to justify a consumer boycott of infant formula manufacturers.
Based on IBFAN’s findings and showing good-faith efforts to be fair, the groups that imposed the boycott have lifted and then reinstated it over the years. Currently, church and consumer groups, businesses and trade unions in 17 countries are active in the boycott in response to findings by IBFAN.
But rather than redressing the marketing wrongs, the infant formula manufacturers’ lobby has wilfully misinterpreted the Code: Despite the word ‘International’ in its title, the manufacturers insist that the Code applies only to developing countries. They have also hammered away to discredit IBFAN’s findings, particularly with governments and United Nations agencies.