Friday, October 23, 2015

OVERSELLING INFANT FORMULA


"Breastfeeding has been associated with enhanced development and balanced growth and maturation of the infant's respiratory, gastrointestinal and immune systems, thereby providing protection of the infant to infection and inflammatory disease."  from Patent # 8802650 entitled, "Method of using human milk oligosaccharides for improving airway respiratory health," filed in 2011 and owned by Abbott Laboratories

Two American bald eagles were soaring and plunging low over the river.  They were a sight to see.  I quickly glanced at them and returned to trying to concentrate on my driving.  Yet my thoughts continued to be scattered and fragmented.  I had just read the NY Times article, "Overselling Breast-Feeding," by Courtney Jung (October 16, 2015).  Should I write about this article?  Here we go again, another article in a major newspaper castigating breastfeeding advocacy.  I am always baffled by these articles written by highly educated women who they say have breastfed their babies. How do I understand their thinking?   This NY Times article is written by a professor of political science at the University of Toronto.  She was educated at Tufts, Columbia and Yale universities.  She is the principle investigator for the Toronto Intiative for Economic and Social Rights.  She just finished a book entitled, "Lactivism:  How Feminists and Fundamentalists, Hippies and Yuppies, and Physicians and Politicians Made Breastfeeding Big Business and Bad Policy."  It appears that the NY Times article is from this recent book.  She has authored two other books but they have nothing to do with breastfeeding.

The first sentence I read in this NY Times article was, "All to often, advocates cross the line from supporting a women in her decision to breast-feed into compelling a woman to do so."  Wow.  Is this a statement by an academic or a propagandist?  Compelling a person is to "force" someone.  I need an explanation of how one forces someone to breastfeed?  One of many propaganda techniques is to use loaded words, creating an emotional response, to sway the audience.  The author in this article does not give evidence of how breastfeeding advocates compel breastfeeding.  Instead she implies that breastfeeding advocacy is equivalent to discrimination against poor women and minorities.  

Women in poverty and some minorities (particularly African-American populations) are the least likely to breastfeed. They are the least likely to breastfeed because of a mega-industry's power through advertising.  And because of social and economic limitations in which poverty creates enormous barriers to breastfeed.  Is the goal of this article to make breastfeeding advocates mute their messages to women in poverty and minorities?  This would be mighty beneficial to the infant formula industry.

The author describes the WIC Program as coercive because women who breastfeed get an enhanced food package.  She states, "The difference in benefits is intended to create incentives for poor mothers to breast-feed, but withholding food from mothers at nutritional risk, and from their babies, seems more like punishment to me."  "Withholding food?" Again the author uses the same propaganda technique, loaded words.  There is a difference between the nutritional needs of a breastfeeding mother and a formula feeding mother.  Likewise there is a difference between the nutritional needs of the breastfed infant and the formula fed infant.   The article states that breastfeeding infants get meat-based baby foods but infant formula-fed infants do not get meat-based baby foods.   I assume that the reasoning for this is that formula fed infants get all their iron requirements from infant formula and would not necessarily need meat-based baby foods.  The WIC Program is a supplemental food program, and its funding is dependent on the congressional budget.  Should we dismantle breastfeeding promotion in the WIC Program in order to promote equality?  Does the author, a Canadian professor of political science, understand the WIC Program and the issues surrounding nutritional risks? 

The author writes about Canadian Dr. Michael Kramer's PROBIT trial.  And states from that study, "breast-feeding having some benefits but did not reduce the risk of obesity, asthma, allergies, dental cavities or attention-deficit hyperactivity disorder."  There are a number of issues with this study that I have discussed in this blog.
see http://vwmcclain.blogspot.com/2009/08/probit-studies-by-michael-s-kramer.html

So the author believes that one study proves her belief that breastfeeding has some benefits but obviously in the words of the author not "a talisman to ward off evil and disease."  And again her words are emotive.  Great propaganda.  I didn't know that I was promoting breastfeeding to ward off evil nor do I know of any other breastfeeding advocate that believes that breastfeeding will ward off evil.  I do know that I am promoting breastfeeding to prevent diseases in mothers and infants. And I am thoroughly amused that this author has no idea that the infant formula industry has patents using human milk components to prevent obesity, asthma, allergies, etc.  The infant formula industry understands and will invest in human milk components. In fact it is the infant formula industry that believes in breastfeeding as a magic talisman.  Breastfeeding is their gold standard upon which the value of infant formula is based.  Why else advertise about their ingredients that "are just like" human milk ingredients?  Yet criticism is not addressed to the infant formula industry but rather against breastfeeding advocacy.  

The article seems like a personal vendetta rather than the writings of a scholar.  Did the author really comb through all the medical literature on breastfeeding?  The author states, "Surprisingly, the question of choice, which is central to so many women's issues, is almost totally absent from discussions about infant feeding."  That statement is a negation of reality.  Choice is the bedrock of infant feeding.  And the reality of choice is that poor women and minorities have no choice in infant feeding.  Their choice is limited because of social and economic pressures.  Change the social and economic through legislation and more women would breastfeed.  Assume that social and economic situations cannot be changed, and what you get is the belief that infant feeding is an equivalent choice.

The author writes the following, "There is a difference between supporting a woman's decision to breast-feed through policy changes like improved maternity leave, flexible work schedules and on-site day care facilities and compelling women to breast-feed by demonizing formula."  Therein lies the crux of her argument, the fear of demonizing formula.  Interesting.  The author never questions how choices are made or whether there really is choice?  Instead her next to the last sentence in her conclusion is about demonizing formula.  

Fascinating.  Currently most if not all universities in the US (and Canada) receive funding from a variety of industries.  The University of Toronto is not an exception to this practice and gets quite a bit of funding from a variety of companies.  The University receives funding in the $100,00-$999,00 range from a large variety of companies.  That list includes Abbott, Mead Johnson, Dairy Farmers of Canada, Heinz, Nestle, etc.  
http://boundless.utoronto.ca/recognition/donor-listing/

Infant formula funding for this University is not particularly surprising particularly because this University was involved in the creation of a very popular baby food in the 1930's.  Three faculty members (Frederick Tisdall, Theodore Drake and Alan Brown) of the University of Toronto Faculty of Medicine  created Pablum. Tisdal gave Mead Johnson permission to manufacture Pablum. 
http://www.facmed.utoronto.ca/about-faculty-medicine/%E2%80%98open-wide%E2%80%99-better-baby-nutrition

How influential is funding of universities/colleges to what professors can and cannot say without risking unemployment? How a person is employed impacts our views.  For instance, I was employed by the WIC Program for 4 years.  And I do have criticisms of the Program and yet I realize I am biased in favor of the Program.  How much of my defensiveness about WIC are because of being employed in the Program?  The author is employed by the University of Toronto.  Is it possible for a professor in a University that receives large funding from the infant formula industry to be unbiased about infant formula feeding? 

Would we ever see an article in a major newspaper about overselling infant formula?  No. Why?  Because it would have an economic impact towards a major industry and because that industry has a major influence in the media.  What is printed in the media has everything to do with who has the power and money.  Creating discord among women benefits the infant formula industry and diverts us from a critical analysis of the influence of the industry.

I was rather shocked to read an article written by Melissa Bartick in the Breastfeeding Medicine blog that was a response to Courtney Jung's article. She states "...let's replace zealotry with compassion and understanding and meet every mom where she is.  And if we see zealotry in our colleagues, let's gently remind them that this may be how we got to the Time magazine cover and New York Times op-ed.  That is the only way we will stop this negative press."

The acceptance of the article by Courtney Jung as truth is a huge mistake.  The result of this acceptance that there are zealots in breastfeeding advocacy and that they need to stay silent because its the only way to stop negative press is a dangerous concept.  It does not help the situation but makes the situation even worse.  Who defines zealots? Who are the zealots we are talking about that are creating negative press?  Why this easy acceptance of this article as if it is steeped in truth?  And that truth means that one should silence the "zealots?"  I understand quite well the silencing of zealots.  This silencing in the breastfeeding advocacy community has been ongoing for many years.  It is destructive and not in the best interests of anyone.
Copyright 2015 Valerie W. McClain






4 comments:

  1. Another great piece of writing Valerie. And while discussions about infant feeding decisions invariably focus on maternal autonomy and maternal choice, nevertheless it is the responsibility of the healthworker to make infant feeding recommendations designed to optimize the health of the most vulnerable member of the dyad - the baby. The mother is free to disregard that recommendation, but this does not absolve the healthworker from the responsibility for making it.

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    1. Thank you Pamela. Yes, healthcare providers have a duty to fully inform a mother and mothers are free to disregard those recommendations. Its like the saying, "You can lead a horse to water but you can't make him drink."

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  2. Excellent thinking, excellent writing!

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