Wednesday, June 10, 2015
"On a macroscale, human milk is a national resource. Its loss is not only an economic burden for poorer families, but it is a waste of existing high protein baby food, time tested over millenia, and has to be replaced by other protein rich foods, usually based on cow's milk. In the developing countries this has been calculated to represent a waste of millions of dollars annually. Similar, but lesser, losses are occurring in poverty areas of industrialized countries, including the United States."
--Dr. Derrick Jelliffe's testimony to the Senate Subcommittee June 5, 1973
Forty-two years later and in the "aftermath" of a major economic recession, we still are wasting this national resource. The resource is breastfeeding. Human milk feeding carries a bigger economic and environmental cost. Food prices are skyrocketing in the USA, and food insecurity is increasing. Food insecurity is defined by the USDA as, "a measure of lack of access at times to enough food for an active, healthy life for all household members."
Feeding America (nation's largest hunger relief organization) has been documenting food insecurity in the USA for the past 5 years. Their stats on food insecurity among children is that the largest estimated population of food-insecure children is in Los Angeles County--nearly 600,000 children, 1 in4 live at risk of hunger. In New York City there is estimated to be more than 400,000 children at risk. Wealthy counties are not exempt from child food-insecurity. One of the wealthiest counties in the USA-Loudoun, Virginia has 10,000 food insecure children.
Florida is one of the top 10 states for child food insecurity (ranked #8) with 1,071,760 children considered food insecure. Congressional District 5 in Florida (one of the most gerrymandered districts in the country, and runs from Jacksonville in the North to Orlando in the center of the state) has one of the highest Congressional District rates of food insecure children with 58,270 children considered food insecure. It appears from maps that in general that the Southern states have the highest rates of child food insecurity. And in general the South has the lowest rates of breastfeeding initiation and duration in comparison to the rest of the country.
According to the US Conference of Mayors 2014 Status Report on Hunger and Homelessness, in a 2013 survey, 62% of all food-insecure households participated in one or more of the three largest federal food and nutrition assistance programs(SNAP, National School Lunch Program, and WIC). Which means that 38% of food-insecure households had only food banks or friends or family to help them. They estimated for the year 2013 that, "3.8 million households were unable to consistently provide adequate, nutritious food for their children."
One of the ways in which food insecure households cope with making ends meet is the purchase of inexpensive, unhealthy foods, getting assistance from friends or family, eating food past expiration dates, watering down food or drinks, selling or pawning personal property, and growing a garden. Food insecure families often have to choose between food or paying utilities, food or transportation, food or medicine/medical care, food or housing, food or higher education.
It appears that many food banks provide infant formula for families who are food insecure. And while it is important to provide infant formula for infants whose mothers can't breastfeed or don't want to breastfeed, it is not the solution to food insecurity. It is a temporary fix. Infant formula in areas of poverty creates more food insecurity. Will the food banks provide for all the infant formula a baby needs? Or will a mother be struggling every week to find enough infant formula for her baby? Even the WIC Program provides a limited amount of infant formula and mothers who need more than the prescribed allotment must pay out-of-pocket for babies that need more than is provided.
How often will infant formula feeding moms in difficult economic circumstances give their infants regular cow's milk or soy milks (since infant formula is so much more expensive than cow or soy milks)? How often will mothers water down infant formula which can cause water intoxication which can lead to death?
How do food banks regulate the distribution of infant formula? Is it handed out to whoever asks for it? Is this situation monitored so that moms who might be interested in relactation get the help they need? Are pregnant moms that show up to food pantries given breastfeeding literature and numbers of where to get breastfeeding help? I don't know what is done but many food banks state that they provide infant formula. Wouldn't it make a lot of sense to provide breastfeeding information?
Over the years I have read in the newspapers about mothers whose infants died or were hospitalized for malnutrition from starvation (some of those moms were charged with murder). In some of the cases the mother was watering down the infant formula (recently a mother was watering down her breast milk). In some of the cases the mother was giving the baby whole cow's milk. Seeing a failure to thrive infant is horrifying. But should the blame for these deaths be placed on mothers? It appears to me that our society has no clue about the importance of breastfeeding. Nor do they understand how to protect breastfeeding or how breastfeeding works. Nor does society in general, even recognize the risks of infant formula for food-insecure families.
The recommendation by the CDC is that newborn and young infants receive liquid infant formula that is sterile rather than powdered infant formula. The reason being the risk of bacterial infection-Cronobacter sakazakii.
The cost of ready-to-feed infant formula on the internet ranged from US $7.28/qt to $7.49/qt. There are 32 oz to a quart. In general the amount of infant formula per day for an infant can be calculated by infant's weight times 2 to 2 1/2 ounces. An 8 pound baby would use the quart of infant formula in approximately 1 1/2 to 2 days. So about $22-$24/week. And as the baby gains weight more and more formula is needed until the addition of solid foods.
An exclusively breastfeeding mother would only need an extra 300-500 calories (1 peanut butter sandwich is approximately 350 calories) per day of food to sustain breastfeeding. Thus the cost of feeding the formula fed infant versus the exclusively breastfed infant is dramatically different. And when you add in that exclusive breastfeeding creates a healthy immune system and that the antibody production creates a milk that protects against pathogens in the environment: bacterium, viruses, parasites and fungi. And breastmilk contains stem cells that encourage growth and repair of all cells. Thus, the exclusively breastfeeding infant is healthier than the formula fed infant, meaning health care costs are lower.
Nature has a system that protects infants and has protected infants for thousands of years. Society must endeavor to protect breastfeeding and particularly when it involves families who face food insecurity.
Copyright 2015 Valerie W. McClain