Monday, September 10, 2018

Infant feeding: Survival or Choice?



"If a multinational company developed a product that was a nutritionally balanced and delicious food, a wonder drug that both prevented and treated disease, cost almost nothing to produce and could be delivered in quantities controlled by consumers' needs, the announcement of this find would send its shares rocketing to the top of the stock market."  --Gabrielle Palmer, The Politics of Breastfeeding. (page1)

I read The Politics of Breastfeeding, when it was first published.  It seems like a life time ago.  I loved the book and shared it with a number of people I knew.  I never got it back but understood why someone would keep the book. So I bought another copy, a newer edition.  The above quote from Palmer's book was one of my favorites and of course she states after that sentence, "Women have been producing such a miraculous substance since the beginning of human existence."   

The statement is certainly a true statement. Yet the statement troubles me now.  The problem is that various multinational companies are mining human milk for the components that make it such a miraculous substance.  Through patenting, they can claim that genetic engineering duplicates the substance.  Of course anytime you mine a natural resource there will be costs passed onto the consumer.  So what was once a free resource has a price.  The infant formula industry is just part of many industries competing for patents on the components of human milk.  There is the vaccine, drug, food and supplement industries that somehow obtained that precious liquid, isolated its components, studied those components, and then proclaimed that they have found the magic bullet to create health.  

The good men and women of science believe in isolation, that separation from the whole can make powerful medicine.  Yet nature does not do isolation.  Isolation in nature is failure, life depends on multiple interconnections.  We see this when looking at the human body.  The organs and tissues of the body work in synchrony, disturb one organ or tissue and its impact is felt throughout the body.  Or consider how one simple act of spraying DDT to kill bugs, results in dead song birds.  Or dumping toxins in a river ends up with human clusters of cancer or birth defects.  The web of life is a complex system.  Disturb one small part of it and we often witness the ripple effect of the consequences of that disturbance. The sad thing about human disruption of nature is that often we do not see the consequences until it is too late. 

Life is complex and the wonder of it never ceases to entertain me.  The internet entertains me, for it too is a web, a web of ideas that ripple across the world.  The impact of those ideas can be beneficial or detrimental to our society.  We can easily get a distorted view of various subjects or we can see our politics more clearly.  I recently read a NY Times article, Breast-Feeding or Formula?  For Americans, It's Complicated by Christina Caron (July14, 2018)

 https://www.nytimes.com/2018/07/14/health/trump-breastfeeding-history-nyt.html

It was an attempt at being a balanced article on breastfeeding and infant formula.  Yet I immediately began to suspect that this article had an agenda.  The author gives us a little history,

"Wet nursing, which began as early as 2000 B.C., was once a widely accepted option for mothers who could not or did not want to breast-feed, but it faced criticism during the Middle Ages and the Renaissance. The profession eventually declined with the introduction of the infant feeding bottle in the 19th century."

Wet nursing was widely accepted because; if a mom refused to breastfeed her infant, the baby died.  If a mom died in childbirth, the need for someone to nurse the baby was imperative.  Who hired wet nurses?  Wealthy women.  I would not describe the history of infant feeding as one of options.  Rather I would describe it as survival.  In the text book, Breastfeeding and Human Lactation, 2nd edition (page 5)

"Wet-nursing may not have been the earliest alternative to maternal breastfeeding, but it ws the only one likely to enable the infant to survive."


Choice is the current ideology (promoted by the infant formula industry). Making it seem as, if women have always demanded options in infant feeding is not particularly accurate.  To ignore the connection between breastfeeding and infant survival, is to ignore a crucial fact regarding the history of infant feeding.  But choice as the bedrock of infant feeding,  does serve the purpose of this NY Times article.

The article goes on to telling an abbreviated history of infant feeding and the information seems geared towards sending a message that the US policy on breastfeeding is based on the need for choice and has always been that way.


"A couple of years later, in 1981, the W.H.O. voted 118 to 1 to adopt a nonbinding code restricting the promotion of infant-formula products. The United States, under President Ronald Reagan, was the lone dissenting vote.
The decision drew a chorus of critics, much like the Trump administration’s recent stance on the marketing of powdered formula to women in developing countries.
Elliott Abrams, then the assistant secretary of state for international organization affairs, said in 1981 that it was a free-speech issue."

But the article never mentions the Senate hearings lead by Ted Kennedy, a Democrat, in 1978 regarding the marketing of infant formula in developing nations which lead to talks which eventually resulted in the creation of the WHO Code. And yes I know a Republican administration (Reagan) refused to sign the WHO Code.

  

 Instead the impression left by this NY Times article is that politically the US has always been against the WHO Code.  The article leaves me with the belief that one side of the story is being told.  Might we believe that this is an issue of infant survival? The WHO Code was designed to save infants from illness and death.  Why do some Americans (and the industry) say this is a free speech issue? When a product sickens and kills some infants, how many infants should we accept as collateral damage?  (considering that 4-6 infants per year are damaged and/or die due to the intrinsic contamination by Cronobacter sakazakii in powdered infant formula, and many more from Salmonella)

The author briefly mentions the tragedy of the infant formula company, Syntex, that decided to delete salt from their formulas, Neo-Mull-Soy and CHO-free. It was believed that 22,000 US infants were affected by this change in formula.  Babies suffered serious health consequences due to the salt deletion.  Two mothers waged a campaign that eventually saw the creation of the Infant Formula Act of 1980.  Here is an article on the mothers who helped change US law regarding the regulation of infant formula.
 https://www.washingtonpost.com/archive/politics/1980/10/11/how-two-angry-mothers-beat-uncle-sam-at-his-own-game/e26a2490-72e6-4720-8d57-5c1b6887e536/?noredirect=on&utm_term=.c80256834a33

Fed Is Best movement emerges as the last topic of the author's history of infant feeding.  The author seems to believe that since the Infant Formula Act of 1980 that formula in the US is safe and bottles are safer because they are BPA-free.  Let's not bring up the fact that there are studies that the BPA-free plastics are not any safer than the BPA bottles.
https://www.scientificamerican.com/article/bpa-free-plastic-containers-may-be-just-as-hazardous/

The author mentions that Similac has organic formula.  Interesting that the author mentions a specific company.  I question this statement since I believe this "organic" product has the Martek oils made from algae and fungi.  These oils are genetically engineered, use hexane for extraction and are not considered organic by organic standards.
https://www.organicconsumers.org/news/brand-name-organic-infant-formula-ingredients-processed-toxic-chemical#close

The author states, 

"What is often missing from the debate over breast vs. bottle is the fact that so many women do both. Breast-feeding is still considered the gold standard, but formula supplementation is commonplace, especially as women return to work after maternity leave. For many mothers, this is the best of both worlds."

Mothers can have it all, the best of both worlds? Or does one negate the other?  Certainly, the infant formula industry can have it all.  The last statement the author makes in the article,

“Malnutrition and poverty are the precise settings where you absolutely do need to breast-feed,” Dr. Michele Barry, senior associate dean for global health and director of the Center for Innovation in Global Health at Stanford School of Medicine, told The New York Times. “Because that’s the setting where access to safe and clean water for reconstituting powdered formula is often impossible to find.”

Choice in infant feeding decisions is predicated on the belief that safe and clean water exists in every town in the US and other developed nations.  Yet tell that to the moms in Flint, Michigan where the levels of lead in their water require the use of expensive filters or buying bottled water.  Or tell that to the families that live down river of the teflon manufacturing plants.  Or tell that to people who read their water department statements.  Cryptosporidium is a parasite that infects water causing diarrhea and other ailments.  It is commonly found in lakes and streams contaminated by animal feces. In immune-compromised individuals it is so serious it may cause death.  It is suggested that severely immune-compromised individuals boil their water. Disinfection is difficult to do because the egg cell is immune to chlorination.  
http://www.health.state.mn.us/divs/eh/water/factsheet/com/cryptosporidium.html

Some babies born prematurely are considered immune-compromised.  Babies not breastfed may be considered immune compromised depending on your viewpoint.  The risk is the water and even if a formula fed infant is not considered immune-compromised, there is an obvious risk of diarrhea.  And diarrhea in an infant is a known-killer.  This article is from 1988.  Has water supplies in the US improved since 1988 or are we faced with another important element of our infrastructure that is broken? 
https://www.nytimes.com/1988/12/09/us/infant-diarrhea-kills-hundreds-yearly-in-us.html

The last quote from Michele Barry failed to mention that she is the director of the Yale/Stanford Johnson & Johnson Global Health Scholar Program.  One might presume that Johnson & Johnson funds this Scholar Program.  Johnson & Johnson sells pharmaceuticals and seems very involved in research regarding hiv/aids in Africa (they are working on a vaccine for hiv). Hm, now why would Michele Barry be interviewed for an article on infant feeding history that also involves the Fed Is Best organization?  

I still very much appreciate The Politics of Breastfeeding.  The last few sentences in the book state,

"A creature from another planet visiting the Earth might ask, "If women are the ones that keep the human race going, why do they get the rough deal?"

Why indeed?  Why is women's history so unknown?  Why does a NY Times reporter distort the history of infant feeding?  Perhaps she needs to read, The Politics of Breastfeeding?  Maybe we should develop a book campaign and send this book to Christina Caron as well as the founders of Fed Is Best?  I imagine they wouldn't read it--too political?  Telling half the history, leaving out the reality is another political choice.  Getting half the story does not illuminate the issue but mentioning all those wonderful products (Similac, bottles) we now have certainly tells us that consumerism is the prime directive.  Choice in products becomes the reality of our world.  
2018 Valerie W. McClain



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