Gabrielle Palmer first published her tome The Politics of Breastfeeding: When Breasts are Bad for Business in 1988. Since then there have been two revisions, the most recent in 2009. The book is quite thorough, covering the history of breastfeeding through different cultures and socioeconomic groups. The other big focus of The Politics of Breastfeeding is the infant formula industry (hence the subtitle: When Breasts are Bad for Business). Palmer begins with the origins of artificial infant milks - when doctors actually used to make and sell formula - and follows the evolution of formulas, formula companies, and formula marketing and advertising to present day. Throw in a healthy serving of discussions on women's rights and our place in society throughout the history of the world, and this book has something for every woman, and would be great educational material for men as well.
We are fortunate to live in a society where breastfeeding versus formula feeding is not the life and death decision that it is in some parts of the world. I always knew that in some places a lack of clean drinking water was one hazard to formula use, but there are other things I never would have considered... Distance to get water for example. Some mothers must travel several hours to get to their nearest source of water, and it may or may not be clean. Then they have to carry it back. Fuel for the fire, and time spent boiling water is another thing I hadn't considered. It takes 10-15 minutes for an open fire to boil water, and that water must boil at least another 10 minutes to kill off any pathogens that may be in the water. And forget preparing multiple bottles or large quantities at one time, because these sorts of places don't have refridgeration. Imagine spending 20-25 minutes boiling water for each feeding. Unfortunately many families in such circumstances are only able to collect enough fuel for 2 feedings - then what? I guess they risk making multiple feedings at once, or not boiling their water. Formula must be mixed while the water temperature is still above 70 degrees because, believe it or not, there are some pretty nasty bacteria in formula (no, it's not sterile) that can cause a world of health problems for baby if it is not prepared correctly.
It may surprise many to hear that in many places in the world it is actually less risky for an HIV-positive mother to exclusively breastfeed than to use formula - yes, you read that correctly. It is possible to spread HIV/AIDs through breastmilk (5-10% chance), but the health risks of using contaminated water to make formula are much greater. The risk a baby contracting HIV/AIDs actually increases if a mother feeds with a combination of breastmilk and formula. Breastmilk coats the gut in a way that prevents most bacteria and viruses from adhering, thus protecting against infection. Formula usage takes away this protective coating, making babies more susceptible (on a side note, while pregnant, I read that just 1 formula feed will completely change the lining of the gut, and it takes a full 3 weeks without formula for the gut to return to its exclusively breastfed state). Now, if an HIV-positive mother has access to clean water, health care, a consistent supply of formula, and is able to afford all of these things, then formula feeding is the best option, but only if all criteria are met. If there is a chance that she will have to use combine feedings due to of formula availability, or lack of money then exclusively breastfeeding is best.
In the US as well as other developed countries those who use formula do so with much less risk than other places in the world, largely because of clean water, clean conditions in which to prepare formula, and access to health care. However, lack of breastfeeding still leads to an increased risk of obesity, diabetes, and heart disease, among other things. Centers for Disease Control gives "only 2 cost effective ways to deal with childhood obesity - less television watching and more breastfeeding promotion." The Surgeon General's goal is that 75% of babies will be breastfed at birth, and 50% at 6 months. Were these goals met it is estimated that there would be a savings of $3.6 billion on health care for 3 childhood illnesses alone.
The amount of information provided about formula companies and how they operate is extraordinary - I'm not even sure where to start, and hopefully this won't get too lengthy...
First of all, on ever single container of infant formula you will find at the store there is fine print that says (more or less) "breast is best" - formula companies are the origin of this expression. However, it is in formula companies' best interest if women don't breastfeed - that means more sales for them. And some of the ways they go about promoting their product surprising. Formula companies often include samples in hospital discharge bags for mother who plan to breastfeed because studies have found that those who give up on breastfeeding use formula longer than those who intended to artificially feed.
In the 1970's Nestle got in big trouble in Africa for tricking mothers into using formula. Nestle hired sales women and had them dress as nurses (called "milk nurses") while promoting and selling infant formula. 87% of mothers who used Nestle formula as a result of this promotion did so because they thought that the hospital was telling them to use formula - they thought these sales women (and yes, they were IN the hospital promoting formula) were real nurses, as was apparently the intention.
I'll use an outline for for this part as it would get lengthy otherwise...
The largest formula market in the world: Women, Infants, and Children (WIC)
- 50% of formula sales in the US are to WIC, which receives huge rebates from the formula companies.
- WIC packages for formula feeding mothers have 3 times the value of those given to breastfeeding mothers.
- In the formula aisle WIC contracted formulas are available in the largest quantities and given the best shelf space. The prices of these formulas are higher than non-WIC formulas, therefore non-WIC families end up paying more if they buy the WIC approved formulas.
- Doctors tend to recommend WIC formulas so as not to differentiate between between WIC and non-WIC mothers.
I could go on and on with statistics and information that surprised me and impressed me from this book. It is a lengthy read, and gets a bit slow in some places (especially when discussing policy), but overall a great read! Very informative!
"I wish I were not writing this preface," says Palmer in the most recent edition. "There should be no need for this book." Yet there is.
No comments:
Post a Comment