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How we feed babies and young kids greatly impacts their health, growth, and future. This affects not only the children but also women and society. While baby formula has its uses, and it literally be a life saver in certain circumstances, it also comes with significant health, economic, and environmental costs. On the other hand, breastfeeding has proven health benefits for both mothers and babies in high-income and low-income settings alike. Despite that, according to the World Health Organization, less than half of babies and young children are breastfed as recommended.

How did this happen?

According to a three-paper series published in The Lancet in 2023, the lack of breastfeeding is due to multifaceted and highly effective strategies used by commercial formula manufacturers of infant formula. The strategies are designed to target and influence parents, health-care professionals, and policy-makers. The industry’s dubious marketing practices are compounded by lobbying of governments, often covertly via trade associations and front groups, against strengthening breastfeeding protection laws and challenging food standard regulations.

This episode of Trickle Down explores the roots of this problem: the infant formula industry in the early 20th century captured doctors and medical associations in order to sell their product. And when they reached the limit of infant formula market in the United States, they simply aggressively sold their powders to mothers in poor countries, with disastrous and deadly consequences.


REFERENCES

Breastfeeding 2023

https://www.thelancet.com/series/Breastfeeding-2023

Apple, Rima. Mothers and Medicine: A Social History of Infant Feeding, 1890–1950. University of Wisconsin Press, 1987.

The Baby Killer (1974)

https://waronwant.org/sites/default/files/THE%20BABY%20KILLER%201974.pdf

Stevens EE, Patrick TE, Pickler R. A history of infant feeding. J Perinat Educ. 2009 Spring;18(2):32-9. doi: 10.1624/105812409X426314. PMID: 20190854; PMCID: PMC2684040.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684040/

Why The Breastfeeding Vs. Formula Debate Is Especially Critical In Poor Countries

https://www.npr.org/sections/goatsandsoda/2018/07/13/628105632/is-infant-formula-ever-a-good-option-in-poor-countries

Ziegler EE. Adverse effects of cow's milk in infants. Nestle Nutr Workshop Ser Pediatr Program. 2007;60:185-199. doi: 10.1159/000106369. PMID: 17664905.

https://pubmed.ncbi.nlm.nih.gov/17664905/

APPLE, RIMA D. “‘TO BE USED ONLY UNDER THE DIRECTION OF A PHYSICIAN’: COMMERCIAL INFANT FEEDING AND MEDICAL PRACTICE, 1870-1940.” Bulletin of the History of Medicine, vol. 54, no. 3, 1980, pp. 402–17. JSTOR, http://www.jstor.org/stable/44441272.

Walters DD, Phan LTH, Mathisen R. The cost of not breastfeeding: global results from a new tool. Health Policy Plan. 2019 Jul 1;34(6):407-417. doi: 10.1093/heapol/czz050. PMID: 31236559; PMCID: PMC6735804.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735804/pdf/czz050.pdf

Munblit, D., Crawley, H., Hyde, R., & Boyle, R. J. (2020). Health and nutrition claims for infant formula are poorly substantiated and potentially harmful. bmj, 369.

https://www.bmj.com/content/bmj/369/bmj.m875.full.pdf

Boatwright, M., Lawrence, M., Russell, C., Russ, K., McCoy, D., & Baker, P. (2022). The Politics of Regulating Foods for Infants and Young Children: A Case Study on the Framing and Contestation of Codex Standard-Setting Processes on Breast-Milk Substitutes. International Journal of Health Policy and Management, 11(11), 2422-2439. doi: 10.34172/ijhpm.2021.16

https://www.ijhpm.com/article_4169.html

Nancy E. Zelman, The Nestle Infant Formula Controversy: Restricting the Marketing Practices of Multinational Corporations in the Third World, 3 Transnat'l Law. 697 (1990).

https://core.ac.uk/download/pdf/303871848.pdf

Infant nutrition : a textbook of infant feeding for students and practitioners of medicine / by Williams McKim Marriott.

https://iiif.wellcomecollection.org/pdf/b29929453

Wattana, Melissa. The Baby Bottle and the Bottom Line: Corporate Strategies and the Infant Formula Controversy in the 1970s (2016)

https://hshm.yale.edu/sites/default/files/files/Wattana%20senior%20essay%202016.pdf

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Comments

Anonymous

Yeah this story about nestle & the beginnings of formula has already been covered extensively by things like NPR & Behind The Bastards & it just doesn’t feel relevant to use to it to shame moms for formula at a podcast primarily about American politics when breastfeeding is often a weapon used against women. Other people have commented from experience here but I just want to say this morning on Instagram I saw a picture of woman working at a fast food place with her baby strapped to the front of her while taking orders. We can’t possibly expect women to afford to breastfeed & work while still providing the majority of emotional & domestic labor for most people in their lives. It’s a physically taxing process that seems to require some mental fortitude that women are constantly shamed for not being able to do. It’s also a wedge issue where people who get really into breastfeeding as a marker of their worth are more likely to get sucked into other bullshit like anti vaccine propaganda & q stuff. Fed is best.

Anonymous

I feel like this episode was lacking analysis on the overt misogyny of the medical field and obstetrics specifically in the late 19th/early 20th century (and today). There was (is) definitely a sense among doctors that women’s bodies are inherently disgusting, feeble and flawed that I’m sure influenced their support of formula. Not a bad episode but could have been a lot stronger…