Controversy over breastfeeding?

Earlier this month, US delegates to the World Health Assembly (the decision-making body of the World Health Organization) in Geneva were said to voice opposition to a resolution aimed at promoting the benefits of breastfeeding over infant formula.  The resolution declared that a mother’s breast milk is the best food for infants and discouraged misleading advertising for formula.  We all know that professional organizations such as the American Academy of Pediatrics recommend breastfeeding as the sole source of infant nutrition for at least the first six months of life.  Not only does breastfeeding protect against infant diseases (e.g. diarrhea, respiratory tract infections, necrotizing enterocolitis, ear and urinary tract infections) and childhood obesity, but for mothers, breastfeeding has been shown to promote quicker recovery from childbirth and reduced rates of breast and ovarian cancer later in life.  In the US about half of new mothers start out breastfeeding, but this drops to ~20% at 6 months.

According to some reports, the US delegates tried to remove language asking governments to protect, promote and support the practice.  They were accused of bullying potential sponsors of the resolution from poor nations in Africa and Latin America by threatening to cut off aid and even suggested that the United States might cut its contribution to the W.H.O.  Contradicting this, Brett Giroir (assistant secretary for health at the Department of Health and Human Services), insisted that the objection was never to breastfeeding per se, but rather to certain language in the guidance recommending that countries impose stringent new regulations on the marketing of any commercially produced foods suggested for children between 6 months and 3 years of age.  Citing the spread of misinformation about the events in Geneva, Giroir claimed that “there are good and valid reasons, both medical and personal, why some mothers cannot breastfeed, or choose not to breastfeed exclusively” and that parents need all the information about choices available.

Another (anonymous) source stated: “women should have the choice and access to alternatives for the health of their babies, and not be stigmatized for the ways in which they are able to do so,” and President Trump tweeted that “the U.S. simply wanted to protect women who need formula for their babies.”  Though this may have been the intent, a more cynical view of US opposition to the resolution could be that it was a ploy to help support the interests of the $70 billion infant formula industry over what is best for most mothers and children.

Fortunately, the final version of the resolution reaffirms "that breastfeeding is critical for child survival, nutrition and development, and maternal health" and calls on member states "to continue taking all necessary measures in the interest of public health to implement recommendations to end inappropriate promotion of foods for infants and young children."

Judith Wolf, MD