“Use my picture if it will help” said the woman in this photograph. The babies are twins: the child with the bottle is a girl – she died the next day – but her brother was breastfed and is thriving. The mother was told that she wouldn’t have enough milk for both children, and so should bottle-feed the girl.
Sometimes I feel like we have to do the same activism over, and over, and over again. OK, a lot of the time.
Nestle and other infant formula companies been hooking poor mothers in to harmful, unaffordable artificial feeding for decades in a variety of countries all over the world, leading to one of the most widespread and longest-lasting boycott programmes in history. These companies have strenuously opposed all legal restrictions on their campaigns to reduce breastfeeding in the most vulnerable of populations.
Now, the Queensland government is reported to be favourably considering a plan to start handing out infant formula and bottles in local Aboriginal communities. The proposal, presented by pediatric surgeon Richard Heazlewood and general practitioner Lara Wieland, is suggested as an social-engineering alternative to the cash baby bonus. There has been an inexorable move toward conditional welfare for Indigenous women over the past year, and this is just one part of that.
The Australian: “Packs to give indigenous infants a good start”
Australia pays lip service to the World Health Organisation infant feeding guidelines and Code for the marketing of breastmilk substitutes. Under the feeding guidelines and Code, infant formula and bottle samples must not under any circumstances be handed out indiscriminately to mothers. An key part of the Infant Feeding Guidelines (which is incorporated into the Australian Dietary Guidelines) is:
Health workers must always ensure that they encourage the initiation and maintenance of breastfeeding and avoid any role in the promotion of breastmilk substitutes.
The very first principle in the Dietary Guidelines for Children and Adolescents in Australia is “Encourage and support breastfeeding“. Free samples of infant formula have been proven again and again to reduce breastfeeding incidence and duration. (For references, see the Ban the Bags campaign.)
And yet, here we have two health workers proposing that we start handing out infant formula freebies.
IBFAN (the International Baby Food Action Network) lays out in detail the ways in which breastfeeding is undermined. “Promotion Using Free Supplies” is number one. This should be banned in all companies who are signatories to the Code.
Method 3 in Undermining Breastfeeding is “Using “humanitarian aid” to create markets“, which also applies to the Queensland situation.
Article 4.2 of the Code calls for the clear information on, “where needed, the proper use of infant formula; When such materials contain information about the use of infant formula they should include:
* the social and financial implications of its use.
* the health hazards of inappropriate foods or feeding methods.
* in particular, the health hazards of unnecessary or improper use of infant formula and other breastmilk substitutes.”
* Most importantly, “such materials should not use any pictures or text which may idealize the use of breastmilk substitutes.”
Will the Queensland Government be paying attention to these precautions?
The ONLY circumstances under which free formula may be safely provided are when:
(a) Breastfeeding, expressed mother’s milk, and donor milk are all unavailable (formula is the fourth choice);
(b) The providing organisation trains the parents appropriately and thoroughly in making its administration as safe as possible;
(c) There must be adequate facilities for cleanliness, and a safe water supply;
(d) Powdered formula must not be provided to any infant under four to six weeks of age, because of the risk of neonatal meningitis bacterium Enterobacter sakazakii, an emerging pathogen and common contaminant of infant formula. (more information at the CDC;
(e) The providing organisation is prepared to provide ALL of that infant’s artificial baby milk needs for a full year (article 6.7 of the Code); and
(f) all of the other criteria of the Code are fulfilled.
Enthusiastic, unconditional, informative & informed support for breastfeeding is absolutely essential in Australia’s most vulnerable populations. The support must take place at all levels of healthcare and community service. Indigenous infants have the highest risk for death from infectious disease of any group in Australia, and breastfeeding is by far the one cheapest and most effective intervention that could reduce that risk. Diarrhoeal and respiratory disease feature prominently, and these are the infections most increased by artificial feeding.
There are a variety of other risks of artificial feeding for both mothers and babies, including an increase in cancer risk, increase in diabetes risk, less optimal child spacing – read the whole list at promom.org, and see kellymom.com for more details.
Yet instead of providing professional breastfeeding support and maternal nutrition programmes in indigenous communities, instead of offering appropriate training to indigenous healthcare workers, instead of funding and fostering woman-to-woman support programmes: we want to throw formula at them.
If Australia is going to look seriously at improving nutrition and the availability of high-quality food in Aboriginal communities, we need to start from the beginning.
Anna Bligh’s office can be contacted at ThePremier@premiers.qld.gov.au .