Severe shortages of infant formula across the United States have prompted glib dismissals of mothers’ concerns and increased pressure for women to breastfeed.
Anti-formula attitudes spreading widely on social media — even from prominent celebrities — at the moment follow decades of aggressive breastfeeding pressure from international public health experts trickling down from the heads of the World Health Organization (W.H.O.). Since at least the passage of the 1981 “International Code of Marketing of Breast-milk Substitutes,” the W.H.O. has partnered with zealous anti-formula organizations to pressure women into breastfeeding and condemn the use of baby formula as illegitimate, dismissing medical evidence that many women simply do not produce enough milk to feed their child.
The W.H.O. refers to breast milk as a “vaccine” — implying that the use of baby formula causes unnecessary immunological damage to infants — and commands that women breastfeed their children for two years.
The U.S. Centers for Disease Control (CDC) estimates that up to 75 percent of parents in America use baby formula in some capacity, either exclusively or as a supplement. At press time, over 40 percent of national baby formula stock is depleted, panicking parents and leaving low-income families who cannot afford to hoard formula particularly vulnerable to malnutrition. A Food and Drug Administration (FDA) shutdown of one of the country’s largest baby formula factories, a Michigan plant run by Abbott Laboratories, in February obliterated the nation’s baby food supply and resulted in the near-total disappearance of popular brands such as Similac from store shelves.
The White House did not have an answer for who was “running point” on the crisis Tuesday; on Thursday, President Joe Biden held a closed-door meeting with baby formula manufacturers and sellers, answering few questions.
Pediatricians largely agree that baby formula from trusted brands is an adequate substitute for women who cannot or do not want to breastfeed. The W.H.O., subsidiaries such as the Pan-American Health Organization (PAHO), and affiliated groups such as the World Alliance for Breastfeeding Action (WABA) have spent years attempting to erode popular trust in baby formula, leading to mothers facing shame for using formula from friends, acquaintances, health workers, “lactation consultants,” and Mike Bloomberg, among others.
The 1981 World Health Assembly, the annual meeting of W.H.O. member nations, resulted in the passage of the “International Code of Marketing of Breast-milk Substitutes.” While not binding international law, the “code” heavily pressures W.H.O. member states not to “promote” the existence of baby formula in any capacity.
“The Code advocates that babies be breastfed. If babies are not breastfed, for whatever reason, the Code also advocates that they be fed safely on the best available nutritional alternative. Breast-milk substitutes should be available when needed, but not be promoted,” according to the W.H.O.
The Code demands that governments control the “marketing and distribution” of formula; the W.H.O.’s official explainer on the code claims that “exclusive breastfeeding from birth is possible for most women who choose to do so,” a claim undermined by the fact that, in America, the vast majority of women do not exclusively breastfeed despite intense pressure from advocacy organizations and “lactation consultants.”
In February, as the FDA shut down Abbott’s Michigan facility, the W.H.O. published a “report” attacking formula companies for marketing their products.
“More than half of parents and pregnant women (51%) surveyed for a new WHO/UNICEF report say they have been targeted with marketing from formula milk companies,” the W.H.O. asserted, calling the marketing a “breach of international standards on infant feeding practices” – meaning its own 1981 Code. Among the alleged violations the formula companies engage in are “free gifts” to customers and “sponsored advice networks and helplines.”
“This report shows very clearly that formula milk marketing remains unacceptably pervasive, misleading and aggressive,” W.H.O. Director-General Tedros Adhanom Ghebreyesus — formerly Ethiopia’s top diplomat under the Marxist Tigray People’s Liberation Front (TPLF) and not a medical doctor — said at the time. “Regulations on exploitative marketing must be urgently adopted and enforced to protect children’s health.”
The campaign following the publication of the anti-formula report repeated dangerous claims like “your baby only needs a very small amount” of colostrum, a mother’s first milk, to be healthy.
In reality, children need to eat a sufficient amount of food from the moment they are born. The aggressive promotion of breastfeeding – including for women not producing milk – has led to growing numbers of cases of malnourished newborns. American women, a 2017 article in the Atlantic documented, are experiencing “lactation consultants pressuring them into avoiding temporary formula use, despite weight loss, dehydration, or jaundice — which infants are at higher risk for if they’re dehydrated or not getting enough calories.”
“Lactation consultants” are individuals who claim to be breastfeeding experts and have enshrined themselves in many hospitals and clinics. They often actively discourage the use of pacifiers or bottles and, the Atlantic details, do not make clear that their recommendations are not commands. The author of the piece, Lindsey Hunter Lopez, described watching her infant lose “more than 11 percent of her body weight before that doctor stepped in” to offer baby formula. In another case Lopez documents, “lactation consultants” barred a mother from access to formula in the hospital, resulting in her baby losing 23 percent of his body weight and landing in the neo-natal intensive care unit (NICU).
In a similar case, mother Jillian Johnson told the Washington Post in 2017 her newborn died of dehydration, as she did not produce milk.
“I couldn’t wrap my head around it. I was frustrated with myself because, there were these doctors and nurses who kept telling me, ‘Just keep feeding him. Just keep him on the breast. You’ve got a great latch. You’re doing fine,'” Johnson told the Post.
Johnson said a lactation consultant specifically told her the baby “had a great latch and was doing fine.”
While an organization exists to oversee “lactation consultants” — the International Board of Lactation Consultant Examiners (IBLCE) — not all self-proclaimed “lactation consultants” have formal training and the “lactation consultant” industry has enthusiastically resisted government regulation, placing mothers and babies at risk.
Johnson’s son Landon died at a “baby-friendly” hospital. The Baby-Friend Hospital Initiative is a W.H.O. and United Nations program to eradicate formula internationally. The Initiative demands that participants “do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.”
“A maternity facility can be recognized as ‘baby-friendly’ when it does not accept free or low-cost breastmilk substitutes, bottles or teats, and has put in place 10 specific steps to support successful breastfeeding,” according to La Leche League.
The W.H.O. and PAHO participate in an event known as “World Breastfeeding Week” every August that condemns the use of baby formula. During last year’s campaign, PAHO adopted the WABA slogan “a shared responsibility” to promote breastfeeding and declared, “it is vital to ensure that breastfeeding mothers do not get targeted by the industry, marketing or public health professional who want to jeopardize their breastfeeding by promoting formula-feeding.”
WABA is an advocacy group network that actively promotes breastfeeding at the expense of using formula and organized “World Breastfeeding Week.” It claims to be “in consultative status with UNICEF and an NGO in Special Consultative Status with the Economic and Social Council of the United Nations (ECOSOC).” The W.H.O. is a United Nations Agency.
In addition to its strong ties to the United Nations, the WABA maintains a partnership with La Leche League, an extremely aggressive anti-formula advocacy group particularly active in the United States. State governments actively promote La Leche League and classes for new parents at hospitals often cite it as a resource. Among the more extreme positions La Leche League has recently taken is the promotion of breastfeeding to fight climate change and pressuring Ukrainian mothers not to accept formula while feeling from the ongoing Russian invasion in that country, distributing a brochure titled “Methods of Raising Lactation in Crisis.”
Anti-formula activists routinely cite a host of dubious studies claiming that breastfeeding can improve a child’s health, future income, intelligence levels, and other life metrics. Doctors and scientists have greatly refuted the results of these studies. As a 2010 article published in the journal Early Child Development and Care detailed, “breastfeeding promotion efforts sometimes overstate or misrepresent what the research actually supports about the benefits of breastfeeding.”
“Psychological or cognitive benefits, particularly for full‐term healthy infants, may be overstated. In some studies, variables such as income, education and maternal IQ are not adequately taken into account,” the study concluded. “Studies that do take these variables into account often find little or no association between breastfeeding and cognitive outcomes except in the case of premature or low birth weight infants. Although often promoted as a benefit of breastfeeding, there is little support of the assertion that breastfeeding enhances bonding between mothers and their infants.”
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