Breast Is Best - But Not For Profits

“After I saw TV ads claiming infant formula with DHA [docosahexaenoic acid] and ARA [arachidonic acid] can help with eye and brain development, I gave my baby formula,” said the 30-year-old mother in the southern Chinese city of Shenzhen. “Then I learned from books and doctors that breast milk is actually best.”

 Experts say that here and in other developing countries, nursing rates would be higher - and infants and mothers healthier - if it was not for the popularity of these formulas boosted with DHA and ARA.
Featuring doe-eyed infants and laughing mothers in newspapers, magazines, and on billboards, these ads are becoming a fixture in developing nations’ maternity wards (where nurses sometimes give free formula to new mothers) and in grocery stores (where saleswomen approach them in the nappy/diaper aisles).

Health experts have responded with alarm.
“Scientific evidence doesn’t support the industry’s statements about ARA and DHA,” said James Akre, a former member of the International Board of Lactation Consultant Examiners (IBLCE), which sets global standards for lactation and breastfeeding care. Heath campaigners say that for decades, formula has consistently proven to be less healthy than breastfeeding - boosting the risk of diabetes, infections and other medical problems, and, when used exclusively, contributes to 21 percent higher infant mortality. They say that due to the addition of ARA and DHA, formula is now growing more expensive. And they warn that in developing nations, formula with additives is often being sold in a way that violates the recommendations of World Health Organization (WHO).

“Scientists can’t make the same form of ARA and DHA that human breast milk contains,” said Elizabeth Myler, a spokeswoman for the US-based NGO that promotes breastfeeding, La Leche League International. “Instead, they extract it from fermented algae and fungus using a toxic chemical called hexane.”
Mike Brady, a spokesman for the UK-based NGO Baby Milk Action, said some infants have adverse reactions to plant-derived ARA and DHA, though it is “currently unclear if this is due to the components themselves, or to the chemicals used in processing.”

Health advocates charge that studies supporting ARA and DHA supplementation are conducted primarily by companies profiting from this practice.

Asked by IRIN to provide independent studies proving ARA and DHA benefits to infants’ health, a spokeswoman from additive-maker Martek Biosciences responded: “There is no reason to believe that the funding source would have any undue influence on the outcomes.”
Nestlé declined to comment, and Mead Johnson provided general data about ARA and DHA consumption, some of it 20 years old.

An independently funded 2010 report from the US-based research NGO Cornucopia Institute, which supports sustainable agriculture, warned ARA and DHA additives have been associated with jaundice, sepsis, colitis, and diarrhoea. The latter is one of the leading causes of infant death in the developing world.
And then there is the cost. According to the US Food and Drug Administration, DHA and ARA boost the cost of formula by 6-31 percent in the US. Though studies have yet to identify how much these ingredients are spiking prices elsewhere, ARA and DHA are now added to most brands sold globally.

Suboptimal breastfeeding accounts for one million infant deaths annually, and 10 percent of the disease burden in children, reported the UK publication, Archives of Disease in Childhood, in 2012. For these reasons, UNICEF, WHO and other authorities advocate exclusive breastfeeding - no other liquids or foods - during the first six months of life, followed by continued breastfeeding until age two.

After commercial infant formula was introduced in the developing world in the early 1900s, cases of lethal diarrhoea spiked (and anti-formula sentiment mounted) leading to the penning by WHO in 1981 of its International Code of Marketing of Breast-Milk Substitutes.
Endorsed by UNICEF and quickly adopted by 150 of 194 WHO member nations (with the US, home to two leading infant-formula makers, voting against it), the code stipulated manufacturers should not distribute free samples to promote their products, that advertising should not “idealize the use of breastmilk substitutes”, and that packaging should include information on the benefits of breastfeeding.


Infant-formula-division sales at Martek Biosciences (based in Maryland in the US and owned by the Dutch company Royal DSM, the leading maker of plant-derived DHA and ARA) have spiked to $317 million annually. And the Penang-based International Baby Food Action Network (IBFAN) reports 23 percent of countries that have adopted the WHO code have not implemented it.

“The code is a recommendation, and not a treaty,” said George Kent, a professor at the University of Hawaii who has researched food, nutrition and ethics and is author of Regulating Infant Formula. “It isn’t legally binding, and it isn’t being enforced as companies work to market products containing ARA and DHA.”

“Progress is difficult because this is a case of shoestring-budget NGOs battling large, deep-pocket commercial interests and their unfettered merchandising.”
Leading manufacturers (Nestlé, in Vevey, Switzerland; followed by Mead Johnson and Abbott Laboratories, both in Illinois in the US; and Danone, in Paris) are among the most successful corporations worldwide.

Fuelled by profits from the baby-foods market (which includes but is not limited to infant formula and generates $30 billion in global sales annually, with growth projected to reach $35 billion in 2016), these companies have funnelled money to projects like the Singapore-based Asia Pacific Infant and Young Child Nutrition Association (APIYCNA). Presented as an NGO, its membership actually includes seven infant-formula industry companies, including the four manufacturers listed above.

According to IBFAN, APIYCNA’s main aim is to foster sales in Asia, where infant formula sales are projected to grow the most by 2016, from the current $6 billion to an estimated $10 billion annually.

Health experts told IRIN they are concerned that in the developing world, formula makers’ marketing push may succeed just as well as it has in developed countries.

In 2004, just two years after DHA and ARA were introduced in the US, government surveys there showed the percentage of people who believed formula and breast milk were “equally healthy” had suddenly doubled. And in 2011, in the wake of heavy lobbying by infant-formula makers, the European Parliament fell short of the vote needed to prevent a disputed DHA claim from being made on formula labels.

“Formula makers have a powerful, pervasive influence,” said Myler from La Leche League. “But it doesn’t bode well for the world’s neediest mothers and infants, whose health is literally on the line.”

Taken from here