Breast-milk – ‘liquid gold’

Werner Schultink, chief of nutrition at UNICEF, said, "Breastfeeding is a cornerstone of child survival, nutrition and development. More investment is required to promote breastfeeding and to encourage governments, health care professionals, workplaces, communities, and families to create an environment that supports, protects, and encourages it."

The Lancet finds that globally, the costs of not breastfeeding amount to more than $300 billion each year, a figure comparable to the entire global pharmaceutical market. About 820,000 child deaths could be prevented annually (about 13 percent of all under-5 child deaths) by improving breastfeeding rates, in addition to the lives already saved by current breastfeeding practices. Nearly half of all diarrhea episodes and one-third of all respiratory infections would be prevented with breastfeeding. For each of the first two years a mother breastfeeds over her lifetime, she decreases her risk of developing invasive breast cancer by six percent. She also benefits from reduced ovarian cancer risk. Approximately 20,000 breast cancer deaths are prevented each year by breastfeeding; improved rates could prevent another 20,000 deaths each year.

Dr. Cesar Victora, emeritus professor from the International Center for Equity in Health, Post-Graduate Programme in Epidemiology, Federal University of Pelotas in Brazil. "Breastfeeding is a powerful and unique intervention that benefits mothers and children, yet breastfeeding rates are not improving as we would like them to--and in some countries, are declining.”

Increasing breastfeeding rates to 90 percent in the U.S., China, and Brazil and to 45 percent in the U.K. would cut treatment costs of common childhood illness and save at least US$2.45 billion in the U.S., US$29.5 million in the U.K., US$223.6 million in China, and US$6.0 million in Brazil.

Yet there exists aggressive marketing of breastmilk substitutes (including infant formula) by their manufacturers and distributors which undermines breastfeeding. Newly commissioned market research conducted by Euromonitor International for the Series found that the breastmilk substitute industry's reach and influence is growing--the retail value is expected to reach US$70.6 billion by 2019. Such a figure far outpaces the dollars spent to promote the benefits of breastfeeding worldwide.

According to Dr. Rollins, the success of the International Code of Marketing of Breastmilk Substitutes, adopted at the 34th World Health Assembly in 1981, depends upon countries enacting legislation, along with rigorous monitoring and enforcement. "The multi-billion dollar breastmilk substitute industry - and its marketing practices - undermines breastfeeding as the best practice in early life."

Dr Alison McFadden, one of the authors and a senior researcher specialising in inequalities in maternal and infant health at Dundee University, said the UK along with other countries should end advertising of formula for babies over six months old. She said: "The work we have done is not about whether individual mothers or babies should or should not breastfeed, it is their choice. We are saying there is no role for the blatant marketing of breast milk substitutes or infant formula. If we compare what the government spend on promoting breastfeeding with the value of the global sales of milk formula then there is absolutely no comparison." Restricting the promotion of alternatives to breast milk, she said, is one way to tackle barriers which make it more difficult for mothers to breastfeed.

The article, also published in The Lancet, says: "BMS companies circumvent the ban on advertising infant formula by promoting follow-on milks that are not nutritionally necessary and for which companies make exaggerated claims. "In some countries, including Bangladesh, Brazil, and the UK, BMS companies were reported to seek to influence health professionals through inappropriate sponsorship of health conferences, promotion of their products (eg, by offering incentives to health professionals who sell or promote their products), and forming links with national health professional associations." They say urgent action is needed to "ensure that the public, health professionals, and decision makers do not continue to be exposed to the dominance of the promotion of BMS."

Despite international recommendations that all children should be exclusively breastfed from birth to six months of age, these rates globally are only at 35.7 percent. The World Health Assembly's global target is for countries to increase the rate of exclusive breastfeeding for the first six months of life to at least 50 percent by 2025.