Breastfeeding controversy shows need for private efforts — not government campaigns

The Trump administration has come under fire for trying to block a World Health Assembly resolution on breastfeeding in developing nations. The resolution contends that nursing is the heathiest option for infants and calls for governments to actively promote it. It also calls for more restrictions on advertisements for breastfeeding substitutes, especially baby formula.

In response, U.S. diplomats reportedly threatened other nations with trade sanctions and reduced military support if they introduced the resolution. Fearing such consequences, over a dozen countries declined to propose the measure before Russia eventually introduced it.

{mosads}Some consider Washington’s stance as “blackmail” and “holding the world hostage.” Others suggest it reveals a lack of knowledge about the health advantages of breast-feeding or demonstrates a corrupt relationship with the baby formula industry.

The White House has fired back. President Trump took to Twitter, writing: “The U.S. strongly supports breastfeeding, but we don’t believe women should be denied access to formula.” Health and Human Services spokesperson Caitlin Oakley told The Hill, “The United States was fighting to protect women’s abilities to make the best choices for the nutrition of their babies” and that “Many women are not able to breastfeed for a variety of reasons.”

Both sides make important points.

Many organizations, including the American Academy of Pediatricians, contend that breastmilk is a healthier alternative to formula feeding. However, it’s also true that baby formula can provide much-needed nutrition for hungry children with malnourished mothers in impoverished countries.

But underneath the allegations of scientific illiteracy, industry pressures, and ideologically tinged misrepresentations lies a crucial question: Can a group of governments effectively and appropriately promote breastfeeding? History and evidence raise doubts. 

Governmental efforts to promote economic development through foreign assistance have routinely failed to secure prosperity. Foreign aid to promote health and human development has also proven underwhelming. In the first study to empirically test the impact of health-sector foreign aid on infant mortality, life expectancy, death rate, and immunizations (DPT and measles), published in the respected Southern Economic Journal, West Virginia University professor Claudia R. Williamson concluded that “aid used specifically for health goals has an insignificant effect on human development.”

Thus, if the World Health Assembly’s breastfeeding resolution were to result in better infant health outcomes, this would be the exception to the rule.

Thankfully, while governments often flounder to promote health, private actors can provide real solutions. 

Consider the La Leche League, a non-profit group that promotes breast-feeding. Formed in 1956 when seven women grew concerned about decreasing U.S. breastfeeding rates, League Leaders began to develop free educational materials and train volunteers to help mothers learn to breastfeed effectively. Today La Leche League has over 6,000 leaders in more than 80 countries. This global presence is financed almost entirely through private donations, requiring no government promotion.

Private solutions also exist for mothers who are unable to breastfeed. In the United States, the Human Milk Banking Association of North America transports donated breastmilk across the country and at no cost to the recipient or donor. 

Other countries have also found success with private efforts to promote breastfeeding.

Even with a complete ban on formula advertising, human milk banks in Brazil faced crippling shortages. This motivated chemist and entrepreneur Joao Arigio Guerra de Almeida to develop a safe and cheap method to store and transport breastmilk. His efforts helped slash Brazil’s infant mortality rates by two-thirds from 1985 to 2013. 

One NBC piece called Brazil’s human milk bank system a “global model,” citing 15 other Latin American and African countries that have successfully adopted similar networks. In 2014, Brazil’s breastmilk banks fed over 155,000 babies and collected from about 150,000 donors. 

Promoting childhood nutrition in developing countries is a pressing and challenging problem. With only two out of five infants under six months old exclusively breastfed according to some estimates, much work remains to be done. But considering government’s lackluster record and the success of private efforts, it seems the latter is up to the task. The sooner we can wean off government programs the better.

Raymond March, Ph.D., is a research fellow at the Independent Institute and assistant professor of economics at San José State University.