Hi Beth,
I think that probably most people who have not looked at this in depth
probably think as you expressed....but there are very good reasons why the
non-targeted distribution of breastmilk substitutes is a very very bad thing
in emergency situations. I'm just polishing off a paper on this subject so
all the numbers are in my mind, the situation for babies in emergencies is
very very bad. Looking at crude mortality rates I found that between 12 and
75% of babies are likely to die and babies not being breastfed have a 1300%
increased risk of diarrhoea (main cause of death). It essentially means that
babies that are not breastfed are likely to die anyway and the best thing
that can be done is to work out how to get them breastfeeding. However, if
milk powder (of any kind) is provided, women stop breastfeeding! I'll give
you a couple of quotes:
From 1999 in the Balkans
"(this disaster took) infant formula off the shelves where it was too
expensive to buy and put it into the clinics and food distributions centres
where it is free."
and from Banda Aceh
"relief supplies of infant formula has (sic) discouraged breastfeeding and
is causing problems, e.g., difficulty finding drinking water to mix with the
formula, additional serious health risks for all formula fed babies"

Essentially, it's not a case of "breast is best" but "breast may save a
child's life, formula may well kill them". Wet nursing, relactation etc are
much preferred to breastmilk substitutes and in places where aid workers
have their act together they can be done. The worst thing that can happen is
to have a stack of milk powder be dumped on mothers and if milk powder is
included in a basic aid pack that is what is happening. However, breastmilk
substitutes can be provided under very strict supervision when there is no
other option. It's a last resort and no one has a problem with this!

It might be helpful to do some basic maths...numbers pulled out of the air
but I think they illustrate the point.
Say there are 10 babies out of 1000 in an area that cannot be breastfed and
will die without milk powder. 10 babies will die if milk powder is not
provided. Say milk powder is provided....this may save the life of 1 baby
but....200 other mothers wean because the milk powder is provided and maybe
180 will unecessarily lose their lives.

That's why we go on about it. BTW, there are some excellent materials on the
net about this. The Emergency Nutrition Network has some of the best.

Karleen Gribble
Australia

And while even in an emergency "breast is best" and
> perfect, that is not the time for us breast-feeding advocates to be on a
> crusade.  It is a time to want the babies saved in whatever means it takes
> for that to happen.  It seems very clear to me.  What am I missing that
> makes the professionals on this list so up and arms about this practice?
I
> don't mean to stir the waters.  I just don't follow the argument against
this!
>

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