Pamela,

Yes, artificial feeding of infants has a very long tradition in Western 
countries, whether from birth or to supplement whatever breast was given. So 
deep-seated is it in the cultural mindset that it has long been seen as the 
"default option" (to use today's computer terms). What do signs and line 
drawings in magazines have as the symbol of the baby? Not the breast, 
unfortunately. You mention, in the context of HIV, how people who have no 
idea of the history, nor of the deleterous consequences downstream, jump in 
and introduce these practices in other parts of the world, justifying it 
with a policy. Policies are only as good as the science and commonsense (or 
lack of) they are based on. When so much harm has been done and women lose 
what confidence they had in their breastfeeding, reversing the harm is very 
difficult, especially when men in suits and taking "trade" and railing 
against "restriction of trade" sit down at tables with powerbrokers round 
the world.

When the undermining of breastfeeding seems such a huge challenge, like an 
avalanche heading downhill, giving up is not the best option. We need to 
remember that the grains of sand on the beach were all part of mountains, 
which wind and rain have eroded. If each of us reaches and supports one 
mother at a time, day after day, that's a big effect overall. If some of us 
work with policy-makers or opinion leaders to reverse the damage that, too, 
is a step forward. If we build a breastfeeding community, and make it 
self-sustainable after we are gone, that is a positive action that keeps on 
giving. If lawmakers legislate to support breastfeeding mothers and provide 
maternity protection and adequate, paid leave, if they prevent unrestrained 
trade that is at the cost of infant lives and well-being, that is where 
those who can make a change need to focus.

As regards the way forward, the document, The Need to Invest in Babies, 
which was launched in Delhi in December and Canberra in February, is a good 
place to start for sound ideas. It is published by IBFAN-Asia and the 
Breastfeeding Promotion Network of India, and challenges governments and the 
global community to act in the best interests of babies, which of course 
means support for breastfeeding in a constructive way. The authors are Radha 
Holla, Alessandro Iellamo, Arun Gupta, Julie P Smith and JP Dadhich. The 
full document provides tables with country-by-country information and 
planning tables to assist national planners. This isn't just another 
document, but one that is intended to be used at policy and planning levels, 
globally.

Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Brisbane, QLD, Australi

----- Original Message ----- 
From: "Pamela Morrison" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, March 17, 2014 5:34 PM
Subject: Re: Australian exports of powdered infant formula to China


> Virginia
>
> I hear you.  Indeed, who is protecting breastfeeding in China?  This 
> should be a matter for international concern. Where is UNICEF in all this? 
> Or WHO?  Or the political clout at the topmost international level to 
> divert what's coming?  Trade always seems to trump health concerns. 
> Formula will probably do more for population control in China than even 
> they ever dreamed of.
>
> You sound as frustrated as I used to be about the "export" of 
> formula-feeding to countries and continents hit hard by HIV.  This 
> exercise was masterminded originally by UNICEF and WHO as a mechanism for 
> avoidance of transmission of postpartum HIV.  Except that there was never 
> any intention to monitor, or to even record, the results to see whether it 
> did good or harm.   I "saw" it as the export of harmful traditional 
> practices of Western nations to unsophisticated peoples for whom it would 
> be devastating, ie those where breastfeeding was a cornerstone of child 
> survival.  It was done on the platform of human rights, using the language 
> and the ideology that we use all the time, promoting the concept of the 
> rightness of maternal choice of infant feeding method with freebies to 
> enable the choice. Once the attractiveness of the concept had taken hold, 
> then the free samples were withdrawn and governments or mothers themselves 
> were expected to take over purchase of supplies.   And there has been an 
> absolutely devastating effect on breastfeeding practices of those 
> countries most badly affected.   It took a decade before there was even 
> anyone brave enough to actually start documenting the scale of the 
> disaster that ensued.  The first was the CDC, bless them and in Botswana, 
> of all places!  And only now, almost a decade after that, are we starting 
> to read review papers of the chaotic results.  But the planning was 
> brilliant in the way that formula-feeding was talked up to the health 
> ministries of unsuspecting  nations who trusted the international health 
> agencies when they provided the fool-proof training courses, complete with 
> funding and expertise to oil the wheels.  Reversing it all has been far 
> less successful.  Support for successive policy changes admitting that 
> formula causes more death than HIV-laced breastmilk has been conspicuous 
> by its absence. And now, beyond finally issuing fresh recommendations to 
> resume breastfeeding, the agencies have abandoned these same countries to 
> conducting their own damage control because of course there's suddenly no 
> more funding available to support a return to breastfeeding.
>
> And now the disaster that's going to be the death of breastfeeding in 
> China looms like a mushroom cloud on the horizon.  I have a good friend 
> who follows this and he describes it as a tsunami.  Thank you for 
> reminding us Virginia that we have a long history of supporting "trade" at 
> the expense of the health consequences for less sophisticated nations.  I 
> wonder what we can do about this one?
>
> Pamela Morrison IBCLC
> Rustington, England
> --------------------------------------------
> At 04:00 17/03/2014, you wrote:
>>Date:    Mon, 17 Mar 2014 11:31:18 +1000
>>From:    vgthorley <[log in to unmask]>
>>Subject: Australian exports of powdered infant formula to China
>>
>>I'm just listening to a radio interview with someone from a dairy milk 
>>factory in Victoria, Australia. He is talking up the positives for his 
>>industry of exporting various dairy products to China, including fresh, 
>>liquid cow's milk, powdered cow's milk for household use - and powdered 
>>infant formula (PIF). The trend of tourists and others sending large 
>>batches of  PIF home to relations in China was mentioned, with the 
>>suggestion that this was beneficial as people in some parts of China don't 
>>have access to PIF. From the interview, he seemed to think of this as an 
>>essential. The man from the dairy company was "all about marketing 
>>success", not what this is doing to breastfeeding in an increasingly 
>>consumer economy.
>>
>>I've mentioned this on Lactnet before. I wonder how breastfeeding rates, 
>>especially exclusive breastfeeding rates, in China in 2013 (when they are 
>>available) will compare with rates five years ago.  Who is protecting 
>>breastfeeding against this rampant trade? I'm angry about my country's 
>>increasing role in spreading the use of breastmilk substitutes round the 
>>world, and lauding this as "marketing" and "trade". In the 19th century it 
>>was opium that was aggressively promoted as "trade" by European powers 
>>(long story). Trade is not necessarily benign, whether on individuals or 
>>recipient economies - as these examples remind us.
>>
>>Virginia
>>in Brisbane
>
>
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