The September/October issue of Ms. (I'm behind on my paper reading because
I'm always doing email!) had some interesting items, including the following
letter. I'm trying to enter it quickly, so please excuse any typos:

Breast vs. Bottle

Thank you for your special report "Breast vs. Bottle" (March/April 1998). As
one of the people quoted in the article, I'd like to clarify a few things in
relation to the situation in Thailand. Our experiences here provide perfect
examples of many of the problems that surround this issue.

The Thai government has a policy of providing all HIV-positive mothers
(about 2% of all pregnant women) with free infant formula. These supplies
are purchased through normal channels by the Ministry of Health. However,
the economic crisis has led to large budget cuts and these free supplies are
in jeopardy.

When the central government distributes formula to hospitals, every effort
is made by the hospitals to ensure that these supplies do not inadvertently
"leak" to the 98% of mothers who are HIV-negative, and disrupt BFing. It
would be preferable if the formula was distributed to HIV-positive mothers
through a completely separate channel or mechanism -- one not simultaneously
charged with the responsibility of promoting breastfeeding. Unfortunately,
such a system has been hard to develop.

At the hospital referred to in your article, free supplies were being
provided directly by the formula companies. Of the 900 tins provided per
month, only 20 went to HIV-positive mothers; 180 tins went to perfectly
healthy babies who might otherwise have been BFing; and up to 500 went to
"sick" newborns, many of whom would probably have been better off BFing.
Formula companies, under the guise of helping HIV-positive women and sick
babies, are flooding hospitals with supplies that severely affect BFing. As
a result, nurses at this hospital stated that some 30% of their newborns
"could not" BF;the real figure, on the globally established average, woulf
be closer to 1%. While some 16% of babies of HIV-positive mothers do
contract HIV through their mother's breast milk, bottle feeding and
insufficient BFing also threaten babies' lives by increasing the risk of
infections and malnutrition to a significant degree, even in developed
countries.
Karen Codling
Nutrition Project Officer, UNICEF
Bangkok, Thailand