Dear David,

I agree with you 100%.  It is a terrible situation.  Especially if we
start this with the information in one study.  Other studies do not show
what this study from South Africa shows.  What are we to make of it?
Your concerns, I know, are justified.

Maybe, in Johannesburg, for some families it would be alright.  But what
about in the Transkei (near Durban and East London)?  I worked there for
18 months.  Death after death after death from bottle feeding (not even
exclusive, usually the babies were partially breastfeeding).  Nobody
mentioned the dirty bottles yet.  Even middle class families with their
babies being admitted to the hospital with marasmus or kwashiorkor.

I don't believe the supplies would be maintained.  Yet another huge bill
for the ministry of health, then, providing all of that milk, water,
information (remember the education necessary "how to bottle feed")
which will all indirectly influence other mothers to bottle feed.  That
money that could go to other things.

For something as universally accepted as immunization, less than 50% of
the children in the Transkei were immunized when I was there, despite
repeated campaigns.  Every day we had city (Umtata) children die of
measles.  How are we going to do everything that is necessary to ensure
"safe" bottle feeding?

It's an incredible tragedy, and the media are irresponsible for treating
it as just another story, and now let's move on to something else.

Jack Newman, MD, FRCPC (who is sick at heart over this)