Bottle-feeding, good or bad? UN agency takes critical vote
* Angelita Flores is a housemaid in Bogota, Colombia. Advised against breast-feeding by the local health clinic, she feeds her little Jorgito on a bottled baby formula donated by a doctor. He calls this the modern thing to do.Skip to next paragraph
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* Irene Dunbar lives 3,000 miles away in southern Massachusetts. After bottle-feeding her first child, she switched to mother's milk for her second baby and will settle for nothing less for her third child. She considers breast-feeding the "modern," nutritional thing to do.
The contrast between Angelita and Irene illustrates one of the odd -- and many feel tragic -- ironies of this century: Just when women in rich, industrialized countries are returning to breast-feeding as a safer and more nutritional method, mothers in many poor nations are dropping traditional breast-feeding in favor of bottle-feeding.
The World Health Organization (WHO) and the United Nations Childrens Fund (UNICEF) see the third-world trend toward bottle-feeding as contributing to infant mortality and malnutrition. And when the WHO meets May 19 in Geneva, they will try to pass an international code of ethics to reverse the trend.
The new code, if passed, would urge governments to do far more to protect and promote breast-feeding and to take responsibility for distributing reliable information about breast-milk substitutes.
For years debate has been raging over the bottled milk vs. mothers' milk issue. Baby-food officials argue they have a useful product. Their critics say that baby-food marketing in poor countries is discouraging mothers from breast-feeding, thus compounding some already severe health problems of babies. They say that bottle-feeding often leads to pollution or over-dilution of the milk formulas.
UNICEF's executive director, James Grant, says that a million infant deaths could be prevented each year if the international community would promote natural breast-feeding.
Seldom has an initiative of the United Nations, which has no real power to enforce its recommendations on its members, generated so much political heat.
The reason: The WHO code could strengthen the hands of politicians who want to diminish the influence of infant formulas. The result could be a far tougher climate for the marketing of mothers-milk substitutes in developing countries -- and even perhaps in the US.
Infant-formula companies scream "Foul!" -- and say the milk question raises the possibility of other government restrictions on free enterprise.
In recent weeks the companies put aside their competitive instincts and combined forces, aggressively lobbying Congress and the Reagan administration to oppose the new code. Some have sent out mass mailings to leading American businessmen. Several weeks ago former Sen. Sam Ervin Jr. testified in Congress to the effect that the code was a totalitarian document that could undermine American constitutional values of free speech, free press, and free competition.
Industry spokesmen have been arguing the dangers no less adamantly.
"We at Mead-Johnson [a subsidiary of Bristol Myers] and other formula companies agree that infant formula should not be promoted at the expense of breast-feeding," says spokesman Gary Mize.
"But as we interpret the code, its prohibitions on communication with the public are far too sweeping, far beyond just cutting back advertising that would discourage breast-feeding, a goal to which we subscribe."
The industry lobby appears to have prevailed. The White House has decided to oppose the code, according to a State Department spokesman. He acknowledged that the US could be the only United Nations member to take that stand.
The reasons for the decision closely parallel reasons why many companies oppose the code. Industry representatives told the Monitor that the code cannot be adopted in the United States without violating rights of free speech and enterprise. They said it could be stretched to apply to other foods besides breast-milk substitutes. The code is not, they say, the best way to encourage breast-feeding, and there is no definitely proven connection between the marketing of breast-milk substitutes and declines in breast-feeding (all points denied by the code's advocates).