Abstract
W
The optimal WHO infant and young child feeding recommendations that we can all recite by heart are importantly universal as our nutritional and physiological needs are universal. Dividing the nutritional and health needs of infants and young children into developed and developing countries denies this universality, in fact it takes the cavalier approach that somehow those in the developing world are different.
The infant and young child feeding data in the CDC Report Card noting that only 58% receive any breastfeeding at 6 months and only 35% receive any breastfeeding at 12 months clearly describes a failure by governmental policy makers and the health care system to adequately support the WHO recommendations. And when we add to that the predatory marketing behavior of the formula and baby foods industries, unregulated in the United States, the picture is far from optimal. Even the 2030 target goals of only 54% receiving breast milk at 12 months suggest that only a little more than half will receive breast milk.
It is of course the very market presence of follow-up formula products with their idealized promotions and claims that undermines breastfeeding practices. To accept simply as “reality” the fact that at 12 months 65% of infants are not receiving any breast milk for developed countries betrays the public health obligations of governments to mothers and children. Furthermore to then claim that these products do not replace breastfeeding because breastfeeding has “long ceased for the majority” is to abandon the responsibilities of ensuring the best possible health outcomes for infants and young children as well as their mothers.
This argumentation that follow-on formulas do not function as a breast milk substitute mirrors the lobby of the baby foods industry and exporting countries at Codex Alimentarius. At Codex public health advocates including IBFAN, WHO, and UNICEF are fighting for policy coherence with the International Code and WHA Resolutions—namely an end to all promotion and misleading labeling of these unnecessary products that target babies 6–36 months.
Unless idealizing and aggressive marketing is ended, parents will believe that these unnecessary ultraprocessed, over-packaged, and environmentally harmful products are healthier than continued breastfeeding and biodiverse culturally appropriate family foods.
Rather than simply accepting the lack of breastfeeding as “reality,” what is really needed is an enabling environment with highly skilled professionals to provide supportive counsel on breastfeeding and infant feeding for the entire recommended period, baby-friendly hospitals, mandatory paid maternity leave with breastfeeding breaks, and international code compliance. To make possible the best possible health outcomes for infants and young children as well as their mothers is the universal war we must fight.