Despite COVID-19 Pandemic, promotion of breast-milk substitutes continues

By Henrylito D. Tacio

“Mother’s milk is a living substance of great biological complexity that not only provides unique protection against disease, but also stimulates the baby’s own immune system.” – World Health Organization***

Mother’s milk is the best.

But despite efforts to stop the harmful promotion of breast-milk substitutes, countries are still falling short in protecting parents from misleading information, according to a new report published jointly by World Health Organization (WHO), United Nations Children’s Fund (UNICEF) and the International Baby Food Action Network (IBFAN).

Even in this time of dreaded coronavirus disease 2019 (COVID-19) pandemic, companies producing breast-milk substitutes are busy promoting their products.  To think, breastmilk saves children’s lives as it provides antibodies that give babies a healthy boost and protect them against many childhood illnesses.

Breast milk, the UN health agency explains, is more than a simple collection of nutrients.  It contains all the essential nutrients like protein, fats, vitamins, minerals, enzymes, and sugars, in exact proportion. It meets the needs of the growing infant at every stage.

“The COVID-19 pandemic highlights the need for stronger legislation to protect families from false claims about the safety of breast-milk substitutes or aggressive marketing practices,” said WHO in a statement.

The two UN agencies – WHO and UNICEF – recommend that babies be fed nothing but breast milk for their first 6 months, after which they should continue breastfeeding – as well as eating other nutritious and safe foods – until 2 years of age or beyond.

Both UN agencies also encourage women to continue to breastfeed their children during the COVID-19 pandemic, even if they have confirmed or suspected COVID-19.

“While researchers continue to test breastmilk from mothers with confirmed or suspected COVID-19, current evidence indicate that it is unlikely that COVID-19 would be transmitted through breastfeeding or by giving breastmilk that has been expressed by a mother who is confirmed or suspected to have COVID-19,” the WHO said.  “The numerous benefits of breastfeeding substantially outweigh the potential risks of illness associated with the virus. It is not safer to give infant formula milk.”

Women with confirmed or suspected COVID-19 can therefore breastfeed if they wish to do so. However, they need to do the following:

  • Wash hands frequently with soap and water or use alcohol-based hand rub and especially before touching the baby;
  • Wear a medical mask during any contact with the baby, including while feeding;
  • Sneeze or cough into a tissue. Then dispose of it immediately and wash hands again. Routinely clean and disinfect surfaces after touching them.
  • Even if mothers do not have a medical mask, they should follow all the other infection prevention measures listed above, and continue breastfeeding.

The new report – Marketing of breast-milk substitutes: National implementation of the International Code – Status report 2020 – analyzed 194 countries.  It has found that 136 of these countries have in place some form of legal measure related to the International Code of Marketing of Breast-milk Substitutes and subsequent resolutions adopted by the World Health Assembly (the Code).

Attention to the Code is growing, as 44 countries have strengthened their regulations on marketing over the past two years. “Only 79 countries prohibit the promotion of breast-milk substitutes in health facilities, and only 51 have provisions that prohibit the distribution of free or low-cost supplies within the health care system,” the report said.

The report, however, added that the legal restrictions in most counties do not fully cover marketing that occurs in health facilities.  “Only 19 countries have prohibited the sponsorship of scientific and health professional association meetings by manufacturers of breast-milk substitutes, which include infant formula, follow-up formula, and growing up milks marketed for use by infants and children up to 36-months old.”

Dr. Francesco Branca, Director of WHO’s Department of Nutrition and Food Safety, deplored, “The aggressive marketing of breast-milk substitutes, especially through health professionals that parents trust for nutrition and health advice, is a major barrier to improving newborn and child health worldwide.  Health care systems must act to boost parent’s confidence in breastfeeding without industry influence so that children don’t miss out on its lifesaving benefits.”

As a result of the current COVID-19 pandemic, health care services aimed at supporting mothers to breastfeed, including counselling and skilled lactation support are strained.

“Infection prevention measures, such as physical distancing, make it difficult for community counselling and mother-to-mother support services to continue, leaving an opening for the breast-milk substitute industry to capitalize on the crisis, and diminish confidence in breastfeeding,” the report said.

“As the COVID-19 pandemic progresses, health workers are being diverted to the response and health systems are overstretched. At such time, breastfeeding can protect the lives of millions of children, but new mothers cannot do it without the support of health providers,” said Dr. Victor Aguayo, UNICEF’s Chief of Nutrition. “We must, more than ever, step up efforts to ensure that every mother and family receive the guidance and support they need from a trained health care worker to breastfeed their children, right from birth, everywhere.”

The Code bans all forms of promotion of breast-milk substitutes, including advertising, gifts to health workers and distribution of free samples. Labels cannot make nutritional and health claims or include images that idealize infant formula. Instead, labels must carry messages about the superiority of breastfeeding over formula and the risks of not breastfeeding.

“The fear of COVID-19 transmission is eclipsing the importance of breastfeeding – and in too many countries mothers and babies are being separated at birth – making breastfeeding and skin to skin contact difficult if not impossible. All on the basis of no evidence. Meanwhile the baby food industry is exploiting fears of infection, promoting and distributing free formula and misleading advice – claiming that the donations are humanitarian and that they are trustworthy partners,” says Patti Rundall, of IBFAN’s Global Council.

Dr. Ameleen B. Bangayan, one of the organizers of the First International Breastfeeding Conference in Davao City some years back, considered mother’s milk as “the optimum source of nutrition” for babies.

Dr. Hiroshi Nakajima, former WHO director-general, described breast milk in these words: “The sole truly universal food for the entire human species.”

“Breast milk is a living substance that is impossible to duplicate or replicate in industry…. No technology is capable of replicating or duplicating mother’s milk. That’s a fact. Any claim to the contrary is a lie,” said Dr. Nicholas Alipui, when he was the UNICEF country representative.

By breastfeeding her baby, a mother can save money.  Filipino mothers spend 21.5 billion pesos a year on infant formula. That’s about 2000 pesos a month per child, according to UNICEF.

As the best source of nutrition for babies, breast milk has been proven many times over that breast milk has components that help protect the child against infection and disease.

Dr. Nakajima said breast milk, until recently, has served as “a vital link for nutrition and survival across the entire span of human existence, nurturing the newborn, the infant, and the young child during the most vulnerable years, all the while providing a powerful source of protection from infectious disease.” – ###

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