Well Being

Five Damaging Myths about Breastfeeding and Poverty

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Welcome Blog Action Day and Carnival of Breastfeeding readers! As thousands of bloggers around the world reflect on the topic of poverty, Breastfeeding 1-2-3 and other breastfeeding carnival participants (see links at the end of this post) are discussing poverty as it relates to the topic of breastfeeding.

Myths about Breastfeeding and Poverty

1. Myth: If a breastfeeding woman is malnourished due to poverty, she should be told to wean and be given formula for her baby.

The truth is that a malnourished mother still produces sufficient breast milk, and breast milk is the perfect food for an impoverished baby who desperately needs the immune protection that breast milk provides. The Breastfeeding Answer Book explains:

Research from developing countries and other parts of the world indicates that even mothers who are mildly malnourished produce an adequate supply of good quality milk for their babies and that only under famine or near famine conditions will a mother's nutrition affect her milk supply or the composition of her milk (Perez-Escamilla 1995; Prentice 1994). Even in famine conditions, milk production may be only slightly affected if the mother has body stores from which to draw energy for milk production (Smith 1947). In some developing countries where food supplies are limited, babies of women given nutritional supplements have not been found to gain more weight than babies of women whose diets were not supplemented (Prentice 1983).

This is not simply an issue in developing countries. The Breastfeeding Answer Book continues:

Some low-income mothers are discouraged from breastfeeding by health professionals, social workers, and others who question whether their diets are adequate. But if the mother is malnourished to the extent that it affects her milk supply, it is much less expensive to feed the mother nutritious food than to buy formula for her baby. Human milk is also healthier for the baby and increases his resistance to illness.

So what should a malnourished and/or low-income mother do if she is given free formula? Consume it herself! Dr. Jack Newman says she can add it to baked goods so she will receive extra nutrition and the baby will still benefit from human milk.

2. Myth: Poor people are more likely to breastfeed.

Given that it costs an average of $1,200 to $1,500 per year to feed a baby formula, it is tempting to assume as a pure function of economics that mothers living in poverty are more likely to breastfeed. Unfortunately that is not true. The National Health and Nutrition Examination Survey from 1999-2006 found:

Breastfeeding rates were lower for infants in low income families. Breastfeeding rates were examined by income status group. Income status was defined using the poverty income ratio (PIR), an index calculated by dividing family income by a poverty threshold that is specific for family size (3). Low income was defined as PIR less than or equal to 1.85, and high income was defined as PIR greater than 1.85. For the total population, the proportion of infants who were ever breastfed was lower among infants whose families had lower income (57%) compared with infants whose families had higher income status (74%).

Those statistics are for babies who were “ever breastfed.” When you look at data for the percentage of babies being breastfed at six months of age, the numbers are even worse. Childtrendsdatabank.org summarizes information from the National Immunization Survey:

Mothers living below the poverty line were less likely to breastfeed in 2004. At six months, 30 percent of mothers living below the poverty line breastfed their six-month-old infant, and of those living between 100 percent and 185 percent of the poverty line, 33 percent breastfed. In comparison, mothers living at 185 percent to 350 percent of the poverty line and those above 350 percent of the poverty line breastfed at rates of 38 percent and 46 percent, respectively.

The U.S. Breastfeeding Committee reports that $578 million per year in federal funds is spent by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to buy formula for families who could be breastfeeding.

But surely the impoverished in less industrialized nations are breastfeeding? An article in the International Breastfeeding Journal answers that question:

Although there is a conventional wisdom that poverty ‘protects' breastfeeding in developing countries, poverty actually threatens breastfeeding, both directly and indirectly. In the light of increasingly aggressive marketing behaviour of the infant formula manufacturers and the need to protect the breastfeeding rights of working women, urgent action is required to ensure the principles and aim of the International Code of Breastmilk Substitutes, and subsequent relevant resolutions of the World Health Assembly, are implemented.

Read on to learn more about the insidious use of formula marketing around the world.

3. Myth: Formula is marketed only to those who can afford it.

Many people boycott the formula maker Nestlé in protest of its marketing practices. The original Nestlé boycott started in 1977 in response to Nestlé's unethical, aggressive and patently harmful marketing of artificial baby milk in Third World countries. The company engaged women to dress up like nurses and distribute free samples that lasted just long enough to dry up a mother's own breast milk. Impoverished women who could not afford to purchase enough of the expensive artificial milk would resort to diluting it with excess amounts of water which led to infant malnutrition. Furthermore, artificial milk prepared with unsanitary water supplies led to unnecessary illness. Add in the fact that the infants were not protected by the antibodies present in human breast milk and children were suffering and dying needlessly as a consequence of Nestlé's deceptive marketing tactics. While the boycott was suspended temporarily in the 1980s, renewed efforts are underway in 20 countries around the world. Nestlé's marketing practices continue to violate the World Health Organization's (WHO) International Code of Marketing Breast-milk Substitutes (PDF document).

UNICEF states: “If all babies were fed only breastmilk for the first six months of life, the lives of an estimated 1.5 million infants would be saved every year and the health and development of millions of others would be greatly improved.” I repeat: 1.5 million innocent lives per year.

For more on the harm from unethical marketing of formula, read the policies of the International Baby Food Action Network and Baby Milk Action.

4. Myth: Breastfeeding is expensive and requires a lot of special equipment and clothing.

When it comes right down to it, all breastfeeding requires are mother and baby. No one needs special nursing pillows, foot stools, clothing, covers, or breast pumps in order to breastfeed. If a mother wants such things, there are free and low-cost options. Hand-expression of breast milk is quite effective as an alternative to pumping. There are several money-saving substitutes for traditional nursing clothing, and many do-it-yourself breastfeeding projects. If a woman needs help with breastfeeding, there are many free resources around the world. Accredited volunteer breastfeeding counselors offer free breastfeeding support through La Leche League in 68 countries!

Visit Kellymom and check out the “Financial costs of not breastfeeding . . . or the cost benefits of breastfeeding.”

5. Myth: Breastfeeding only saves the cost of formula.

There are all sorts of savings attributable to breastfeeding. I already mentioned the obvious — that breastfeeding actually saves babies' lives. It also saves the cost of additional health care expenses, lost work hours, and environmental impact. The U.S. Breastfeeding Committee's paper on the Economic Benefits of Breastfeeding (PDF) contains these amazing facts:

For private and government insurers, a minimum of $3.6 billion must be paid each year to treat diseases and conditions preventable by breastfeeding.

If a parent misses 2 hours of work for the excess illness attributable to formula feeding, greater than 2,000 hours—the equivalent of 1 year of employment—are lost per 1,000 never-breastfed infants.

110 billion BTUs of energy ($2 million) used each year in the United States for processing, packaging, and transporting formula.

550 million formula cans, with 86,000 tons of metal and 800,000 pounds of paper packaging, added to U.S. landfills each year


In conclusion, I offer this quote from the late James P. Grant, past Executive Director of UNICEF:

Breastfeeding is a natural safety net against the worst effects of poverty. If a child survives the first month of life, the most dangerous period of childhood, then for the next 4 months or so, exclusive breastfeeding goes a long way towards cancelling out the health difference between being born into poverty or being born into affluence. It is almost as if breastfeeding takes the infant out of poverty for those few vital months in order to give the child a fairer start in life and compensate for the injustices of the world into which it was born.

Other Carnival Entries on Poverty and Breastfeeding

Please enjoy these carnival entries as they become available:

~ Motherwear Breastfeeding Blog: How Breastfeeding Fights Poverty
~ BreastfeedingMums: Lack of Knowledge Affects Breastfeeding Rates
~ Babyfingers: Interview with a WIC Counselor
~ Mama Knows Breast: Breastfeeding Can Fight Poverty