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Actually, I’m Glad The Trump Administration Opposed The WHO Breastfeeding Resolution

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Yesterday, my newsfeed was full of shock and outrage about the Trump Administration’s actions during the World Health Association conference in Geneva. The issue at hand was a breastfeeding resolution. I have to admit, when I saw the NY Times article shared on social media, I wondered, “what now?” The session played out like a political drama, with the delegates from Ecuador planning to introduce a resolution to promote breastfeeding, and the delegates from the U.S. threatening them with sanctions if they did. They proceeded to bully other countries, until the Russian Federation stepped in to introduce the resolution with no further protest from the U.S. delegation.

Yep. This actually happened. About breastfeeding. I know, right? It hardly seems real.

And what kind of person doesn’t want to promote breastfeeding, anyway? At first it sounds so ridiculous. From the article it seems as though Trump is anti-science (which he kind of is), hates babies (which might be true, but I don’t know), and is being influenced by lobbyists from the formula industry (there is actually zero proof of that actually happening, by the way).

The Department of Health and Human Services’ stated they had other reasons for opposing the resolution. As spokesperson Caitlin Oakley told Mother.ly,

“The United States was fighting to protect women’s abilities to make the best choices for the nutrition of their babies. Many women are not able to breastfeed for a variety of reasons, these women should not be stigmatized; they should be equally supported with information and access to alternatives for the health of themselves and their babies.”

Basically, some people can’t breastfeed, others don’t want to, and they all deserve the information they need to feed their babies how they choose. Wait. What? That actually sounds like, really reasonable. Perhaps that’s why some people don’t want to believe it’s true.

Friends, we need to remember, and this is huge — just because Trump rejected this resolution in a really gross way, and we hate him (and I really do) that doesn’t mean that the resolution is good. It turns out the saying, “the enemy of my enemy is my friend” isn’t actually true, when it comes to health policy.

While it’s easy to assume that a policy promoting breastfeeding is intrinsically good, I think we ought to slow our roll, and actually, you know, read it, before making up our minds. Because when you actually look at the science and sociology of infant feeding, the WHO’s recommendations are pretty freaking terrible. The proposed resolution, Agenda Item 12.6 Infant and young child feeding starts from the premise that breast is not only best, but critical, which is so not true.

“breastfeeding is critical for child survival, nutrition and development, and maternal health”

They urge member-states to implement the so-called Baby-friendly Hospital initiative, which promotes the WHO Ten Steps to Successful Breastfeeding.

“to reinvigorate the Baby-friendly Hospital Initiative, including by promoting full integration of the Ten steps to successful breastfeeding, in efforts and programmes aimed at improving quality of care for maternal, newborn and child health”

They also want member states to enforce their policies regarding the marketing of infant formula.

“to implement and/or strengthen national monitoring and enforcement mechanisms for effective implementation of national measures aimed at giving effect to the International Code of Marketing of Breast-milk Substitutes”

I am actually opposed to all three of these things. Yes, I am serious.

First off, I can think of at least 100 situations when breast is definitely not best. When you consider that human milk researchers estimate that as many as 15 percent of women have overt lactation failure, and 60 percent of new moms don’t make enough milk, policies like this resolution hurt babies. New parents are under enough pressure, without also having to try to live up to an impossible expectation and made to feel like failures when they can’t. 

I should know. I was one of those moms. The BFHI hospital where I gave birth pressured me to breastfeed exclusively, and told me not to supplement with formula when my daughter was starving. This ultimately resulted in her being re-admitted to the NICU for jaundice, dehydration, and losing over 20 percent of her birth weight. I later learned that I couldn’t produce enough breast milk, which I was told (again by hospital staff) was super-rare, when I now know it is actually probably more common than being able to exclusively breastfeed. Seriously.

The BFHI is not evidence-based, and we need to stop saying it is. Let’s take a look at some of their false claims. According to their policies, hospitals and health care professionals need to

  • inform all pregnant women about the benefits and management of breastfeeding.” While it’s true that breast milk is a great choice, and has some health benefits, the benefits of breastfeeding are largely overstated to the degree where most people believe it will make a huge difference, when research shows otherwise.
  • “Give infants no food or drink other than breast-milk” Women are told that supplementing with formula or pumped milk will hurt breastfeeding, when this practice has been shown in research to promote breastfeeding, and might save lives in the process.
  • “Practice rooming in – allow mothers and infants to remain together 24 hours a day.” Hospitals should require exhausted people who just gave birth to care for babies 24-7 (a practice that has resulted in baby injuries and deaths)
  • “Give no pacifiers or artificial nipples to breastfeeding infants.” This is presumably to avoid “nipple confusion,” which is totally not a thing.

BFHI hospitals must maintain an 80 percent or higher exclusive breastfeeding rate at discharge. What about afterwards? When tired parents like me are faced with delays in their milk coming in, supply issues, and other breastfeeding problems and their babies are re-admitted for dehydration, jaundice, malnutrition, and failure to thrive? I, for one, would like the BFHI to start tracking those rates. You know, are babies really healthier, when breastfeeding is promoted at all costs?

As for the WHO’s International Code of Marketing of Breast-milk Substitutes, I think it’s more than a bit ridiculous to want to influence another country’s laws as they pertain to marketing a safe and healthy food for babies. In the U.S., formula is safe, nutritious and highly regulated. New moms are perfectly capable of making choices about how to feed their babies even if they get a formula sample in the mail or see a commercial or internet ad for bottles. I mean, seriously, it’s so patronizing.

Now, you might be wondering, what about lower-income countries where formula feeding might not be safe? Well, people have lactation and breastfeeding issues in these places, too. It’s easy for privileged people in the U.S. and Canada to talk about how evil formula companies like Nestle are for their horrendous marketing tactics in Africa during the 1980’s. Hell, I boycotted them for the same reasons, but babies in Africa need formula (and clean water), too.

Where in their resolution was funding for wells and water filters? Why does the World Freaking Health Organization still operate from the false premise that everyone can and should breastfeed, rather than supporting all parents in safely feeding their babies? It’s sexist and paternalistic.

Worse, breastfeeding advocates are now using the Trump Administration’s horrendous bullying tactics, to garner support for. Every story I’ve read on the subject starts the same way — science says breast is best, and Trump once again shocks everyone by rejecting science. It’s like the biggest straw man argument ever, and so not logical.

Now, I’m not saying that I in any way support the Trump Administration or their attempts to bully lower-income countries during an international diplomatic conference. That’s bullshit.

But, do you know what else is bullshit? Promoting the idea that breast is best and that all women and other people who birth babies can and should breastfeed. It’s sexist, anti-feminist, and scientifically inaccurate.

I hate Trump more than just about anyone, but I’m actually glad the U.S. rejected the WHO breastfeeding resolution, and not because I hate breastfeeding. I actually think it’s awesome. But, because I love babies, science, and bodily autonomy more than breastfeeding, and you should, too.

Image credits: Steph Montgomery, all rights reserved.

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3 Comments

  1. Thank you for this article. I was just talking today about the lack of evidence surrounding the steps of the BFHI. I appreciate this article. Just to note: ALL formula companies were present in Africa during the horrific events in the 70’s it wasn’t just Nestle. There is evidence on this available.

  2. Thank you, you said (and cited) everything I have wanted to say about this, much better than I could.  I hate Trump and his administration with the heat of a thousand suns, but I also can not stand the entire Baby Friendly Hospital Initiative.  Convincing parents that starving their newborns is what is best for their babies is not Baby Friendly, convincing new parents and pregnant people that formula is bad/lesser/inadequate for their baby is not Baby Friendly, NOT telling new parents that their milk may not come in for 3 to 5 days and they may need to supplement  after they give birth is not Baby Friendly,  expecting exhausted new parents to take care of a newborn alone in the hospital(especially following a C-Section) and expecting them to forgo pain meds so they can breast feed or so they don’t drop or fall asleep on the baby is not parent friendly or baby friendly.

    Interesting article about what some of the research on breast feeding advantages actually show:

    Everybody Calm Down About Breastfeeding

    People in third world countries need more access to clean water (and fuel to heat that water) and more information about how to safely breastfeed and safely supplement.  Women with AIDS need more access to Anti-retro viral meds and information about living with AIDS in pregnancy and feeding options after the baby is born.

    Strong arming other countries is wrong and was a very dictator-like move but I’m not real happy with the WHO either (their totally fabricated “recommended” C-Section rate recommendations come to mind)

  3. Yes, but the converse is also important to consider: What about places where there’s no potable water? We’re talking about rural communities in, call it the Third World, developing countries, the Global South, whatever.

    And beyond childbirth, yeah, where are those fucking filtration systems? Hepatitis and its fecal-oral buddies are nasty.

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