The mercenary economics of breast-milk substitutes

Yes, nutrition advocates are all aflutter over recent attempts by US representatives at the UN-affiliated World Health Assembly to block a resolution that called on governments to “protect, promote and support” breast-feeding and, later, to dilute the text that sought to regulate the marketing of breast-milk substitutes.

Evidently under the influence of infant-formula manufacturers, who resent the World Health Organisation’s advocacy of stringent regulations on the marketing of such substitutes. The global baby-food and infant-formula market is estimated at $50 billion; it is expected to grow to $70 billion in five years.

No, but the attempt to browbeat international delegates — in some cases, by threatening trade retaliation if they introduced the resolution on breast-feeding — is considered extraordinary.

This is particularly galling given the body of evidence that establishes the supremacy of breast milk in providing nutrition for infants. The Lancet journal, which analysed more than 1,300 studies, has established that breast milk is as good for economies as it is for infants.

As a 2017 document, titled ‘Nurturing the Health and Wealth of Nations: The Investment Case for Breastfeeding’, notes: “Breastfeeding is not only an investment in improving children’s health and saving lives, but also an investment in human capital development that can benefit a country’s economy.” Every $1 invested in breast-feeding, it estimated, generates $35 in economic returns.

Yes, and that’s not all. The Lancet analysis established that breast-feeding could prevent about 800,000 child deaths a year. In China, India, Nigeria, Mexico and Indonesia alone, inadequate breast-feeding was seen responsible for more than 236,000 child deaths each year; in these countries, the estimated future economic cost of mortality and cognitive losses attributed to inadequate breast-feeding were estimated at $119 billion per year.

There is evidence that breast-fed babies grow up with slightly higher IQs. In fact, the journal reckoned that making a whole generation of children just that bit more clever would yield economic benefits of about $300 billion a year, which is many multiples of the global infant-formula market!

Actually, breast milk predates sliced bread! But then, given the merits of breast milk, market forces have begun to play around with the ethics of it.

There is a thriving international market for breast milk: some new mothers have trouble lactating, and social factors — such as the absence of paid maternity leave — create a demand, but the supply side has been somewhat controversial.

In 2016, it was revealed that an Australian company, Neolacta Lifesciences, was sourcing milk from poor mothers in Bengaluru without any remuneration, and selling it in the market.

In 2017, the Cambodian government cracked down on the export of breast milk to the US: unlike in the Indian case, Cambodian women were being paid to sell their milk.

A government statement hinted at the sentiments involved in what it saw as a form of trafficking in human organs: “Even though we are poor, we are not so poor that we have to sell human breast milk.”

As The Lancet put it succinctly, “breast is best”.

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