The Trump administration is ignoring decades of research on the superiority of breast milk over formula. Here's the real deal on breastfeeding.

Andrew Burton/Getty ImagesEligia Spinosa breastfed her 2-month-old son during a rally outside City Hall in New York City. New York law now requires employers to provide mums with break time to pump breast milk at work.
  • The US delegation to the World Health Assembly shocked the world when it refused to agree that breast milk is the best possible meal for newborn babies, ignoring decades of research.
  • Scientific studies have shown that breast milk is the healthiest thing new mothers can feed their growing babies, with very few exceptions.
  • The World Health Organisation and the American Academy of Pediatrics recommend that mothers feed their children breast milk exclusively for the first six months of life, unless they are HIV-positive or active drug users.
  • But formula makers have long sought to downplay the health benefits of breast milk.

The US shocked the world earlier this year when the country’s delegation to the World Health Organisation’s World Health Assembly refused to go along with language that champions a mother’s breast milk as the best possible meal for a newborn.

According to The New York Times, the US delegation even threatened to withdraw military aid to countries that didn’t back down from the resolution.

President Trump took to Twitter on Monday to support the US’ position.

“The U.S. strongly supports breastfeeding but we don’t believe women should be denied access to formula,” Trump’s tweet read. “Many women need this option because of malnutrition and poverty.”

The resolution wouldn’t have denied anyone access to formula – it was simply a public-health recommendation. In his tweet, however, President Trump touted the same argument that many formula companies recited in the 1970s and early 80s to market their drinks to women around the world.

The claims are so egregiously false and dangerous that in 1981, the WHO developed an international marketing code to keep formula companies in check. The rules mandated that formula containers state “the superiority of breastfeeding” clearly on their packaging.

Today, doctors and researchers agree that the benefits of breast milk are unequivocal.

“The public-health evidence that supports that is pretty irrefutable,” Dr. Joan Younger Meek, chair of the American Academy of Pediatrics Section on Breastfeeding, told Business Insider.

There are very few exceptions to the rule that breast is best. While formula can be a convenient option when a mother’s milk isn’t available, no infant formula could ever fully replace all the nutritional benefits of breast feeding.

“Breast milk is really a living substance,” Meek said. “It has whole cells. It’s not something that you can pour out of a can.”

Yet the Trump administration’s stance embraces the interests of formula manufacturers, according to the Times’ report. And dangerous formula marketing practices still persist in many places around the world today.

Here’s the established science on how breast milk boosts a newborn’s health:

  • The American Academy of Pediatrics encourages breastfeeding exclusively for an infants’ first six months of life. Yet only an estimated 22% of women in the US do this, according to CDC surveys. Researchers estimate that if 90% of Americans breastfed their babies exclusively for the first six months of life, more than 900 lives and $US13 billion would be saved every year.
  • Breastfeeding rates are lower among people with lower incomes.While low-income mums breastfeed at a rate of around 67.5%, roughly 84.6% of mothers who make more money (and are not eligible for food stamps) breastfeed. “One of the major purchasers of infant formula is the US government, because it’s used and distributed thru the WIC program [food stamps],” Meek explained.
  • The very first milk a mother gives her child after he or she is born is called Colostrum. This milk is like a super-fuel elixir for babies. Colostrum is high in antibodies and infection-fighting immunoglobulins, which enter the baby’s intestinal tract and make their way into the infant’s bloodstream. The milk protects the baby from diseases, reduces his or her risk of infection, and protects against diarrhoeal diseases.

    Duckworth baby in congressChip Somodevilla/Getty ImagesSenator Tammy Duckworth (D-IL) became the first senator to give birth while in office, and her baby Maile became the first newborn allowed onto the Senate floor during a vote.
  • A mother’s breast milk produces targeted antibodies if she’s exposed to an infection, so babies who drink their mothers’ milk are essentially lapping up preventive care that can keep them from getting sick. “There’s really no way you can replace that, in terms of putting those health [benefits], those whole cells, and those immune factors into a can of formula,” Meek said.
  • Infants who are fed breast milk are less likely to develop all kinds of severe illnesses. These include respiratory tract infections, pneumonia, and serious colds. Babies who get breast milk are also less prone to ear, throat and gastrointestinal infections, including the potentially deadly necrotizing enterocolitis that can destroy the walls of an infant’s intestines. When they do get sick, breastfed children’s illnesses are less severe – bronchitis cases in breastfed infants, for example, are 74% less severe.
  • Babies fed breast milk are less likely to develop asthma or long-term skin problems like eczema.
  • Breastfeeding also helps protect against obesity and diabetes.In one study that compared more than 400 sibling pairs, the body-mass indexes of babies who were breastfed were .39 standard deviations lower than their bottle-fed brothers and sisters, on average. That amounts to a predicted 13-pound weight gain for a 14-year-old kid raised on formula.
  • Breastfed kids are less likely to develop childhood cancers such as leukemia and lymphoma.
  • There’s no evidence that breastfeeding might malnourish a child. In fact, the opposite is true. “Malnutrition in developing countries occurs more frequently in children that are formula fed than in children that are exclusively breastfed,” Meek said. “Even if mother doesn’t have adequate calories herself, she will still produce good quality breast milk for her baby.”
  • Breastfeeding mothers don’t have to worry about sickening their babies in places without clean drinking water. Formula and bottles, on the other hand, could be contaminated by water from dirty drinking sources. According to a 2018 report from Save the Children, 823,000 child deaths around the world could be avoided every year in low- and middle-income countries alone if mothers opted for breast milk. Another problem with bottle-feeding babies in the developing world is that some mums who can’t afford to buy enough formula dilute the concentration of powder to save money, making the mix much less nutrient-rich.
  • Breastfeeding isn’t just good for babies – it also helps mothers stay healthy. Breastfeeding reduces postpartum recovery issues like dangerous haemorrhaging, while also providing some long-term protection against breast cancer and ovarian cancer.

There are few cases where breastfeeding is not recommended, however:

  • Women who are HIV-positive can transmit their infection to their children through breastfeeding, so they’re generally advised to avoid breastfeeding. However, even mothers who are HIV-positive may feed their children breast milk with a relatively low risk of transmission if they have been on anti-retroviral drugs for their entire pregnancy and feeding period.
  • The HIV-relative human T-lymphotropic viruses can also can be transmitted in breast milk, so women with HTLV shouldn’t breastfeed (though the disease is not common in the US).
  • A rare genetic disease called galactosemia makes an infant unable to metabolize galactose, one of the milk sugars in breast milk. These babies need to be fed a special lactose-free formula.
  • Women with untreated tuberculosis should not breastfeed directly until their condition has been treated, since the baby has to stay a safe breathing distance away. But they can pump their milk and have it fed to the baby.
  • Women with active herpes lesions on their breast should not breastfeed, and should not feed their baby breast milk from the infected breast. But if a woman has a herpes outbreak on one breast, it’s OK to feed the child from the other nipple.
  • Finally, mums who are actively using illicit drugs (like cocaine, heroin, or meth) shouldn’t breastfeed. Mothers with a history of drug use who are not currently using, however, can feed their babies breast milk safely.

Meek said that with these rare exceptions in mind, most mothers should be feeding their babies breast milk exclusively for the first six months of life, then start introducing other foods as desired and continue to breast feed for one to two years.

That’s also the recommendation from the World Health Organisation, and it’s what the American Academy of Pediatrics says, too. Both base their recommendations on decades of scientific studies.

“It would certainly be nice if our policies were supportive of what we know from our scientific and evidence base, in terms of what’s best for public health,” Meek said.

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