At Large : 'Infant formula kills'
Posted 02:54am (Mla time) May 21, 2005
By Rina Jimenez-David
Inquirer News Service
Editor's Note: Published on page A15 of the May 21, 2005 issue of the Philippine Daily Inquirer
UNICEF figures show that the average monthly cost of feeding one baby with infant formula is P4,000, not including the cost of bottles and nipples, the fuel expense entailed in boiling water and sterilizing the implements, as well as the hidden cost in health care.
In fact, Unicef says, a child is 25 more times as likely to die from diarrhea and four times more likely to die from pneumonia than a breast-fed infant, mainly because of infections caused by the use of unsafe water, improper or inadequate sterilization of bottles and nipples, and the mixed formula itself going bad. WHO estimates that 20 percent of infant deaths in the country can be traced to formula-feeding.
In the face of growing poverty, even the most loving and caring of parents would tend to cut corners. Thus, we see mothers and caregivers reducing the proportion of formula to the water, or using improper substitutes like condensed milk. Such shortcuts have life- and health-threatening implications, and will
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almost surely result in malnutrition.
Unicef estimates that 12 percent of infants below one-year-old and 32 percent of one-year-olds are underweight, almost surely the result of bottle-feeding.
The bottle-fed infant is disadvantaged well beyond infancy. "Formula-feeding retards children's cognitive ability and educational achievement," says Unicef. In various tests, formula-fed babies consistently scored lower in IQ and other standardized tests than breast-fed babies, with "the cognitive differences increasing with longer breastfeeding and persisting until late childhood." Bottle-fed babies also scored lower in reading comprehension, mathematical ability and overall scholastic ability than their breast-fed peers.
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THESE facts and figures are already well-known. They were first publicized when Unicef and non-government organizations launched a breast-feeding campaign in the early 1980s. The campaign, in fact, resulted in the adoption of the Milk Code in 1986 that sought to control the unethical marketing practices of milk companies and promote breast-feeding.
Why trot out these dismaying statistics now? Because, decades after the passage of the Milk Code, the law has proven inadequate. The latest health data, in fact, show an alarming drop in the number of mothers who breast-feed. Not only are fewer mothers breast-feeding, those who do are breast-feeding for shorter periods. While both WHO and Unicef recommend at least six months' duration for exclusive breast-feeding (no formula or semi-solids in the mix) "for optimal infant growth, development and health," the average duration of exclusive breast-feeding among Filipino mothers is only 24 days, down from 1.4 months in 1998. Indeed, only 1.4 percent of babies six to seven months old are still exclusively breast-fed.
The persistent popularity of infant formula is a problem not just of young parents and babies but of the entire country. WHO estimates that Filipinos spend P43 billion a year to formula-feed their infants. And because of limited milk production in the Philippines, the country relies on milk imports to provide breast milk substitutes. The National Economic and Development Authority says the country spent P20.5 billion on milk imports from January to November last year.
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THEN there are the "hidden costs" associated with bottle-feeding.
To safely bottle-feed, a family needs access to clean water and fuel for sterilization. Without these, bottle-feeding becomes life-threatening.
Then, because infectious illnesses are common among bottle-fed babies, their families have to spend more for doctor's consultations, medicines and hospitalization. WHO estimates that the cost of out-patient treatment for acute respiratory infections caused by formula-feeding comes to P55.7 million per year, while hospitalization costs total P26 million per year.
In addition, the infants' persistent health problems mean their parents will miss more working days, resulting in loss of income and productivity. WHO estimates that the total lost wages due to tending these children during their first six months is P1 billion.
And should the unthinkable but probable happen, funeral costs associated with the 16,000 child deaths due to formula-feeding and other inappropriate feeding practices totals P563 million a year.
Environmentalists might also be interested to know that formula-feeding produces huge amounts of waste cans, cartons, old feeding bottles and rubber nipples. Aside from which, in rural areas where firewood is the main source of cooking fuel, the need to boil water puts pressure on rural families to cut down more and more trees to produce firewood.
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WHO'S to blame for this dismaying turn of events? Sad to say, it's mainly the milk marketers who, with their advertising companies, conceive and produce all that warm, touchy-feely advertising featuring cuddly babies and toddlers in their parents' loving arms.
These images, in fact, constitute a violation of the Milk Code, which prohibits the use of "any picture or text in informational and educational materials which may idealize the use of breastmilk substitutes." The same Code also prohibits the use of the health care system -- public and private doctors, nurses, midwives, hospitals and clinics -- to promote breast-milk substitutes. And yet, as a survey in 1997 showed, gifts for the personal use of health personnel have been given as inducements to promote the products of milk manufacturers.
Perhaps it's time for stronger language. Instead of merely promoting breast milk -- "breast is best" -- it may now be time to say instead that "infant formula (or powdered milk) kills."
'Infant formula kills'
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