Tempers high but the stakes are higher: entering the breastfeeding debate

Before I even put finger to keyboard to write this blog, I know it is going to be one of the trickiest I’ve written. In all the years I have been working on issues surrounding global child health I have never encountered a subject that invokes as much passion and emotion as breastfeeding. It polarises opinion like no other topic.

Rightly so. The stakes are high with this one. The Lancet, one of the most respected voices on global health, has said that breastfeeding could make more difference to global child survival than anything else and our own research estimates that over 800,000 babies could be saved each year if every child was breastfed in the first hour.

It’s for these reasons that Save the Children is drawing attention to the need to boost breastfeeding rates around the world – it’s a life or death issue. We don’t make our recommendations lightly.

A question of choice

We enter this debate with our eyes open. We know that every woman is different – some mothers will not be able to breastfeed, some will choose not to, some may follow the World Health Organization guidance to the letter.

I’m not a mum so I haven’t had to face the breast vs bottle question yet, but if or when I do I hope I’m given the support and information I need and then left the hell alone to make my own decision. No guilt-trips please.

So I was a disappointed that some of the responses we’ve had to the report on breastfeeding I’ve just helped write were that we were trying to make women feel guilty if they don’t breastfeed. Much of the debate has centred on our petition where we ask breast milk substitute companies to increase the size of the warning labels on the products they produce.

The warnings are already there, mandated by the 30-odd-year-old World Health Organization International Code on marketing of these products but in practice they are tiny. The can of formula from Pakistan that I’ve had on my desk for the last couple of weeks has the warning in tiny lettering, which can’t be bigger than 7pt script. People don’t read the small print and companies know that.

Inappropriate marketing

I accept there is one obvious comparison when it comes to health warnings on products and the Daily Mail shorthand which suggests we are calling for ‘cigarette-style’ warnings is unhelpful. Infant formula if used correctly, as it tends to be in countries with clean water on tap and electricity in every home, is not dangerous.

In fact it is the only safe alternative to breastfeeding. But in some of the poorest countries where the rates of infant mortality are high, women simply don’t get the information they need about how best to feed their children.

They don’t have the support and advice of a well-trained midwife and, as our report and a recent Guardian investigation highlight, in countries like Pakistan and Indonesia there is evidence that some breast milk substitute (BMS) companies are still marketing their products inappropriately by targeting mothers and health workers and giving out free samples.

These tactics that can seriously undermine breastfeeding have been almost eliminated in the UK thanks to a clampdown by government and health officials.

The need for a global standard

South Sudan is not Southampton. We are not naïvely suggesting that the risks are the same wherever you are in the world but a global standard would ensure that we’re treating all women the same.

It would mean there were fewer loopholes for companies to exploit and would mean that the benefits of having this information would remain when products cross borders.

This is a serious global issue that needs a serious global solution – of which changing the labelling of packaging is just one element.

Please click here for more information on our new report and campaign: The Power of the First Hour: How breastfeeding saves lives.