Today, Explained - I can't believe it's not breastmilk

Episode Date: July 12, 2018

Breastmilk. Research says it’s the best, so why did the U.S. threaten to shut down a breastfeeding proposal at the World Health Assembly? Vox’s Julia Belluz says it all boils down to baby formula, the $70 billion industry lurking in the shadows. ******************************************* Are you pregnant? Have you ever been? Vox wants to provide more explainers on women's health and would love your help. You can fill out the survey here: http://bit.ly/voxpregnancy Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hey, hey, hey. Amazing. It's like you expect me to call you to tell you that Uber is adding a bunch of new features that are designed to take the stress out of your pickup and that you can find out all of the ways Uber is moving forward and see the improvements they're making to their app at uber.com slash moving forward. Yeah, it's almost as if we've done this before. I'm no scientist, but I can guarantee you none of us would be here if it weren't for breastfeeding.

Like, even if you weren't personally breastfed, all of your ancestors were. Let's just get this out of the way. Breast milk is good. Yeah, this is like the gold standard for babies. And there's massive consensus on this among medical organizations and the scientific community. And only in the last hundred years have we seen this massive evolutionary shift to most babies being fed baby formula instead. This evolutionary shift to baby formula strangely became a thing the entire world was talking about for a second this week.

And it all goes back to a meeting in Geneva. It happened this past May. A new report says U.S. delegates to the World Health Organization pushed to scrap a resolution meant to encourage breastfeeding in underdeveloped countries. Julia Balouze writes about health for Vox, and she's going to take us there. So where this all starts, every year the World Health Organization, which is the UN's global health agency, ministers, heads of state, civil society, they all gather in May for this meeting called the World Health Assembly, and it takes place in this beautiful setting on a lake in Geneva.

There are peacocks roaming around the grounds of the European headquarters, World Health Assembly, and it takes place in this beautiful setting on a lake in Geneva. There are peacocks roaming around the grounds of the European headquarters, which kind of looks like an old European palace. And over the course of several days, delegates from the WHO's 194 member countries bring forward resolutions about global health. So we're basically talking about a forum of the WHO where all the countries of the world come together to set global health. So we're basically talking about a forum of the WHO where all the countries of the world come together to set global health policy. And that means they're talking about everything from pandemic preparedness to antimicrobial resistance, maternal and child health. Together, we can create a world in which all people can lead healthy and productive lives, regardless of who they are or where they

live. And in that context, this year, what seemed like a pretty innocuous resolution about breastfeeding came forward, and it was supposed to be put out by Ecuador's delegates. And the resolution just called on countries to protect and promote breastfeeding. It asked policymakers to restrict misleading marketing of baby formula, which is something we know has undermined breastfeeding and often caused moms to switch to formula when they don't need it. And it let countries know that the WHO had put out new documents about breastfeeding in emergencies and hospitals. So it was pretty non-controversial and health advocates who were at the meeting told me they thought it would pass with no issue.

But before Ecuador could put the resolution forward, Trump officials started meddling. So Andrew Jacobs at the New York Times broke a story this weekend about how the Trump administration sought to water down the language in the resolution, and when they didn't get their way, they started to bully other countries, threatening Ecuador with trade sanctions and withdrawing aid, and this caused Ecuador to back off. And it kind of put health advocates who work on maternal and child's health in this scramble to try to find another country who would put this resolution forward and no one wanted to piss off the U.S. basically. One person who was at the meetings told me that

in the negotiating rooms it was really America against the rest of the world and countries like Bangladesh and other low and middle income countries were speaking out against the rest of the world. And countries like Bangladesh and other low- and middle-income countries were speaking out against the bullying tactics the U.S. delegation was reportedly using. And European countries that often align themselves with the U.S. around issues of infant feeding, they were also turned off by America's behavior. And then in this weird geopolitical twist, Russia took on breastfeeding, so they ended up bringing the resolution forward. The U.S. pushed back with a counter-resolution, and that failed, but only after two days of debate.

And so the Russian resolution ended up passing with most of the original pro-breastfeeding language intact. This happened back in May, right? Yes. Why are we just finding out about it now? I think many of us miss this, basically, because I noticed that there were people who were at this meeting, including breastfeeding advocates and maternal and child health advocates,

who were tweeting about what was going on. And the World Health Assembly doesn't always maybe get as much coverage as it deserves. And I think many of us, quite frankly, miss the story. So has the United States acknowledged this since? So, yeah. So the story broke on Sunday and Trump responded to it on Monday through his favorite medium, Twitter. And he called it fake news. And he said he's not anti-breastfeeding, but he wants moms to be able to choose an access baby formula if they need it.

And that's kind of been the line out of HHS and the administration, that they're not anti-breastfeeding, but they believe that women should have the right to access and choose baby formula if they want or need it. A spokesperson for HHS Health Human Services basically denied that any threats regarding trade were made. And yeah, they're kind of out there denying the story. Who's to be believed? That's the question. I think I'd side with fake news on this one. I'd side with fake news, New York Times, and other people who I've since spoken to who are at the meeting and said,

this is not only characteristic of how this administration who were at the meeting and said, this is not only characteristic of how this administration was acting at the World Health Assembly, but in other meetings on breastfeeding. It seems like common sense and an obvious question, but what are the health benefits of breast milk? Yeah, so breast milk is basically this perfectly calibrated food for the baby. It's rich in vitamins and minerals. It has antibodies that boost a baby's immune system and get it working. The strongest evidence is that breastfeeding helps protect against a range of illnesses, so ear, throat, and sinus infections, pneumonia, and diarrhea, which are really common killers of infants worldwide. It's a little bit more controversial,

but there's quite strong evidence linking babies who are breastfed to higher IQ later lower rates of chronic disease like obesity and diabetes and yeah the best estimate on you know how many lives would be saved if breastfeeding were near universal comes from the Lancet and they suggest it's about 820,000 lives. So we're talking about something that's essentially inoculating babies against death and disease. Now, lest we be sounding too teen breast milk here, where's formula come from? What's the story of formula? How does it enter the scene? So formula starts to emerge in the late 1800s. And from a medical standpoint, it's viewed as something that can be used when babies

can't get breast milk, or a woman can't breastfeed or chooses not to, or they have an infection that might be transmitted to their baby through breast milk. In that case, then formula is a good option. And part of the rise in popularity for formula comes from aggressive marketing on the part of industry, but it also syncs up with women entering the labor force. In just a minute, the time the aggressive marketing of formula killed millions of babies. This is Today Explained. In 1978, a United States Senate investigation under Senator Edward Kennedy's chairmanship

was called to look into the marketing practices of the baby mark industry. Nestle was one of the key witnesses. Would you agree with me that your product should not be used where there is impure water? Yes or no? We give all the instructions. Just answer. What is your position? Of course not,

but we cannot cope with that. How are you today? How are you feeling, Brie? I'm feeling good. I just had my breakfast. I'm doing a little bit of work from home today on transcription. And I miss Fox. I miss Today Explained. I want to come back. But me calling you to do these Uber ads has worked on some level to make you feel a little closer to the show, to the program? Yeah, I feel tethered to the show still.

And you now know that Uber's making it easier for you to verify the details of your ride and showing you your driver's name, car, and license so you can make sure you take the right ride every time. And with service in more than 600 cities around the world, Uber's increasing their efforts in community service and partnering with organizations that make a difference. I want to come back tomorrow if, you know, something happens with my car. I'm getting in that Uber.

Yeah, you might want to read up about the company before you get in that car at uber.com slash moving forward. I will, certainly. Have you been spending a lot more time with your family since you've been home this past week? Absolutely not. Do you ever disagree with your family? Do you guys have a lot of contentious debates at home? We argue about house things like, hmm, you know, is the dishwasher clean or dirty?

Why didn't you let me know? You know, but nothing more intense than that. Oh, fair enough, because I wanted to tell you about this new podcast from the Vox Media Podcast Network. It's called The Arthur Brooks Show. And on the show, Arthur Brooks sort of explores the art of disagreement. And the first episode is about disagreeing with the people we love. It's called Family and Friends.

And you can find it now on Apple Podcasts or Google Play or Stitcher or wherever you get your podcasts. I need to get into that, because if there's one thing I love to do, it's argue. As I understand what you say is where there's impure water, it should not be used. Yes. Where the people are so poor that they're not going to realistically be able to continue to purchase that, and which is going to mean that they're going to dilute it to a point, which is going to endanger the health, that it should not be used. Yes.

All right, now then my final question is, is what do you do, or what do you feel is your corporate responsibility to find out the extent of the use of your product in those circumstances in the developing part of the world? Do you feel that you have any responsibility? We can't have that responsibility, sir. May I make a reference to... You can't have that responsibility? No, no. In the 70s, it came to light that baby formula makers were sending out sales representatives dressed as nurses in sub-Saharan Africa, and they were pushing formula. They were suggesting not only that it was equivalent to breast milk, but that it might even be better for babies. And women in these places don't have access to fantastic clean water and great sanitation systems. So they were mixing the baby formula with contaminated water. And it's believed that

millions of babies died as a result from drinking these formulas instead of their mother's milk. And that's why, you know, we still talk about these things at meetings like the World Health Assembly. It's to prevent these types of tragedies from happening again. Do we have any idea how much of the world is breastfeeding versus using formula? Globally, 40% of babies are exclusively breastfed for the first six months of life. So that means 60% are getting something else or they're, you know, having formula and breast milk or in some countries they're using tea or porridge or other things to supplement breast milk. So it's pretty wild again to think about that massive evolutionary shift from all

babies getting milk from women to babies getting milk from powder and bottles and other things. What makes a happy mom? A happy baby. And a happy feeding. So, if introducing infant formula, start happy and see why no other formula is like Good Start Probiotic. And surely some of this must be happening because formula companies have pushed their product really hard on people, right? That's absolutely true. So there's definitely sociological changes like people having higher incomes, women entering the workforce, urbanization.

But there's this very aggressive marketing on the part of industry to push this idea that there's an equivalence between breast milk and formula. Similac is introducing the first and only infant formulas with 2-FL human milk oligosaccharide, an immune-nourishing prebiotic previously only found in breast milk. So they created this idea which absolutely isn't true and we're only learning about all the ways breast milk is far superior to formula. I wonder how this sort of becomes a more political issue. How is the United States going before this international body in 2018 and advocating formula against breastfeeding?

Health advocates and other officials who have been in on some of these negotiations say this is really about basically big baby formula and the dairy industry shaping maternal and infant health policies. That's the thing, big formula. Big baby formula is a huge industry, yeah. It's projected to be valued at $70 billion by next year. And the number one product in baby formula is dairy. And so countries that have these big formula companies that have big dairy industries tend to be on side with policies that are more supportive of baby formula.

And which of those countries? It's not just the United States? It's not just the United States. So European countries tend to be in line with the U.S. So France, Switzerland, the Netherlands, they're home to some of the world's biggest formula makers. And which of the companies we're talking about, are they familiar names? Absolutely. So we're talking about Nestle in Switzerland, Danone in France. There's Friesland Campina, which is a Dutch company.

Mead Johnson, a U.S. company that's now U.K.-owned, and then there are these two big U.S. giants, Abbott Laboratories and Heinz. So these six companies have half the world's share of the baby formula market, and yeah, this is a really big business. One of these companies, Abbott Labs, which makes formulas, spent nearly $800,000 in lobbying just this year alone. So thinking about these companies that have been around for a while, this United States approach to supporting big formula

must go back before Donald Trump got into office. Yeah, so there's a long history here, and yet it's definitely important to remember that it way predates the current president. So in 1981, the World Health Assembly in Geneva, remember the peacocks and the lakes? When Reagan was president, the WHO launched the International Code of Marketing of Breast Milk Substitutes. It's known as the code and basically it talks about how companies shouldn't put

bold health and nutrition claims on labels, that they shouldn't aggressively market their products since, again, breastfeeding is seen as the gold standard. And so they shouldn't be pushing their products on women. They shouldn't be doing something that still happens in a lot of places today, giving out free samples in maternity wards, sending women home with like advertising and formula kits. Many studies that have shown that when women access those products, they tend to stop breastfeeding exclusively sooner than women who don't have access to formula. So countries have used this code to set laws and prevent formula companies from directly targeting moms and doctors. And when the code passed in 1981, 118 countries voted to support it and the U.S. was the sole descending vote.

Today, the U.S. is one of the few countries that has none of these formula marketing laws to enforce the code, basically. So big formula is basically getting pushback everywhere in the world except here in the United States. Are they finding workarounds? I think the next big thing that we're going to be hearing about, there's this fast-growing category of baby formula called follow-up formulas that are targeted at older babies, so babies six months and older.

Since their very first days, your baby starts to write their future. Inspired by 40 years of breast milk research, our experts created our range of optimal follow-on milks. And essentially, it's a category that was created by the baby formula industry to get around all the regulation that's been put in place for the infant formulas. And they are pushing to have these products be seen as foods instead of breast milk substitutes, which means they wouldn't have to curtail their marketing practices. And it's hard to tell the difference. They look almost identical to the infant products. And so I think that's a very active debate, how we should treat these products, how we should regulate them.

It's something the U.S. is reportedly involved in. Again, I've been told that they're siding with Big Baby Formula on this one as well. Is there a difference between how the United States advocates formula in these global forums and how the United States promotes formula or breastfeeding in the United States? In the U.S., the FDA regulates our food, including infant formula, and they have some extra provisions and oversight in place since it's this vulnerable population that's getting the formula. But I think it's important to acknowledge that the U.S. has better rates of breastfeeding than many other high-income countries.

So in most high-income countries, less than 20% of infants are breastfed at one year. In the U.S., the number is 27%. And it's been rising in recent years. And that's in part because women are more aware of the benefits of breastfeeding over formula. But it's also because we've put in place policies at the national level through Obamacare that have supported breastfeeding over formula, but it's also because we've put in place policies at the national level through Obamacare that have supported breastfeeding. So lactation consultants and breast pumps are now essential health benefits. They're now covered by insurance companies. Through Obamacare, workplaces also have to make safe places for women to breastfeed or pump at work.

So we are doing better nationally, although obviously this administration has been trying to tear away Obamacare. So what happens with those provisions remains to be seen. I mean, and coupled with that, how does it look for the United States to roll into this World Health Organization meeting in Geneva in May and be advocating big formula and bullying countries like Ecuador into

doing the same. Yeah, it doesn't look very good for the U.S. It sends a pretty important signal that we're not moving in the direction we should be around breastfeeding and doing, you know, everything we can to save babies' lives and increase the number of women who feel they can breastfeed instead of relying on baby formula. Places that give me hope are countries like Brazil. They have bans on formula marketing, they have paid maternity leave, and they're seeing their breastfeeding rates go up. And so that suggests that, you know, when you have a policy environment that supports women and that focuses on this issue, you can have success. Julia Blues reports on health for Vox.

I'm Sean Ramos from This Is Today Explained. The show's executive producer is Irene Noguchi. Bridget McCarthy is our editor. Noam Hassenfeld produces. Luke Vanderploeg produces. And Af McCarthy is our editor. Noam Hassenfeld produces. Luke Vanderplug produces. And Afim Shapiro engineers. Catherine Wheeler and Bree Seely are spending their summers with us, and the sunny Breakmaster Cylinder is making music for us. Today Explained is produced in association with Stitcher, and we are part of the Vox Media Podcast Network.

Side note and pro tip. Dog had an eye infection once once put breast milk in the dog's eye cleared up in an hour some say it's not possible i watched it with my own two milk of the gods just saying Thank you.