
U.S. Opposition to Breast-Feeding Resolution Stuns World Health Officials - endorphone
https://www.nytimes.com/2018/07/08/health/world-health-breastfeeding-ecuador-trump.html
======
usaar333
For the NY Times, this is rather lazy reporting.

The quote by the HHS doesn't go into the details of what they see are
unnecessary hurdles for women. Did the reporter not try to dive in more?

> A 2016 Lancet study found that universal breast-feeding would prevent
> 800,000 child deaths a year across the globe and yield $300 billion in
> savings from reduced health care costs and improved economic outcomes for
> those reared on breast milk.

Well, yes, this is true, but context here would help. This isn't due to
formula substitutes (i.e. Abbott laboratories isn't going around killing kids
to make money), this is due to improper substitutions (e.g. giving children
actual mashed food). See
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866289/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866289/)

> Scientists are loath to carry out double-blind studies that would provide
> one group with breast milk and another with breast milk substitutes. “This
> kind of ‘evidence-based’ research would be ethically and morally
> unacceptable,” Ms. Sterken said.

There absolutely is controlled research out there on the effects of
breastfeeding. Here's some:

[https://jamanetwork.com/journals/jama/fullarticle/193490](https://jamanetwork.com/journals/jama/fullarticle/193490)

(or for using pumped milk):

[http://cochranelibrary-
wiley.com/doi/10.1002/14651858.CD0029...](http://cochranelibrary-
wiley.com/doi/10.1002/14651858.CD002971.pub3/pdf)

A good overview:

[https://fivethirtyeight.com/features/everybody-calm-down-
abo...](https://fivethirtyeight.com/features/everybody-calm-down-about-
breastfeeding/)

~~~
endorphone
This story got quickly flagged off the front page, and your falsehood laden
comment sits at the top. Both are a bit surreal and demonstrate how bizarre
partisan everything is.

"There absolutely is controlled research out there on the effects of
breastfeeding"

Neither of those studies is remotely as you claimed. One researched how
effective breastfeeding advocacy was, and the other on the outcomes of
alternatives for children who couldn't be breastfed. The first only controls
education, and the other is purely observational.

"A good overview"

Not even remotely a good overview. Someone else looking for justifications.

"This isn't due to formula substitutes (i.e. Abbott laboratories isn't going
around killing kids to make money), this is due to improper substitutions"

This is just fundamentally wrong. Just as we exported tobacco when we got
wise, formula has become a big export market where the same misleading
advocacy presents it as an equal if not superior alternative. Cultures that
had no issue breastfeeding started treating it as brutish, moving to worse
alternatives.

~~~
jstandard
While I'm not as familiar with these issues, GP did at least attempt to cite
sources. Can you cite sources which prove or suggest the contrary?

In particular, I'm interesting in this claim:

> "Cultures that had no issue breastfeeding started treating it as brutish"

~~~
endorphone
GP didn't cite relevant sources. They simply included some tangential links as
a bit of sophistry, and it's a ruse that unfortunately works too often.

As to me citing sources, what are you looking for a source on?

[https://www.theguardian.com/lifeandstyle/2018/feb/27/formula...](https://www.theguardian.com/lifeandstyle/2018/feb/27/formula-
milk-companies-target-poor-mothers-breastfeeding)

There are thousands of articles like this. As the formula makers were limited
to actual reality in the first world, they moved on to developing countries
(following the playbook set out by tobacco companies) where the rate of
breastfeeding absolutely collapsed. This is a recursive cycle, though -- if
you don't exclusively breastfeed from birth, the natural result is often the
loss of the ability for that child. So now formula is the only option, yet
it's out of reach financially as the exclusive choice so those mothers start
adding in cow milk, water, juice, etc. This is all a trivial search away.

We know observationally that breastfed babies have a huge array of outcome
benefits, but there are no truly controlled studies because the morality of
telling a group of mothers not to breastfeed would be reprehensible and is
unfathomable.

All of this is a trivial search away. As is the fact that the WHO estimates
that 800,000 babies a year die because of this problem.

~~~
jstandard
Thank you, the link is appreciated. However, it doesn't support your claim
that "Cultures that had no issue breastfeeding started treating it as
brutish".

It does support the claim that formula makers are using underhanded tactics
and aggressive incentives. It's awful they're doing that. It's also far away
from your claim that shifting a cultural mindset to viewing breastfeeding as
"brutish".

I can tell you're passionate and knowledgeable about the topic which is why I
was interested in your perspective. But you also seem guilty of hyperbole so I
can't take what you write seriously.

------
chrisseaton
A problem (at least in the UK) is the promoting breast feeding has actually
turned into some really nasty state-sponsored bullying of often vulnerable
women who for whatever reason don’t manage to breast feed.

The push the breast feeding seriously needs to be calmed down. The stress and
shame it causes can’t be good for mothers or babies.

‘Breast feeding is great if you can do it’ is fine but the state line is only
just short of being ‘if you don’t breast feed you’re a terrible mother.’

~~~
ekianjo
> ‘Breast feeding is great if you can do it’ is fine but the state line is
> only just short of being ‘if you don’t breast feed you’re a terrible
> mother.’

To me this is something you decide on a private level. I don't see what the
government or the society has to decide about what you do at home, as long as
you don't actively, purposely aim at making your children suffer.

~~~
mirceal
Yes. It’s a private decision that the family makes when the mom has to return
to work 2 weeks after giving birth (oh hello unpaid vacation). Fuck this. You,
as the government, need to help the people and need to ensure that where
matters are clear cut (like breastfeeding) you make it stupid easy for people
to be informed and to follow the right path.

Ultimately it should be your choice, but you should not struggle to make the
choice.

~~~
usaar333
> It’s a private decision that the family makes when the mom has to return to
> work 2 weeks after giving birth (oh hello unpaid vacation). Fuck this

I suppose you are alluding to this, but FMLA permits 12 weeks of unpaid leave.
(obviously this doesn't work if you are self-employed, but that's clearly a
private matter) Some states may additionally offer partial compensation (e.g.
CA has 55% of salary for 12 months).

It's a deeper question whether the US' stress on individual responsibility is
a good or bad thing. Regardless, in our "parents pay for things" environment,
it's a rare case where you'll be able to afford raising a child (while
working) if you haven't been able to save enough money while NOT raising a
child to take 3 months off work.

~~~
mirceal
Yes and no. For me that’s what social security should be about. Instead what?
The privilege to take 12 weeks without pay? Fuck that. Look at Europe and the
Scandinavian countries if you want to see how it’s done.

The US would be in a world of pain as far as an aging population if not for
the influx of immigrants. But no worries. We’re gonna “fix” that.

------
mirceal
So the US started threatening other countries until Russia stepped up? WTF is
wrong with the US delegation? You have tens of years of data telling you that
breast milk is the best thing for a baby and you go ahead and do shit like
this?

If this wasn’t the real I would guess this is some sort of flat earth society
kind of thing.

~~~
fencepost
_WTF is wrong with the US delegation?_

I can think of at least 6 possible explanations, with some overlap between
them and with none of them complimentary.

They pretty much all can be categorized into one or more of Incomprehension,
Misinformation, Corruption or Malicious Intent.

~~~
mirceal
I know. It was mostly venting and pinching myself to ensure this us not a bad
dream.

------
Puer
Are we really surprised by this? Here's a quick reminder of the awful things
Nestlé has done with regards to breast milk "substitutes".

[https://en.wikipedia.org/wiki/Nestl%C3%A9_boycott](https://en.wikipedia.org/wiki/Nestl%C3%A9_boycott)

------
ekianjo
> countries should strive to limit the inaccurate or misleading marketing of
> breast milk substitutes.

Why do you need a new resolution for that? Isn't that kind of things already
covered by advertising laws in all member countries? And especially, why can't
each individual country decide what standards to apply by themselves?

~~~
mhluongo
Did you read the article? Clearly the resolution tweaked the US- eg
threatening to withdraw military aid from Ecuador- implying there's a large
couched interest.

~~~
AdamM12
Is this stopping mothers in Ecuador from breast feeding?

------
dnautics
Why is the UN doing this? Shouldn't this be the responsibility of the states?

~~~
ekianjo
Yes, pretty much the responsibility of the states. WHO's obviously trespassing
here (and this is not the first time).

~~~
sanderjd
Coordinating global health strategy is well within the mandate of the WHO.
Globalism skeptics certainly question the usefulness of such a mandate, but
this particular resolution is not unusual within it.

~~~
ekianjo
There is reason for skepticism when it comes to WHO:
[https://www.reuters.com/investigates/special-
report/health-w...](https://www.reuters.com/investigates/special-
report/health-who-iarc/)

~~~
endorphone
How is that a possible reply to your nonsensical, ridiculous reply that the
WHO is "trespassing" when they're doing exactly what they are mandated to do?

------
cjhanks
> “The resolution as originally drafted placed unnecessary hurdles for mothers
> seeking to provide nutrition to their children,” an H.H.S. spokesman said in
> an email. “We recognize not all women are able to breast-feed for a variety
> of reasons. These women should have the choice and access to alternatives
> for the health of their babies, and not be stigmatized for the ways in which
> they are able to do so.” The spokesman asked to remain anonymous in order to
> speak more freely.

------
alexmlamb2
The breastfeeding research seems like peak "bad science", because there's so
much obvious confounding between the causes of breastfeeding as a behavior and
the properties of the child.

I probably would suspect minimal effect unless there were (1) a clear
mechanism of action, (2) really strong associations even after adding
controls, (3) a causal study, perhaps on non-humans.

~~~
sanderjd
Have you reviewed the literature? Are you certain none of your points have
been attempted? (Citations would be welcome.)

------
Grue3
Good. The government shouldn't tell women what to do with their own body.

------
AKifer
I think such a matter being discussed at this level is void and a nonsense.
Are parents really needing to delegate the choice of breastfeeding their
children or not to the government or the WHO ?

------
wool_gather
Boy, the next few decades are going to be...interesting...with how bent the
current U.S. government seems to be on inverting the relationships that have
coalesced over the last seventy or eighty years. Especially over small
potatoes like this. Diplomatic disruption is not a recipe for peace.

~~~
weiming
I'm wondering how much "the State" should intervene in matters like this. Some
families may choose to breast-feed, some won't. Should this decision be
government organization-mandated?

If the administration's decision is based on "the government should stay out
of your family's life," then I may see logic here.

~~~
fencepost
The topic of breastfeeding versus formula has been a huge one for decades
particularly in developing nations. Look up "nestlé advertising formula
Africa" for huge amounts of information.

One problem is that if mothers use formula instead of breastfeeding early on
then their milk dries up. At that point they are stuck with formula, but if
for economic reasons they are unable to get adequate supplies of formula then
they may resort to over-watering, which then leads to malnutrition.
Cleanliness of water supplies used for mixing of formula may also be a problem
in many areas.

Edit: after seeing some of the other discussion of what's apparently become a
bullying culture around breastfeeding I can see that as a valid concern.
However most of that discussion appears to be centered around the US, Canada,
Europe, etc where formula availability should be pretty good and relatively
affordable. A lot of the places where this is relevant are in _much_ poorer
nations where "slightly expensive" formula by US standards is prohibitively
expensive by local standards.

Would folks in the US feel that formula was a good alternative if it cost as
much as your rent/mortgage? How about if you got a free supply to start out,
just long enough for the mother to mostly stop lactating?

~~~
dnautics
The very fact that there are legitimate deltas in concern between the rich and
poor countries suggest that this should _not_ be handled at the level of the
UN.

------
jjuhl
America (USA) being America (USA) once again. Can't wait for them to navel
gaze enough to remove themselves from global politics - the sooner the better.

~~~
sctb
This site is for intellectually interesting discussion and nationalist
dismissals aren't that.

[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

------
dingo_bat
Tl;dr USA refuses to be a nanny state and impugn on the liberty of private
citizens.

------
devmunchies
when given a choice between American health and supporting American animal
agriculture, the government almost always chooses the agriculture.

------
foobarbazetc
Ecuador: “Breastfeeding is good, actually.”

United Corporate States of America: “We will turn your country into a
smoldering ash heap.”

Russia: “Breastfeeding is good, actually.”

UCSA: “Yes, Boss! Whatever you say!”

------
AdamM12
What would the resolution even do? Like are WHO officials gonna be following
around mothers telling them what to do? Seems like much to do about nothing.
Doubtful many people are gonna change their behavior because of some
resolution by some way off organization.

~~~
emiliobumachar
With lots of conflicting anecdotes out there, a WHO resolution provides a
strong appeal to authority argument.

At least here in Brazil, "The World Health Organization stated that..." gets
thrown around a lot.

