What to know about infant feeding guidelines, as the US opposes world breastfeeding resolution

The World Health Organization advocates for a "breast is best" feeding policy.

July 9, 2018, 8:07 PM

The U.S. delegation attempted, unsuccessfully, to derail a resolution on the topic of breastfeeding at the World Health Organization's annual meeting in May, The New York Times reported over the weekend.

The resolution was aimed at limiting "inaccurate or misleading marketing of formula," and encouraging breastfeeding support in all countries.

In opposing the resolution, the U.S. was said to align with the corporate interests of formula manufacturers. The Department of Health and Human Services has since responded, saying the U.S delegation was advocating for a variety of feeding options because some women are unable to breastfeed.

"The issues being debated were not about whether one supports breastfeeding," Caitlin Oakley, national spokesperson for the Department of Health and Human Services, said in a statement. "The United States was fighting to protect women’s abilities to make the best choices for the nutrition of their babies."

The United States and many countries around the world currently abide by the International Code on Marketing of Breast-Milk Substitutes, a health policy framework for promoting breastfeeding adopted in 1981. The code urges countries to stop the inappropriate marketing of formula and other substitutes as better for babies and aims to ensure breastmilk substitutes are used safely -- according to the directions, without diluting the formula -- when necessary.

As part of global nutrition targets, countries who are part of the WHO have vowed to increase rates of exclusive breastfeeding in the first six months of life to at least 50 percent of mothers by 2025. Breastfeeding rates vary by country, but two out of three infants worldwide are not breastfed for the recommended six months and this rate has not improved in several decades, according to a WHO, UNICEF and International Baby Food Action Network report from 2016.

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a baby’s life, followed by breastfeeding plus other appropriate, nutritious foods thereafter.

The recommendations are based on an established body of evidence showing breastmilk is nutritionally, economically and ecologically superior to formula or other breastmilk substitutes. Its many health benefits matter both for newborn and mom. In the mother, breastfeeding decreases the risk of cancer, cardiovascular problems and type 2 diabetes, among many others. In babies, the benefits can include increased IQ, reduced number of infections like colds, stomach viruses, cases of pneumonia, and ear infections, and decreased rates of later obesity. Recent studies have shown that breastfeeding may reduce the risk of allergies and autoimmune conditions like type 1 diabetes and celiac disease.

A 2016 report in the medical journal The Lancet estimated that 823,000 child deaths around the world could be prevented each year through universal breastfeeding.

Although the U.S. and many other countries promote a "breast is best" policy, many mothers are unable to breastfeed for a variety of reasons like medical challenges, insufficient maternity leave, or inability to afford time away from work often required for exclusive breastfeeding. Some mothers simply feel it isn't the best choice for their families.

"Many women are not able to breastfeed for a variety of reasons, these women should not be stigmatized," Oakley added in the statement. "They should be equally supported with information and access to alternatives for the health of themselves and their babies."

The WHO said its resolution was aimed, in part, at reducing these barriers and putting more support systems in place to allow for successful breastfeeding -- along with ensuring that formula cannot be advertised in deceiving ways.

Dr. Edith Bracho-Sanchez is a pediatrician.