Better Breastfeeding Laws for a New Normal

Malnutrition causes about one-third of deaths among children under five. More than half of these deaths are because of inappropriate feeding practices during the first year of life. As a way to improve young children’s health and nutrition, the World Health Organization (WHO) recommends that mothers breastfeed their children within the first hour of life. Evidence shows that exclusive breastfeeding for the first six months up to two years has the single largest impact on a child’s likelihood to survive and thrive.

In 1981, WHO adopted the International Code of Marketing of Breast-Milk Substitutes (the Code). The Code prohibits promotion of breast-milk substitutes including advertisements, gifts to health workers, and distribution of free samples. It also requires that breast-milk packages contain a message about the superiority of breast-feeding over formula. The Code does not absolutely prohibit breast-milk substitutes. WHO’s recently released resolution in June 2016 guides governments and companies on how to better handle breast-milk substitutes: “they should be readily available, but not promoted.” However, out of the 194 WHO member states, only 39 countries have laws executing all provisions of the Code; only six have allocated budget or funding for monitoring and enforcement.

The WHO, United Nations Children’s Fund (UNICEF), and the International Baby Food Action Network (IBFAN) say breast milk is safe, clean, and contains antibodies that help protect against many common childhood illnesses. Breastfed children perform better on intelligence tests, and are less likely to be overweight, obese, or diabetic. Mothers also benefit from reduced risks of breast and ovarian cancer. UNICEF Chief of Nutrition, Werner Schultink, emphasized that mothers should be aware of the “readily available means to protect the health and well-being of their children.”

According to the United Nations’ most recent report on nutrition, breastfeeding has the potential to save lives of more than 820,000 children and 20,000 women. Additionally, the global economy can gain up to $300 billion if every infant is exclusively breastfed for at least six months. Still, the more developed countries are plagued with breastfeeding controversies. In March, earlier this year, a woman in D.C. was fired for pumping breast-milk for her newborn child during her break at a desk job. A federal judge ruled in March that the D.C. police officer could sue the city. Also earlier this year, at the London Heathrow Airport, security threw out a mother’s two weeks worth of breast-milk. Several airports have long had equipment to securely check large amounts of liquid such as milk for young children.

Lancet, a UK medical journal, suggests some ways to improve protection and promotion of breastfeeding. Increased provisions for paid maternity leave and Affordable Care Act provision for protected nursing breaks and insurance coverage for breast pumps could increase breastfeeding by up to 25%. However, there is concern on whether breastfeeding can transmit infectious diseases such as the Ebola Virus and AIDS. Researchers from the University of Cambridge and Wellcome Trust Sanger Institute published case studies in the Virus Evolution journal, stating that a mother may have transmitted Ebola to her baby by breastfeeding. Previously, WHO advised that HIV-positive mothers to refrain from breastfeeding. However, on November 2009, WHO revised its recommendations. HIV-positive mothers risk less than 1% chance of transmission if they also take antiretroviral drugs throughout the period of breastfeeding.

Advocacy groups such as the United States Breastfeeding Committee are driving collaborative efforts for policy and practices that could protect and promote breastfeeding in the U.S. Still, the U.S. has yet to create laws that mirror the Code.