Donald Trump Tweets About Breastfeeding—But Misses the Whole Point

Donald Trump Tweets About Breastfeeding—But Misses the Whole Point
Women need better support and better nutrition, not “access” to expensive substitutes.

Early this morning, while breastfeeding my baby and scrolling through The New York Times’s briefing, a headline caught my bleary eyes: “Opposition to Breast-Feeding [sic] Resolution by U.S. Stuns World Health Officials.” According to the story, the U.S. delegation to the United Nations–affiliated World Health Assembly had pressured countries to drop a provision intended to encourage breastfeeding and promote regulations on the marketing of formula.

As a mother who has breastfed but has also been grateful for the life- and career- and sanity-saving ability of formula, tracing out the implications of the story left me in something of a muddle. The American Academy of Pediatrics recommends “exclusive breastfeeding for about six months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for one year or longer.” And when I reached out to the AAP about this story, their stance was similarly straightforward: “The AAP agrees we should promote, protect, and support breastfeeding globally and in the U.S.,” said Colleen Kraft, president of the American Academy of Pediatrics, “[as well as] public policies that support mothers who are breastfeeding.”

But the science surrounding breastfeeding is controversial to say the least. Typing these words, I can almost feel the Twitter DMs being launched in my direction, but let me try to quickly gloss that statement. Essentially, it’s extremely hard to do a randomized trial on the benefits of breastfeeding that controls for factors like the mother’s education and economic status.

The story also apparently snagged the attention of our president, too, who tweeted this morning that he doesn’t believe “women should be denied access to formula”:

That language has a certain pleasing ring to it: Who’s not for “access,” after all? As the Department of Health and Human Services rep quoted in the Times article said: “We recognize not all women are able to breastfeed 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.” That also sounds pretty nice, but it misses the point. The measure promoted—and eventually put forward by Russia, strangely enough—is not about preventing stigma, it’s about preventing misleading marketing from formula makers seem like the easy option when breastfeeding may be safer and more beneficial. According to the World Health Organization’s estimates, if breastfeeding became near-universal globally—an impossible standard, but it gives a little context—more than 800,000 infant lives would be saved each year.

While it may be difficult to fully parse the benefits for women and infants in developed areas, the advantages of breastfeeding for women in poorer countries, where water-quality issues can lead to dangerously contaminated formula, presents an easier calculus. In fact, a recent Guardian/Save the Children investigation found violation of regulations and the WHO’s international codes on the marketing of formula in the Philippines, often in areas where the cost of formula represents a real economic hardship. Women who are targeted with aggressive advertising from formula companies need better nutrition and breastfeeding support—not increased access to an expensive breast-milk substitute.

Breastfeeding is hard, women should choose how to feed their children, et cetera. But that doesn’t seem like a reason for back-channel machinations that are likely to have adverse overall effects on infant health. As comedian Molly Knefel put it on Twitter: This isn’t the kind of help we need.

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