The Breast Milk Cure.... or Curse? It's the Water Not the Formula

 Breast milk, the miracle cure for child malnutrition and global poverty?

Nicholas B. Kristof, The New York Times, The Breast Milk Cure

That's what New York Times foreign affairs columnist (i.e. not a trained science writer) proposed in his latest compassionate yet flawed, okay, botched attempt at public health advocacy - The Breast Milk Cure
What if nutritionists came up with a miracle cure for childhood malnutrition? A protein-rich substance that doesn’t require refrigeration? One that is free and is available even in remote towns like this one in Niger where babies routinely die of hunger-related causes?
Impossible, you say? Actually, this miracle cure already exists. It’s breast milk.
Why is it such a good cure?  It's natural, readily available and oh yeah - doesn't include contaminated water

Oh that minor issue - the water.  The filthy water used to make infant formula. 

Citing research showing a link between breastfeeding and lower mortality rates (hello, confounding factors!! correlational results!!), Kristof eagerly argues breastfeeding can save lives as do the experts he digs up: 
“As far as nutritional interventions that have been studied, we have crushing evidence of breast-feeding’s efficacy in reducing child mortality,” said Shawn Baker, a nutrition specialist with Helen Keller International, an aid organization that works on these issues.

Crushing evidence for sure but evidence of the curative powers of breast milk? No, not exactly.  Maybe evidence of the Curse of Breast Milk - health authorities the world over ignoring what the data really say in order to glorify the almight powers of breastfeeding. 

The curative powers of breastfeeding have little to do with breast milk and plenty to do with the fact babies who get the boob don't have to suffer the dirty water.

Gee, do you think the moms who nurse could be more informed say, about children's health? Might they differ in any number of substantial ways from those who didn't opt for the breast?  Hmmm.  

Why oh why can't public-health minded peeps be honest and accurate about the benefits and limitations of breastfeeding?

No child has ever died due to insufficient breast milk.  Despite that crazy Harvard study shouting about 900 annual baby deaths - there is no evidence whatsoever that not breastfeeding kills infants.  In Niger where Kristof focused his editorial insights, children die because of the unsafe water and a host of poverty-related factors that have nothing to do with sub-optimal levels of breast milk.

Should more women in Niger breastfeed? Absolutely.

Only 9% breastfeed exclusively for 6 months (compared to 13% in the US) according to Mr. Kristof who opines on the reasons women in Africa breastfeed in such low numbers. 

That's when the you-know-what really starts flowing:
It’s not clear why a human instinct to nurse went awry.  Just like the instincts to kill our competitors, our babies and run like hell when we hear a  loud noise? Speaking of going awry...Does it have something to do with the sexualization of breasts? In Africa? Has he seen the movie Babies in which it becomes clear even to my 8-year old that breasts are just another limb and not a cash cow for the fashion and cosmetic-surgery industries.  Or with infant formula manufacturers, who irresponsibly peddled their products in the past but are more restrained now? Maybe formula should be outlawed? Along with high fructose corn syrup, trans fats and white bread, I mean honestly, aren't those parents in Africa worried about their children's health? I know there's a horrific famine and all but honestly, stooping to formula? Or is it just that moms worry that their babies need water on hot days? Nobody really knows.  Mainly because no one has bothered to figure it out because it's so much more productive churning out flawed studies showing links between breastfeeding and health benefits.   
Then there's the fact that it's not easy charging up a double breast pump in the middle of the Sahara desert.  It's not like women can run over to the nearest village and find breast milk storage bags either to say nothing of the perfect nursing bra or nipple cream.

Hey, honey, on your way to the military coup, could you pick up another Boppie cover?

So, please, Mr. Kristof, get the story straight.  Doesn't take a genius to poke holes in your plaintive plea. You've won the Pulitzer, you are a genius and by the way, you have a huge stage.  You the man, don't abuse it.


amanda said...

Just needed to tell you that this article you wrote in response is great. Thank you.

Polly Palumbo, Ph.D. said...

Thanks, Amanda!

TherExtras said...

Does the end justify the means? I mean, if more women in Niger (who read the NYT, of course) breastfeed, what does it matter that every convincing statement is untrue or hyperbole-ated?

You know that's a rhetorical question, Polly.

It.does.matter. The untrue means to a wholesome outcome births more urban legend that twists the lives of untold women (who read the NYT) and their babies.

Keep fighting the good fight.

Polly Palumbo, Ph.D. said...

Good point, does the end justify the means? I think there are some VIPS at the WHO and AAP who might not worry too much about the means...witness the "pregnant woman riding the mechanical bull" public health ad a few years back. I mean, riding a mechanical bull while with child is just as dangerous as not breastfeeding, right????

Anonymous said...

Qualifying the statement that no child has ever died due to insufficient breast milk, that is presumably assuming sufficient formula. Many West Africans consume milk only in the rainy season because animals don't produce enough milk in the dry season. Fluctuation in milk production is not just about whether women work hard enough to increase lactation (nor is it just about the obviously critical minimum hydration and nutrition levels).

Polly Palumbo, Ph.D. said...

Hey Anony! Thanks for posting, sounds like you've studied this issue? However limited the supply of food, milk, sustenance, whatever, it is starvation, dehydration or contaminated water that kill, not formula. I am all for more breastfeeding (and it especially makes sense when other substances run low) but I am also for relaying the truth about the benefits and limitations of breastmilk. Or in this case, the benefits of not drinking contaminated water.

Polly Palumbo, Ph.D. said...

But yes, of course, "no child has died to insufficient breastmilk" assumes formula is available. But I make that point in reference to studies linking infant formula to higher mortality rates that Mr. Kristoff cites.

Polly Palumbo, Ph.D. said...

(Sorry, Anony, my computer keeps publishing as I keep typing! So I will finish here...hopefully) Anyhow, thanks for the reminder, I should have been more precise! On a related note, here in the US some babies have died from "insufficient breastmilk" when their mothers don't realize it's insufficient and are not supplementing. But that's not really what I meant in that statement. There I'm referring to the supposed "dangers" of providing alternatives (i.e. formula) and thereby giving "insufficient" breastmilk.

Anonymous said...

You the WOMAN, girl! Well done!!

Glenda said...

Breast feed is the best for babies up to two years. Also, mother's breastmilk has no waste products and leaves no carbon footprint. So it's very essential food to all children. Thank you for sharing this very informative post.