Of all the things that we feed to our children, breast milk may be the best: custom-designed for each and every baby, locally sourced, available on-demand and free. Yet parents spend about $11.5bn a year on baby formula, an expensive, less healthy and less sustainable substitute.
In an effort to change that, the World Health Organization (WHO) and UNICEF have, for the past 20 years, worked to make hospitals around the world more "baby-friendly". This Baby-Friendly Hospital Initiative has focused especially on reducing formula use by new mothers. A variety of creative strategies are part of this:
• Educating mothers of the significant benefits of breastfeeding
• Helping new mothers initiate breastfeeding immediately after birth
• Stopping the pernicious distribution of free formula samples which conveys to new mothers that the hospitals support formula as much as or even more than breastfeeding
• Tracking disbursements of formula by nurses to increase staff accountability
And the initiative has had results. Thus far, 15,000 hospitals in 134 countries have been accredited. Even the US, a laggard on breastfeeding globally, had 172 hospitals with Baby-Friendly accreditation by the start of 2014, covering 6.9% of all births, up from 2.9% in 2007.
Yet, while a step in the right direction, this is not enough to combat the global formula industry, an industry supported by millions of dollars of marketing, and in many countries, health policies that give insufficient support to new mothers to breastfeed over the critical first six months of their childrens' lives.
What can be done?
What WHO and UNICEF should do now, after decades of modestly successful efforts to curb the dangerous use of baby formula, is to push for a global treaty: a Framework Convention on Formula Control modeled on WHO's successful Framework Convention on Tobacco Control (FCTC). This could ban all marketing of formula, such as advertising, free samples and product placements (as the FCTC did with tobacco marketing); require breastfeeding assistance at hospitals; provide paid maternity leave so that women could have the time and security to breastfeed, and so on. It could even make formula a prescription-only product, making formula accessible only as a food of last resort.
Of course, if ratified, the industry would shrink like an unmilked breast (fun fact: the free formula sample bag given in many hospitals includes an ice-pack to help stop milk flow in new mothers). But a sustainable future will require certain industries – not just tobacco and fossil fuels, air travel and automobiles, even baby formula – to become much much smaller to sustain a population of nine billion human beings.
The truth behind baby formula
Formula is no substitute for breast milk, even if the marketing suggests otherwise. Over the past decades, a large body of research has revealed the many benefits of breastfeeding – both to baby and mother. Breastfeeding helps reduce children's risks of a variety of illnesses, including sudden infant death syndrome, asthma, many types of infections, type 1 and type 2 diabetes and even obesity. And mothers who do not breastfeed increase their chances of type 2 diabetes, as well as breast and ovarian cancer. Breastfeeding even helps babies sleep better at night, something new parents prize.
Moreover, formula leads families to spend hundreds of dollars on an inferior privatized product instead of one that the body freely provides. Not to mention that if access to pure water is a challenge, using formula can be very dangerous (as families in developing countries and Nestlé learned the hard way back in the 1970s).
Even today, the WHO finds that if all of the world's children were exclusively breastfed for the first six months of life, as opposed to just the current 35%, 1.5 million fewer children under the age of five would die each year. And that's not even exploring the many sustainability issues with formula: plastic bottles, exposing babies to chemicals like BPA, or the untold energy used to manufacture, ship and prepare formula.
Recognizing all the advantages of breastfeeding, the baby-friendly hospital initiative was born, as were more recent efforts like New York City's marketing campaign to encourage breastfeeding. And while these are important steps in re-normalizing breastfeeding, they are far from enough.
With such a perfect substitute as breast milk, free and available to nearly all mothers (and breast milk donations or prescription-formula available to the small percentage of those that cannot produce milk), phasing out this unneeded product offers us an easy step to formulate a healthier and more sustainable human population. Barring the massive resistance of an industry resisting its own demise, of course. But that's what the treaty would be for.
Erik Assadourian is the Transforming Cultures project director at the Worldwatch Institute and co-director of State of the World 2013: Is Sustainability Still Possible?