Reproductive Health

Infant-Formula Companies Milk U.S. Food Program

Monday, November 7, 2011

The U.S. is joining a global consensus about the public-health importance of breast milk. But a federal agency with huge sway over infant nutrition still distributes more than half the infant formula sold in the nation. A special investigation of infant formula and WIC.

(WOMENSENEWS)--In recent years, it had begun to seem as if the United States were joining the rest of the world in championing the wonders of mother's milk.

Following the lead of World Health Organization, the U.S. Department of Health and Human Services now endorses exclusive breastfeeding for six months, a time period widely recognized as necessary for long-term disease resistance for both mothers and babies.

The U.S. Surgeon General launched a campaign in January 2011 to reduce the obstacles to breastfeeding.

First Lady Michelle Obama has added breastfeeding to her "Let's Move" project to fight childhood obesity.

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The Internal Revenue Service is on board too, ruling in February that breast pumps and other nursing supplies could qualify for tax breaks.

And the health reform law required many employers to provide nursing women on their payrolls with lactation breaks starting in January 2011.

However, the federal program with arguably the greatest practical influence over the nation's infant-feeding practices--the Special Supplemental Nutrition Program for Women, Infants and Children, better known as WIC--continues to distribute more than half the infant formula sold in the U.S. each year. That formula, which is provided to WIC at a discount, cost taxpayers an estimated $627 million in 2008, the most recent figure available (equivalent to a $2 billion value on the retail market).

And the habits and brand loyalty formed by the WIC rebate system can hook women on paying retail prices for formula once their stipend runs out each month.

WIC, which provides extra nutrition to low-income pregnant women and infants who may not be able to afford the food they need, enrolls women and children who live at or below 185 percent of the federal poverty level, or below $27,214 per year for a single mother and her child.

WIC helps feed 2.14 million women and 2.17 million infants a year; roughly half of all U.S. infants.

On the one hand, WIC was the first U.S. agency to join the global consensus on breastfeeding in 1997--far ahead of the Health Department or any White House programs. That year, it joined the American Academy of Pediatrics in formally recommending six months' exclusive nursing. In 2004, WIC also began hiring breastfeeding peer counselors and in 2009, it began distributing more food to enrollees who breastfeed than those who do not.

On the other hand, WIC, which provides formula to low-income mothers who need it for health reasons or who choose not to breastfeed their babies, continues to funnel what critics say is too much money to infant-formula makers, propping up products its own counselors call second-best.

This contradiction is partly due to an extremely effective press blitz by formula companies, which have met official U.S. breastfeeding promotion with a barrage of ads and in-hospital promotions that health advocates have been unable, politically, to do much about.

Touting new chemical ingredients in their products, formula makers target many of the neighborhoods that WIC serves--low income communities of color--with ads claiming that their new, enhanced formulas offer the nutritional equivalent of mother's milk. Manufacturers also offer mothers free hospital discharge packs, free product shipments to their doorsteps, and discount shopping coupons.

"Formulas containing [common additives] DHA and ARA have been shown to provide visual and mental development similar to that of the breastfed infant," assert promotional materials from the International Formula Council, an industry trade group in Washington, D.C. The group describes these ingredients as backed by "years of research studying the clinical effects…in infants."

Most of that promising research, the council neglects to point out, was industry funded.

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This article gives an overall summary of the situation in the US. However - the WIC of 10 or 15 years ago is not the WIC of today. Half of all infants born in the US are covered by WIC. Several years ago there was almost no budget for breastfeeding promotion, then they received $10 million dollars, which is nothing in this kind of universe. Then changes really happened and little by little they are reducing the amount of formula given out in the early months of infants lives. They need to be lauded for this. WIC people are aware of the WHO CODE and the work of lactation advocates. Women in the US would probably breastfeed if they had paid maternity leave. The US is one of the few developed countries in the world that does not give any. Women need to be supported when they go back to work with time to extract their breastmilk or feed their babies. Society as a whole has failed mothers. WIC is doing its best and improves all of the time.

Interesting article. It is sad that WIC gets put down for giving out formula, however our first priority is to feed the baby. If we didn't provide formula, mothers would be using very unsafe methods of feeding their babies, including cows milk or other types of artificial feeding. I feel bad that the article doesn't mention anything about how much WIC tries to encourage mothers to breastfeed, including the new peer program. We cannot force mothers to choose breastfeeding and for WIC to be attacked for giving out free formula is not fair, when we try our best to get mothers to breastfeed.

I work for WIC and although I don't agree with the amount of formula the program allows parents it also does promote nutrition education for the whole family and also strongly supports and encourages breastfeeding. If these families aren't getting formula through WIC they will use their food stamps or even give their children substandard foods. In order to get more women to breastfeed we need to have an environment that will encourage and support them to breastfeed. We need to put pressure on the formula companies to follow the International Cose of Marketing of Breastmilk Substitutes that was eventually signed by the United States. All formula companies are in direct violation of the code but there is no penalty for them. The Code states:
1. NO advertising of breast milk substitutes directly to the public.
2. NO free samples to mothers.
3. NO promotion of products in health care facilities.
4. NO company "mothercraft" nurses to advise mothers.
5. NO gifts or personal samples to health workers.
6. NO words or pictures idealizing artificial feeding, including pictures of infants on the products.
7. Information to health workers should be scientific and factual.
8. All information on artificial feeding, including the labels, should explain the benefits of breastfeeding, and the costs and hazards associated with artificial feeding.
Unsuitable products, such as condensed milk, should not be promoted for babies.
9. All products should be of a high quality and take into account the climatic and storage conditions of the country where they are used.

Once these things start to happen we may see a shift in the number of women who choose to breastfeed and breastfeed longer.

Since human milk is clearly superior for all babies (barring extremely rare metabolic problems), it is best to encourage breastfeeding as much as possible. However, formula is needed when a baby does not get human milk. I think the companies who sell to the WIC program should be required to have labels which do not indicate which brand they are. Providing formula is not necessarily evil, but giving free advertising to the manufacturer is not necessary and does undermine breastfeeding.

This article is so annoying in its omission of class analysis. First, the new health reform legislation only began in January of this year and only gives UNPAID lactation breaks to employees of SOME companies with 60 or more employees. Who knows whether/how that legislation will be enforced. (Talk to some factory workers lately about OSHA legislation long on the books?) Breastfeeding is hard work for those of us with one job outside the home and a partner to help make it work. I can't imagine breastfeeding while raising more than one kid, working 3+ jobs in places that throw up resistance, sucking up UNPAID breaks to pump. It's shameful to shame women for choosing formula when they often do so because it will make them insane to try to breastfeed under impossible circumstances, or because it will make their families that much poorer, for not doing so. We need structural, systemic change that reaches far beyond UNPAID mandatory breaks for SOME employers.

100% agree with this. While WIC should do their best to educate women about breastfeeding and their options with it (our WIC office certainly did), it also needs to be acknowledged that families on the WIC program are clearly suffering some sort of hardship. There are so many more pressing issues to a low-income family than breastfeeding. I got lucky in that when I worked two jobs, I had bosses that were mothers and supported me pumping at work, and that I managed not to lose that milk when pumping at two jobs proved too stressful to be worth it.

All mothers don't have that kind of support or resources, which is a shame. Lambasting WIC for providing formula to families that desperately need it seems a bit narrow, and doesn't acknowledge the larger issues at hand.