American Medical Organizations Denounce US Breastfeeding Stance

July 12, 2018

Leading medical organizations have this week criticized the stance taken by the US government at a United Nations (UN) health assembly earlier this year, whereby it tried to defeat a resolution calling on all world governments to "protect, promote, and support breastfeeding" and to limit misleading marketing of formula milk.

The story first emerged in the New York Times and was based on numerous interviews with many of those attending the assembly who alleged that the United States objected to the resolution encouraging breastfeeding and had attempted to intimidate other countries into dropping it too. The United States also threatened to cut its funding to the World Health Organization (WHO), the report claims; currently it is the largest single donor providing 15% of contributions.

The UN resolution was eventually passed, with US support, but only after the Russian government reintroduced it using a modified text.

The United States did, however, successfully eliminate language calling for WHO support to nations trying to prevent "inappropriate promotion of foods for infants and young children," and added the phrase "evidence based" to certain provisions.

President Trump immediately hit back at the New York Times report in his own inimitable way.

"The failing NY Times Fake News story today about breast feeding must be called out. The US strongly supports breast-feeding but we don't believe women should be denied access to formula. Many women need this option because of malnutrition and poverty," he tweeted on Monday evening.

Experts say the president lacks knowledge about the history of the marketing of baby formula to women in developing countries and the benefits of breastfeeding.

"Malnutrition and poverty are the precise settings where you absolutely need to breastfeed," tweeted Michele Barry, MD, director of the Center for Innovation in Global Health, Stanford School of Medicine, California.

"Access to safe and clean water for reconstituting powdered formula is often impossible to find" in such settings, Barry told the New York Times in a follow-up story published Tuesday.

Barry also said that poorer women in wealthier countries may dilute expensive formula milk to make it last longer, potentially leading to nutritional deficits in the child.  

Medical Organizations Hit Back

After the initial report in the New York Times on Monday, the American College of Obstetricians and Gynecologists (ACOG), American Academy of Pediatrics (AAP), and a number of other medical organizations reiterated their support for breastfeeding in posts on social media.

The American Public Health Association (APHA) tweeted: "US opposition to UN breastfeeding resolution defies evidence and public health practice."

ACOG tweeted that it "supports efforts to educate patients on the benefits and mechanics of #breastfeeding, and encourages healthcare providers, nursing staff, and government assistance agencies to remain strong advocates for breastfeeding."

It then linked to its own clinical guidance on the issue of breastfeeding in underserved women.

"The American Academy of Pediatrics believes that breastfeeding is the optimal source of nutrition through the first year of life," the society tweeted and linked to its own advisory detailing how breastfeeding benefits a baby's immune system.

Meanwhile the American Academy of Family Physicians (AAFP) said in its tweet: "The AAFP recommends that all babies, with rare exceptions, be breastfed and/or receive expressed human milk exclusively for the first 6 months of life."

ACOG and AAP Presidents Join Forces

In addition, Colleen Kraft, MD, president of AAP, and Lisa Hollier, MD, president of ACOG, joined forces and wrote a letter to the editor of the New York Times, which appeared in print today.

"The discussions at the World Health Assembly reveal that mothers still lack the support they need to initiate and continue breastfeeding their infants," say Kraft and Hollier.

"Breastfeeding provides protection against newborn, infant, and child infections, allergies, asthma, inflammatory bowed disease, and sudden infant death syndrome. The benefits of breastfeeding extend into adulthood, with lower rates of obesity, cardiovascular disease risk factors, diabetes, and some types of cancer," they write.

"There are also health benefits for the mother, as it reduces the risk of breast cancer, ovarian cancer, diabetes, hypertension, and heart disease," they add.

They then speak to the issue of policies that can help support women to breastfeed.

"Helping mothers to breastfeed takes a multifaceted approach, including advancing public policies like paid family leave, access to quality child care, break time, and a location other than a bathroom for expressing milk."

And finally, they emphasize that "as physicians who care for women and children, we urge the US and every country to protect, promote, and support breastfeeding for the health of all women, children, and families."

Follow Lisa Nainggolan on Twitter: @lisanainggolan1. For more diabetes and endocrinology news, follow us on Twitter and on Facebook.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.