The Politics of Breastfeeding to my family Gabrielle Palmer is a nutritionist and a campaigner She was a breastfeeding counsellor in the 1970s and helped establish the UK pressure group Baby Milk Action In the early 1980s she worked as a volunteer in Mozambique She has written, taught and campaigned on infant feeding issues, particularly the unethical marketing of baby foods In the 1990s she co-directed the International Breastfeeding: Practice and Policy Course at The Institute of Child Health in London until she went to live in China for two years She has worked independently for various health and development agencies, including serving as HIV and Infant Feeding Officer for UNICEF New York She recently worked at The London Schoo of Hygiene and Tropical Medicine where she had originally studied nutrition She is a mother and a grandmother The Politics of Breastfeeding WHEN BREASTS ARE BAD FOR BUSINESS GABRIELLE PALMER PINTER & MARTIN The Politics of Breastfeeding When breasts are bad for business First published by Pandora Press 1988 This third updated and revised edition first published by Pinter & Martin Ltd 2009, reprinted 2009, 2011 This ebook edition first published 2011 All rights reserved © 2009 Gabrielle Palmer Gabrielle Palmer has asserted her moral right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act of 1988 ISBN 978-1-905177-74-5 British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library This ebook is sold subject to the condition that it shall not, by way of trade and otherwise, be copied, reproduced, transferred, distributed, leased, lent, resold, hired out, or otherwise circulated without the publisher’s prior consent Any unauthorised distribution or use of this text may be direct infringement of the author’s and publisher’s rights Pinter & Martin Ltd Effra Parade London SW2 1PS www.pinterandmartin.com contents preface to the third edition why breastfeeding is political the right to call ourselves mammals: the importance of biology how breastfeeding works – and how it was damaged beauty, books and breasts a taste of infant feeding it’s not just the milk that counts your generous donations could more harm than good hiv and breastfeeding life, death and birth 10 population, fertility and sex 11 from the stone age to steam engines: a gallop through history 12 other women’s babies: wet nursing 13 the industrial revolution in britain: the era of progress? 14 markets are not created by god 15 the lure of the global market 16 what is the code? 17 power struggles 18 dying for the code 19 documents and declarations 20 work, economics and the value of mothering 21 ecology, waste and greed epilogue acknowledgments abbreviations and frequently used terms appendix 1: the global strategy summary appendix 2: the innocenti declaration 2005 appendix 3: the ten steps appendix 4: section from the convention on the rights of the child appendix 5: millennium development goals appendix 6: mishaps, recalls and contaminants appendix 7: infant feeding definitions appendix 8: cedaw useful addresses references and notes index illustrations 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 Hanging upside down in caves cartoon Exploiting ignorance: Cow & Gate leaflet 2006 Woman bottle-feeding in Costa Rican maternity ward Notice forbidding mothers contact with their newborns Mother and baby in KMC Unit Nurses bottle-feeding newborns in Singapore ward Woman sleeping with her newborn in hospital bed ‘Mum – just let Dad give me a bottle’ cartoon Paternal bliss: Stephen Clark with his son Lewis Baby being fostered after Mynamar cyclone Collecting water, Niger Cooking the family meal, Ethiopia A river may serve as an open sewer, Sierra Leone Egyptian woman breastfeeding her baby in the street Our terror of babies cartoon Why you can’t be a mother and PM cartoon Oversized aristocratic family, including deceased infants Mummified infant from Xinjiang Region, China Advertisement for Borden’s Condensed Milk Glaxo advertisement 1917 Highly complicated formula used in infant feeding Advertisement for Nestlé’s Food, 1912 La Maternité, Nestlé advertisement, 1935 Baby in fancy dress at 1945 Victory party Empire Marketing Board Poster Cow & Gate advertisement published in 1940s/50s UK Nestlé milk nurses in South Africa, 1950s Graphic of baby in bottle for The Baby Killer, 1974 Bear Brand Coffee Creamer label, 2008 Milupa advertisement promoting follow-on milk Philippines product labels with misleading claims Brazilian parents with triplets Millennium dollar coin Ethiopian mother and her baby Mongolian mother suckling her premature twins Mother and baby breastfeed their own way preface to the third edition I wish I were not writing this preface There should be no need for this book In a world beset by overwhelming problems, here is a resolvable issue Twenty years ago when I was writing the first edition, more than three thousand babies were dying every day from infections triggered by lack of breastfeeding and by the use of bottles, artificial milks and other risky products This is still happening In the first and second editions I described the pressures on women, on health workers and on governments I wrote about the culture of artificial feeding and the collusion between the baby food companies and the medical, nutritional and healthcare establishments They have all promoted products and practices which have contributed to the suffering, illness and death of millions of babies and often their mothers too This is still happening This third edition is necessary because some things have changed Scientific research has revealed more amazing facts about breastfeeding It is now known that even in a rich country, a millionaire’s baby who is artificially fed is less healthy than the exclusively breastfed baby of the most disadvantaged mother Long term health problems such as high blood pressure and diabetes are influenced by how babies are fed, and breastfeeding women reduce their own risk of breast cancer Better understanding of women’s bodies shows how adaptable they are and what a resilient process breastfeeding is when it is not sabotaged from the start Knowledge serves no purpose if it is not spread around As the poor get poorer and the rich get richer, an entrenched ignorance is kept in place through a culture created and maintained by commercial interests This new edition shows how the baby food and bottle companies use ever more aggressive promotion Challenged by the new evidence, they work harder and pour more resources into more sophisticated marketing strategies; they manipulate the media, influence governments’ policies and infiltrate the very agencies that are supposed to protect health Those who work to combat these influences have become more skilled, but progress is undermined by widespread misinformation and lack of awareness I am so impressed by the talents of groups who struggle for human welfare: the women who support each other, the campaigners and those health workers who strive to cure their colleagues of the nonsense they learn from outdated training and text books and misleading promotional information This book is not written for mothers, but for everyone; man or woman, parent or childless, old or young, because this issue concerns us all I have added some facts and updated others, but the main theme remains unchanged I hope that this will be my last preface and that this book will become merely the record of a tragically foolish phase in human history why breastfeeding is political “From politics it was an easy step to silence.” Jane Austen, Northanger Abbey, 1818 If a multinational company developed a product that was a nutritionally balanced and delicious food, a wonder drug that both prevented and treated disease, cost almost nothing to produce and could be delivered in quantities controlled by consumers’ needs, the announcement of this find would send its shares rocketing to the top of the stock market The scientists who developed the product would win prizes and the wealth and influence of everyone involved would increase dramatically Women have been producing such a miraculous substance, breastmilk, since the beginning of human existence, yet they form the least wealthy and the least powerful half of humanity As subjects of research, breastfeeding and breastmilk have attracted much attention during recent decades, yet as academic careers thrive on discoveries1 of how breastfeeding works and what breastmilk contains, women and their babies are still prevented from fulfilling this unique relationship As knowledge about breastfeeding increases, so global sales of artificial milks and feeding bottles This may surprise those who live where breastfeeding is still part of the culture or where well-educated women have access to support, information and their babies There are policy documents, promotional initiatives and media attention in many countries However, all over the world women are impeded from protecting their own and their babies’ health, and often survival, because of factors beyond their control Why, after about a million years of survival, has one of the principal evolutionary characteristics by which we identify ourselves as mammals become so damaged? Have women been freed from a time-wasting biological tyranny to lead nobler, more fulfilling and more equal lives? In this book I examine the political reasons for a situation which has a profound effect on the whole world from the major economic effects of squandering a natural resource to the individual misery of a sick child or an unhappy woman Why is it that whether we were breastfed ourselves, or breastfeed our own children, depends on our social and economic position? How is it that in many societies, 100% of poor, undernourished women all breastfeed easily, while in others, groups of privileged, well-nourished women believe they cannot? Why is the right to breastfeed fought for so vehemently by some women and rejected so forcefully by others, often according to their class, education or society? And why, if women participate in the modern economic structures which are claimed to be for the benefit of us all, must the breastfeeding relationship be curtailed and restricted? For many women, what could be a simple compromise becomes an agonising decision power and sex ‘Politics’ does not only refer to economic and territorial power structures, it also means sexual politics The fact of women’s separate biological capacities has been used as a pretext for excluding drugs used in labour 124 lactation suppressants 138 dummies 81 duration of breastfeeding 100, 235, 237, 273 rates 35, 311–12, 316 WHO/ UNICEF guidelines 10 Earle, Charles Warrington 217 ecology 345–60 economics of artificial milk see baby food industry of breastfeeding 4, 319–44 of breastmilk 328–44 capitalism 25, 170, 254–6, 354, 359 economic value of mothering 319–44 free-market economics 258, 280–3, 284, 305, 349, 351–2, 360 profit motive 4, 5–6, 35, 69, 73 redistribution of income 351–3 ‘religion of’ 358 Elia, Irene 11 emergency situations 91–7 see also aid work employment see working mothers Endicott, Karen 156 energy requirements for breastfeeding 52–3 Enterobacter sakazakii 70, 71 entitlement to food 340 environmental issue, breastfeeding as 345–60 environmental pollution 74–9 enzymes in breastmilk 49–51 episiotomy 123 erotic, breasts as 2–3, 33–4, 146–8 EU Blueprint for Action 288 EU Commission Directive on Infant Formulae and Follow-on Milks (European Directive) 285–8 European Food Safety Authority (EFSA) 69 Europe’s implementation of the Code 285–8 exclusive breastfeeding benefits of 10, 23, 30, 36, 47–8 and HIV 99–101, 108–10 rates 311–12 WHO/ UNICEF guidelines 10 expressing milk generally 31, 43, 80, 86–9, 163, 355 see also milk banking breast pumps 19, 31, 86–9 contraceptive effect of breastfeeding 136 hand expression 87, 88–9 for premature babies 58 eye-contact 85 failed milk supply/ lactation failure 16–17, 21–2, 26, 37–8, 55–6, 139–40 Fall River study 213 family size 129, 130, 336–7 see also birth spacing; contraception Farb, P 161 fashion (clothing), undermining breastfeeding 180–1 fashion (nutritional), affecting artificial milk composition 67–9, 248 fat storage 13 fathers as birth companions 125 and childcare 86, 87i, 89i, 342–4 paternity rights 338–9 fatty acids, imitation of 68 feedback inhibitor of lactation (FIL) 29, 30 feeding regimes (e.g 4-hourly) 22, 24–5, 26, 39–40, 228 female fraility, cult of 215–16 feminism 320–1 fertility and breastfeeding 131–4 see also birth spacing; contraceptive effect of breastfeeding lactational fertility control (mechanisms) 136–9 state fertility control 167–9 viewed as burden 154, 157–8 Figueira, Prof Fernando 313, 316 Fildes, Valerie 175–6, 178 Firestone, Shulamith 321, 353 Fisher, Chloe 32, 96 fluids, female 40–2 fluoride 70 follow-on milks (FOMs) 273, 274i, 293 Food and Agriculture Organisation of the United Nations (FAO) 71 Food and Drug Administration (FDA) 68, 88, 247–8 food code see Codex food miles 347 foot-binding, parallel with ‘fore’ and ‘hind’ milk 39–40 ‘formula’ use of the term 212, 217 see artificial milk Formula for Disaster (UNICEF) 290 formula industry see baby food industry Forsyth, Prof J S 46 fortified foods 50, 51, 58, 65, 353 foundling hospitals 185 France 168, 189, 336 free samples 263–5, 293, 296 free supplies of artificial milk 104, 305–6, 323 free-market economics 258, 280–3, 284, 305, 349, 351–2, 360 fuel supplies 116, 117 fungus 68 Galbraith, JK 238 Gambia 139–40 gastrointestinal disease 73 see also diarrhoea gatherer-hunters 154–60 gender relations, physiology of 12–14 General Agreement on Tariffs and Trade (GATT) 277 ‘Generally recognised as safe’ (GRAS) status for ingredients 68–9 generic infant formula 104 GenPharm 73 Gerber 277–8 Gerhardt, Sue 80–1, 342 Germany 178 Ghana 37 gifts to health workers 267–9, 290, 293–4 Glaxo 211 Global Alliance for Improved Nutrition (GAIN) 65–6 Global Compact 279–80 global markets 238–59 Global Strategy for Infant and Young Child Feeding (WHO/ UNICEF) 310, 324, 367 ‘good’ babies 26 Goodall, Jane 84 governments and global companies 279–88 graphics used to promote artificial milk 269–71 Greenwood, Mrs 197 growth, economic, pursuit of 357–60 growth charts 55 Guatemala 36, 37, 277–8, 332–3 guilt 85, 148 Guinea-Bissau 91 Hadza 158–9 Haiti 107, 118 Hampton, Christopher 127 hand expression 87, 88–9 Hanson, Lars 54–5, 184 Hartmann, Peter 64 health agencies developing the Code 256–7 implementation of the Code 276–7 see also specific agencies health centres links with baby food industry 240 and milk depots 208 restrictions of the Code 266 see also health workers health cost savings of breastfeeding 328–9 ‘health warnings’ 272–3 health workers aid agency workers 92–3 books and information for 43–4 free samples 264–6 lack of understanding about breastfeeding 5–6, 8–9, 38 salespeople dressed as/ ‘milk nurses’ 238, 246, 267 as targets of promotion from baby food industry 267–9, 271–2 training for health workers 37–8 heavy metals 74, 78 Hendrikse, Dr Ralph 242 Hertz, Noreena 351 Hilpern, Kate 337 ‘hind’ and ‘fore’ milk 39–40 HIV and breastfeeding 8–9, 30, 41, 55, 92, 98–112 Hochschild, Arlie Russell 354 Horlicks 220, 221 hormones adrenaline 32 oestrogen 70 oxytocin 31–2, 83, 143, 265 prolactin 29, 137, 139, 143 Hosken, Fran 320 hospitals 37 attitudes to breastfeeding 34, 35 see also Baby Friendly Hospital Initiative (BFHI) hospital childbirth 213–14 practices which damage breastfeeding 37, 122–6 household budgets and artificial milk 118, 252 housework and childcare 340–1 human milk fortifiers 353 Hunter, Dr William 187 Hunter, M 289 hunter-gatherers see gatherer-hunters Hutterites 138 hydrolysed cow’s milk formula 70 ‘hygiene’ practices which undermine breastfeeding separation of mother and baby 41, 83, 90, 214 washing babies 20 washing nipples 27 illegitimate births and abandoned babies 185 imagery of breastfeeding 31 immunology 48, 54 incubators 57 India 117, 119, 130, 178 Indonesia 117, 319 industrialisation 191–211 infant feeding companies see baby food industry infant formula see artificial milk Infant Formula Action Coalition (INFACT) 246, 256 infant mortality and artificial feeding 223, 249–50 and breastfeeding 30, 73, 91–7, 106, 107 Fall River study 213 industrialisation 195 Pakistan 292 in the rich world 113–14 USA 222–3 informed choice 7–9 Ingham, Lindy 328, 334–5 initiation rates 35, 307, 312 Innocenti Declaration 35, 309, 311, 368–72 insufficient milk problem 16–17, 21–2, 26, 37–8, 55–6, 139–40 insulin analogy International Association of Infant Feeding Manufacturers (IFM) 276 see also International Council for Infant Food Industries (ICIFI) International Baby Food Action Network (IBFAN) 257, 280, 289 International Council for Infant Food Industries (ICIFI) 245, 257, 276 International Dairy Federation 72 international health agencies developing the Code 256–7 implementation of the Code 276–7 see also specific agencies International Labour Organisation (ILO) 168–9, 199, 310 IQ and breastfeeding 329 iron 51, 64–5, 157 Japan 90, 135 Jelliffe, Dr Derrick and Patrice 38, 159, 240, 243, 275, 319 Jones, Steve 21 kangaroo mother babycare (KMC) 59–63, 353 Keneba 139–40 Kennedy, Edward 253, 254 Kenya 104, 108, 118 Koplick, Dr 41–2 Kosovo 96 k-strategy of biological development 12, 52 !Kung 138, 155, 156–7 kwashiorkor 233–4 La Leche League 321–2 labelling of baby foods complementary feeding 64 condensed milk 230 labelled and non-labelled ingredients 72, 77 and literacy levels 118–19 local language labelling 95, 96, 104, 269–70 restrictions of the Code 269–71 sell-by dates 275 lactase 17 lactation suppressants 138 lactose 70 lactose intolerance 69 Lamy, Pascal 287 Landes, David 339 Lang, Sandra 88 Lang, Tim 347 latch 28–9, 42 Latham, Prof Michael 40 Laverty, Moira 189 Layard, Richard 339 laying-in period 37, 204 Leach, Penelope 342 lead pollution 78 Lebanon 92 Lee, Laurie 211 let-down reflex 31–2 Lewis, Jane 196 libido and breastfeeding 149–53 Livingstone, Carole 80 Llewellyn Davies, Margaret 202–4 local language labelling 95, 96, 104, 269–70 long-chain polyunsaturated fatty acids (LCPAs) 68 long-term health effects of lack of breastfeeding 226 love and brain development 80–1 hormone of love (oxytocin) 31–2, 83, 143, 265 low birthweight babies 57–63, 88 Macedonia 95–6 Makil, Lorna 250 Malan, Prof 63 Malawi 121, 122, 269–70 Malaysia 227–9, 231 male attitudes to breastfeeding 86, 146–8, 149 male dominated medical profession 4, 24 male lactation 21, 86 male-female relations 12–14 malnutrition 53, 65–6, 233–7, 276 maltodextrin 67 manganese 70 marketing breastmilk substitutes advertising of artificial milks see separate heading ‘advertising’ ‘closest to human milk’ claim 67, 69, 72–3 creating market conditions 212–38 direct marketing to mothers 267, 299 in disaster situations 94–5 ‘ethical’ marketing of commercial infant foods 218–19 promotional material see separate heading ‘promotional material’ relationship between companies and medical profession 8, 212–23, 240, 276, 317–18 subtle tactics Marshall, Kirstie 15 Martek 68–9 Martinez, Dr Hector 59 Masefield, John 113 Maseko, Janipher 325–6 mastitis 29 maternal mortality death related to child-bearing 120–2 industrialisation 194–5 Maternity Protection Convention 199 maternity rights/ breastfeeding breaks 199, 310, 312–13, 323–4, 338–9, 343, 349 Maypole, Jack 16 McGrath, Marie 91 McKenna, Prof Jim 136, 142 McNaught, Margaret 138 McNeilly, Alan 137 Mead, Margaret 155 Mead Johnson 218–19, 221, 292–3, 305 medical profession male-dominated 4, 5–6, relationship with commercial companies 212–23, 240, 276, 317–18 Meguid, Dr Tariq 122 Meiji 293 melamine in milk scandal 17, 47, 73–4, 223, 251, 273–4 menarche (first period) 131–2, 156 mental health, and artificial feeding 224 mercury pollution 78 Mexico 296 microbes and pathogens in powdered artificial milk 70–1, 107, 116 in pumps and bottles 88 midwifery 121, 214, 321 milk banking 56, 112, 315–16, 329–30 milk depots 207–8 milk fever 187 ‘milk nurses’ 238, 239i, 246, 267 milk siblings 184 milk supply issues 16–17, 21–2, 26, 37–8, 55–6, 139–40 Millennium Development Goals 310–11, 375–6 missionaries 203 mixed feeding see supplementary feeding Moberg, Kerstin 32 Monbiot, George 269 Montague, Ashley 83 Morley, Dr David 144, 242 Morocco 36–7 motherhood, attitudes to 12, 14, 200–3, 319–44 mother-to-mother support 316, 321–2 Mozambique 41, 146, 155, 346 Murad, Dr Ferid 73 Nepal 142 Nestlé Bear Brand Coffee Creamer 270 boycott 246–7, 253–4, 285, 296–7 in Brazil 313–14, 316 and the Code 257, 293–6, 297–301 condensed milk 206, 208, 216, 229–31 and the dairy industry 348 in Europe 286 and the Global Compact 280 history of 206, 218 and labelling 269–70 market share 66, 293, 300–1 ‘milk nurses’ 238, 239i, 246, 247 Nestlé trial 243–5 in Pakistan 293–5 promotion techniques 106, 220, 239–41, 268, 269, 289, 293–5, 317–18 Nestle, Marion 350 Nigeria 235 night-time feeding 163 see also co-sleeping nipple sucking 29, 81 nipples, sore 26–9 nitrates 77 non-birth related lactation 19 ‘novel oils’ (imitation fatty acids) 68–9 Nutricia 293, 347 nutrient bioavailability 49, 66 nutrition 49–53, 64–6, 76–7 see also malnutrition Oakley, Ann 321 obesity 26, 55, 66, 307–8 observation of others breastfeeding 35–6, 45, 47 Odent, Dr Michel 32, 61, 125 oestrogen 70 oils, ‘novel’ 68–9 over-dilution 104, 118 overfeeding 23–4, 25–6, 208 overpopulation 127–8 overseas aid see aid work oxytocin 31–2, 83, 143, 265 pacifiers 81 Page, Charles 206 pain and soreness 26–9 Pakistan 29, 292–5 Papua New Guinea 36, 45, 163–4, 276 parent-friendly employment practices 338–9 parenting books, coverage of breastfeeding 42–4 paternity leave 337–8 pathogens in powdered artificial milk 70–1, 107, 116 in pumps and bottles 88 payment for breastfeeding 331, 336, 351–3 Perera, Dr Chris 62 Persistent Organic Pollutants (POPs) 74–5 Phillipines 249–51, 252, 289–92, 299 phthalates 74, 78 physical contact, cultural ideas about 84–5 physical size and social dominance 13–14 phytic acid 70 phytoestrogens 70 plantation working 228 plastics 77–8 Poland 286 policy documents to promote breastfeeding 309–18 and appendices Pollock, Linda 172, 176 pollution 74–9 polygynous societies 146, 203 poor countries education and literacy 118–19 establishing markets for artificial milk 231–2 fuel in 116, 117 healthcare services 119 midwifery 121 public health 9–10 risks of artificial feeding 114–20 sanitation 116–17 water supplies 114–16 see also specific countries, aid work and poverty population, issues of 127–31 Porter, Roy 195 positioning 30 see also attachment to the breast potatoes 67 poverty 7, 9–10, 101, 114–20, 351–3 powdered infant formula (PIF) see artificial milk pregnancy, breastfeeding in 145 pre-industrial societies 169–72 premature babies 57–63, 78 preparation of artificial milk 71, 105, 116, 225, 267 primates (e.g chimpanzees) 31, 64, 67, 83, 84 profit motive 4, 5–6, 35, 69, 73 prolactin 29, 137, 139, 143 promotion of breastfeeding 76, 313–16 promotional material for artificial milks advertising see separate heading ‘advertising’ free samples 263–5, 293, 296 free supplies of artificial milk 104, 305–6, 323 gifts to health workers 267–9, 290, 293–4 information provided to health workers 271–2 information provided to parents 272 protein 233–4, 304 Protein Advisory Group 241, 245 public breastfeeding 34, 147–8, 352, 355–6 pumps for expressing 19, 31, 86–9 quality control of artificial milk 70–4, 247–9, 273–5, 303–5, 357 radio advertising of artificial milk 238–9 radioactive contamination 78–9 randomised clinical trials 107–8 Ready to Use Therapeutic Foods (RUTF) 66 Reagan, President Ronald 258 redistribution of income 351–3 reflexes, baby’s 20 refrigeration 17, 116, 208–9 refugees 91–7 see also aid work Janipher’s story 325–6 Reid, Dr George 196–7, 198–9 relactation 38, 39 reproductive health, and feeding method in infancy 132 research funding 6, 317–18 Rey, Dr Edgar 59 risks of artificial feeding 6, 30, 46–9, 85–6, 106, 113–20, 272–3 of not breastfeeding 106, 226 of pumping 88 robustness of lactation 52–3 Rollins, Dr Nigel 98 Romania 167, 286 Rotch, Dr Thomas Morgan 215–16, 218 routine-based feeding 22, 24–5, 26, 39–40, 228 Roy, Arundhati 345 Royal College of Midwives, UK 271–2 Rumball, Sylvia 356 Rwanda 105 Sacagawea 361–2 Salmonella 71 sanitation 116–17, 196 Sanlu see melamine in milk scandal Saunders, Sue 268 Scandinavia 2, 4, 35, 86–7, 123, 164, 178–80, 194–5, 298, 322, 336, 338 ‘scientific age’, artificial feeding as part of 212–17, 353–4 self-regulation of the baby food industry 259, 275 Semmelwies, Ignaz 194, 195 Sen, Prof Amartya 340 separation of mother and baby 41, 83, 90, 214 sex and breastfeeding 144–6, 149–53, 176, 184 sexual abstinence 144–6, 175, 203 sexual objects, breasts as 33–4, 146–8 sexual politics 2–3, 33–4 sexual taboos 84, 144–6 shared suckling 173–6 see also wet nursing shareholder pressure 245–6 Sheean, Dr Tracie 70 shelf-life issues with artificial milk 72, 275 Silveira, Dr Mirian 314 Simpson, Mayling 250 Singapore 168 skin-to-skin 20–1, 59, 83 see also kangaroo mother babycare (KMC) slavery 164–7, 189, 326–7 sleeping through the night 142 SMA (Synthetic Milk Adapted) 219–21 Smith, Julie 328, 334–5 social attitudes to breastfeeding 33–4, 140–4 socialism 322–3 solids, introducing 63–6, 159, 311 soreness 26–9 South Africa 62–3, 88, 98, 99, 104, 108, 109, 174, 298 soya beans 69–70, 78 soya-based infant formula (SIF) 69 spells and curses 32 spillover 105–7 Sri Lanka 62, 96–7 standards for artificial milk 68–9, 70–4, 247–9 Steingraber, Sandra 132 stem cells, cord blood for 65 sterility (non) of powdered formula 71 stress 32, 92 sucking, babies’ need for 81 suckling 19, 22, 28, 33–4, 136–7 Sudden Infant Death Syndrome (SIDS) 48, 85, 135 suffocation whilst feeding 42 supplemental nursing systems 19, 60 supplementary feeding 22, 23, 25–6, 30, 47–8, 56, 108–9, 136 support for breastfeeding 36–7, 96, 111, 179–80, 205, 222, 316, 321–2 support in childbirth 124 swaddling 20, 23 Syntex story 67, 247–9 syphilis 177–8 Tanner, JM 131 technology, artificial feeding as 216, 353–4 Ten Steps 373 see also Baby Friendly Hospital Initiative (BFHI) testing of artificial milk 218, 247, 249, 273–5 Thailand 31, 79, 102 Thatcher, Margaret 258 Thomas, Mark 270 Thompson, Flora 198 Tomkins, Prof Andrew 95 tongue-tie 28 top-up feeds see supplementary feeding touch, value of 80 see also skin-to-skin Toynbee, Polly 319, 349 traditional birth attendants (TBAs) 121 traditional societies 35–9, 45, 154–60 training for health workers 37–8 Truby King, Dr Frederick 24, 85, 143–4 Truswell, AS 156 Truth, Sojourner 154 Uganda 38, 119 Ullman, Liv 289 umbilical cord clamping 65 UNICEF 35, 104, 256–7 dried skimmed milk 234–5 see also Baby Friendly Hospital Initiative (BFHI) unpaid work, inclusion in economic calculations 332–6 urbanisation 193–4, 212 USA artifical milk market 212–24, 231–7, 305–8 and attitudes to big corporations 254–6 attitudes to breastfeeding 322 ‘Ben and Bradley’ case study 247–9 and the Code 258–9, 266, 279, 284, 288, 296 infant mortality 48, 169 maternity rights 252, 349 restrictive practices against breastfeeding 252 welfare 173, 305–7 wet nursing 188 Usino women 163–4 Vallaeys, Charlotte 68 van Estersick, Penny 144 van Rooyen, Dr Elise 63 vegan parents 69 vegetable oils 68 Veil, Simone 322 Vitamin A 52, 108, 236 Vitamin B1 52 Vitamin B6 248 Vitamin D 50, 157 Vitamin K 51 vitamins and shelf-life 72 von Liebig, Justus 67, 72, 205 Walker, Marsha 304, 306, 329 Waring, Marilyn 331–2 water supplies 114–16 Waterford, Judith 186 ‘weaning’ use of the term 63 see also complementary feeding Weaver, Gillian 56 weight gain 55–6 see also low birthweight babies Wennen, Dr Catherine 240 West Darfur 92 Western influences on traditional societies 35–9 wet nursing 23, 38, 92, 173–6, 182–91, 215 WHO (World Health Organisation) breastfeeding guidelines 10 and Code implementation 280–1 Consensus Statement on prevention of HIV transmission 111–12 developing the Code 256–7 Global Co-ordinated Survey of POPs in human milk 75–6 growth standards 55 guidelines for preparation of infant formula 71 and HIV 101 policy on complementary feeding (solids) 64 WHO Code see Code of Marketing of Breastmilk Substitutes WIC (US Special Supplemental Nutrition Program for Women, Infants and Children) 305–7 Widström, Ann-Marie 19 Williams, Dr Cicely 53, 181, 222, 229–30, 233, 238 Wilson, Bee 303 Woodburn, James and Lisa 159 work and motherhood, separation of 200–3 work-home balancing 323–5 working mothers 163–4, 196–7, 323–7, 354–6 workplace, breastfeeding in 2, 80, 147–8, 159, 168, 198–200, 252, 306 World Alliance for Breastfeeding Action (WABA) 310 World Bank 328 Wretholm, Dr Carl 179 Wyeth 248, 292–3, 296, 347 zinc 64 Zulu traditions 40 other breastfeeding and nutrition titles from Pinter & Martin available as ebooks Complementary Feeding: Nutrition, Culture and Politics Gabrielle Palmer (published May 2011) The International Code of Marketing Breast-Milk Substitutes Sami Shubber Ina May’s Guide to Breastfeeding Ina May Gaskin The Womanly Art of Breastfeeding La Leche League International Saggy Boobs and Other Breatsfeeding Myths Val Finigan and Lou Gardiener visit www.pinterandmartin.com for further information ... grandmother The Politics of Breastfeeding WHEN BREASTS ARE BAD FOR BUSINESS GABRIELLE PALMER PINTER & MARTIN The Politics of Breastfeeding When breasts are bad for business First published by... emphasise the risks of not breastfeeding This coyness seems not only due to a desire to spare the feelings of parents, but also the delicate emotions of the artificial milk companies When the US Office... revealed the risks of not breastfeeding, there is no excuse for the medical and commercial promoters of substitute milks to continue their practices, but many are so caught up in the whirlwind of career