Formula for Profit: How Marketing Breastmilk Substitutes Undermines the Health of Babies

By Jennifer Coburn
Issue 101, July/August 2001

Because of the strident societal and economic impact wielded by the formula industry, bottle-feeding has today become the social norm in the US. Fewer than half of all US babies are exclusively breastfed during their first day or two in the hospital.1 By the time they are six months old, only 19 percent of US babies receive any breastmilk,2 and only 2 percent of one year olds. Contrast this with the average age of weaning worldwide, which is 4.2 years. This country's societal hostility towards breastfeeding is such that many states have had to pass laws protecting a mother's right to breastfeed her child anywhere that she is otherwise permitted to be.

The very need for such legislation is a sad commentary on the lack of appreciation for the broad range of health, social, and environmental benefits of breastfeeding. Nevertheless, the slogan "breast is best" is no exaggeration. Breastmilk contains 400 nutrients that cannot be recreated in a laboratory, and several studies suggest that breastfeeding reduces the risk of sudden infant death syndrome.3, 4, 5 An absence of breastfeeding has been linked to an increased risk of hospitalization,6 childhood cancer, 7, 8, 9 diarrheal diseases,10, 11, 12 lower respiratory illness,13 ear infections,14 bacterial infections,15 diabetes,16 infant botulism,17 Crohn's disease,18 ulcerative colitis,19 and even cavities.20 In Milk, Money and Madness: The Culture and Politics of Breastfeeding, Naomi Baumslag, MD, MPH, asserts that breastfed babies also have lower incidence of allergies, urinary tract infections, obesity, learning, behavioral and psychological problems, later-life heart disease, pneumonia, neonatal sepis, and giardia infection.21

Children are not the only ones who benefit from breastfeeding. Nursing mothers enjoy a reduced risk of premenopausal breast cancer,22 ovarian cancer,23 and osteoperosis.24 Breastfeeding is advantageous for people who are outside the mother-baby unit, when you consider healthier babies mean lower health insurance premiums for everyone, and lower absenteeism among working parents. The production of formula, bottles, plastic nipples, and formula cans, not to mention cleaning artificial feeding supplies--all create pollution and in some cases hazardous waste. Finally, breastmilk is also free and convenient, considerations that should give pause to families faced with an average yearly cost of $800 per baby if they choose to formula feed.

The economic implications of formula are certainly significant. The industry generates $5 to $6 billion in sales each year,25 and its executives reap huge profits--the CEO of Abbott Labs earns more than $4 million per year; his counterpart at Bristol-Myers Squibb (makers of Enfamil), nearly $13 million. Part of the reason the industry is so profitable is the fact that every dollar formula makers charge their retail distributions outlets costs them a mere 16 cents on production and delivery.26 Formula is, in short, big business--the result of a complex social marketing campaign that began half a century ago, one that has speciously managed to define artificial feeding as a convenient, liberating, and "modern" way of feeding one's infant.

Science Crushes Nature
" At the beginning of the 20th century, basically women breastfed, had a wet nurse or their babies died," says Mary Lofton, spokesperson for La Leche League International (LLLI). Insofar as artificial baby milk became available as a life-saving alternative to breastmilk, it was deemed a blessing. "The crucial social phenomenon," Lofton adds, "was the shift from home to hospital in childbirth.... Women were given anesthesia, babies were taken away, schedules were rigid, and all those interferences led to problems with breastfeeding."

Considering formula to be nutritionally equal to breastfeeding, doctors began recommending it to patients. Tangentially our society experienced a burgeoning captivation with science and technology, and became increasingly enamored with an efficiency-model of infant feeding and care. The advent of World War II encouraged women to work outside the home, which only furthered the reliance on artificial feeding. By the 1950s, infant formula gained the widespread endorsement of the pediatric community, and artificial feeding increasingly became seen as equal--if not superior--to nursing.

Marian Tompson, one of the founding mothers of LLLI, thinks the 1950s doctor acted out of ignorance. "I think anyone with half a brain would realize that human milk is species-specific," she says. "No one ever suggests that I feed my kittens with milk from the cocker spaniel next door." Nevertheless, with its decidedly scientific-sounding name, formula fit right into the landscape of an America mesmerized by the march of modernity, leisure, and ease. Measuring formula, sterilizing bottles, the modern mom became a domestic chemist. Bottle-feeding became a symbol of modern living, prosperity, and progress--indeed, healthful living! In contrast, breastfeeding took on the aspect of a primitive, retrograde thing to do.