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Johann Hari: There is a smart drug – it's called breast milk

Thursday, 19 June 2008

Imagine if today, scientists discovered a drug that could save 13 per cent of all the babies who currently die. Now imagine that drug also made your baby cleverer – and dramatically slashed her chances of developing heart disease, diabetes, leukaemia, asthma or obesity as an adult. Oh: and imagine it was free.

The "drug" exists. It is called breast milk. Yet in the developed world, we often stigmatise women who give it to their babies as "creepy". In the developing world, we allow corporations to tug babies from their mother's nipple, and put them on to powders that bring more profit – and more death.

I come at this from a strange perspective. My mother breastfed me until I was nearly three; she only stopped the day I wrote her a note saying I expected to be breastfed that afternoon. Today, whenever I have a success, she clutches her breasts and exclaims: "It's thanks to these!" Whenever my bottle-fed brother and sister have a failing in life, she howls: "Think what you could have been if I'd given you the tit." (Whenever she gets a bit too self-congratulatory, I remind her she also smoked 40 cigarettes a day. "Ach," she says, "it's stressful having a little bastard suckin' at you all the time.")

It's the best thing you can do for your baby – without it I'd be even fatter and more disease-ridden. It's good for you too, significantly reducing a mother's risk of osteoporosis and cancer of the ovary. Yet my mum was made to feel like a flasher. She was glared at in public places, and asked to leave restaurants, parks and even buses. Unsurprisingly, Britain today has the worst record on breastfeeding in the developed world, after Belgium. Some 24 per cent of our babies never taste breast milk at all – and by six weeks, a majority have shifted entirely to formula.

Why? Why do we hobble our babies, and our country? Let's rule out some of the more glib explanations. The number of women who physically can't breastfeed with the right support is negligibly small: the World Health Organisation (WHO) puts it at 1 per cent. Nor is it because women prefer the "liberation" of the bottle. A Department of Health study found that 90 per cent of mothers who stopped feeding at six weeks said they wanted to carry on, while 40 per cent of those who stopped at six months felt the same.

The most primal reason belongs to an old, old story: women are conditioned to find their own bodies disgusting, except when they can be used to entice men. A get-your-tits-out-for-the-lads culture doesn't want you to get your tits out for your baby: they're for titillation, not nurture. This week, one of the Government's best ministers – Harriet Harman – has succeeded in peeling this back, by including the legal right to breastfeed your baby in public into the new Equalities Bill.

But the biggest reason most women give for reluctantly pushing their baby on to the bottle is their need to return to work. How do we change that? For clues, look at the country where breastfeeding rates are still 90 per cent at six months: Norway. They give mothers a year off with 80 per cent pay, and give state employees breastfeeding breaks when they do come back. Yes, this costs businesses some money up front – but it saves a fortune further down the line, because you have a cleverer workforce that pays more tax and puts less pressure on the health service. If British babies were breastfed at Norwegian rates for just three months, the NHS would save £50m annually in the treatment of one disease alone – gastroenteritis.

That leaves another dark explanation for the fall-off: the role of unchecked corporate power. There is no profit to be made from a mother's milk, so at the turn of the last century corporations tried to find a way to divert babies from nestling at their mother's breast to Nestlé-ing at the corporate teat. They invented "baby formula" and marketed it as the classier, cleaner alternative. Cow & Gate powder was sold with a crown on the tin, bragging the Windsor children used it. (Look how that turned out.)

Gradually, in the democratic world, the corporations were restrained from making the most blatantly bogus claims about breast milk – but they keep slipping the leash. In Britain, they are banned from marketing baby formula to those younger than six months old. But instead they market "follow-up formulas" for older kids with exactly the same logo, covered with claims that it is "closer than ever to breast milk".

This has produced a situation of startling public ignorance, where a third of mums think baby formula is "as good" or even "better" than breast milk. The poorest women know least and shift to formula first – adding another milky layer of inequality to our island. This dodgy marketing needs to be banned today.

But this breast-con swells to a 52DD scandal in the developing world. I recently visited Bangladesh, where mothers are routinely told to abandon their healthy breast milk and spend great swaths of their income on formula. I think of all the dead and dying babies I saw, and wonder how many could have been saved by a substance that was there, free, all along. WHO calculates that 1.3 million babies die every year because they are not breastfed. That's a World Trade Centre-full a day.

Nestlé are still the most notorious offenders, controlling a near-majority of the world market. In Botswana, Nestlé has distributed a pamphlet claiming if you give your baby its "acidified" formula, "diarrhoea and its side effects are counteracted". In reality, babies who use this rather than breast milk are more likely to contract diarrhoea – and die. Public health campaigns can hardly fight back: the corporation's annual marketing budget is bigger than the entire annual budget of the world's 28 poorest countries.

Nestlé says they consistently promote breastfeeding as the first, best option – but in 1999, a British Advertising Standards Authority studied the evidence and ruled they had to remove from their advertising the claim they sold their formula "ethically and responsibly". It is only tight, binding international regulation – here, and abroad – that will tame corporations from milking the poorest with misinformation. To join the campaign to make it happen, visit www.babymilkaction.org.

And yet, for all the evidence, it still seems like an implausible story. Can a powder mix of misogyny and unregulated corporate power really induce women against their will to harm their own children? It does, baby, every day. These are still shockingly powerful forces. Now suck on that – or fight back.

j.hari@independent.co.uk

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Comments

191 Comments

William says, "I know several adults who were all breastfed as babies and intelligient they are not. In fact, they're downright stupid. Equally I know people who were bottle fed but who are very academically able."

Yes. No doubt you also know some smokers who lived to 90, and some non-smokers who died of cancer at 40. So what? There are such things as "scientific studies" which go beyond your (or my) little anecdotes to find general trends.

"I think we get onto dangerous ground when we put down one entire section of the population, saying that they must be less intelligent because they were bottle fed. It's offensive, if nothing else."

I find it offensive to say smokers get cancer! Ban it! Stop writing those articles! Silence!

Posted by Petie | 23.06.08, 21:22 GMT

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I'm getting a bit tired of the 'intelligence' argument. It's obvious that breast milk is the best start if possible, and I'm sure with more help and suport from medical staff it will be possible for more women. But I know several adults who were all breastfed as babies and intelligient they are not. In fact, they're downright stupid. Equally I know people who were bottle fed but who are very academically able. It's about background, parental support and class.

I think we get onto dangerous ground when we put down one entire section of the population, saying that they must be less intelligent because they were bottle fed. It's offensive, if nothing else. It's also a receipe for playground bullying if children themselves start to repeat that information.

Posted by William B | 23.06.08, 14:16 GMT

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Morgan Gallagher: 'Formula fed babies do not fulfill normal growth and thus do not achieve their full potential'

I had to bottle feed my son due to illness: Achievements to date: Age two and a half, reading age of six. Age four, reading age of eleven point five. Age seven, moved into top class as he has completed everything primary school had to offer him. Five grade A A levels, now a first class honours degree from a top university and still going. What more does he have to prove? He left his breastfed classmates behind by miles. I would always encourage breastfeeding whenever possible, but to condemn bottle fed children as being less intelligent is wrong. It's simply not true. And I don't care about the reports, I have the proof under my own roof.

Posted by Amelia | 23.06.08, 13:59 GMT

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Catherine, breast milk does not magically increase intelligence. Breastmilk contains exactly what the human brain needs to fulfill its full genetic potential. That's because it's part of the biological matrix of being human. So it has what human brains require for maximum growth.

Modified cow's milk does not have those vital elements, so formula fed babies do not fulfill normal growth, and thus do not acheive their full potential.

I cannot post URLs in these comment boxes, but if you go to the BMJ site, and locate the Edinburgh study

Geoff Der, G David Batty, and Ian J Deary
Effect of breast feeding on intelligence in children:
BMJ 2006; 0: bmj.38978.699583.55v1

You will find a rapid responses section, where peers have extensively highlighted the flaws in the study and torn to shreds the reported outcomes.

And no one has suggested that family background does not affect academic acheivement - it's just that lack of breastmilk affects it too. Both are true.

Posted by Morgan Gallagher | 23.06.08, 12:04 GMT

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Firstly, I was not disputing that breast milk is more healthier for the baby than formula, rather I was disputing that breast milk magically increases a baby's intelligence. And where did you get those statistics? How was the research that you're eluding to carried out? How was the Edinburgh study deeply flawed? The British Medical council said children from the same families had generaly the same intelligence even if one was breast fed and one was not. Is anyone genetically an A or D student? Exam results seem to rely on family input. I'm sorry Megan 'the Science' on this is not 'clear'.
I also do not know f you are middle clas or not as doctors, professors and dentists often lable themselves 'working class' these days. IQ tests are also deeply flawed, but i'm not going to start on that one. I supposedly have an IQ of 156 despite one being breast fed for two days- - mother got a terrible nipple infection.

Posted by Catherine Warner | 23.06.08, 11:37 GMT

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Catherine, the Edinburgh study was deeply flawed, although I like the message that as a breastfeeding mother, I'm more intelligent! But I'm not middle class. There are several other research groups who have published on this, and the results are astoundingly clear. Formula fed babies have, on average, 5 less IQ points than those fed normally. This is no big deal if your are gentically going to be an A+ student, but a big deal if you are gentically going to be a C student, as you're now a D student. The science is clear - formula fed kids have much higher risks for illness than normally fed ones. Mums too, have higher risks of such things as breast cancer. This should not be such a surprise, as cow's milk is for feeding baby cows, not baby humans.

It is just modifed cow's milk you know. Modified to make it less dangerous to baby than whole cow's milk. Hardly suprising it's less than the Real Stuff. Human milk for human babies - it's not rocket science, just common sense.

Posted by Morgan Gallagher | 23.06.08, 11:17 GMT

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My midwife and health visitor encouraged me to stop breastfeeding as my baby wasn't gaining enough weight, after 10 days I did, a few months later I was tested for an underactive thyroid, since then I have breastfed my 2nd baby for 7 months, I wish they had been more willing to find out why I couldn't rather than just saying I couldn't.

Posted by Danielle | 23.06.08, 08:48 GMT

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Catherine Warner - you have ignored Fishtar's point that recent research into the effect of breastfeeding on intelligence controls for social class and mother's educational level. Of course it is true that family background 'matters more', but that does not mean the impact of infant feeding on IQ is negligable.

Posted by gabydolores | 23.06.08, 08:24 GMT

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Actually Fishstar, according to researchers from the Medical Research Council (UK) and Edinburgh University, breast fed babies seem more intelligent because a higher percentage of highly educated mothers tend to breastfeed. Breast fed babies also tend to be brought up in a more stimulating environment. The British Medical Journal also comments that 'what matters more to a child's development is family background'. This is bourne out by the findings that siblings from the same family generally had the same level of intelligence even if one was breast fed and another was not.
This does not mean that there are little health benefits to breast feeding a child.

Posted by Catherine Warner | 22.06.08, 16:48 GMT

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I agree with all the posts about poor support for new mothers who are finding it difficult to establish breast feeding. I found it difficult and when I told the midwife on the ward she simply went into the nursery and came back with a bottle. That was 24 years ago and from all the posts here I would say nothing has changed.

Posted by Lacey | 22.06.08, 13:34 GMT

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