Saturday, April 07, 2007

Bottle feeding

The following picture, from the International Baby Food Action Network website, shows a mother feeding her twin babies. She was told that she wouldn't have enough milk for both, so she breastfed her son and bottlefed her daughter (who died the day after the photo was taken).

UNICEF estimates that reversing the decline in breastfeeding would save the lives of 1.5 million children per year.

In many parts of the world, bottle feeding isn't simply a "choice" as it is in rich, Western nations. It is literally a matter of life and death.

17 comments:

  1. Wow. That's such a telling photo on so many levels. The power of a doctor to tell a woman she can't breastfeed two, the striking difference in the two children, and of course the gender preference. I wonder if (assuming there was a milk production deficit) supplementing both children instead of all for one would have saved them both. I'm sure it tells us more.

    -violet

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  2. I'm uncomfortable with this picture. This baby looks like she was unintentionally starved to death. And if she was bottle-fed, why is the mom not holding the bottle? I think this girl probably tried to eat on her own and this is what happened. I don't think that this is a good picture, especially to say "bottles kill" above it. Ignorance kills, on so many levels. She was misinformed on nursing, and then something went horribly wrong after that. I agree with their cause, but some part of me thinks there is more to that picture than we are aware of.

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  3. I don't know much more about the history of the photo, although I do know from the website I linked to that the mother requested it be used. My guess is that it was posed, for a striking visual illustration.

    Yes, the gender preference is disturbing.

    Does ignorance kill? Maybe. But in developing nations, it's not ignorance so much as deliberate misinformation (combined with poverty and unsanitary water supplies), and most of the guilt rests squarely on the formula manufacturers. It's worth taking the time to read about the WHO code for breastmilk substitutes and how formula companies continue to violate this code to this day.

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  4. I have known this image for a long time. It is a very powerful piece of anti-formula propaganda. I remember sobbing with grief and shock when I first saw it.

    But I agree with Sarah, and I have a sense that without more information, it is propaganda. I have not been able to learn more about this unfortunate family than the same info as Rixa provides for caption, so I'm guessing this is how this picture is circulated. I understand that it is used to discourage unsafe bottlefeeding practices, but something about it feels very manipulative...

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  5. This photo and story are misleading. The bottle-fed baby is malnourished, but malnourishment is a result of a health condition (from parasites to an illness) and not necessarily a lack of food (or a result of being fed formula rather than breast milk). In less developed countries, where children die from malnourishment, the cause of death is NOT generally lack of food; rather, it is medical complications of a disease or parasite - often the result of improper hygiene and sanitation. In the case of this child, if the mother used unsafe drinking water in preparing the formula, no amount of food could save the child. The photo paints a simple story, but the causes of the malnourishment are not simple - but most likely NOT simply because one baby was fed formula and the other breasmilk.

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  6. ...I just have to answer in response to the reply above. It IS because of sanitation problems and unsafe water that the baby girl died...but if she had been breastfed, she would most likely not have been exposed to the bad water in the first place. She would have had the protection of her mother's antibodies and not direct exposure to the parasites. Propoganda-picture or not, this photo does tell a story of the dangers of formula feeding in developed counries. It has been documented that families are encouraged to start formula, mothers lose their milk supply, and families are forced to dilute the formula to dangerous levels to stretch finances, and use bad water for preparation. There is a reason many folks choose to boycott Nestle, an early and current pusher and violator of the WHO code in developing nations (not to mention the US of course!).

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  7. I think it's clear to us that the formula did not kill this child, rather the water with which the formula was prepared. Obviously the breastfed sibling is at a much lower risk (if any) of drinking contaminated water.

    However, the baby did die SIMPLY (although not directly) because she wasn't breastfed. It's not the direct cause of death, but it involves a simple set of alternatives.

    A third alternative is roughly what we have in industrialized countries, where sanitation and advanced medicine significantly narrows the gap between artificial feeding and mother's milk. Perhaps it's my western bias that I feel the picture tell the story in a manipulative way, because in developed countries, this could not happen.

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  8. okay Jen you beat me to it :)

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  9. But in developed countries, this can and does happen. Yes, the photo is very in-your-face and emotionally manipulative.

    We could probably debate forever whether it's formula, or bad water, or poverty, that kills the baby. I think the compelling point of the website and organization I linked to, is that the easiest and cheapest way to fix this problem is to encourage breastfeeding. In fact, it's not just cheaper--it's free! Sure, most babies would not die from formula feeding IF the per-capita income rapidly grew to an industrialized nation's level, IF poor sanitation and water supplies were totally fixed... But realistically is that going to happen? And why choose an expensive, complicated, and unrealistic solution when a simple and elegant one already exists?

    Well I am sure most of you here agree with that...guess I'm just rambling.

    Here's a more pressing question: what can WE--wealthy, educated, privileged women--do about this very pressing issue?

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  10. This picture is horrifying and of course, I'm sure, you posted it because of that. I followed the link to the original source and saw the point of the article accompanying it was a world away from how you described the story behind the picture in your post. The point of that picture is to educate the world about UNSAFE bottle feeding due to unsterile teats and dirty water sources. In third world and poor countries. That's why that child died, not because he was bottlefed. Your post leaves all of that information out, and all you say is that breastfeeding would save millions of lives, with the message of "look here's a breast fed thriving child and here's a dying bottlefed child".

    I just think this post is another example of how ardent breastfeeding advocates leave out the real information to scare the bejesus out of mothers who can't or won't breastfeed their child using imagery like this without backing it up with the correct information. I've never left an unsupportive comment on a blog before, but I couldn't let this one go by without saying something. I enjoy your blog and I think you have lots of wonderful things to say; I disagree with much of your birthing philosophy, but I do respect your right to have it. I just completely disagree with relaying information incorrectly with the intent of scaring and guilting women who are unable to breastfeed into feeling like they are "killing" their children.

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  11. "I just completely disagree with relaying information incorrectly with the intent of scaring and guilting women who are unable to breastfeed into feeling like they are "killing" their children."

    Hi Jen,
    This post wasn't about trying to scare or guilt women, especially women in industrialized countries, into not formula feeding. It was to illustrate the dire situation in developing nations where breastfeeding can make a difference between life and death. I thought the last sentence of my post made that distinction...maybe not, though. That's also why I linked to the original article, rather than just posting the picture.

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  12. Well this is exactly what I meant when I said there's something manipulative in this image because of its intensity! I don't think Rixa presented it in a misleading way: the link, the comment at the bottom, and if that's not enough, the mother's clothing itself all point to this primarily being a third world issue.

    But the sight of that poor emaciated infant emotionally breaks down all the rational distance and we (I at least) recoil in terror, the voice inside screaming "oh my God I hope I'd never do that to a baby of mine by feeding formula"
    It's a shock effect.

    I understand the second Jen's reaction (not jen b.) I just don't think Rixa's presentation is responsible for it.

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  13. This would make an excellent discussion for a rhetoric class (speaking as a former university rhetoric instructor...ahhhh, the good old days of a grad student, right?)

    You could talk about the power of images to strike an emotional reaction, investigate the spoken and unspoken assumptions behind the breast vs. formula debates, analyze people's reactions to seeing the website or the blog, versus what is actually being said.

    Almost make me want to teach rhetoric again. Almost.

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  14. this is an incredibily sad photo. i have twins. it was never an option for me to give one formula and he other breastmilk - although it was suggested to me. I choose donated breastmilk until I could increase my milk supply.

    But this is because I am from a culture of privilege, resources and was able to get safe donated breastmilk and information.

    I have no doubt whatsoever that this very sad an unnecessary death was a result of the formula/bad water/lack of resources to purchase enough formula, and poor information as well as formula advertising to lead women to believe that they can not breastfeed twins. So, in my opinion it was the lack of breastfeeding - therefore the act of formula feeding that did cause the death of this baby.

    As for why the mom is not holding the bottle - have any of the posters tried to breastfeed two babies simultaneously or breastfeed and bottle feed simultaneously? It is difficult more difficult than you can imagine. There is never enough hands to properly support both babies/breasts and bottle.

    This picture is disturbing and it very accurately shows the differences that breastmilk can provide to babies - especially in poor countries without access to safe water. however, babies in NICU's throughout the developed world still die as a result of being formula feeding by contracting NEC.

    this photo is no more propoganda than the unethical advertising of formula.
    Erin

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  15. Reminds me of a photo I have:

    http://images.orfay.com/i/photos1/2007/02/14/16/5/c/c/5cc58979b4c93b1284454359ca9a93390_large.jpg

    Those are two puppies from the same litter. The puppy on the left nursed from her mother. The puppy on the right was weak and couldn't latch on properly, so we bottle fed her with puppy formula. They both lived, but even as adults the difference between them was just as astonishing.

    -Jill

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  16. Good gracious! I find it ridiculous to blame formula feeding on the size difference. I have four children and successfully breastfed the first two.

    When I had the twins however, no matter my effort and determination I just didn't have enough milk! I persisted and persisted until I finally brokedown emotionally because of the incredible guilt I felt as you are always told 'breast is best'. One of the twins was not gaining weight so I ended up bottle feeding them and they are both really chubby, healthy, happy and bright. I felt so angry that the pressure to breastfeed caused me to go through so much emotional pain and guilt.

    It's ads like these that contribute to that unyeilding pressure when the reality is that sometimes woman truly cannot breastfeed their babies for valid reasons. It is not like we are feeding our babies poison or harming them in any other way. This ad basically really offends me.

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  17. Hi anonymous,

    The point of the picture, and the website I linked it back to, isn't to guilt wealthy, Western mothers about bottle feeding. (And please read the article "Breast Is Not Best" for an excellent discussion about guilt). The photo illustrates the dramatic difference that bottle feeding can make in developed nations where poverty, unsanitary water supplies, lack of education about proper bottle feeding, and marketing by formula companies combine to create a lethal combination. I hope you would have understood that from reading the website and the comments on this post.

    We have the luxury of relatively safe bottle feeding here in North America. But bottle feeding, as practiced in poverty-stricken countries, does kill and harm. It's not an issue of guilt at all (except for the formula manufacturers and their deliberate breaking of the marketing code).

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