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Jan. 25, 2024 - QAA

05:58

Trickle Down Episode 14: Like Mothers Milk (Sample)

How we feed babies and young kids greatly impacts their health, growth, and future. This affects not only the children but also women and society. While baby formula has its uses, and it literally be a life saver in certain circumstances, it also comes with significant health, economic, and environmental costs. On the other hand, breastfeeding has proven health benefits for both mothers and babies in high-income and low-income settings alike. Despite that, according to the World Health Organization, less than half of babies and young children are breastfed as recommended. How did this happen? According to a three-paper series published in The Lancet in 2023, the lack of breastfeeding is due to multifaceted and highly effective strategies used by commercial formula manufacturers of infant formula. The strategies are designed to target and influence parents, health-care professionals, and policy-makers. This episode explores the roots of this problem: the infant formula industry in the early 20th century captured doctors and medical associations in order to sell their product. And when they reached the limit of infant formula market in the United States, they simply aggressively sold their powders to mothers in poor countries, with disastrous and deadly consequences. REFERENCES Breastfeeding 2023 https://www.thelancet.com/series/Breastfeeding-2023 Apple, Rima. Mothers and Medicine: A Social History of Infant Feeding, 1890–1950. University of Wisconsin Press, 1987. The Baby Killer (1974) https://waronwant.org/sites/default/files/THE%20BABY%20KILLER%201974.pdf Stevens EE, Patrick TE, Pickler R. A history of infant feeding. J Perinat Educ. 2009 Spring;18(2):32-9. doi: 10.1624/105812409X426314. PMID: 20190854; PMCID: PMC2684040. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684040/ Why The Breastfeeding Vs. Formula Debate Is Especially Critical In Poor Countries https://www.npr.org/sections/goatsandsoda/2018/07/13/628105632/is-infant-formula-ever-a-good-option-in-poor-countries Ziegler EE. Adverse effects of cow's milk in infants. Nestle Nutr Workshop Ser Pediatr Program. 2007;60:185-199. doi: 10.1159/000106369. PMID: 17664905. https://pubmed.ncbi.nlm.nih.gov/17664905/ APPLE, RIMA D. “‘TO BE USED ONLY UNDER THE DIRECTION OF A PHYSICIAN’: COMMERCIAL INFANT FEEDING AND MEDICAL PRACTICE, 1870-1940.” Bulletin of the History of Medicine, vol. 54, no. 3, 1980, pp. 402–17. JSTOR, http://www.jstor.org/stable/44441272. Walters DD, Phan LTH, Mathisen R. The cost of not breastfeeding: global results from a new tool. Health Policy Plan. 2019 Jul 1;34(6):407-417. doi: 10.1093/heapol/czz050. PMID: 31236559; PMCID: PMC6735804. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735804/pdf/czz050.pdf Munblit, D., Crawley, H., Hyde, R., & Boyle, R. J. (2020). Health and nutrition claims for infant formula are poorly substantiated and potentially harmful. bmj, 369. https://www.bmj.com/content/bmj/369/bmj.m875.full.pdf Boatwright, M., Lawrence, M., Russell, C., Russ, K., McCoy, D., & Baker, P. (2022). The Politics of Regulating Foods for Infants and Young Children: A Case Study on the Framing and Contestation of Codex Standard-Setting Processes on Breast-Milk Substitutes. International Journal of Health Policy and Management, 11(11), 2422-2439. doi: 10.34172/ijhpm.2021.16 https://www.ijhpm.com/article_4169.html Nancy E. Zelman, The Nestle Infant Formula Controversy: Restricting the Marketing Practices of Multinational Corporations in the Third World, 3 Transnat'l Law. 697 (1990). https://core.ac.uk/download/pdf/303871848.pdf Infant nutrition : a textbook of infant feeding for students and practitioners of medicine / by Williams McKim Marriott. https://iiif.wellcomecollection.org/pdf/b29929453 Wattana, Melissa. The Baby Bottle and the Bottom Line: Corporate Strategies and the Infant Formula Controversy in the 1970s (2016) https://hshm.yale.edu/sites/default/files/files/Wattana%20senior%20essay%202016.pdf

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	[MUSIC PLAYING]
	In the late summer of 1975, two representatives of the multinational food processing giant Nestle
	visited the pediatric ward at the University Hospital in Nairobi, Kenya.
	The visit was inspired by self-defense.
	Activists and journalists were claiming that corporate promotion of infant formula, like that sold by Nestle, was responsible for high rates of infant malnutrition and mortality in poor countries.
	Nestle had been a pioneer in the manufacturing and sales of infant formula for a century, so such an accusation wasn't merely damaging to their brand, but to them it was outright defamatory.
	The two Nestle representatives were accompanied by Dr. Elizabeth Hillman, a senior lecturer and pediatrician at the Nairobi Teaching Hospital.
	Coincidentally, at that same hospital in the emergency ward, there was a severely malnourished infant who was exclusively fed Nestle brand name formula since birth.
	The representatives wanted to see the infant for themselves.
	However, the health of the baby collapsed shortly after they arrived.
	The two Nestle representatives watched in horror as Hillman and the attending medical personnel tried in vain to resuscitate the infant.
	Hillman later recalled, It was a vivid demonstration of what bottle feeding can do.
	Because this mother was perfectly capable of breastfeeding.
	They walked out of that room very pale, shaken, and quiet.
	And there was no need to say anything more.
	That needless tragedy was the culmination of many decades of infant formula manufacturers cleverly exploiting the trust of doctors and mothers.
	And as horrifying as it was, that event and countless other tragedies did little to stem the sales of formula worldwide, even to mothers who did not need it.
	I'm Travis View, and this is Trickle Down, a podcast about what happens when bad ideas flow from the top.
	With me are Julian Field and Jake Rakitansky.
	Episode 14, Like Mother's Milk.
	This is this is a real sad one.
	So this episode is inspired in part by a fantastic series of articles which were published by the medical journal The Lancet last year, which were called Breastfeeding 2023.
	And I'm going to include those articles at the top of the show notes if you want to check them out for yourself.
	And those papers address an always crucial issue, which is infant nutrition.
	How we feed babies, young kids, greatly impacts their health, growth and future.
	And, you know, this affects not only children, but also women and society at large.
	Now, while baby formula, it certainly has its uses and literally can be a lifesaver in certain circumstances.
	It also comes with significant health, economic and environmental costs.
	On the other hand, breastfeeding has proven health benefits for both mothers and babies in high income and low income settings alike.
	Despite that, according to the World Health Organization, less than half of babies and young children are breastfed as recommended.
	Now, the advice that the World Health Organization gives is to exclusively breastfeed for the first six months and to start other foods while continuing to breastfeed for at least two years.
	So how did this happen?
	According to that three-paper series in The Lancet, the lack of breastfeeding is due to multifaceted and highly effective strategies used by commercial manufacturers of infant formula.
	The strategies are designed to target and influence parents, healthcare professionals, and policymakers.
	The industry's dubious marketing practices are compounded by lobbying of governments, often covertly via trade associations and front groups, against strengthening breastfeeding protection laws and challenging food standard regulations.
	It's another instance of a massive industry using their sway to not only influence new mothers, but like scientists and doctors that the mothers trust.
	I was really blown away by that paper.
	I read it back in February.
	So I started researching like, you know, kind of like how this happened and the roots of the problem.
	And it can partly be traced back to infant formulas entry into global markets and the targeting of poor mothers, which was like this huge public issue in the 1970s.
	When I looked further into it, I learned thanks to Decades of work of scholars who have investigated the matter that the real roots go even deeper and can be found in the 19th and early 20th century at the beginning of the infant formula industry.
	It was in this time that the infant formula manufacturers cozied up to the fledgling field of pediatrics and leveraged the trust and authority placed in doctors in order to sell the formula and consequently decrease the rate of breastfeeding.
	But before I go into that, I want to clarify, like, why breastfeeding is generally considered superior to formula.
	Like, with the caveat that I'm a podcaster, I'm very much against getting health advice or, like, having your health practice dictated by podcasters.
	Listen, we are, you know, three guys, three middle-aged guys, two of which are childless, talking about infant formula and breastfeeding.
	So that's something just keep in mind.
	I'm giving you, I can, I'm citing all my sources.
	I think that this is, this is solid information, but at the same time, like just, you know, caveat emptor.
	Just, you know, I think you need to check your fucking sources on me being middle aged, buddy.
	Yeah.
	And all you can field all complaints to me.
	Hey there, you've been listening to a sample clip of trickledown.
	This is a side project that I've been working on.
	It's a 10 episode series about Misinformation and bad ideas that flow from high authority sources.
	I think it's fascinating and I mean it's a way for I guess me to explore the way people who should know what they're talking about don't always actually.
	I'm not gonna lie uh some of it's kind of a bummer but um if you're anything like me that's actually more of a reason to dive into the subject matter.
	Like with the premium episodes of QAnon Anonymous, all the episodes of Trickle Down are available to people who support us through Patreon.
	Still the same $5 a month, double the extra content, same price that we've been doing since 2018.

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