Appropriate Infant Feeding Practices

Address by Anwar Fazal, Director Regional Office for Asia and the Pacific, International Organization of Consumers Unions at the IBFAN Asia Conference ‘86 on “Protection and Promotion of Appropriate Infant Feeding Practices” held in Thailand, 5-12 October 1986, organised by the International Baby Food Action Network (IBFAN).

“Milk and Murder” was the provocative title of one of the earliest and most powerful statements ever made on protecting and promoting breastfeeding. Yes, “Milk and Murder”.

It was made nearly 50 years ago and, significantly, it was made in this very region, not far from where we are meeting, in Singapore.

It was made by a remarkable woman, a pediatrician, born in Jamaica, qualified as one of the first women doctors from Oxford, who worked in Asia and Africa and became the first Head of WHO Maternal and Child Services.

That outstanding public citizen of the world, a “worldian”, was Dr Cicely Williams.  She said, and I quote:

“If you are legal purists, you may wish to change the title of this address to Milk and Manslaughter”, but if your lives were embittered as mine is, by seeing day after day this massacre of the innocents by unsuitable feeding, then I believe you would feel as I do that misguided propaganda on infant feeding should be punished as the most criminal form of sedition, and that these deaths should be regarded as murder.” (1939)

Dr. Willams spent the years of what is called World War II in a prison in Singapore. Out of those terrible years and wretched conditions came one of the greatest testaments on the power of breastfeeding.  The statement was about babies born in that prison.  Dr. Williams wrote in her prison diary:

            “20 babies born,

            20 babies breastfed,

            20 babies survived

            you cannot do better than that!”

Very sadly and tragically, the kind of misguided propaganda on infant feeding that Dr Williams talked about swept the globe. It was engineered by those hungry for profits and armed with the technology of processed cows milk and the technology of mass marketing.

The bottle and the teat became commonplace, including one of the greatest behavioural changes in child rearing of all times.  These instruments displaced a gift of nature, a gift of love, a gift of God.

Societies succumbed wholesale to glorified pseudo-modernisms based on creating new addictions to meet the insatiable greed of commercial religion whose altars are violence, manipulation and waste.

The kind of violence that has been associated with the deaths of one million babies a year and the hurting of  10 million more.

The kind of manipulation that, through insidious marketing, captures the minds of health professionals and bureaucrats and tempts and seduces. It seduces in subtle and sometimes downright corrupt ways, that destroy informed choice and subvert the right of the child to the life force that breastmilk is.

The kind of waste that moves us away from a self-reliant, fully autonomous, nutritious and life-saving supply system to dependency on an inferior product and dependency on corporations, local and multinational, and their “cash register” ethics. Breastfeeding is a continuous flow of goodness and wealth, it has been estimated that in Indonesia it has a direct net market value of US$400 million annually. (If we take the indirect benefits of health and fertility into account, it grows to US$520 million.)

How could we fight this culture of violence, of manipulation and waste? It needed nothing less than a revolution!

Dr Cicely Williams showed us the way with her anger, her bravery and her example. Many voices joined hers over the years.

And in the last decade there has been a magnificent proliferation of people power. Caring professionals, women’s organisations, consumer groups, a sensitive media, responsive bureaucrats have led to an explosion of concern and action.

Throughout the world people began rediscovering the joy and power of breastfeeding.

The world’s highest moral conscience, the United Nations, began asserting itself on this issue.

The world saw one of the most successful global consumer boycotts of all times, the Nestle Boycott.

The world saw the birth of a new global citizens network, IBFAN that has sustained and energised the movement for protecting and promoting breastfeeding.  IBFAN has also provided inspiration for several others citizens networks – Health Action International on pharmaceuticals, Pesticides Action Network pesticides, etc.

And the world saw a new ethical frame take shape in 1981 in the form of the WHO International Code of Marketing of Breastmilk Substitutes – the first ever detailed consumer protection code to be applied globally, universally.

But as those involved in revolution will tell you, the real work of reconstruction begins after such victories and it is tough work.

IOCU/IBFAN’s global report cards on the performance of both governments and companies do not tell a happy story. Company practices are far behind policies and the words of governments are far ahead of their action.

But there are changes and changes for the better and where they have occurred, they have usually done so because of constant pressure and action.

One world agency has played a very critical role in seeing the revolution into real tangible gains. Without that agency, there might not have been a code.

Without it, there would not have been a global programme of action oriented, participatory projects in breastfeeding.  IOCU has worked closely with that agency.  That support enabled us to hold the first Asian Seminar on Breastfeeding in 1982 in the Philippines. We have worked together in programmes in Africa, Latin America, in Europe and recently in the Middle East.

It is their support again that made this meeting possible.

That agency, UNICEF, this year celebrates 40 years of remarkable work. UNICEF has shown better than any UN agency I know, how to work with people and people’s organisations.

I would like to ask all of you to join me in expressing not just our thanks, not just our admiration for this work, but also a pledge of our continued support for the many things IOCU, IBFAN and UNICEF have achieved together.

New paths are made by walking and gaining new friends and new strengths.  For this Conference, we have brought together a truly remarkable mix of people, a mix that reflects both the global character of the problem as well as its multidimensional nature.  We have people from the North to share with us their experiences as well as enable us to confront some of the structures in the North that have been and continue to be part of the problem.  We have brothers and sisters from the Pacific, from Africa, from the Middle East. We have mothers and fathers, doctors and consumers, community organisers and government planners. We have people in the communications area. We have students of Dr Cicely Williams and we have Suveera who is nine months old and breastfeeding, who, with her smiles and her demands for breastmilk, will remind us why we are here and what we must do.

This mix reminds us that breastfeeding and infant nutrition in general is not a simple technical matter. It has complex social, economic and political dimensions and we must continue our revolution working at many levels and directions, keeping in mind all those dimensions.

We need to enlarge our work for mother support programmes as well as we need to confront the structures that create the problem. As we do our little tasks we need to remember our larger vision for a better, more just and humane society.

I would like to share with you two stories that help me remember these ideas:

(1)    “A man sees a baby drowning in a river. He jumps in and saves the baby. As he is bringing the baby ashore, he sees another baby floating down the river and he rushes in again to save the second one. And then he sees a third, and a fourth, a fifth.  He is so busy saving the drowning babies, that he has no time to look up the river to see the person throwing the babies into the water.”

(2)    “Two workers are laying bricks at a construction site. Somebody asks the first one ‘What are you doing?’ and the worker answers ‘I am laying bricks’. She asks the other one ‘what are you doing?’ and he says ‘I am building a community centre’.”

The first story shows us that tackling a problem without tackling its causes, the structures that create the problem, will not help us solve it.

The second story shows us that we can see what we do merely as a task or we can, like the second bricklayer, have a vision of what the task is to achieve.

I hope very much that such “structural thinking” and such “distance thinking” will become part of your work, your strategies and your goals. I hope also that this meeting will help you generate the action to make real change and also create the solidarity that gives us added strength to continue to be a force for happiness.

Thank You.

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