Markets, breastfeeding and trade in mothers’ milk

Abstract

This introduction to a special issue on the economics of breastfeeding draws attention to the lack of economic justice for women.Human milk is being bought and sold. Commodifying and marketing human milk and breastfeeding risk reinforcing social and gender economic inequities. Yet there are potential benefits for breastfeeding, and some of the world’s poorest women might profit. How can we improve on the present situation where everyone except the woman who donates her milk benefits?Breastfeeding is a global food production system with unsurpassed capacity to promote children’s food security and maternal and child health, but it is side-lined by trade negotiators who seek instead to expand world markets for cow’s milk-based formula. Regulators focus on potential risks of feeding donated human milk, rather than on health risks of exposing infants and young children to highly processed bovine milk. Similarly, policymakers aspire to provide universal health care access that may be unaffordable when two thirds of the world’s children are not optimally nourished in infancy, resulting in a global double burden of infectious and chronic disease. Universal breastfeeding requires greater commitment of resources, but such investment remains lacking despite the cost effectiveness of breastfeeding protection, support and promotion in and beyond health services. Women invest substantially in breastfeeding but current policy - epitomised by the G20 approach to the ‘gender gap’ - fails to acknowledge the economic value of this unpaid care work. Economic incentives for mothers to optimally breastfeed are dwarfed by health system and commercial incentives promoting formula feeding and by government fiscal policies which ignore the resulting economic costs.‘The market’ fails to protect breastfeeding, because market prices give the wrong signals. An economic approach to the problem of premature weaning from optimal breastfeeding may help prioritise global maternity protection as the foundation for sustainable development of human capital and labour productivity. It would remove fiscal subsidies for breast milk substitutes, tax their sale to recoup health system costs, and penalise their free supply, promotion and distribution. By removing widespread incentives for premature weaning, the resources would be available for the world to invest more in breastfeeding.

Economic Efficiency or Gender Equality: Conceptualizing an Equitable “Social Framing” for Economic Evaluations to Support Gender Equality in Disaster Risk- and Environmental-Management Decision-Making

“…Despite the known benefits to breastfed infant's cognitive and immune development, for food security, and for the mother's health, formula feeding is promoted. Benefits of breastfeeding are not examined from breastfeeding mother's perspectives, however, and so often go unnoticed in policy [13]. It is necessary, therefore, to question the "social framing", and the potential motive behind the "social framing", of the CBA if these assessments are to positively influence gender equality.…”

“…In the absence of a market for a good, the benefits of an activity may be largely ignored. Smith [13], for example, illustrates how market regulations in G20 countries discourage breastfeeding, for which there is no market, and encourage formula feeding, for which there is a market. Despite the known benefits to breastfed infant's cognitive and immune development, for food security, and for the mother's health, formula feeding is promoted.…”

“…A study by Smith [13] examines how current market mechanisms incentivize formula feeding (i.e., bovine-milk formula), discourage mothers from breastfeeding, and the negative impacts of this on women's and infant's health and food security. Smith highlights the healthcare benefits of breastfeeding such as the potential of breastfeeding to minimize healthcare costs, to improve children's food security, to provide secondary impacts on fertility (e.g.…”

Artificial Infant Formula Consumption and Breastfeeding Trends in Ecuador, A Population-Based Analysis from 2007 to 2014

“…Breastfeeding is an essential part of human development and the most important source of nutrients in newborns; however, the practice of exclusive breastfeeding can be compromised, as a result of idiopathic, cultural, practical or pathological conditions (Ahluwalia, Morrow, & Hsia, 2005;Scott, Aitkin, Binns, & Aroni, 1999). Breastfeeding is readily accessible in most cases, and should be considered a priority for children´s nutrition, especially for infants under 6 months of age and those who live in geographically or social disadvantaged populations (Smith, 2015). Women´s decisions and maternal practices may be influenced by globalization and marketing strategies that overemphasize the benefits of artificial infant formula, leading to misinformation about breastfeeding (Organization et al, 1981;Rosenberg, Eastham, Kasehagen, & Sandoval, 2008;Smith, 2015).…”

“…Breastfeeding is readily accessible in most cases, and should be considered a priority for children´s nutrition, especially for infants under 6 months of age and those who live in geographically or social disadvantaged populations (Smith, 2015). Women´s decisions and maternal practices may be influenced by globalization and marketing strategies that overemphasize the benefits of artificial infant formula, leading to misinformation about breastfeeding (Organization et al, 1981;Rosenberg, Eastham, Kasehagen, & Sandoval, 2008;Smith, 2015). Investing human and economic resources to promote breastfeeding would positively contribute to the development of healthier infants and would reduce household expenditures on formula (Christensen, 2012;Pérez-Escamilla & Chapman, 2012).…”