Why do mothers feed their babies formula milk instead of their own milk?

All over the world, women start breastfeeding their babies after giving birth. However, according to the World Health Organisation, only 44% of these women continue to breastfeed for six months.

Infants cannot eat solid foods for the first six months, so they are fed breast milk or infant formula. This is why the current shortage of formula milk in the US has made the situation dire, as only a quarter of mothers in the US breastfeed their babies for six months.

The shortage of formula milk in the US was caused by problems related to production and supply chain, and further problems were caused by the Food Department's investigation into Abbott Nutrition, the leading manufacturer of formula milk. Abbott and three other companies produce 90 percent of the formula milk.

Research shows that breast milk is the healthiest and safest source of food for infants. It also plays a key role in the mother-child relationship. So why are mothers preferring formula feed instead of breastfeeding?

We will try to find out what structural and clinical factors are behind this phenomenon. Basically our question is why mothers prefer formula milk for babies over their own milk?

There are many factors that cause a baby not to breastfeed. But many experts say a mother's hospital experience at the time of childbirth matters. The World Health Organisation has been emphasising for decades that hospitals should provide a 'baby-friendly' environment to promote breastfeeding. The first 24 hours after birth are very important for newborns and during this time they learn how to drink breast milk.

In the hospitals of Europe and America, 'newborn friendly' initiatives have been taken, but in other regions of the world, this has not happened yet. Antonina Mutoro, a researcher with a child care agency in Kenya, helped conduct surveys for a recent United Nations report examining the situation in Nairobi's informal settlements.

The results of this survey revealed that only two percent of the mothers of newborns were exclusively breastfeeding their babies. This is also important because the mothers living in these densely populated settlements could not even afford to buy formula milk. Instead of feeding her own milk, she was giving the children cow's milk and soft foods.

Mitoro says that one of the main reasons for not breastfeeding was that mothers were not taught how to breastfeed their babies after giving birth in the hospital. She explains: “If the newborn-friendly facility is not available in the respective hospital after birth, many times the staff say to give the baby to us, we feed it with formula milk. And so the chain begins.'' Besides, doctors sometimes tell the mother that her milk is not enough. However, Mitoro says that after birth, when the baby is placed on the mother's breast, demand is created, which also produces milk.

The problem is not ignorance of the benefits of breast milk. According to Mayutoro, medical staff know how important breast milk is to a child's health. But the structure to promote this process is not there. Many doctors and nurses do not train mothers on how to breastfeed and instead give formula milk.

The influence of formula milk manufacturers

Then there is the influence of infant formula companies. In 1981, the World Health Assembly, the decision-making body of the World Health Organisation, developed the Code of Marketing of Breast Milk Substitute Products. Under this regulation, formula milk manufacturers are prohibited from advertising their products in a way that discourages breastfeeding.

However, according to the World Health Organization report released in February this year, these companies are actively promoting their products online, and for this purpose, they are using online advertising methods that were regulated in 1981. They did not exist at the time of making. These methods include providing access to mothers by collecting information through algorithms and apps. The report stated that even after four decades of implementation of this regulation, the rate of breastfeeding remains stagnant, but the sales rate of formula milk has doubled.

Lack of practical training

Rafael Pérez Escamilla, one of the authors of the World Health Organization report, says that even in most newborn-friendly hospitals, women are not given the training or support to know how to breastfeed their babies after going home. Is it? According to Escamilla, there are two main reasons for this. The first reason is that most medical nursing schools only teach how to breastfeed for two hours during training.

Because of this lack of practical training, nurses are unable to teach mothers about breastfeeding. Therefore, this is usually done by other breastfeeding counselling providers. In most countries, the health system does not hire or pay for such consultants. Therefore, such professionals can only train women privately who can pay them.

Another important reason, according to Escamilla, is that despite knowing the importance of breastfeeding, some officials deliberately avoid promoting it because the formula industry pays them. "Many of them were invited to dinners, paid to attend conferences, given books and some even bribed to recommend a certain number of products," she says.

Breastfeeding, a full-time job

If mothers breastfeed their babies, their breasts fill with milk every few hours. This milk has to be removed from the body, either by breastfeeding or by pumping. If this is not done, they face pain. In Germany and many other European countries, women can take up to one year of paid leave after childbirth. Thus, breastfeeding and pumping do not become a big problem. Many other countries, including the US and Kenya, do not have laws requiring women to take unpaid leave.

If a mother can't take off work, she has to pump at work. In America this is possible and women should be legally provided with a place where they can pump milk while at work. However, according to Professor Kelly Snyder, jobs where separate offices are available to women are possible, but it is not possible to provide separate space in every industry and every office.

In such situations, even mothers who want to exclusively breastfeed their children are forced to rely on formula milk. The reasons for using formula milk are not only economic and social. There are also women who cannot breastfeed for other reasons. We will examine these reasons in the second report of this series.