Breastfeeding and Use of Human Milk

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Breastfeeding Policy Statement

In Response to Questions About the American Academy of Pediatrics Section on Breast Feeding's Policy Statement, Breast Feeding and the Use of Human Milk, The International Formula Council Offers the Following Statement:

The International Formula Council (IFC)* agrees with the American Academy of Pediatrics Section on Breast feeding that breast feeding is best, and that it offers specific child and maternal health benefits.

The IFC strongly supports the positive promotion of breast feeding, and agrees with the Academy's Section on Breast feeding that the challenges of breast feeding for women in society, particularly those in the workplace, should be addressed. We are pleased that, through a concerted effort by the health community, government, and industry, recorded breast feeding rates in the United States (U.S.) have increased during the past decade. (Mothers Survey, Abbott Nutrition) The IFC recognizes that breast feeding initiation and duration rates in the government's special supplemental food program for Women, Infants and Children (WIC) still lag 20 percentage points behind those of non-WIC participants. Because nearly half of all infants born annually in the U.S. participate in the WIC program, the IFC believes the Academy should encourage pediatricians and other health care professionals to focus particular effort and attention on helping local WIC programs to increase breast feeding rates.

The IFC also agrees with the Academy that infants weaned before 12 months of age should receive iron-fortified formula. The U.S. Food and Drug Administration, WIC, the American Dietetic Association and other leading organizations recognize that infant formula is a safe and nutritious feeding option for babies whose mothers cannot or chose not to breastfeed. The IFC underscores the statement made by the U.S. Department of Health and Human Services (HHS): "HHS strongly recommends and encourages women to breastfeed exclusively for six months. But it understands that there are mothers who are unable to breastfeed or shouldn't breastfeed. Infant formula is safe and nutritious for those women who are not able to breastfeed." Each of these entities has thoroughly reviewed the science behind infant formula in reaching their conclusions. The critical health risk of infant feeding choices, which is not noted in the AAP Policy Statement, arises when neither breast milk nor infant formula is chosen.

The IFC disagrees with the Academy's interpretation as fact of the results from a single paper that suggested breast feeding was associated with a decrease in infant death - especially since the paper only showed a possible association in reduced deaths due to injuries. This paper, by Aimin Chen and Walter Rogan (Pediatrics, 2004) did not show cause and effect.

As the authors (Chen and Rogan) of the cited study state, "…breast feeding may represent a package of skills, abilities, and emotional attachments that mark families whose infants survive," so any association between breast feeding and lower rates "may represent something as simple as physical proximity." In addition, the effects of breast milk and breast feeding cannot be totally separated from inherent and lifestyle factors of the mother and child. For instance, the children who died also had a higher birth order and were more often male, black and born at a low birth weight; their mothers were younger, less educated, and smoked more often during pregnancy. It is likely that these complex, interdependent factors play a greater role in infant health than the presence or absence of breast feeding.

The IFC also disagrees with the Academy's Section on Breast feeding including, within its list of other potential health benefits associated with breast feeding, a statement noting that some studies suggest breast feeding reduced risks of several serious, chronic diseases, without acknowledging that the overall weight of scientific evidence indicates no such association. Chronic diseases have complex etiologies and multiple postulated causative factors, so risk for each chronic disease will differ among children and adults within, and between, each infant feeding group (breastfed vs. not breastfed).

Cato Research (CATO) - an independent research organization of physicians and Ph.D. level scientists who have contributed significant medical expertise to the successful development of many therapeutic areas, including those related to women's health - recently conducted a comprehensive review of the clinical literature regarding the impact of infant feeding practices on specific health outcomes and disease states. Contrary to the statements included in the Academy's Policy Statement, CATO concluded that the scientific literature does not suggest that breast feeding prevents chronic diseases such as obesity, cancer or diabetes.

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*IFC is an international association of manufacturers and marketers of formulated nutrition products (e.g., infant formulas and adult nutritionals) whose members are predominantly based in North America. IFC members include all major U.S. manufacturers: Mead Johnson Nutrition; Nestlé Infant Nutrition; Abbott Nutrition; Solus Products; and Wyeth Nutrition.