The theme of this year's World Breastfeeding Week, held annually between 1st - 7th August, is "Breastfeeding in the Information Age". Over 120 countries around the world will participate, with initiatives aimed at improving our knowledge about breastfeeding, sharing ideas, and finding ways to counter negative arguments or 'threats' to breatfeeding;

"Breast is best" merely has to be uttered and a yawn goes around the room. Yes, of course, as midwives, we all know breast is best. Indeed, mothers also know this but may be unsure as to exactly WHY it is best. During the last century, breastfeeding, particularly in developed countries, has become an 'endangered activity'. It has been meddled with, doubted, and largely replaced with powdered milk substitutes from other mammals.

Think of how the artificial baby milk manufacturers describe their substitutes: 'even closer to breastmilk', 'to complement breastfeeding', and 'nutritionally complete'. These claims are misleading - one artificial baby milk may be compositionally slightly nearer to breastmilk than others, but this is like saying that London is nearer to the South Pole than Birmingham - they are still both a long way away. 'Complement' breastfeeding implies that breastfeeding is somehow inadequate, when in fact we know that breastmilk alone is the perfect food for babies up until 6 months of age. And to say that artificial milks are nutritionally complete flies in the face of research which demonstrates time and time again the unique composition of breastmilk - full of immunoglobulins, antiviral agents and more besides. Artificial milks lack all of these.

Perhaps this years World Breastfeeding Week, focusing on communication and information, will spur us into being a little more honest with ourselves and mothers about the real differences between breastfeeding and artificial feeding.

We could make a start by dropping the phrase 'breast is best' and instead saying 'breastfeeding is the normal way to feed a baby, other ways of feeding a baby are associated with health disadvantages'. Admittedly - not quite as catchy, but, as with smoking, do we tell mothers that fresh air is great? Or do we tell them that smoking is likely to have negative health consequences for both themselves and their babies? It is not within the scope of this article to tackle the issue of guilt (which inevitably this issue raises) but isn't it the health professionals who should be feeling guilty if they haven't really informed mothers of the facts?

Much of our 'natural' knowledge about breastfeeding has been lost through the generations, and in many so-called developed countries it is now artificial feeding which is seen as the 'norm'. (How many times have you read an article in the papers about a woman being thrown off a train / out of a restaurant because she fed her child with a bottle?) The rise in artificial feeding, and the myth that it is as good as breastfeeding, is fuelled largely by the artificial baby milk companies. It is interesting to note that a leaflet about infant feeding produced by a baby milk manufacturer will not allude to any risks or disadvantages associated with the use of its products. Although some leaflets, for example, one by Boots, goes as far to admit that breastfed babies have 'fewer gastric upsets'. Only the "Informed Choice" leaflet by MIDIRS states the facts: "Bottlefed babies are five times more likely to be admitted to hospital with diarrhoea..." Why don't the artificial baby milk companies tell us this? Why don't health professionals tell mothers this?

One of the main ways to ensure that accurate information about breastfeeding (and artificial feeding) is communicated to health professionals and mothers would be to adhere to the WHO/UNICEF International Code of Marketing of Breast-milk Substitutes and subsequent relevant Resolutions. The Code protects a woman's right to make the decision about how she feeds her baby, in an environment which is free from commercial pressure and on the basis of full and accurate information. As midwives, we are surely morally bound to cease burying our heads in the sand and to begin to give women the information with which they can really make an informed decision about how they feed their babies.

WABA: email: secr@waba.po.my

Website: http://www.waba.org.br