China: Infant Formula Scandal Highlights Decline in Breastfeeding

Health authorities in China reported this week that nearly 53,000 children have become sick after consuming tainted infant formula. As the effects of these contaminated dairy products become more widespread, many are discussing the alternative to formula — breastfeeding.

The scandal erupted earlier this month when Sanlu, China's top-selling infant formula manufacturer, publicly recalled its products. The baby formula was deliberately contaminated with melamine, an industrial chemical that can cause kidney problems. Since then, thousands of children have become sick and the milk powder has been blamed for the deaths of four infants. The crisis has not only raised questions about food safety, but also about why so many children are being fed formula in the first place, instead of being breastfed.

Thanks to its numerous health benefits, the World Health Organization recommends that children be breastfed exclusively for the first six months of life. However, despite a long tradition of breastfeeding in China, rates have declined as more mothers turn to milk formula. The rates of exclusive breastfeeding during an infant's first four months decreased from around 76 percent in 1998 to 64 percent in 2004. At six months, the percentage of babies being exclusively breastfed is only 51 percent.

Many blame China's shift away from breastfeeding on formula companies who aggressively target the 17 million babies born each year in China. Mr Dennis says:

“With the recent tainted formula scare in China I immediately became suspicious – why are so many Chinese using formula anyway? It is a poor country, surely they would be breastfeeding? Sure enough, just like in the West in the 40s and 50s, formula is being promoted in China as better than breast milk.”

He goes on to cite a report that blames the marketing of formula:

“Under Chinese consumer protection regulations, ads can’t claim or hint that a product is a replacement for breast milk. Nor are ads permitted to use images of breastfeeding women and babies. Nonetheless, infant formula companies often flout these regulations.”

Mike Brady, blogging for Baby Milk Action, also blames formula companies and their unethical advertising tactics.

“Consider a little further why there is a growth in formula use in China. It is undergoing rapid industrialisation and urbanisation, but that does not have to mean the fall in breastfeeding rates that is being experienced. Part of the cultural change is prompted by western companies. For example, Nutricia, now owned by Danone, promoted its ‘Kissing my Baby’ formula in China in 2004 with this gift CD with children's music.”

Some say that this push to use formula comes from doctors themselves. This despite the fact that China has banned the promotion of breast milk substitutes in hospitals since it launched the Regulation of Human Milk Substitutes Distribution in 1995. One article claims that almost 63 percent of babies receive formula in Chinese hospitals anyway. The same regulation also says that doctors must promote the advantages of breastfeeding.

Covenofovens, commenting on this article, shares his story of pushy doctors:

“We breastfed our baby exclusively for a year (breast milk and water only for the first 4 months, then breast milk, water and food after that)…This is not to say that we had formula pushed on us by doctors – especially the doctor that came to check on my wife a week after the birth. She brought a sample pack of formula produced close to Shenzhen (where our son was born), which sat on the shelf until we eventually threw it away.”

Nase, blogging from Malaysia on My Solitude of Space, says that the moms in his local Chinese community are less likely to breastfeed. He asked his mother as to the reasons why.

“Apparently (according to my mom and many Chinese moms), the main concern is about sagging breasts (quote from momma Rose: If I'd breastfed all five of you rascals, I'll be walking on four legs now!)…Other less convincing reasons given by my momma Rose was that due to inconvenience, as moms also need to work and care to other whims of their older children and husbands too!”

minipumpkin agrees that body image is an issue, but also blames a lack of time and the misconception that formula is healthier:


“Now there are many young mothers who are worried about their time and their body shape. Even though they have enough milk, they decide not to breast feed their babies. Moreover with so many infant milk formula ads in the market, these mother may feel that the infant formulas are very nutritious and it is very convenient too. Babies grow very fast and look healthy, so why not. I don't want to criticize those mothers who decided not to breast feed their babies, some of them may be forced to use milk powder because they don't have enough milk. I just feel fortunate that I have made a right decision. And now that the Sanlu scandal broke out, I decide to extend the breast feed period for my baby.”

kakb2006, quoted from Hong Kong's newspapers, points out that working can be an especially large obstacle to breastfeeding for migrant workers.


“Because many rural migrant workers go to the city to work, many women after giving birth need to return to the city and leave the babies in the village. As the mothers are not around to breastfeed the babies, they can only rely on milk powder. And because they are poor and cannot afford expensive infant formula, they can only use the cheaper brand. That's why economic infant milk has a large market in the rural area.”

Some Chinese researchers have said that the shift back to breastfeeding will require greater promotion of its benefits. Hoyden About Town adds that this change will only happen if breastfeeding is supported financially, socially and practically. Perhaps the infant formula scandal will start pushing this change to happen in China. A post from the South China Morning Post reports:

“A lack of nursing skills, breastfeeding rooms, and public awareness are among the scores of reasons mainland mothers have abandoned breastfeeding over the years, but the melamine milk scandal is one factor forcing many to reconsider. Hospitals have been packed this week with scared mothers asking about breastfeeding, while the topic has become the most popular source of discussion on maternity and childcare websites.”

Image of Breastfeeding Allowed posted by Topinambour on Flickr.

Oiwan Lam contributed translations of quotes from Chinese to English for this post.


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