Breast feeding: A preferred infant nutrition in postage stamps

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Have you ever wondered about old baby-food advertisements. In these advertisements, we could see healthy-chubby infants and happy composed mothers. Once frequent on television and in print media, these have faded away. Often these advertisements projected condensed milk as a preferred option. In India we had sought to curtail these in 1992. Eventually they went away in the year 2000. It was a battle between bottle and breast-feeding, later had won. Postage stamps and philately have also contributed to this movement, and let’s explore how.

Breast feeding was a historic norm

Presence of breast tissue is the basis of identifying various animals as mammals. Amongst them, human being have a position of prominence. All mammals suckle or nurse their progeny. Till 18th century, if mother had died during childbirth, or if she was not producing enough milk, wet-nurses would step in. These were women, who would nurse infants, in addition to their own. Wet-nurses could be from within a family or outside. They would also take care of the child, and the mother, till the later recovered from pain of childbirth. In India “Maa” is mother, and “Dai-Maa“would be wet-nurse. While, wet-nurses were safe, only rich and aristocracies had a greater access to them.

Invention of commercial milk substitutes

What if someone could not afford a wet-nurse. As a substitute, orphanages used dry-nurses (rearing goats, cows, or mares) as source of milk for infants. Prior to 1850s, preservation of milk was tough. Pasteurisation of milk was not yet perfected, and refrigeration not yet discovered. Quest for artificial milk continued throughout 19th century. In 1865, a German scientist Justus von Leibig produced first cow-based infant feeding formula. Over next 40 years, commercial manufacturers like Nestle, Horlicks, Mellin and Ridge had brought out their powdered versions of infant milk-substitute feeding formulas. Thereafter, we had condensed milk, and Soya based milk formulas. Commercial preparations came with a cost, as well as their own problems.

By 1960s infant-food companies were marketing a number of commercial products. More and more mothers stopped feeding their children and relied on commercial formulas. In fact, less than a third of all mothers in developed countries were practicing exclusive breast feeding. At this time, media, advertising, and popular perception all viewed breast-feeding as inferior, inappropriate, and indicative of poverty. Commercial feed was portrayed as a better and complete care. To dispel these beliefs, La Leche league, established in 1956, was first voluntary breast feeding promotion organisation.

Bottle vs breast-feeding

A period between 1960-1980 was a battle between mothers who wanted to continue breast feeding, and commercial manufacturers who were promoting their formulae. New ingredients such as iron, vitamins, cod-liver oil etc were added to bottle feeds – to make them appear superior. In addition to a popular perception, manufacturers pushed their products through doctors. Nestle was a biggest sponsor of paediatric meets and conferences.

However, by 1980s hazards of bottle feed were more apparent in the developing world. Use of more expensive, inferior and more diluted product was leading to medical starvation. Mothers would dilute these feeds, so as to make a more economic sense. Further, many commercial feeds lacked essential nutrients, that were already there in breast milk. On the other hand breast milk has immune regulators, and cellular substances, infants were missing out on. After all, it is least expensive, and most useful, 100% natural product.

In 1980, UNICEF launched its four-pronged strategy – with an acronym GOBI. It stands for Growth, ORS, Breast-feeding and Immunization. Infant feeding formulas were more tightly regulated. Government mandated advertisements to support breast feeding. This was as per WHO code for marketing breast milk substitutes.

Activism gains momentum

In 1991 WHO launched BFHI – Baby friendly hospital initiative. It became mandatory for all health facilities to promote exclusive breast feeding for six months. In the same year, in December 1991, Indian paediatricians and gynaecologists formed Breast Promotion network of India or BPNI. This resolve, materialised in a breast-feeding workshop held at MGIMS Sevagram – with Dr Felicity Savage, Dr Helen Armstrong, Dr R Anand, and Dr MB Kumta as key facilitators.

In 1992 activists formed WABA – World alliance for breast-feeding action. These actions gained momentum and world breastfeeding week was established – which is observed from 1-7th August every year.

In 1992, Government of India passed Infant Milk Substitute (IMS) act. This act barred any IMS producing company to give any inducement to individuals or doctors to promote formula feeds. In the year 2000 an additional legislative protection was granted to breastfeeding through the Cable TV Networks Amendment Act that banned any advertisement of the infant milk substitutes, infant foods and feeding bottles in the Cable TV network services in India.

Breast feeding in 21st century

In recent years, there is an increasing concern in the west about food-allergies, obesity, and diabetes mellitus. These concerns have prompted a movement back towards breast feeding. Workplace breast feeding promotion is now mandatory. Today, there is a strong support for lactation. It is a robust, resilient, and reliable survival mechanism. There is a need to further ensure that infants do not miss out on this valuable resource.

Every year we celebrate 1st-7th August as World Breastfeeding week. With advances in preservation technology, many countries are in process to establish human milk banks. These banks have an aim to preserve and distribute natural product, will most of its advantages. Today we celebrate breast-feeding as most useful public health policy of the century.