The Strange “Economics” of Breast Milk


December 1, 2006


Browse in Childhood Diseconomy Health Philippines
December 1, 2006
By Jonathan Rowe

You probably heard about the woman who was kicked off a Delta flight recently for breast feeding her daughter.  She was in a window seat, next to her husband.  She was being discreet; nothing was showing. A flight attendant asked her to cover up with a blanket anyway.  The woman declined; and so off the plane they went.

The episode prompted nurse-ins at airports throughout the U.S.  The airline apologized; and I’m willing to believe that the flight attendant thought she was just doing her job. Still, there’s an issue here that goes beyond the lingering residues of prudery – namely, the pervasive bias in favor of commodities, and against anything people can do for themselves for free.  Has anyone ever been thrown off a plane for giving infant formula to a baby, which is inferior to breast milk?  I doubt it.

Childhood in the U.S.  has become a case study in this bias.  Kids now need high-tech toys in order to play, organized leagues for sports, drugs to focus their attention, video screens (another form of drug) to occupy them in cars – on and on. The inner lives of children, their innate capacity to imagine, learn and grow, is turning into a Petri dish of deficiency and need. By the conventional economic reckonings, need and craving is what kids are for.

This process has penetrated down to their first form of nutrient – milk.  I had thought that the infant formula mess had been resolved a while back, but I was wrong.  Around the same time as the Delta nursing-mother expulsion, a controversy was simmering in the Philippines over this very question. Research is overwhelming that breastfeeding is best for children.  Mother’s milk has all the right nutrients, plus hormones, active enzymes, immunities and other things that cannot be replicated in formulas.

Children who are breastfed do better physically, emotionally, and every other way (except perhaps as consumers of remedial drugs and services later on.)  For families there is a financial side as well.  The Philippines is a poor country. Officially the per capita income is a bit over $1000 a year; given the gross disparities in wealth, it’s actually less. Yet close to 40% of infants there are fed commercial formula instead of breast milk, at a cost of over $400 million a year.  A quarter of those are “poor,” which in the Philippines means really poor.

So why are the poorest people in a poor country spending money they can’t afford on a product most of them don’t really need because they have a better version of it already?  Advertising is part of it. Global pharmaceutical companies have the resources to propagandize for infant formula in ways that make people feel backward if they don’t get with the modern American ways.

To combat this, the Philippines banned advertising of infant formula, which would seem a sensible step.  What purpose does such advertising really serve? Does there exist a mother who does not know already that formula is available for sale? Would anyone contend that the corporations that make it are the best sources of guidance on whether or not a mother should use it?

Banning the ads would seem no loss and all gain except for the corporations involved.  Which is why the biggies — Abbot Laboratories, Mead Johnson, Novartis, GlaxoSmithKline, et al –held up the new regulations this summer with a challenge to the nation’s highest court.   The challenge framed the issue in terms of the rights of Filipinos themselves – in particular the “right of the people to access to information.”

Exactly what is “informative” about these ads, as opposed to emotively suggestive, they didn’t say (and judges tend to show a staggering lack of curiosity about the difference.)  The Court ruled against the drug companies anyway.  So now the U.S. Chamber of Commerce has weighed in with a letter to Philippines President Gloria Arroyo that threatens dire consequences if the regulations go into effect.

The letter warned of the “risk to the reputation of the Philippines as a stable and viable destination for investment.”  Gee, I wonder what exactly they mean by that.

Such threats are not small matters in a country struggling to put an economy together. Arroyo has been compliant with U.S. wishes, especially on intellectual property enforcement. But so far she hasn’t caved on infant formula; and public health professionals from around the world have expressed outrage at the corporate intimidation tactics.

But the corporations are simply obeying their own internal mandates. They can’t look upon children any other way than as a potential lode of what economists call “demand.” It’s their nature. When television first came to my wife’s village in the Philippines a few years ago, I asked people there about the changes it had brought. Practically to a one they said, “The kids all want to go to Jollybees,” the local fast food chain that has beaten McDonalds there.

These children have food literally right outside their doors: rice, chicken, pigs, goats, swamp cabbage, bananas, yams. They were happy with that until commercial television came along.  Now they want an expensive (to them) and nutritionally inferior version of what they have already; just as the pharmaceutical companies want to push an expensive and inferior version of what most mothers have already.

There was another bit of news around the time all this was going on.  The U.S. Food and Drug Administration has once again approved, after a 14-year ban, the sale of silicone breast implants.  The numbers are rough, but according to a Wall Street Journal report the market for these could soar quickly to over $600 million a year, not counting the surgeons fees that could run the total to $2 billion or more.  That’s five times what the Philippines spends on infant formula.

There is something bizarre about those numbers.  One represents the effort by corporations to render the human breast useless, and to displace it with something they sell for money.  The other represents a kindred effort to commoditize the breast itself and make it useful to the corporation.  Displace what is in the breast with something the mother has to buy; then convince the mother that she has to buy something to put back in.

That’s pretty much what they do to children: hollow them out emotionally, and substitute their products for the capacities the children once had on their own. And not just children – all of us.

I am sure the Delta flight attendant wasn’t thinking of any of this when she booted the breast-feeding mother off the plane. (I didn’t mention that the flight was delayed three hours, so it is understandable that mom was in no mood to be told she had to hide her nursing baby under a blanket.) But that’s the thing about cultural patterns: they replicate themselves silently, without people even thinking.