Death in a Bottle

The lives of millions of future Third World babies are at stake. Western medicine has persuaded the world that HIV-positive mothers should formula-feed whenever feasible–a decision taken with a teaspoon of data and a gallon of assumptions.

Few now disagree that, for most babies, “breast is best” to reduce the risk of death and illness due to diarrhea, intestinal disorders, meningitis, ear infections, respiratory infections, SIDS, and many other sicknesses. A World Health Organization (WHO) analysis showed that the risk of death in poor countries was three to four times higher in formula-fed infants in their first six months of life.

A Hasty Decision

After only two letters in medical journals, the Center for Disease Control (CDC) recommended against breastfeeding by HIV-positive women in 1985–with no analysis of the risks of formula feeding versus breastfeeding. This resulted in a virtual ban on breastfeeding by HIV-positive women in rich countries.

The only thing saving babies in the third world is that formula feeding is usually not affordable and always dangerous, often because of poor water quality. Only reluctantly are women allowed to continue breastfeeding. A spate of international initiatives is trying to change that.

Sloppy Science

Researchers involved in a Kenyan study published in the Journal of the American Medical Association, Nov. 2001, admitted that, for the two-year length of their trial, they were unable to find increased mortality in the breastfed infants. However, they never properly defined breastfeeding. Data from mothers who formula-fed were used for the breastfeeding arm of the trial, and data from mothers who breastfed were used for the formula arm of the trial.

The trial was rigged in favour of formula by limiting participation to mothers who had access to treated water. A sign that there are more serious problems in the study was the higher death rate among mothers. This was blamed by the researchers on stress due to breastfeeding, but might also show that the trial was not properly randomized, with healthier women more likely to be told to formula-feed. Healthier women, of course, have healthier babies and are better able to care for them.

Breastfeeding vs. the Bottle

Research from South Africa reported in AIDS, Feb. 2001, showed that when breastfeeding is better defined as either “exclusive” (no other fluids or foods) or “mixed,” the rate of HIV transmission was similar between the “exclusive” group and those formula-feeding their babies (but higher in the “mixed” group). This research has been pooh-poohed by some because it was not a randomized trial of feeding method (but then it’s likely that the Kenya research was not randomized either).

In Oct. 2003, the Journal of Nutrition reported evidence that formula-feeding programs are dangerous. In a group of 148 babies of HIV-positive mothers in India, all hospitalizations during the first six months were in the formula-fed babies.

If you are concerned about this issue, before you support an AIDS charity, ask if they support breastfeeding and, if they do not, request the peer-reviewed health outcome studies that support their position.