Breastfeeding is flavor learning.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is flavor learning.

Through mother’s milk, human infants are “exposed to a bewildering variety of flavors that influence subsequent liking and choice.” [Beauchamp & Menella]

Differently, baby milk substitutes (BMS) or baby formulas offer static flavor. Formula manufacturers are only able to add flavoring to follow-on formulas at which point, it is too late to stimulate flavor detection, explains Dr. Julie Menella.

A breastfed baby experiences textural variations such as viscosity and mouth coating so “breastfeeding provides an even richer variation in oral sensory stimulation,” as recorded in Flavor Perception in Human Infants.

Before birth, flavor learning begins around the sixth month of gestation when the fetus begins to inhale and swallow amniotic fluid marking its first chemosensory experiences. [Thomas, 2022

Photo by Amina Filkins

The flavors a baby is exposed to signal things like the flavors of one’s culture, which foods are safe to eat, and biodiversity which later impacts food choice thereby affecting overall health and wellness. 

Mennella makes clear, “breastfeeding confers greater acceptance of healthy foods…only if they are part of the mothers’ diet…” 

One study which looked at the effects of maternal garlic ingestion on the odor of milk and the suckling behavior of the infant, found that the nursling detected changes in mother’s milk and stayed attached to the breast for longer periods of time, sucked more when the milk smelled like garlic, and tended to ingest more milk.  

Similar findings were noted when vanilla ingestion was investigated. 

Just as infants can detect the flavors of healthy and aromatic foods in their mother’s milk, they can also detect those of potentially harmful substances. For instance, Menella found that “infants can readily detect the flavor of alcohol in mother’s milk but…the decrease in consumption at the breast after maternal alcohol consumption is apparently not due to the infants rejecting the flavor of alcohol in their mothers’ milk.” 

It has also been found that babies can detect the flavors in cigarettes in breastmilk. Still, the researchers note, “We do not suggest that lactating women who smoke occasionally should stop nursing. However, the knowledge that the milk of mothers who smoke smells and may taste like cigarettes provides an additional reason to avoid smoking.”

Photo by Derek Owens

As artificial sweeteners gain prevalence in the food industry, Philip O. Anderson’s How Sweet It Is: Sweeteners in Breast Milk summarizes current knowledge regarding the transmission of sweeteners into human milk. 

Dr. Anne Eglash points out in a 2019 Clinical Question of the Week

There is preliminary research evidence that a maternal diet high in fructose may increase body weight and fat mass in breastfed infants. When mothers consume foods or beverages high in fructose, the level of fructose rises in breastmilk. This is not true for glucose, because maternal insulin rapidly normalizes the maternal glucose level after glucose ingestion. Insulin does not moderate the fructose level like it does for glucose.

Photo by Anglea Mulligan

And increasing sweetness of breastmilk via artificial or natural sweeteners in the maternal diet might predispose to later obesity. This may be partially mediated by an alteration in the gut microbiome by the sweeteners.”

As infants transition to complementary feeding at six months of age, the flavors they’ve already been exposed to in utero and through breastmilk will help them to explore a breadth of healthy table foods. While human milk is meant to be the primary staple of infants’ diets, human milk alone cannot provide everything babies need nutritionally, especially micronutrients like zinc and iron. [More on appropriate complementary feeding here— Food before one is NOT just for fun.]

Newer research is starting to investigate odor-active volatile compounds in preterm breastmilk and the effect of smell and taste of milk during tube feeding of preterm infants. Find some of those studies here, here, and here.

 

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us:  Do you have a funny infant feeding story?

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

Breastfeeding is a human right.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is a human right. 

Breastfeeding is often presented as a choice, but in many societies, infant feeding is impacted by systems of oppression and lack of supportive measures like paid parental leave, rather than simply being a product of parental choice. 

Source: United States Breastfeeding Committee

Michigan Breastfeeding Network Executive Director Shannon McKenney Shubert, MPH, CLC has put it this way:  “In my 12-year career in the field of human milk feeding, I have never once met a birthing parent who ‘chose not to breastfeed.’ In this country, whether to breastfeed is not a choice. In this country, whether to breastfeed is a question of ‘Within all the systems of oppression that I navigate, what is the best combination of things I can do to ensure the survival of my baby, myself and the rest of my family?’” 

Access to unbiased information and support and protection to make informed decisions about proper infant and young child nutrition is a core human rights obligation and must be projected as such in international human rights law, as articulated in a Global Breastfeeding Collective (GBC) convening this fall. 

What’s more, children have the rights to life, survival and development, and the highest attainable standard of health, all protected under the Convention on the Rights of the Child.

More specifically, under Article 24 of the Convention on the Rights of the Child, children and families explicitly have the right to have information about the advantages of breastfeeding and to be supported in making choices about the best nutrition for children as part of the right to health and health care.

Source: United States Breastfeeding Committee

Strangely, children’s rights and women’s sexual and reproductive rights communities often find themselves polarized on the issue. Because the mother and child are often regarded as separate entities, issues that impact women and children can appear as though one right is above the other. But a mother and her child should be extolled as an inseparable dyad, and human rights and health advocates must continue to articulate and emphasize this important point. Breastfeeding as a human right is not an either/or argument.

Source: United States Breastfeeding Committee

Marcus Stahlhofer, WHO Maternal and Newborn and Adolescent Health and Aging, lays out how approaching breastfeeding as a human right:

  •  helps to provide legitimacy and accountability for state or government action or inaction and helps set benchmarks to assess these actions,
  • enhances multi-stakeholder engagement through indivisibility and interdependence of human rights including involvement of global, regional and national human rights mechanisms,
  • elicits a paradigm shift that transitions from nutrition and health needs to legal entitlements and associated obligations, and 
  • empowers people to demand that their rights are not negatively interfered with, such as through breastmilk substitutes and commercial milk formula (BMS/CMF) marketing.


Stahlhofer has pointed out that BMS companies use human rights arguments effectively by drawing on ideas around freedom of expression, right to intellectual property, women’s rights to autonomy, bodily integrity, and free choice to justify their predatory practices. 

There are key human rights tools and mechanisms that health advocates can employ specific to infant feeding. Some of them include:

The Academy of Breastfeeding Medicine (ABM) issued a position statement in regard to breastfeeding as a human right. 

“The ABM asserts that it is a moral imperative to protect the mother’s and child’s basic rights to breastfeed for their own health and wellness, as well as that of the nations in which they reside. Given the importance of breastfeeding and human milk in reducing infant mortality, governments should include breastfeeding as a leading health indicator and work toward eliminating disparities in breastfeeding outcomes and increasing rates of breastfeeding,” it reads in part. 

The White Ribbon Alliance (WRA) Charter on the Universal Rights of Women and Newborns created a proclamation on the universal rights of women and newborns. Find that here.  

You can also explore GBC’s collection of documents that support breastfeeding as a human right here.

Source: United States Breastfeeding Committee

——–

As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us: What does breastfeeding support look like in your community?

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

Industry lies and the Code

“Even in the harshest of trade regimes, there is space for public interest laws to meet legitimate health objectives when they are founded on internationally adopted standards and recommendations such as the Code and subsequent relevant WHA resolutions.”– WHO, 2016

All three of my kids sport a similar look when they lie.  As soon as the fabrication tumbles out, their cheeks suck in ever so slightly toward pursed lips. Once they’ve heard themselves, their eyes widen a smidge and their bottom jaw drops just a few degrees. 

Most of us don’t like to be lied to, but usually the dishonesty we encounter can be considered trivial. “I didn’t do it!” when there’s crayon art on the kitchen walls. “Your hair looks great!” when you know it doesn’t. “Of course I remember you!” when you haven’t the slightest clue. 

Just as humans tend to react physiologically when we lie, we have an ability to detect when someone is lying to us. Inundated by the lies told by marketing companies on behalf of major industries though, detecting truth and falsehoods can be majorly challenging. There’s no lip biting, no shifting eyes, no perspiring to give it away. Instead the tactics industries use are cunning, targeted, sometimes irresistible and truly brilliant in many ways. The lies they tell are perpetual, and their claims have completely saturated our culture, influencing just about every facet of our lives, all for commercial gain.

There’s a promotional video featured by a cooking show that showcases a chef professing his allegiance to gas stoves. The video was created by a utilities provider though, and having worked aggressively with state legislatures “to block legislation that would provide cleaner, electric-based building codes,” their marketing got us to believe that cooking on a gas stove is somehow the best while simultaneously waging “war on local electrification initiatives all over the country.” [https://www.thresholdpodcast.org/season-4-episode-6-transcript]  

Here’s another example. Most of the seafood that we purchase and consume in the U.S. is mislabeled as something completely different. This “Seafood Fraud” is detailed in (Mis)labeled Fish

President of the  Center for Science in the Public Interest Peter G. Lurie, MD, MPH calls out unfounded claims of “healthy alcohol” in Peter’s Memo: The Jungle

Fossil fuel companies are greenwashing their efforts, helping to sow doubt about the fossil fuel industry’s role in the climate crisis. 

As explained on How to Save a Planet: “They’ve… done it indirectly, by funding organizations who lobby congress, launching fake grassroots campaigns, and perhaps most importantly, through advertising. These ads, according to Martin Watters at the nonprofit firm ClientEarth, are greenwashing.” 

The tobacco industry pushes “green” public relations too.

Now consider the baby milk substitute (BMS) industry. A recent WHO report examines the scope, techniques and impact of digital marketing strategies for the promotion of breast-milk substitutes which reveals how the $ 55 billion baby formula industry “insidiously and persistently” targets parents online through “tools like apps, virtual support groups or ‘baby-clubs’, paid social media influencers, promotions and competitions and advice forums or services, formula milk companies can buy or collect personal information and send personalized promotions to new pregnant women and mothers.” [https://www.who.int/news/item/28-04-2022-who-reveals-shocking-extent-of-exploitative-formula-milk-marketing

Their efforts have further adapted to target older children with their toddler milks and  formulas. Lurie again calls out false claims like  “Brain & eye development” and “Plant-based protein for toddlers.”

He writes: “The multibillion-dollar infant-formula industry is trying to convince parents that children older than 12 months need formula. They don’t. The beverages—made largely of fortified powdered soy or dairy milk, oil, and corn syrup solids or maltodextrin—typically supply added sugars. They certainly don’t beat a diet of healthy foods.” 

The WHO report confirms these concerns: “Science is a dominant theme in the marketing of formula milk across all eight countries, including scientific imagery, language and pseudo-scientific claims. Formula milks are positioned as close to, equivalent and sometimes superior to breast milk, presenting incomplete scientific evidence and inferring unsupported health outcomes. Ingredients, such as human milk oligosaccharides (HMOs) and docosahexaenoic acid (DHA), are advertised as ‘informed’ or ‘derived’ from breast milk and linked to child developmental outcomes. Examination of the scientific evidence cited does not support the validity of these claims.” (p. 9)

In response to the absurdity of BMS industry claims during Protecting Breastfeeding in the United States: Time for Action on The Code, David Clark, International Public Health and Human Rights Lawyer and Legal Advisor for the UNICEF Nutrition Programme (1995 to 2020), laughed “I don’t think I’ve seen anything so outrageous in my life.”

The marketing of formula products is different from other commodities because it impacts the survival, health and development of children and mothers; disrupts truthful information– an essential human right as noted by the Convention on the Rights of the Child; disregards the International Code of Marketing of Breast-milk Substitutes; and exploits the aspirations, vulnerabilities and fears at the birth and early years of our children solely for commercial gain. (WHO/UNICEF, 2022, p. x) 

Considering the current state of affairs– the industry’s guileful tactics, the permeation of their influence in every sphere of life, our nation’s lack of adoption of the International Code of Marketing of Breast-milk Substitutes/ subsequent WHA resolutions and any monitoring or enforcement systems– it’s easy to feel crushed as a maternal child health advocate, like the way forward is straight into the Apocalypse. 

Fear not. Researcher Britt Wray has suggestions on how to keep ourselves within our windows of tolerance in order to continue to mobilize. While Wray’s work focuses on the climate crisis, her findings are easily applied to maternal child health advocacy. Learn about these techniques here

There are also simple actions (and some bigger ones too) that we can employ to continue to move the needle.

Françoise Coudray of ADJ+ Allaitement Des Jumeaux et Plus offered this to health advocates attending the launch of WHO’s latest report : “The mosquito: small, small, but have one in your bedroom and you will have a very bad night; so do the mosquito, let us all do the mosquito.” 

  • On Facebook, find the three little dots in the upper right hand corner of the ad to locate the “Report ad” prompt.

    When marketed formula products on social media platforms, report them directly to the platform.

  • Make a presence at the Codex Committee on Contaminants in Foods Public Meetings. In April, individuals like Consumer Reports Senior Staff Scientist Mike Hansen, Ph.D, Environmental Defense Fund’s chemicals policy director Tom Neltner and Center for Science in the Public Interest’s Thomas Galligan, PhD made clear in brief comments that we need to rethink how toxin levels are approached at CCCF. Hansen pointed out that the current permitted levels are not sufficient to protect infants and young children. Echo these demands for safer products. [While we wait for more stringent requirements, consumers can check out the Clean Label Project to find information about food and products not available on their labels.]  
  • Join forces with other advocacy groups to put pressure on the enforcement agencies responsible for food safety. 
  • Check out this Indonesian model of a platform for reporting violations of the Code
  • Support relactation efforts. Artificial feeding does not have to be the default.  Ines Fernandez in the Philippines has a model for this work.  There is also information about this included in the Global Breastfeeding Collective’s recordings of Building Better Breastfeeding Counselling Programs
  • Get people fired up. Increase public interest participation using NACCHO’s flyer on advocacy and lobbying to drum up attention about how the Code benefits all babies, no matter their feeding method. This has been grossly overlooked and cannot be overstated as formula companies often attempt to pit breastfeeding advocates against those who do not breastfeed.
  • Support the Baby-Friendly Hospital Initiative (BFHI). In the U.S., this is the only “federal” program that is enforcing the Code, albeit voluntary participation.  
  • Encourage divestment. Check out Norwegian Secretary-General of Save the Children Tove Wang’s push for the Norwegian Government Petroleum Fund’s withdrawal from investments in companies aggressively pushing infant formula in developing countries. According to Save the Children’s Don’t Push It, “The largest global fund management firms have more than $110 billion invested in companies that market milk formula. As we have documented in this report, the profits these companies generate are fuelled in part by marketing practices that directly – and profoundly – harm children….Active investment funds have the power to wield huge influence over the boards of the companies they have a stake in.” (p44-45)  
  • Support the work of Baby Milk Action. Patti Rundall, Mike Brady and colleagues work tirelessly to uphold the Code and its resolutions including speaking at shareholder meetings.
  • Stay tuned for an engaging opportunity with the newly formed INFACT USA to uphold the Code here in the U.S.

Many of these immediate and long term actions are outlined in Constance Ching and colleague’s piece Old Tricks, New Opportunities: How Companies Violate the International Code of Marketing of Breast-Milk Substitutes and Undermine Maternal and Child Health during the COVID-19 Pandemic.

 

Add your name to #EndExploitativeMarketing here. Tell us about your efforts engaging with the Code. Email us at info@ourmilkyway.org.