Infant feeding and planetary health go hand in hand

I recently woke up to a headline with the words “climate” and “hope” strung together. As author Jeff Brady points out, it’s “…something you don’t hear much when it comes to climate change: hope.” 

Brady goes on to illuminate a recent International Energy Agency (IEA) report that shows “countries are setting records in deploying climate-friendly technologies…” 

There’s more: “While greenhouse gas emissions keep rising, the IEA finds that there’s still a path to reaching net-zero emissions by 2050 and limit global warming to 1.5 degrees Celsius, or 2.7 degrees Fahrenheit. That’s what’s needed to avoid the worst effects of climate change, such as catastrophic flooding and deadly heatwaves,” he writes.

Photo by Mika Baumeister on Unsplash

It’s hard to imagine that we’re in a place where there’s still the potential for “the worst effects.” Are we not already there? 

Not long ago, when extreme weather occurred, we were told it wasn’t possible to link specific events to the climate crisis. Now though, scientists have figured out a model to represent how the climate crisis produces specific weather events like hurricanes and extreme heat.

Extreme weather events and other disasters and emergencies will continue to occur, so it’s imperative that we develop infant and young child feeding in emergencies (IYCF-E) preparedness in the U.S., something we are seriously bad at.  

Jennifer Russell’s, MSN, RN, IBCLC, NHDP-BC, Ph.D. Candidate in Nursing Science from the University of Tennessee Health Science Center co-authored Domestic Preparedness Journal article “Challenges with pediatric mass care feeding,”(p 27-31) details the importance of and how state, local, tribal, and territorial organizations’ (SLTTs) can “safely, effectively, equitably, and quickly provide pediatric feeding support” in emergencies. 

Namely, the authors state: “SLTTs must estimate and plan for the logistical distribution and cost of breastfeeding and re-lactation supplies along with safe alternatives to mothers’ breastmilk and other pediatric feeding items.” The authors bust some common misconceptions about emergency response and offer ways in which we can improve existing guidance. 

Photo by Dave Clubb on Unsplash

In her most recent guest post on Our Milky Way, “Nourishing Children and the Planet”,  Healthy Children Project’s Donna Walls considers the critical weather events of late and highlights the urgency of education, legislation and action.

Walls points out that lactation care providers (LCPs) and health advocates can and should take a leading role in the fight for the health of our planet.  LCPs are important actors within the greater need for national-level policy development, and LCPs’ work helps to mitigate the more grandiose challenges of the climate crisis.  

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The first best food for infants is mother’s own milk. We all know about the benefits for mothers and babies, but we don’t often discuss the benefits for the health of the planet.

https://www.gifa.org/en/international-2/green-feeding/

This is a win-win situation. By providing our infants and children with cleaner, “greener” foods, we also create a cleaner, safer environment for our families, our communities and the world. 

By contrast, commercial milk formulas (CMFs) are harmful to the planet because they require procurement of ingredients and manufacturing and transport of the product. All of these processes use resources and contribute to the increasing burden of greenhouse emissions. Read Powdered Baby Formula Sold in North America: Assessing the Environmental Impact for a detailed look at the environmental and Greenhouse Gas impact of powdered baby formula, which as the authors note, “should be considered when developing and funding infant and young child feeding policies and supportive programs.”

Water resources are scarce in many countries around the world, and yet “about 5000 litres of water are used for every kilogram of milk powder, including producing the milk, then processing the powdered milk, preparing the feeds, and sterilising feeding equipment.” (Linnecar, van Esterik, 2023).  Unnecessary use of precious water resources threatens the very survival of children across the globe.

It’s true that “the few extra litres of water required by a breastfeeding mother are negligible compared to the amounts of water for formula production and preparation.” (Linnecar, van Esterik, 2023

Destruction of natural resources, such as the rainforest for harvesting ingredients as well as ever-mounting pollution from plastics is creating a negative impact on the environment ultimately contributing to rapid climate change. 

By supporting breastfeeding families,  LCPs can be the first line of defense by reducing pollution and minimizing the powerful effects of the climate crisis. Breastfeeding  is, without doubt, the cleanest, “greenest” form of infant nutrition. 

Ultra processed foods (UPFs) impact on  health

What’s more, we have evidence that breastfed infants consume less ultra processed foods (UPFs) as they get older (Paharia, 2023). 

UPFs not only strain our resources but have been shown to increase rates of type 2 diabetes, obesity, hypertension, cardiovascular disease and dementia further straining resources as communities struggle to care for sick individuals. Shockingly, research shows “67% of children’s calories come from empty ultra processed foods” in the U.S. (Berg, 2022).

Food additives– “any substance not normally consumed as the food itself and not normally used as a typical ingredient of the food, whether or not it has nutritive value” (FAO, Codex Alimentarius, 2021)– frequently found in UPFs, present a myriad of concerns including central nervous system disruptions, hyperactivity or other behavioral or neurological issues in children. (Health Effects Assessment: Potential Neurobehavioral Effects of Synthetic Food Dyes in Children, 2021

Predatory marketing lulls families into believing that these convenient food sources are not harmful. Information and research about the toxicities and harm is usually assigned to the small print or not disclosed at all. 

The Environmental Working Group (EWG) has published information on several food additives that are especially troubling. These include:

  • Nitrates and nitrites- meat preservatives  linked to stomach cancer, esophageal cancer, and possibly brain and thyroid cancers
  • Propyl paraben- a preservative in pastries shown to cause developmental and reproductive harm.
  • Food dyes (especially red and yellow dyes) linked to cancers
  • Potassium bromate- carcinogen found in baked goods
  • BHT and BHA- preservatives in foods are possible carcinogens
  • Titanium dioxide- color additive implicated in DNA damage
  • PFAS- known as forever chemicals used in food packaging which has been shown to leach into foods. These are known to increase the risk of cancer, damage to the immune system and hormone disruption. 
Food additives’ impact on environmental health 

According to Lempart-Rapacewicz, et al, the latest literature classifies food additives as one of the groups of so-called Contaminants of Emerging Concern (CECs), defined by the United States Environmental Protection Agency (USEPA) and United States Geological Survey (USGS).

These chemicals are not naturally occurring, and so require manufacturing resources ie; water, energy, systems for disposal of by-products and waste and packaging materials, to either develop or alter the final product.  Pollution of our air and water are well documented consequences of this type of manufacturing. 

These  substances are also found in sewage where current processes are unable to remove them from the systems, leading to concerns of the micropollutants in the ground and water tables. 

Additives such as ascorbic acid might sound harmless, but when found in large quantities,  alters the pH of water and soil, affecting the basic growing medium for plants and crops. Ongoing research investigates the long-term consequences on plant and crop properties and the effects on biodiversity. Some studies have found mutagenic and teratogenic effects on fish and aquatic vegetation after exposure to food additives. ( Lempart-Rapacewicz, et al, 2023)

Plastic ingestion

Infants and children can be especially susceptible to  exposure to micro or nano plastics–plastics so small they are measured in micrometers or nanometers (microplastics are plastic particles under 5 millimeters in size, and nanoplastics are under 0.001 millimeters in size). They’ve been detected in many of the foods we eat,  in the air we breathe and the water we drink. Micro and nanoplastics are absorbed into our bodies through food packaging or in infants and children through feeding bottles and teats, baby food containers and pouches. Significantly more particles are released when the food containers are heated in the microwave (Hussain, et al, 2023).

Photo by Zeesy Grossbaum on Unsplash

The health effects of ingesting plastics are not completely understood yet, but early research implicates micro and nano plastics in imbalances in the microbiome, altered lipid metabolism, reproductive system, brain and lung dysfunctions. 

More on environmental degradation

In 1962,  Rachel Carson wrote the groundbreaking book Silent Spring, sounding the alarm about the use of pesticides and herbicides. Concerningly, as a nation, we have yet to heed her warnings. 

Use of these powerful chemicals is negatively impacting plants by causing them to produce less phytonutrients– the vitamins and minerals we need to stay healthy. 

Scientists are finding “dead zones” in bodies of water, areas that are so polluted they can no longer sustain aquatic animals and plants on account of run off of these toxins. Disruptions in the ecosystems have led to the rapidly changing climate and instability of our weather patterns.

Since the publishing of Carson’s book, micro and nano plastics have been found to inhibit the growth of healthy microbiota in aquatic animals and have also been shown to obstruct the digestive system of marine organisms such as mussels and oysters. 

Scientists note increasing contamination of agricultural soils with these particles, reducing plant growth and overall productivity (Amboyne, et al, 2021). Soil contamination negatively affects inhabitants such as earthworms and nematodes resulting in changes in the soil microbiome.

Learning to live in balance
Photo by Derek Owens on Unsplash

On an individual level, tackling the catastrophic challenges spurred by the way we produce and consume food, is insurmountable and requires system-level action;  however, there are resources for families to consult when working to make the healthiest choices for their families. Beyond breastfeeding,  families can check out theEWG’s  “Dirty Dozen” and “Clean 15” listing of foods to find the most budget-friendly way to provide cleaner, organic foods. There is no question that organic foods are the healthiest. 

When we learn to live in balance with the natural world, the health of both flourishes.  It can sometimes seem an uphill battle to create a cleaner, greener world but as individuals, and collectively, it is our privilege and responsibility to do whatever we can. One person at a time, one family at a time, one community at a time. One of my life-long favorite quotes is from Margaret Mead, and it is as important now as when she wrote it in 1978: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed it is the only thing that ever has”. This seems to be the time for those committed to caring for mothers and babies to also commit to caring for Mother Earth as well.

More resources to consult

Global Nutrition Report 

Green Feeding Tool

IBFAN’s Health and Environmental Impacts

Report on CARBON FOOTPRINT DUE TO MILK FORMULA: A study from selected countries of the Asia-Pacific region

Register to attend  Infant and Young Child Feeding in Emergencies: Preparedness Systems for Communities to Keep Our Babies Safe webinar hosted by U.S. Breastfeeding Committee (USBC) and the National Association of County and City Health Officials (NACCHO) on November 1 from 2:00 – 3:30 pm ET. The session will provide an overview of the Centers for Disease Control and Prevention’s (CDC) infant and young child feeding in emergencies (IYCF-E) toolkit, share current research exploring personal experiences and disaster-related factors that influence breastfeeding, describe how NACCHO has supported communities in emergency preparedness for maternal and child population.



Green Feeding

Guest blog post collaboration with Donna Walls,  RN, BSN, IBCLC, CLC, ANLC

At its core, Green Feeding means taking action from birth to safeguard the health of humans and the environment.

Photo by Akil Mazumder

Green Feeding encompasses the promotion, protection and support of breastfeeding as the most valuable natural resource from 0 to 36 months of age.

In May 2019, the International Baby Foods Action Network (IBFAN) in partnership with the World Breastfeeding Trends Initiative (WBTi), published Green Feeding–climate action from birth, issuing a plea for awareness on the impact of infant feeding practices on the environment and to promote breastfeeding which nurtures a healthy population and planet.

Green Feeding practices should continue beyond exclusive breastfeeding. When complementary foods are introduced at six months of age, guidelines include:

  • foods which are naturally occurring foods (such as plants and animals),
  • minimizing processed (foods prepared with salt, sugar, oils such as canned fruits or vegetables or simple cheeses),
  • culturally appropriate, family foods which rarely contain concerning levels of sugar, salt, fats, and toxic additives,
  • and the avoidance of ultra processed foods (foods altered by processing and additives not normally found in foods like dyes, preservatives, stabilizers). Infant formulas fall into the category of ultra processed foods.

 

Human and planetary health interplay 

Breastfeeding is a frequently ignored topic by global climate action leaders despite it being an almost cost-neutral intervention with a huge impact on human and planetary health.

Photo by willsantt

“Recent studies have highlighted the environmental cost of decades of disinvestment in services to support breastfeeding,”  the authors of Support for breastfeeding is an environmental imperative write. “When breastfeeding is encouraged and supported the associated infant and maternal health outcomes produce healthier populations that use fewer healthcare resources.”

Authors of Why invest, and what it will take to improve breastfeeding practices? note that breastmilk is a “natural, renewable food” that is environmentally safe and produced and delivered to the consumer without pollution, unnecessary packaging, or waste.

By contrast, breastmilk substitutes leave an ecological footprint and require energy to manufacture, materials for packaging, fuel for transport distribution, and water, fuel, and cleaning agents for daily preparation and use, and numerous pollutants are generated across this pathway.

Human health is often sacrificed for business interests and profits; the “bottom line” is about dollars and not  families’ precious health.

The Green Feeding advocacy document continues to spell out the interplay between human and planetary health through the lens of healthy infant and young child feeding (IYCF).

As a renewable natural food resource, mother’s milk contributes to local food and water security and biodiversity.

Differently, the run-off of waste from dairy farming used in artificial milk development, threatens our water supply with contamination by toxic chemicals, pesticides and harmful microorganisms.

The global food system, from production through all stages of processing, distribution, food preparation and consumption, accounts for an estimated 19 to 29 percent of global anthropogenic greenhouse gas emissions. Animal-based food products generally have a higher climate impact than plant-based foods, due to emissions from feed production, manure management and, in the case of ruminant animals, enteric fermentation, as noted in The carbon footprint of breastmilk substitutes in comparison with breastfeeding.

Not breastfeeding poses the risk of multiple avenues for exposure to toxic heavy metals like contaminated foods and artificial baby milks and contaminated water.   Municipal tap water, groundwater or well water is used to reconstitute powdered formulas and cereal foods and can contain high levels of toxic chemicals. This same water is used for cleaning feeding equipment and for drinking. The risk is increased because powdered formulas and foods prepared with water are the sole or the major source of food and drink at the most vulnerable stage of infant and young child development.

“Exposure to toxic heavy metals causes permanent decreases in IQ, diminished future economic productivity. Toxic heavy metals endanger infant neurological development and long-term brain function,” according to a 2021 IBFAN report.

Plastic pollution is a huge environmental concern made worse by the need for bottle feeding supplies and consumption of single-use articles.

Green Feeding contributes to the work of social justice and poverty reduction, offering protection to the most vulnerable infants and their families, creating a “level playing field” for family budgets. It challenges inequalities in marginalized households and communities that are most negatively impacted by climate change. The high cost of infant formula and ultra-processed baby foods can overwhelm low and middle income households.

 

Green Feeding begins prenatally

There’s a growing body of research connecting prenatal and early life toxic exposures to poor health outcomes.

Photo by Thiago Borges

For example, high urinary metabolite concentrations for several prevalent phthalates were associated with greater odds of delivering preterm, and hypothetical interventions to reduce phthalate exposure levels were associated with fewer preterm births. The most consistent findings were for exposure to a phthalate that is used commonly in personal care products like nail polish and cosmetics, noted by the authors of Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth: A Pooled Study of 16 US Cohorts

Things like air pollution, heavy metals, phthalates, plasticizers (PCB) and per- and poly-fluoroalkyl acids (PFASs) which are produced during industrial manufacturing and are widely used in consumer items such as food packaging and non-stick cookware have been known to lead to childhood liver disease, development of diabetes and developmental delays in children.

Endocrine disruptor exposure prenatally and early in life also present a major concern to children. Dozens of these endocrine disrupting chemicals are found in pesticides, personal care products, flame retardants and are found in the air, water and foods. They mimic the female hormone estrogen and thus interfere with the action of the body’s natural hormones which influence reproduction, immunity, metabolism and behavior. More on endocrine disruptors can be found in Endocrine disrupting chemicals and the battle to ban them.

In studies from the University of Rochester Medical School, it was found that wistar rats exposed prenatally to environmental estrogens resulted in damage to the alveolar cells of the breast to the extent that the mother rats were unable to nourish their offspring, as documented in Dioxins In Food Chain Linked To Breastfeeding Ills. 

Authors LaPlante and Vandenberg note reduced milk production in mice exposed to 17α-ethinyl estradiol, and less “mothering behaviors” in rats exposed to environmental estrogens, including reduced nesting behaviors and pup retrieval have also been documented.  These, and other studies, show a concerning trend in the future care of offspring.

 

Eliciting change from the top down 

UNICEF’s 2022 report Places and Spaces: Environments and Children’s Well-Being calls on national, regional, and local governments to make protection of children’s environmental health a priority. Clean air, water and food make up an essential foundation for infant and childhood health. Creating a cleaner, healthier environment begins with the cleanest first food, breastfeeding, and continues with toxic-free foods throughout childhood and adolescence. Taking these steps now reduces the risk of food-induced illnesses including childhood obesity, diabetes, hypertension, asthma, neurodevelopmental delays and immune dysfunction. While we continue to see the predatory marketing of altered foods claiming to offer health benefits, there is no evidence that any of these are superior in any way to clean, naturally occurring foods.

 

Eliciting change from the bottom up 

Anthropologist Margaret Mead said, “Never doubt that a small thoughtful, committed group of citizens can change the world: indeed it is the only thing that ever has.”

Photo by Nandhu Kumar

Advocate for breastfeeding. Join local breastfeeding support groups and talk about the risks of not breastfeeding for mother, infant, and the environment. Connect with “breastfeeding adjacent” groups such as breast cancer advocates or prenatal and infant information groups or toddler play groups.

Talk with local stores selling maternity or infant care products about the opportunity to present this information to customers. Use social media to help spread the word.

Stay politically aware of legislation and contact your local, state or federal representatives and let them know why and how you support breastfeeding and climate-friendly actions. The United States Breastfeeding Committee (USBC) is a great launching pad for this type of activism.

If you, your family or friends need to use infant feeding bottles, teats and other products, find safer alternatives like non-plastic infant feeding bottles and plant-based food storage containers.

Connect with local health food or natural food stores, local organic farms or community assisted agriculture groups to brainstorm ways to distribute recipes and meal ideas for cleaner, healthier foods. Local food pantries can also be a great starting point to connect with community resources to encourage healthier family foods.

Local childbirth education and doula groups can also be a great resource for connecting with pregnant or new families to discuss feeding choices.

Many local gardening groups may have information on growing and preparing natural, organic foods.

Join food cooperatives wherever possible and offer education to families on breastfeeding, clean foods and safer food storage/preparing/serving utensils.

Join civic groups in starting community gardens in public spaces, schools, churches and housing complexes.

 

Additional resources to explore 

Safely Fed Canada

Assessing the environmental impact of powdered baby formula sold in North America

The Unseen Dangers of Ultra Processed Foods

Breastfeeding for the Health and Future of our Nation 

Carbon Footprints Due to Milk Formula. A study from selected countries of the Asia Pacific region

Ultra-Processed Foods and Health Outcomes: A Narrative Review

Food safety, climate change, and the role of WHO

Food safety considerations for commercial complementary foods from global operational guidance on infant and young child feeding in emergencies

Plastic-free parenting 

Ensuring Safe and Toxic-Free Foods Act of 2022

Protecting Brain Development in Children: Neurotoxic Effects of Phthalates and Need for Critical Policy Reform webinar

 

Spotlight on Fédora Bernard, Program Officer at The Right Livelihood Foundation

Fédora Bernard is currently Program Officer at The Right Livelihood Foundation, an organization established to “‘honour and support courageous people solving global problems’… now widely known as the ‘Alternative Nobel Prize’”. 

Bernard presenting in Rio.

Before transitioning into her work at The Right Livelihood, Bernard served as Geneva Association for Baby Food and International Liaison Office of the IBFAN Network (GIFA) Program Officer beginning in April 2019, having just newly graduated from the Institut des Hautes Etudes Internationales et du Développement with a Masters in International Affairs. 

This week, Our Milky Way is pleased to share a Q&A session with Bernard. 

Q: Please share a few highlights during your time with IBFAN. 

A: I am deeply passionate about human rights and GIFA was specialized in exactly that. I think that throughout my time at IBFAN, some highlights would probably be the sessions of the Committee on the Rights of the Child that I attended and advocated at, the World Health Assembly, the fifth session of the Open-ended intergovernmental working group on transnational corporations and other business enterprises with respect to human rights and of course, the World Breastfeeding Conference in Rio. They were all avenues where we could raise awareness and advocate for better national policies.

Q:  What would you consider your greatest triumph with IBFAN?

A: I am not sure I could speak of triumph, at the end of the day my time with IBFAN was quite short and all I did was trying to keep up with the amazing work that has been done by the Geneva office for the past 40 years. Nevertheless, I am very proud of the achievements with the Committee on the Rights of the Child, as during my time with IBFAN, “breastfeeding” was mentioned in almost all concluding observations.

Q: In November 2019, you had the opportunity to present IBFAN’s Green Feeding documents. What was that like? How was it received by participants at the World Breastfeeding Conference? 

A: It was an incredible experience, it was an honor to prepare this with Alison Linnecar, who wrote the document and to present it along with experts in the field. I don’t think that I can define myself as an expert, let alone a breastfeeding expert, but I am starting a career in advocacy. I therefore decided that I wanted to emphasize how the Green Feeding Documents could be used as an advocacy tool from an environmental perspective. Therefore, while Alison explained the science behind all of it, I focused on the link between breastfeeding and human rights, more in particular how it can be used in relation to the right to a safe, healthy environment. At the end of the presentation, I was so happy to see that most people in the audience wanted a copy of the green feeding documents…I thought that 30 copies would be enough, but clearly, I was wrong! I wish I had brought more.

Jose Angel Rodriguez-Reyes, expert of the Committee on the Rights of the Child pictured alongside Bernard.

Q: In your piece BREASTFEEDING: BEYOND “WHAT IS BEST FOR YOUR CHILD”, you mention the WHO/UNICEF Global Strategy on Infant and Young Child Feeding to Protect, Promote and Support Breastfeeding. We have the framework for better global health outcomes; What is holding us back? Is there one significant barrier standing in the way of a better world? 

A: I believe that from a political perspective, two things are holding us back: The first being the patriarchy and political systems dominated by men. As long as women will not be allowed to play a greater role in global health governance and domestic politics, public health issues such as breastfeeding or issues surrounding menstrual health will not be given the right amount of attention. 

The second element is political will, which is deeply related to the first. Breastfeeding is only seen as a public health issue in developing countries, and aggressive marketing from the formula industry has managed to convince women themselves that they are actually more empowered if they don’t breastfeed. Breastfeeding is thus seen as a weight imposed on them rather than a right that should be protected, promoted and supported by governments. In some societies, it is indeed currently a real hurdle for women to achieve their breastfeeding goals but instead of women in their breastfeeding journeys benefiting from policies, they are given a bottle. I am of the idea that improved breastfeeding policies are not only a matter of public health but also of women’s rights. 

Q: Any advice on how to navigate a climate where people dispute basic facts?

A: That is a very difficult question…Especially because those disputing basic facts are often deeply attached to their position and will give you alternative “facts”…I believe very much in trusted sources, and would always advise these people to check their sources and question them. For instance, if someone shows me an article from the industry containing “facts on breastfeeding” I would draw their attention on why this article could be biased and not based on adequate scientific evidence.

Q: Breastfeeding is a topic that spans across all disciplines. Will you please give us a glimpse into the work you’re doing at The Right Livelihood? 

A: The Right Livelihood Foundation honors and supports courageous people solving global problems, in all disciplines. IBFAN is actually one of them. With civil society space shrinking all over the world, human rights defenders are facing increasing difficulties, which is very true also for breastfeeding advocates. My work at the foundation therefore consists in using the advocacy skills that I developed with IBFAN, to support laureates all over the world.