by Heidi Green
September 26, 2008

The numbers are chilling: approximately 53,000 infants sick. 13,000 hospitalized. At least 3 dead. It’s not happening in our backyard—and the FDA says it won’t—but that doesn’t make it any less astonishing. While I hear the experts calling for “more regulation” and “better quality controls” for Chinese food products, I don’t hear anyone calling for something else that might make a big difference: support for breastfeeding.

According to the Washington Post’s John Pomfret, the rate of breastfeeding in China is low. One study has found that 47.9 percent of women in Beijing were breastfeeding at four months; another suggested that rates in the area were as low as 13.6 percent.

Whatever the specific numbers, it seems clear that parents in China have embraced formula-feeding, probably for many of the same reasons U.S. parents have: convenience, return to work, belief that formula is “as good as” or “nearly as good as” breast milk. (In case you wonder, it’s not.)

And look at the price they’re paying. Chinese parents fed their babies infant formula, which they thought was regulated, tested, and safe. Safe for their babies. Imagine the heartache and sense of betrayal. Imagine the “if onlys.”

For parents raised in a culture with the expression ren nai zhi bai bing (Human milk cures 100 illnesses), the first “if only” must be: “If only I had not used formula.”

I do not write to blame the parents, but to imagine and empathize with their feelings. It’s likely that all parents worry at some time about causing their infant children to be hurt by making a poor choice. These parents did. The formula should have been safe, but it must be heart-rending to think that there was another, safe feeding choice readily available. One that would have contained no melamine and needed no external regulators or quality control checks to ensure its safety.

Parents, please listen. This problem didn’t happen here, but it could have. Infant formula in the U.S. has been contaminated by Enterobacter sakazakii, and even metal shavings. (You may be surprised to note that the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) have issued a joint statement of caution that powdered infant formula is not sterile and can cause infection leading to illness and even death in at-risk infants.) But the problem in China could have been avoided altogether if Chinese mothers received breastfeeding support from their health care providers, workplaces, families, and society.

“If only” isn’t helpful to the infants who have been sickened, those who have died, or their families. But it is hard not to think that the real call shouldn’t be for Li Changjiang, the chief of China’s General Administration of Quality Supervision, Inspection and Quarantine to step down. (After all, this isn’t the first problem China’s had with its infant formula, and I am skeptical that it will be the last.) It shouldn’t be for Nestlé to admit its role in the problem. It should be for us to think about how we—as people—feed our young, vulnerable infants. And what we can do to protect them.

To think, it was just a few decades ago that breastfeeding was, to use Pomfret’s term, “universal” in China. I wish it were now.

October 4, 2008—Editor’s Note
Much has been revealed about the scope of the contamination and the ramifications in China since this initial post. Here’s an update, with links for more information.

• Several countries have been affected, including: China, Hong Kong, Taiwan, Russia, South Korea, Australia, Phillipines, and even the U.S. (Here’s a summary from earlier today.)

• Melamine, a binding agent used in plastics and as a flame retardant, was mixed with formaldehyde to make it dissolve. (My stomach drops again, this time at the idea of formaldehyde in these substances.)

• The U.S. Food and Drug Administration (FDA) has set “safe” limits of melamine in foods. The agency states that no amount is safe in infant formula, but that amounts less than 2.5 parts per million are “risk free” in other foods. (Am I the only one to think the addition of a plastic, flame retardant agent to our food is completely unacceptable?)

• Chinese officials and dairies seem to have known about the adulteration of the milk and its health consequences. MSNBC looked at the government’s actions before and after the recent outbreak of infant illness.

• The addition of melamine to Chinese milk has been widespread. Melamine has been found in products from more than 20 Chinese dairies.

• The problem is not new. At least one of the milk suppliers began adding it to milk three years ago. The formula maker Sanlu began receiving complaints from parents about infants sickened by formula as early as last December. Doctors and reporters began sounding the alarm this past spring.

• More products than just infant formula are affected. As if formula isn’t bad enough, AP writer Audra Ang reports that contamination has also been found in liquid milk, yogurt, and other milk-containing products. Cadbury recalled a 11 types of chocolates that were made with Chinese milk. Authorities in Hong Kong reported that melamine was found in Chinese-made milk tablets and in cookies made by Japan’s Lotte China Foods Co.

• Chinese government officials have promised better food safety, ethics. Let’s hope so. But will American markets, still reeling from a series of recent reports about lead-tainted Chinese-made toys, accept this so easily? Should they?

• One feeding method Chinese parents can control has had a resurgence in popularity: Breastfeeding. Reuters writer Tan Ee Lynn reports on a joint statement released by UNICEF and the World Health Organization.

• One feeding product also has had a resurgence in popularity: “Wet nursing.” The Wall Street Journal’s Geoffrey A. Fowler and Juliet Ye report on a new, demand-driven market for the milk mothers make in China. For some, expressed human milk may be agreeable; other families who seek wet nurses want them to live with the paying family, leaving their own infants behind.

• La Leche League encourages relactation. Resources and information are available from the international organization.