Book review of “Milk, Money, and Madness” by N. Baumslag

• Conclusion
• 1. Summary
• 2. Book review
• • Section 1: Breastfeeding Beliefs and Practices
  • 2.1. Breastfeeding Beliefs and Practices
  • 2.2. Wet Nursing, Surrogate Feeding, and Healing Qualities of Breastmilk
  • Section 2: Breastmilk: The Miracle Food and Medicine
  • 2.3. “Cow's Milk Is for Cows”
  • 2.4. Artificial Feeding
  • Section 3: Breastmilk Economics — Shaping Corporate and Governmental Policies
  • 2.5. The Global Search for Formula Sales
  • 2.6. Women and Work
• 3. About the book

Naomi Baumslag, M.D., M.P.H., is a Clinical Professor of pediatrics at Georgetown University Medical School in Washington, DC. She is president of the Women’s International Public Health Network (WIPHN) (for 2015 as well) in Bethesda, Maryland.

She has also served in an advisory capacity for the USAID, UNICEF, and WHO, the Georgia Department of Human Resources, the PAHO Foundation (prev. PAHEF), and for government agencies in many developing countries, as well as on the Health Council of La Leche League International (LLLI) and the World Alliance for Breastfeeding Action (WABA).

Professor BAUMSLAG has written more than 100 articles und eight books. She also gives lectures, both internationally and in the United States.

DIA L. MICHELS is a science writer for newspapers and magazines around the world. Her commitment to breast-feeding stems both from her own research and her personal experience of breast-feeding her own children over the past six years.

This is the second book she has coauthored with Professor BAUMSLAG. In 1992, the authors published "A Woman’s Guide to Yeast Infections", Pocket Books (288 pages).

According to Open Library, the author Dr. Naomi Baumslag also wrote the following books:

• Murderous Medicine (2005),
• Primary Health Care Pioneer (1986),
• A Woman’s Guide to Yeast Infections (1992),
• Family Care (1973).

In the United States, women, at least in certain states, have not been allowed to breast-feed in public.

For example, one woman who was nursing her child in her own parked car was warned by a police officer that she was in danger of breaking indecent exposure laws. The breast has been transformed into a sexual object.

In the early 1980s, the Food and Drug Administration (FDA) received the following message from the American Society of Plastic Surgeons (ASPS):

There is a substantial and enlarging body of medical information and opinion to the effect that these deformities [small breasts] are really a disease [that left uncorrected, results in a] total lack of well being (p. 7)

In other words, small breasts are a disease that needs to be cured.

This organization has had much success. In 1990 alone, a total of 130'000 women in the United States had operations to have their breasts enlarged. The FDA did not even begin to intervene in spite of the negative health consequences and reports of fatalities.

In several tribes in Africa, in particular, there is an intercourse taboo during the breast-feeding period. For example, in the Zulu tradition, it is believed that a man will become impotent if a drop of breast milk falls on his skin (p. 8).

Men have pressured their nursing wives for decades to accelerate the weaning process by switching over to formula, which is good for our dairy companies.

In addition, women on birth control pills that contain estrogen (oestrogen) produce a significantly lower amount of milk.

And in many cases, women who give birth (delivery) in hospitals are seen as “cleaned out” and the traditional intercourse taboos no longer apply (p. 10). This means that the time until the next child is born will most likely be shorter — with all of the disadvantages this brings.

The hormone "oxytoc..", which is produced for the birthing process and during breast-feeding, helps nursing mothers to feel calm and nurturing. However, it also reduces vaginal lubrication, which can make sex uncomfortable. Nature has actually provided a process that allows a child to better develop, without a second pregnancy occurring too soon. But we ignore this natural process (p. 10).

We haven’t known for so long that when pregnant mothers drink alcohol, it can cause problems for the child — to a smaller extent, this can also happen when nursing mothers drink alcohol.

In Sierra Leone, pregnant women aren’t allowed to drink alcohol.

In Sri Lanka, nursing mothers are prohibited from drinking cow milk, and in other regions coconuts are off limits. Both of these foods can cause allergic reactions (p. 13).

The practice of eating clay is also well known and was popular among African American women.

Clay contains a high amount of iron and also chemical elements (trace elements) such as sodium (Na), manganese (Mn), arsenic (As), silver (Ag), molybdenum (Mo), and uranium (U).

Because of its high pH, clay also has an antibacterial effect. Recent studies have indeed shown that clays rich in iron from several deposits have this effect.

Sodium is one of the elements that is essential for all animal organisms.

Manganese is an essential element for all living things and a component of various enzymes.

Arsenic is a trace element in humans, but its biological significance for us has not yet been fully established.

Arsenic is also an essential element for many animals.

Silver is used as the color additive E 174 in the food industry, for example, for the shells of sweets such as pralines and in licorice.

Molybdenum is a trace element that is essential for almost all living organisms as it is a component of the active site of a number of enzymes such as nitrogenase, nitrate reductase, and sulfite oxidase.

The Indian system of Ayurvedic medicine (Ayurveda) also believed colostrum to be harmful: As far back as the second century BC, Indian Ayurvedic medicine recommended honey and clarified butter for the newborn's first four days, during which the birth mother's colostrum was expressed and discarded (p. 24).

This also happened in biblical times. The authors describe similar serious mistakes made in other cultures, for example, in Guatemala, Afghanistan, Sierra Leone, and Lesotho.

And Greek, Roman, and later French, English, and other European physicians recommended the same course of action up until the eighteenth century — without stopping to question the practice.

The British physician Dr. Ettmueller came into serious conflict with the medical establishment of the time when in 1699 he recommended that newborns should be breast-fed and receive colostrum from the beginning.

Another 50 years would have to pass until a similar call to action by the physician William Cadogan in 1748 would turn out to be more effective:

The mother’s first milk is purgative and cleanses the child of its long hoarded excrement; no child can be deprived of it without manifest injury (p. 24).

Wikipedia cites William Cadogan (1711–1797) as the first physician who advocated the complete abolition of swaddling. He did so in an essay in 1748 titled "An Essay upon Nursing and the Management of Children, from their Birth to Three Years of Age".

Before this time, people were obliged to strictly follow this practice.

At the beginning of the twentieth century, the physician Truby King from New Zealand popularized the harmful practice of nursing babies every four hours and encouraged mothers to stop the practice of demand feeding.

In addition, nurses analyzed the fat content of the milk and prescribed supplementary feeding.

Again this was done instead of giving the mothers nutrition advice and finding out more about their environment. These were also standard practices in England (pp. 28 and 128).

Our inner clock ensures that we maintain a stable 24-hour rhythm, for example, of sleep and wakefulness and is also responsible for many endocrine processes such as the production of cortisol and melatonin.

The functions of our central nervous system show clear, endogenously controlled daily rhythms, which are called circadian clocks (circadian rhythms).

See also circadian rhythm sleep disorder, Neurologie der Bindung (Neurology behind the connection between mother and child, German only), and cosleeping.

I find that sleep training is the wrong method as it isn’t natural, even if nobody has published studies on this topic ...

The central circadian clock is found in the suprachiasmatic nucleus (SCN) of the ventromedial hypothalamus. Nerve cells in the SCN rhythmically express clock genes.

Molecular circadian rhythms are also found in peripheral organs such as the liver, pancreas, kidneys, adrenal glands, heart, and lungs. The hypothalamus controls these peripheral clocks.

A chronic disorder of the circadian rhythms can cause a higher rate of heart and circulation disorders, obesity, type-2 diabetes, and cancer.

The clock gene was first researched in the Drosophila melanogaster.

On the symbiosis between mother and child from Wikipedia (German version): Margaret Mahler sets the beginning of the symbiotic phase at around two months, during the oral phase. At this time, the child is physically and mentally dependent on the mother.
"It cannot yet distinguish between inside and outside, between itself and objects, or between itself and its mother. It experiences the mother as part of its own self, and has an inseparable symbiotic unity with her."

"The mother must be able to recognize the child’s needs in order to ensure that it is satisfied and healthy since the child has not yet developed conscious thinking. If the mother is available to the child during the symbiotic phase, the child can develop basic feelings of security and trust. The relationship between mother and child serves as the foundation for later relationships."

See also Erikson’s stages of psychosocial development from the psychoanalyst Erik H. Erikson (1902–1994).

The renowned anthropologist Ruth Fulton Benedict (1887–1948) commented that women have expressed their fundamental values in their swaddling techniques.

As examples, Benedict describes swaddling practices in Russia and Rumania.

In the 1740s, the physician William Cadogan at Foundling Hospital in London warned that children must receive breast milk and be free to move.

Nevertheless, swaddling is still practiced today in some areas of Eastern Europe, in Asia, and in the Middle East in countries such as Mongolia, Afghanistan, Turkey, and Greece.

How just very different breast-feeding practices are can be seen in the fact that as late as the 1820s English women in East Lincolnshire apparently let their children drink breast milk until they were seven or eight years old. In the Solomon Islands, breast-feeding was continued until children were 15.

But in 1991, a mother in Syracuse, New York, was found guilty of neglect for breast-feeding her child for more than two years. Her child was even taken from her and placed with a foster care family for a short time.

This can lead to appalling inequality as UNICEF shows with an example from Children’s Hospital Islamabad in Pakistan. The doctor had advised a mother to do so, which led to her daughter suffering from malnutrition (marasmus) and dying. The authors have included a photo on page 37 that the mother gave to UNICEF to use as a warning in their publications.

Most Egyptians, Babylonians, and Hebrews breast-fed their children for about three years, but richer Greeks and Romans used slaves as wet nurses.

The authors discuss the topic of wet nurses in detail and give an overview of practices in many cultures and time periods.

The authors also include the story of the wet nurse Judith Waterford, who in 1831 at the age of 81 proudly showed that she could still produce milk that was of the same quality as milk produced by younger women. When Waterford was 75, she regretted that she now only had enough milk for one child and could no longer take on two children.

Most people believe that only a woman who has just given birth to a child can breast-feed.

Read also more about induced lactation or relaction and erotic lactation. Sometimes, no milk is visible in this period of breast pumping, but as soon as the infant latches on, the milk comes in (p. 52).

This method is still common today in certain parts of Africa. The authors include a quote from Margaret Mead from 1933 to show that even she had difficulty accepting such practices.

In newspapers and in the Charleston Medical Journal and Review, an article appeared in 1874 telling of how a 60-year-old woman had, as part of play, offered her breast to a child for three weeks and then was amazed to see that after this time milk appeared and even in greater quantities than in the case of the child’s own mother.

The authors describe how milk can be expressed by hand or with a variety of different types of breast pumps. They also provide information about breast milk banks, which have been and are still often found in children’s hospitals. This milk can be cooled, but shouldn’t be heated. Sweden and Denmark are examples of countries that have active breast milk bank programs. The banks accept milk that women produce within the first three or four months of lactation and pay a good price for this.

Eastern European countries have had an even stronger tradition. For example, 200'000 liters of breast milk were collected in the eastern part of Germany in 1989. In contrast, there are or were eight breast milk banks in the United States and one in Canada. But this milk is pasteurized in order to make sure there is no risk of contracting HIV or hepatitis.

A list of current milk banks in North America shows three for Canada, 19 for the United States, and seven that are currently in planning. See hmbana.org/locations.

When Finland began to pasteurize the milk in its banks, they found that the infection rates in infants increased and were ultimately higher than what they had been with nonpasteurized milk. Canada closed down all of its milk banks, and this turned out to be worse for the children than introducing pasteurization (p. 57).

But even today, some bedouins let their babies drink from goats or sheep in such cases.

© Public Domain, Curt Teich, Scan of a postcard

More about human–animal breastfeeding. This and the opposite have been practiced for thousands of years.

And conversely, women have also breast-fed animals: Animals have been nursed by women for a variety of reasons, including to aid destitute animals, to relieve engorged breasts, to prevent conception, to promote lactation, and to develop ‘good nipples’—to name a few (p. 59).

The authors provide examples from a number of countries, in particular, with dogs and pigs.

One of the most famous ophthalmologists from the middle ages, Ali Ibn Isa, also described the healing properties of breast milk around the year 1'000 CE.

In his work, he mentions ophthalmia neonatorum, which is also called neonatal conjunctivitis. This is an infectious inflammation of the conjunctiva (conjunctivitis). Ali Ibn Isa’s main work is called Kitab Tadkirat al-Kahhalin; in it, he describes 130 eye diseases.

The authors describe various other ways in which breast milk has been used to treat diseases in countries around the world.

For example, in Samoa it was used to treat a viral epidemic of acute hemorrhagic conjunctivitis.

In 1982, The Centers for Disease Control published the successful results of this old folk remedy.

The hormones contained in these can accelerate the child’s "growing" in an unnatural manner.

The German Wikipedia entry for infants states the following: After three to five months, healthy infants will have doubled their birth weight and have grown about 6 inches (15 centimeters).

In other words, we have gotten used to an unnaturally quick "growthrate" and find it to be abnormal when a child grows at the rate that nature planned!

In 1799, the physician Michael Underwood (1736–1820) compared these differences in his "Treatise on Diseases of Children" (treatise) and showed that mare’s milk is chemically closest to human breast milk and therefore a better replacement product than cow’s milk.

At the time, other major differences such as in the case of "growthhormones" were not yet known.

In addition, breast milk adapts to the changing needs of infants as they grow (EE: and likely also to their genetically determined needs).

Researchers first isolated N-Acetylglucosamine from the protein-free fraction in breast milk. However, today we know that the bifidogenic effect of breast milk is not based on any single factor, but rather on the complex interaction of numerous substances. These include oligosaccharides, high lactose levels, low protein levels, antimicrobial proteins such as lysozyme and lactoferrin, and specific sIgA antibodies that work against the accompanying flora.

For healthy brain "growing", babies also need the special amino acids found in breast milk such as cystine, taurine, and linoleic acid. Breast milk also contains many more important unsaturated fatty acids and fewer “bad” saturated fatty acids than cow’s milk. In addition, cow’s milk doesn’t contain lipases, which are important for the digestion of fat.

Cow’s milk includes far too much sodium, chloride, and potassium with levels that are at least double to triple what they should be. And babies get four times more calcium and six times more phosphates than their bodies are prepared for.

Bioavailability also plays a role. For example, cow’s milk contains more iron than breast milk, but infants only absorb 10 % of this iron, whereas they absorb 49 % of the iron in breast milk.

Baumslag writes, If every newborn in the United States were breastfed for just twelve weeks, the health care savings from avoiding nonchronic diseases in the babies’ first year of life would amount to $2–4 billion annually (p. 70).

When a baby drinks breast milk, it is getting the right vitamins in the right amount and enough water. The authors calculate that the illnesses related to formula cost a total of $333 billion annually.

The authors explain that having small breasts is no reason to worry. The size of the breast is determined by the fat cells, which are either present in the body to a smaller or greater extent. The milk ducts are not affected.

However, if a mother is malnourished, the fat reserves can help her to produce enough milk.

When a mother breast-feeds her child, the milk the baby drinks at the beginning is called foremilk and the milk at the end hindmilk. These two types of milk are quite different and it is important that the baby receives a good balance of foremilk and hindmilk.

The foremilk is significantly lighter in color and not as yellow as the hindmilk.

These include "oxyto.." ("pitoc..") and ergot (product: "Methergi.." from Novartis), which was previously used to stop uterine bleeding.

A mother who is breast-feeding shouldn’t clean her nipples with alcohol because the baby may then not “acquire the taste” (olfaction). And for this reason, they shouldn’t rub their breasts with a coarse washcloth or apply lanolin (wool wax) or other oils even though this is a recommended standard practice in many hospitals.

© CC-by-sa 2.0, Bibl. nationale de France, Wikipedia

During the breast-feeding period, lanolin is also used to help with cracked nipples. When washing, you should go around the nipples and aerola, avoiding this area. And you should only touch your breasts after you wash your hands with a mild soap.

According to Wikipedia, mothers should leave the last bit of milk on their nipples as this helps to prevent drying out. It also has an antibacterial effect and helps prevent cracked nipples.

Dr. Baumslag describes the entire process of milk production and the stimuli required. She also discusses the various organs involved, but that is not of central importance for our task at hand, which is why I chose not to include this part.

The smell of the breast is important for infants. For example, newborns can find the breast with their eyes closed. They simply follow the direction of the smell of the excreted, protective sebum.

Colostrum has a lower nutrient density than mature breast milk, but this allows babies to first build up their antibodies and have their first bowel movement, which is mostly the excretion of blackish green meconium.

As a result, babies usually lose about 10 % of their weight at the beginning. Meconium, unlike feces, does not contain food.

© CC-by-sa 2.0, Jürgen Schaub, Wikipedia

A newborn normally excretes meconium only in the first 24 to 48 hours. Meconium is not a digestive end product (feces or stool). Instead it is a dark viscous substance that collects in the intestine, which is not yet functioning. Meconium is made up of the desquamated epithelial cells of the mucous membranes, thickened bile, and hair and skin cells swallowed along with the amniotic fluid.

Meconium aspiration syndrome (MAS) can be life-threatening for an infant. But MAS is rare even though 13 % of all newborns enter the world in amniotic fluid containing meconium. Only 5–12 % of these newborns develop MAS. Extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) is only necessary in very difficult cases.

Next there is a table from 1987 that shows how the mortality rate of infants in developing countries increases dramatically when they are not breast-fed exclusively. This holds true in spite of the use of modern medicine.

When a woman has a preterm birth, her breast milk is different than that of a mother who gives birth between weeks 37 and 40 of the pregnancy. Breast milk is alive and changes to meet the needs of the baby.

The authors include a convincing list showing the benefits that breast-feeding has for babies (15) and mothers (12) and the disadvantages that it has for artificially fed babies (7).

Diarrhea, gastrointestinal illnesses, and urinary infections, in particular, are less common. The same holds true for respiratory diseases, ear infections, allergies, and sudden infant death syndrome (SIDS).

According to the statistics, breast-fed babies also have fewer problems with learning and behavioral difficulties and show better psychological development.

They develop a more energy-efficient and rhythmically functioning nervous system and are less likely to develop heart disease and cancer later in life (p. 78).

A breast-fed baby gets enough liquid, which you can be sure of if the baby has soft stools and enough wet diapers (6–8 per day).

Studies in India and Honduras have shown that even breast-fed babies in these hot climates receive enough fluids. The reason for this is that the babies are fed on demand, whereas formula-fed babies have to wait three hours until they have digested the artificial milk.

This can lead to a vicious circle in which the baby no longer uses the proper sucking techniques and virtually loses its appetite, and as a result the mother produces less milk (lactation) (p. 81).

The authors spend several pages explaining the reasons behind the disadvantages listed of giving a baby formula as compared to breast-feeding. Then they provide reasons as to why breast milk is perfect and information about the substances contained in breast milk. Certain substances are also found in cow’s milk, but the amount and quality of these are ideal for calves, not humans.

The anti-infective components of breast milk include the following anti-infectious factors: bifidus (bifidobacterium), secretory form (dimer) of Immunoglobin A (IgA) and IgG or gamma globin (The book incorrectly lists IgC here; see also immunoglobin superfamily), antistaphylococcus factor (staphylococcus), lactoferrin, lactoperoxidase (LPO), complement C3 and C4 (complement system), "interferons" (IFN), lysozyme (muramidase), B₁₂ binding protein (see transcobalamin and haptocorrin), lymphocytes, and macrophages (scavenger cells and MΦ).

Dr. Baumslag explains why it is so important that preemies receive the breast milk that is specifically tailored to their needs and development phase.

The breast milk helps, for example, to protect their intestine. The Australian reproductive biologist and cell biologist Dr. Roger Valentine Short writes why the feces of a baby who is exclusively breast-fed don’t smell “unpleasant” to the mother. He shows how primates can develop specific antibodies (IgA) just by consuming even the smallest amount of the infants’ feces. The IgA in the breast milk then helps to protect the child (p. 90).

Breast-feeding also has very positive benefits for the mother.

It helps contract the uterus, mothers lose the pregnancy weight more quickly and are able to get back in shape, and they feel more relaxed and happy.

There are certain groups that try to make the public believe that the negative effects of formula milk, as compared to breast milk, only apply to developing countries.

It is true that the use of formula results in much greater negative effects in these countries than in industrialized countries. But it has been shown that breast-feeding has extensive medical benefits, in all places, at all times, and for all women (p. 93) — and today there is no way that we can deny the existence and logic of these scientific results.

Dr. Baumslag strengthens her arguments by providing statistics from 1981, 1989, and 1992. In this period, bottle-fed babies had gastrointestinal illnesses five times as often as breast-fed infants.

For fans of logic: by listing out the ways that breast milk is tailored to babies, this book shows how breast-feeding is highly superior to all artificial means of feeding babies. But it is a futile battle (almost) to try to change the current situation with just a few books and articles. How could this be enough in light of the huge budgets of multinational companies and the influence they have on politics and media? It is similar to the struggle of Don Quixote, in the novel written by Miguel de Cervantes.

In a section on contraception, the authors quote Aristoteles, who wrote in 350 BCE that menstruation doesn’t occur during breast-feeding and that a women’s milk will dry up after she conceives. This is generally true, but there are some exceptions. (p. 93)

Women should avoid radical diets when they are pregnant and breast-feeding. When fat is released (as a result of dieting or starving oneself), the fat-soluble toxins stored there enter the bloodstream and also the breast milk. These toxins include substances such as polychlorinated biphenyls (PCBs), heptachlor, and dioxins. Furan, used as a flavor enhancer in coffee, can also accumulate in fat tissue.

A Swedish study showed that after the nuclear accident in Chernobyl, the cow’s milk in Italy and Austria contained 300 times more radioactive iodine and cesium than the breast milk.

But thanks to the "oxytoc.." that is produced during breast-feeding, mothers have less need for these types of drugs and focus more on the needs of their babies than mothers who give their babies formula.

There are very few good reasons to stop or take a break from breast-feeding. However, if the mother is going to have chemotherapy or treatments with radioactive compounds or gets food poisoning, she should do so. If radioactive iodine is used in a diagnostic exam, the mother should stop breast-feeding for 24 hours.

In the case of a herpes sore (herpes simplex) on the nipple or aerola, the mother should only breast-feed with the other breast. If a small infant is infected with herpes, it can lead to very serious problems.

Neonatal herpes simplex, the HSV infection in newborns, is very rare. The disease can be transmitted during birth if the mother has herpes genitalis and is then very dangerous. However, this is not at all related to a herpes sore on the breast.

If a mother or father (or other family member or friend) has herpes in the mouth area, they shouldn’t kiss the child if there are any blisters or scabs around their lips.

It is important to always wash your hands thoroughly before you touch a child. Before breast-feeding, a mother should always inspect her breasts. Cosleeping is dangerous in this case?

According to experts from the Centers for Disease Control (CDC), WHO, and UNICEF, even in the case of an HIV infection, the death rate of babies is higher if they don’t receive breast milk. This doesn’t apply to conditions and areas where child mortality is low. It is a known fact that breast-fed children who are HIV positive develop AIDS later than do formula-fed children (p. 100).

In 1990, physicians were alarmed because a 15-month-old child and a 72-year-old woman were suffering from Vitamin D intoxication (cholecalciferol).

The milk from the dairy was analyzed, and it contained up to 914 % more Vitamin D than is standard.

And then eight more people in Massachusetts also got sick from consuming too much Vitamin D.

It was discovered that the milk they drank contained anywhere from absolutely no Vitamin D up to 500 times the recommended amount.

Formula milk that was tested at the time contained up to 4.5 times more Vitamin D than stated on the label.

© CC-by-sa 2.0, Mike Muller, 1974, babymilkaction.org

Cholecalciferol, which is physiologically present in all people, or rather in all living creatures with cells containing a nucleus (eukaryotes), is called vitamin D3. Since cholecalciferol is produced in the skin from 7-dehydrocholesterol, with the help of UVB radiation (previously called Dorno radiation), it is actually a prohormone and not a vitamin. A vitamin D deficiency can cause rickets in children and osteomalacia in adults.

Wikipedia (German entry): Fortifying everyday foods with vitamin D is currently prohibited in Germany because of the toxicity of vitamin D. Since butter has a high level of vitamin D naturally, manufacturers have special permission to add vitamin D to margarine so that they can make it similar to the original product.

Note: Consuming too much vitamin D can lead to the occurrence of schizophrenia, seizures, and liver damage. Small children reach the toxicity level much more quickly than adults. If certain conditions are met, sunlight is the best source of vitamin D.

The rBGH in cow’s milk causes the production of more "InsulinGrowthFactor" (IGF-1). And IGF-1 promotes the progression and malignancy of breast cancer, as well as the spread of cancer into other tissues (metastasis). Newsweek magazine called this “a medical disaster” (p. 102).

EE: I call this the accelerator for cancer. While physicians are hitting the breaks, patients are consuming more dairy products and with these more "growthhormones".

Here I will only list out some of the problems:

• klebsiella contaminants (which can cause respiratory and urinary tract infections),
• salmonella contamination (which can lead to serious infections),
• glass contamination (2 instances),
• general bacterial contamination,
• toxic vitamin A levels,
• and deficient levels of vitamin D, folic acid (vitamin B₉), zinc, copper, linoleic acid, vitamin B₆, and thiamine (vitamin B₁).

The authors then describe instances of problems with formula in developing countries. But similar problems have also occurred in the U.S., and in this time entire factories had to shut down as the problems were so serious.

Wikipedia explains a case in New Zealand in the entry titled the 2013 Fonterra recall.

Fonterra sold about 1'000 tons of whey contaminated with bacteria to companies that produce formula and sports drinks. The products were then exported to seven different countries.

The Ministry for Primary Industries brought attention to the case and announced the recall. Although the discovery was made much too late, the company was lucky because the strain of clostridium bacteria turned out not to be toxic.

The case does however show that we can’t claim that incidences like those described in the book are no longer possible.

On Wikipedia, you can go to the entry on infant formula to read more about the problems with artificial milk. The good news is that the nutritional information in this entry is presented in a fairly neutral manner. You will find many aspects that verify the information in this book.

A wide range of mistakes are made in the preparation and storage of formula. Low water quality, such as too much lead in the water, can also play a role.

In the United States, very high levels of lead are often found in the drinking water. And many parents, and babysitters and grandparents, add more formula to the water than is recommended because they believe that this will only help the child. However, this practice has caused death in multiple cases (p. 104).

Since 1989, "bromocripti.." ("Parlod.." from Sandoz, possibly also Pravidel, Kirim, and Umprel) has been the only drug that is approved in the United States after other drugs caused numerous cases of serious complications and several deaths.

But promocriptine (from Avenzor), a "dopamineagonist" only available as a prescription, has also caused 13 deaths and a number of health problems in the United States (p. 106).

In 1994, the FDA was forced to withdraw the approval of "bromocripti.." as a lactation-suppressing drug. "Parlod.." is now labeled only as a medication to treat Parkinson’s disease, but physicians have the right to prescribe any drug that is approved.

EE: Borden introduced milk in bottles in 1885 and began selling evaporated milk in 1892.

© CC-by-sa 2.0, MODO, Mexico, Wikipedia

Evaporated milk is dehydrated milk from which about 60% of the water has been removed. It can be stored at room temperature for months, or even years, and only takes up half the room that milk does. This homogenized and sterilized milk is sold in tin cans. It can’t be compared with condensed milk (usually sweetened to allow for longer storage) or powdered milk.

In the 1990s, over 50 % of American women still chose not to breast-feed. Only one in five children is still being breast-fed after the age of five months. Even though the numbers have improved, it has primarily been more educated and affluent women who have accounted for this change.

The practice of bottle-feeding has increased drastically in many developing countries. Between 1986 and 1989, the percentage of infants in developing countries who were exclusively breast-fed during the first four months was as follows: Nigeria (1%), Ghana (2%), Brazil (3%), Thailand (4%), Senegal (6%), Mali and Togo (8%), and Zimbabwe (9%).

The authors include some relevant statistics. For example, in the mid-1760s in London, there was an average of 16'283 births per year, and 7'987 children under two died. An additional 26 % died before they turned five.

The British businessman and philanthropist Thomas Coram (1668–1751) worked for twenty years to open an institution that would take in foundlings so that they literally would not have to rot on dung heaps. In 1745, he was finally able to open Foundling Hospital, the first foundling hospital in the world for children who had been abandoned by their parents. Thomas Coram died destitute soon thereafter.

Since it wasn’t possible to give the infants breast milk, the foundling home had a death rate of two-thirds. Of the 15'000 infants in the home, 10'000 died. However, in certain parts of London, the death rate was as high as 80–90 %.

This horrendous mortality rate is included in the article Breastfeeding, Fertility and "Populationgrowth" by Roger Short, in the ACC/SCN Symposium Report, UNICEF, August 1993.

A century later, in the nineteenth century, the infant death rate was still 40 %.

At about the same time, the obstetrician Pierre-Constant Budin (1846–1907) introduced milk stations where the infants were weighed and given sterilized milk if their weight gain was not satisfactory.

In 1880, both chlorination of drinking water and better methods of sewage disposal were introduced. There were also new regulations to ensure healthier dairy herd housing and feeding.

The authors describe the miserable conditions in the dark stalls where the cows were kept. They often had typhus, tubercolosis, skin problems, and other diseases. Sometimes they were so weak that they had to be hoisted up before they could be milked (image: Harper's Weekly, May 15, 1858).

The storage, transport, and treatment of the milk also improved. For example, Louis Pasteur (1822–1895) developed the process of pasteurization. All of these measures contributed to the fact that the life expectancy of bottle-fed children gradually improved (p. 117).

However, a study from 1985 conducted in an urban area in southern Brazil showed that bottle-fed children died of diarrhea 14 times more often than breast-fed children (p. 113–114).

After birth or miscarriage, the uterus is like a large wound surface. The cervix is still widely open in the days following the birth. This makes for a direct connection between the uterus and vagina, and absolute hygiene is necessary.

Vaginal discharge (lochia) after birth and previously margination (macrophages) beforehand help to naturally prevent infections. When the mother breast-feeds, she produces "oxytoc..", which supports this process.

In 1843, Oliver Wendell Holmes argued that physicians also transmit diseases. Dr. Semmelweis then introduced hygienic practices in his department. This effectively prevented puerperal infections (postpartum infections, puerperal fever, or childbed fever). When he tried to convince his colleagues to do the same, Dr. Semmelweis (not Semmelweiss) was ridiculed by his colleagues for over 20 years. He died in an asylum at age 47. An attendant beat him to death.

Joseph Lister was the first physician to introduce effective hygienic practices based on findings made by Louis Pasteur (and Casimir Davaine, 1863). Physicians in German-speaking countries followed suit five years later.

This is at least very true in the case of baby food, milk, and dairy products.

© Public Domain, Morgan Riley, Wikipedia

The Russian physician Osip Krichevsky developed powdered milk in 1802. William Newton developed and patented sweetened condensed milk (SCM) in 1835 (1837), after Nicolas Appert (1749–1841) made condensed milk in 1922. Tin cans were introduced in 1810 by Peter Durand and then commercially produced by Bryan Donkin and John Hall starting in 1813.

Appert opened a food bottling factory in 1804 and used Durand’s tinplate cans starting in 1812. In 1856, Gail Borden patented the industrial production of condensed milk, and starting in 1866 Nestlé marketed condensed milk in tin cans. John B. Meyenberg developed dehydrated milk without added sugar, and starting in 1885 he used his process at the Helvetia Milk Condensing Company.

Refrigerators didn’t become common until after World War II. Although one in two households in the United States had a refrigerator in 1937, they weren’t introduced to the general public in Europe until after the war. Refrigerators made it possible for people to store the milk for a few hours or even a few days.

Information about refrigerators (previously iceboxes): In 1748, William Cullen gave the first demonstrations of artificial refrigeration. Starting in 1834, these systems were commercially marketed by Alexander Twinning. And In 1859 Ferdinand Carré used gaseous ammonia dissolved in water to develop a gas absorption refrigeration system.

Some of the “milk depots” offered bottled milk free of charge to the needy, for example, the stations owned by the philanthropist Nathan Straus (1848–1931), (not Strauss as is listed in the book) in New York (p. 122).

Some of these milk stations were later turned into clinics that recommended breast-feeding. Nurses, doctors, and other public health officials made home visits as a way to improve the health of children.

Dr. Sara Josephine Baker (1873–1945) showed in 1908 that these visits were responsible for a significant decrease in the infant mortality rate.

She started “the little mother leagues,” which was a program that provided young girls with practical information about birth, breast-feeding, and childcare, and in which they served as “missionaries” to spread this important information. In poorer families, in particular, if the mother worked, girls in the family often took care of the household.

England had the Truby King program, which was started by Sir Frederic Truby King (1858–1938). In this program, nurses provided families with advice on how to best care for their infant. King also emphasized the importance of breast milk, but he advocated the undesirable practice of nursing babies every four hours instead of on demand. Most of the women either didn’t have a clock or didn’t understand how to use the clock (Rapport 1925) (pp. 28 and 125).

People thought that nursing at irregular times was the reason for “summer complaint” (summer diarrhea, not Shigella), which in the United States occurred primarily in cities. The disease was very common in children between the ages of 4 and 20 months and was often fatal. Mothers followed this program and chose to let their children cry rather than nurse them on demand.

The pediatrician Dr. Preston Alexander McLendon (1893–1980) and psychologist and new mother Dr. Frances Parsons Simsarian (1912–2005) are to thank for the fact that women were again encouraged to feed their babies on demand and not according to the clock.

In 1942, Dr. Simsarian nursed her baby when it seemed hungry and after a few days it was calmer and adapted to a schedule of breast-feeding six or seven times a day.

Dr. Benjamin McLane Spock (1903–1998), pediatrician and psychiatrist, included information about this experiment in his book "Baby and Child Care" in 1946. Before he died, fifty million copies of the book had been sold.

Kathleen Auerbach was a leading figure in La Leche Liga (LLL), which was founded in the United States in 1956. Today, the LLL is integrated into the LLLI, which stands for LLL International.

LLL consultants are mothers who have nursed their own children and completed training to become LLL lactation consultants. They support parents during the nursing period and offer help with breast-feeding, when there are difficulties or uncertainty about certain aspects. This can take place via telephone, email, or personally in a breast-feeding group. The consultation is free as the consultants work on a volunteer basis. The organization is funded by donations and membership fees.

© Public Domain, pinakoteka, National Museum Kraków

The LLL supports attachment parenting, which was developed by William Sears. LLL is the most important organization that works to provide mothers with information and support about breast-feeding. Contact information can be found here. First select your country.

This safest milk for infants and children again led to high child mortality rates. At the time, it was already common to quote physicians in advertisements.

And then later came statements from Nestlé such as indispensable as a diet for infants (p. 127). In 1873, Nestlé sold a half a million boxes of “farine lactée.”

The manufacturers of this baby formula knew that this milk was not near to being able to meet the needs of infants. The formula was therefore continually changed over the next century. The changes were naturally made to improve the formula, but also to save on costs.

The book author Kathleen G. Auerbach wrote the following in the Journal of Tropical Pediatrics in 1992:

The formulations for artificial baby milk are changed frequently and represent one of the largest uncontrolled experiments in altered nutrition for humankind ever conducted (p. 127).

The book explains how the many different baby formulas available often contain widely differing ingredients. In the middle of the 1990s, this industry had annual revenues of eight billion dollars.

On the following pages, we learn about the different types of feeding bottles used from 1777 until 1990. At first, metal feeders of varying shapes were used. As these are only of historical interest, I will not go into further detail.

The patent for a “nursing attachment” that covered both breasts (1910) is both interesting and grotesque. It included a tube from the breast to the baby so that it would be possible to nurse in public (p. 139).

© Public Domain, phil.cdc.gov, Wikipedia

The pediatrician Dr. Cicely D. Williams discovered the disease called kwashiorkor and correctly described how it is caused. It was previously thought to be pellagra, a disease caused by a severe deficiency of vitamin B3. Kwashiorkor, on the other hand, is caused by insufficient protein consumption. Although she correctly described and differentiated kwashiorkor from pellagra in The Lancet in 1935, her colleagues and supervisors on the Gold Coast were hostile to her for years and ended the work with her on unfriendly terms in 1936.

Dr. Williams was sent to Malaya to teach at the University of Singapore. She quickly recognized that she had an entirely different problem to deal with: a high child mortality rate influenced by helpers from Nestlé and other infant food manufacturers who were dressed as nurses and sent to recommend condensed milk in place of breast milk.

After spending difficult years in a Japanese prison and only nearly escaping a death sentence, Dr. Williams was appointed director of the Mother and Child Health division at the World Health Organisation (WHO) in Geneva. Wikipedia describes her story in detail. Click on her name above to read more.

In a table on page 149, the authors show the many channels used for marketing, distribution (sales logistics), and influence. And it shows how physicians, nurses, and midwives have been provided with grants, remuneration of expenses, equipment, literature, gifts, advice, recipes, free samples (product samples), brochures, and other helpful items to make promoting formula easier and more rewarding.

Hospitals received gifts and even free architectural services for the renovation of their maternity wards. The formula industry lured professional organizations with direct donations, conventions, research grants, free dinners, conferences, travel money, and other services.

The authors describe just how intense the advertising for baby formula was and how the extensive marketing worked to generate large amounts of money in the cities of developing countries.

For example, trained nurses were given commission when they convinced mothers to use formula, and the mass media was also used to reach mothers.

Previously, the quality of breast milk had never been questioned. But then all of a sudden, the slogan was: When breastmilk fails, choose Lactogen (p. 50). People even began to believe that breast milk was inferior and that formula was something like medicine.

In just one month (August 1974) in Sierra Leone, there were 135 30-second advertisements for Lactogen (Nestlé), 66 for Similac (Abbot Labways), and 45 for Cow & Gate (Unigate).

The message was clear: sterile, scientific, superior.

You can imagine the sanitary conditions under which water was added to the formula to prepare it for the child. The term “bottle-baby disease” was coined.

To read more about the work conducted by Plank and Milanesi, see the book "Breastfeeding and HIV/AIDS: The Research, the Politics, the Women’s Responses" written by Edith White. There you will read that mixed-feeding, as described by Stephen J Plank and Milanesi ML, was found to be connected with a slightly higher infant mortality rate (86.5 per 1'000 infants) than exclusive bottle-feeding (84.5 per 1'000 infants).

See also their article titled "Fertility in Rural Chile" (1973).

Their work also showed (p. 22 in "Nutrition and an Active Life: From Knowledge to Action" by Wilma Freire, 2005, PAHO) that bottle-fed infants who survive the first three months are three times more likely to die by age three than are breast-fed infants.

Puffer RR and Serrano CV (sic!) wrote many books, including "Patterns of Mortality in Childhood", 1973, PAHO.

See also the book "Birthweight, Maternal Age, and Birth Order: Three Important Determinants in Infant Mortality" by Ruth Rice Serrano and Carlos V. Puffer — as well as other books and articles written by these authors.

The authors list a number of publications, some of which have reached a larger audience, for example an interview in the New Internationalist in 1973 with David Morley and Ralph Hendrikse, two pediatricians who were working for change in Africa.

In 1974 a brochure titled "The Baby Killer", written by Mike Muller and published by the charitable organization War on Want in London, uncovered the shocking practices used by baby formula companies.

Additional publications, for example, a Consumer’s Union investigation into the food and pharma industries by Robert Ledogar and the book "The Nutrition Factor" by Alan Berg, prompted the WHO in 1974 to conduct a review of the practices of these multinational formula companies.

The documentary "Bottle Babies" by Peter Krieg (pseudonym), which was filmed in 1975, brought this issue into the spotlight.

Around this time, Arbeitsgruppe Dritte Welt (AgDW) (a Swiss third world action group) translated "The Baby Killer" into German. For the German version, AgDW retitled the film "Nestlé Kills Babies".

This led to a libel suit against Nestlé, which unfortunately ended up causing more harm than good. Shortly before the trial began, the formula manufacturer created the International Council of Infant Formula Industries (ICIFI) as a way to better and more neutrally influence the public. The council announced its intentions to publish a code of ethics that the formula companies would then follow.

The process set off a chain reaction in the United States: American church groups concerned with world hunger and social responsibility filed stockholder resolutions with American companies in which they owned stocks, requesting information on international sales practices (p. 157).

After these and other steps were taken, Bristol Meyers agreed to remove its milk nurses from Jamaica. And Abbott agreed to at least not send out its “mothercraft nurses” in uniform.

In Minnesota, a consumer organization called Infant Formula Action Coalition (INFACT) was created; INFACT started a consumer boycott against Nestlé in 1977. See the box below for more information.

In 1979, the WHO listed out the 50 brands and 200 varieties of breast milk substitutes. UNICEF estimated that 1.5 million babies died each year because they did not receive breast milk.

See also the book "The One Best Way?: Breastfeeding History, Politics, and Policy in Canada" by Tasnim Nathoo and Aleck Ostry (2009), who give a similar account of the work of Dr. David C. Morley (1923–2009) and Ralph Hendrikse.

In the entry "Ethics in pharmaceutical sales", Wikipedia shows how certain aspects of business ethics are often lacking in corporations. See also these beneficial anticompetitve practices.

Wikipedia has a separate entry on the Nestlé boycott.

The authors quote various passages from the book "The International Code of Marketing of Breast-Milk Substitutes" by Sami Shubber.

Jean-Claude Buffle wrote the book "Dossier N. comme Nestlé" (fr.), which was published in 1986.

However, many initiatives sponsored by Nestlé and Coca Cola followed soon thereafter, such as the International Nutrition Congress in Rio de Janeiro.

Media Benjamin, one of the participants at the conference distributed a petition criticizing the promotion of infant formula and was then promptly arrested and imprisoned. She was only released after a U.S. government agency intervened, and then she was sent back to the U.S. wearing men’s clothing as a disguise. This is a good example of the power that these corporations wield.