This is what not enough breastmilk looks like

breastfeeding starving 3

The image is horrifying. The story behind it is possibly even more horrifying.

It is featured in a BabyCenter blog entitled Giving thanks for formula during World Breastfeeding Week. Midwife and photographer Marry Fermont took the photo during an internship in Cambodia.

Fermont explains:

One day I saw a woman with two little babies who were both really upset, but one baby was much larger than the other baby. I didn’t understand how this was possible, because there didn’t seem to be 9 months between them, but neither did they look like twins.

[pullquote align=”right” color=”#7adfda”]Because the mother did not have enough milk, she only fed the boy.[/pullquote]

Fermont’s interpreter spoke with the mother:

…[W]e learned that it indeed was a twin. A boy and a girl, but because the mother did not have enough milk, she only fed the boy.

The mother was able to support twins inside her body, but not outside. In truth, both babies were starving.

“I could not bear to see the children so upset and begged the woman to latch them,” Marry went on to say while sharing her recollection of the emotional meeting. “Soon I realized, even though I had no experience with breastfeeding or babies, that they were not calming down, there was just no milk. The mother gave me the little girl to hold and all I wanted in that moment was that my breasts could give milk, right here and right now…”

The photo demonstrates that the claim that every mother produces enough milk is a cruel lie.

Yes, these were twins, and yes, the mother might have been able to support one baby, but not necessarily. We know that 5% of women simply don’t make enough breastmilk to support the normal growth of a baby. The photo indicates that this mother probably did not suffer from insufficient glandular tissue of the breasts. And the classic canard that mothers who choose not to breastfeed are just lazy certainly does not apply. She simply couldn’t make enough milk to naturally nourish the children she had naturally conceived and naturally nurtured inside her body during pregnancy.

It probably did not take this mother long to realize that she did not have enough milk for two babies, so she made a hideous choice. She chose to feed the more “valuable” child, the boy, and was letting the girl starve to death. She could not bring herself to do what other mothers throughout time have done in that situation, leave one baby exposed outside to die or be eaten by predators. It might have been better for the boy, if the mother had killed the girl outright since he hadn’t been getting enough milk either. Both babies suffered terribly and Fermont was deeply affected:

We went back to the city and bought loads of powdered milk and a week later we went back to take it to the mother. We were too late…not only the girl, but also the boy had also passed away…

Fermont reflects on how this has influenced her thinking about World Breastfeeding Week:

We live in a country where everything is available; we can provide what is needed for our children. We have the luxury of switching to powdered milk when breastfeeding is not possible, we have the luxury to choose powdered milk if we do not want to breastfeed and our child will grow up and will have all the chances in the world.

Yet it seems that we just make it hard for each other; guilt if you choose to bottle feed instead of the breastfeeding, guilt if breastfeeding does not work, discussions about feeding your child in public. Why can’t we support each other? We only want one thing: to raise our children.

She concludes:

I think it is important that mothers know all the possibilities and the benefits of breastfeeding. Not to condemn you if you make a different choice, not to make you feel bad if breastfeeding did not work out for you. Whatever you choose or have chosen, your child grew up with it, and that’s something we should be grateful about.

As I wrote yesterday, nourishing=flourishing, and isn’t that what we want for all children?

That means encouraging breastfeeding when it is possible AND working for both mother and baby. But it also means celebrating formula feeding if needed or preferred. To that end, we should devote our efforts to bring clean water to places where it isn’t currently available. Formula made with contaminated water can be deadly, but it’s the water that makes it deadly, not the formula. Formula producers ignored that brutal reality for years, and countless babies died because their mothers were convinced to abandon breastfeeding for formula. That is a scandal of massive proportions. Yet, it seems remarkably cruel to promote breastfeeding to avoid contaminated water only to let breastfed children die as preschoolers from the very same contaminated water.

Motherhood is powered by love, not by breastmilk. Honoring the fierce love between mothers and babies means honoring any feeding method that leads to a flourishing baby. Often times that’s breastfeeding, but often times that is formula.

World Breastfeeding Week is marred by a literally fatal flaw; some babies die if exclusively breastfed. Therefore we should not be celebrating a method of feeding; we should be celebrating healthy outcomes. If that’s what World Breastfeeding Week were about, there would be a lot less guilt and a lot more thriving babies and mothers.

Motherhood powered by love

83 Responses to “This is what not enough breastmilk looks like”

  1. Neya
    August 9, 2015 at 9:24 am #

    This is why UNICEF and charities like it are so important.

  2. Chi
    August 8, 2015 at 7:19 am #

    Didn’t Nathan Fillion do a charity thing for his birthday to bring clean water to parts of Africa?

    • KeeperOfTheBooks
      August 8, 2015 at 8:21 am #

      He did! Ethiopia, IIRC. Reason #497 to like that guy. 😀

      • Chi
        August 9, 2015 at 2:20 am #

        He’s seriously one of my favourite actors of all time. I reckon he’d be a really awesome person to just hang out with for a day.

        If he EVER makes his way out to this small country of mine, I will do whatever it takes to get tickets to whatever event he’s attending.

  3. Christie del Castillo-Hegyi
    August 8, 2015 at 5:20 am #

    Wow! Dr Tuteur, your pieces just pierce right through me. Your work is amazing.

  4. EllenL
    August 8, 2015 at 2:36 am #

    That article is heartbreaking. But I’m glad you pointed it out. We need to be reminded of the critical issues in infant feeding – which have nothing to do with whether your next-door neighbor in suburbia is breastfeeding or using formula.

  5. Sue
    August 8, 2015 at 12:50 am #

    Lactivists will argue that this picture shows a setting of extreme poverty and malnutrition, and that wealthy women are not malnourished so they “should” be able to produce milk.

    Pity our bodies don’t always work like they “should” – well-nourished or not.

    • Angharad
      August 8, 2015 at 11:24 am #

      It’s not like anything else about my body works so perfectly – I have terrible eyesight, hypothyroidism, and bad knees, despite always having adequate nutrition. I don’t understand why the lactivists think milk production and childbirth are immune to the problems the rest of the body can develop so easily.

    • Allie P
      August 10, 2015 at 4:30 pm #

      5% is one in 20. That’s common enough that we should let go of the blame game.

      • pinky
        August 10, 2015 at 6:27 pm #

        No it’s 5 in 100, which means that 95 in 100 can produce enough milk.

        • Roadstergal
          August 10, 2015 at 6:58 pm #

          “No it’s 5 in 100”

          Why did you say ‘no’? 5 in 100 is 1 in 20. Didn’t you take fractions in grade school?

        • Nick Sanders
          August 10, 2015 at 7:03 pm #

          Which sounds nice, until you do the math on just how many people there are.

          • Roadstergal
            August 10, 2015 at 7:47 pm #

            Can you imagine the horrorshow if 5% of all commercial airline flights crashed?

          • The Bofa on the Sofa
            August 10, 2015 at 8:16 pm #

            And remember, that 5% is just the number of women who CAN’T breastfeed because of inadequate supply, and doesn’t include those for whom breastfeeding is very difficult or impractical for other reasons.

            IOW, 5% is a starting point.

        • Cobalt
          August 10, 2015 at 7:22 pm #

          4 million babies born in the US each year. 200,000 of them would be severely malnourished or dead EACH YEAR if breastfeeding were the only option.

          TWO HUNDRED THOUSAND. EACH YEAR. Just from insufficient nutrition.

          Tell me again how “breast is best”.

        • An Actual Attorney
          August 10, 2015 at 8:35 pm #

          Was this sarcasm or serious? Honestly can’t tell.

    • fiftyfifty1
      August 10, 2015 at 7:20 pm #

      Except then you look at the woman and she is well nourished. Certainly not underweight. I suppose you could argue that even a robust appearing woman like in this picture may have microdeficiencies in her diet, but then the lactivists always argue that microdeficiencies don’t matter, that plenty of nutritious milk will be produced anyway, that even babies born to mothers in concentration camps thrived. etc etc.

  6. Rosalind Dalefield
    August 7, 2015 at 7:01 pm #

    I know a woman who just couldn’t produce enough breastmilk for her babies, although she only had them one at a time. She struggled to feed the first two before switching to formula. By the time the third baby arrived, she knew to just go straight to formula.

  7. yugaya
    August 7, 2015 at 6:11 pm #

    It is a disturbing story on so many levels, but to me personally the worst thing in it is how this mother “only fed the boy”. I’m raising my girls in a world where choosing to feed the boy and not the girl when both are hungry is default in too many places still. 🙁

    • Wombat
      August 8, 2015 at 4:29 pm #

      Just to be fair though: It’s not this one, impoverished woman’s fault that feeding the boy was the reasonable choice in the framework she was given. It’s the framework’s fault, which is part cultural, part socioeconomic, and part bigotry (though usually on the part of those with power).

      Even if she had made what some would see as the ‘right’ choice (not saying you are that some, for the record) and fed both children with what she had available (limited supply of breast milk), this story shows that it is extremely likely that neither would have lived. Feeding one gave her the chance of having one surviving child, an absolutely necessity in a society where children are labor for (barely) subsistence farming, and the only form of emergency caregiving, retirement, or elder care remotely available.

      Bringing clean water, access to formula, access to prenatal care (selective reduction would have done wonders here, even though it is very very sad that it would have been the girl reduced), access to healthcare. Helping to improve local economic conditions (while there are arguments about the best ways to do so, no one argues that it is an important and worthwhile thing). Some embrace of females will come simply with that. Families do not hate having daughters for the most part – they hate having a dowry they can’t afford. A child who can never have an income. Additionally, dowries will become less of a thing for either gender when poverty to the point that having another family member is a near impossibility is less of a thing But even what doesn’t come with that will be much more reasonable and easy to attempt to share and education when we’re not showing facts, figures, and explanations to people who aren’t even there to listen because they literally can’t stop working or they starve.

      Most third worlders aren’t much of anything by choice. They are nearly everything they are, everything they do, out of necessity. What little bit isn’t covered by that is usually literal ignorance. Working on the former and then the latter just makes sense.

  8. Bystander
    August 7, 2015 at 2:17 pm #

    Horrifying indeed, but no, not in the slightest bit unusual. Where I grew up, you could amble to the feeding clinic at the teaching hospital and see dozens of infants and young children like this. Too poor to afford good alternatives is hell.
    It’s why my take on nutrition is that the first rule of a reasonable diet is ENOUGH. Enough food, enough calories to live, to have an immune system, to think, to move, to not be permanently miserable. That’s by far the first priority. Everything else is secondary — the ‘perfect’ nutritional mix that there isn’t enough of is pretty terrible. It immiserates the adult, stunts the child and destroys the infant.

  9. Charybdis
    August 7, 2015 at 12:28 pm #

    My cynicism may be showing, but I wonder how the lactivists are going to try and spin this. Blame the mother “she was only nursing the boy, of COURSE she couldn’t make enough. It’s a supply and demand thing” or ” she needs to drink some mother’s milk tea and drink more water to help boost her supply”. Maybe try the “well, that can’t happen here. There are enough resources in wealthier countries so that absolutely cannot happen and then repeat their mantra that ALL women can breastfeed and can produce adequate milk to feed their babies”. Perhaps the old “that photo was staged; notice how she is not holding the babies correctly for a good latch, it’s obvious that neither baby is nursing at all, they paid someone to pose for the picture, they aren’t even her babies” tactic. Anything to continue to advance their agenda.

    OTOH, that picture and corresponding story is heartbreaking. Formula is not the work of the antichrist, nor is it the Drink of the Devil or Evil Elixir. It is food for infants, period.

    • Angharad
      August 7, 2015 at 12:57 pm #

      I cried. It isn’t fair that I could give my daughter safe, nutritionally sound formula and watch her go from screaming in hunger to sleeping contentedly, while this mother watched her two babies starve and die.
      There are already several comments on baby center saying formula wouldn’t have helped because of bad water (no mention that they want to donate to clean water foundations or do anything else to help make formula a viable option in developing nations), and the mother probably just didn’t spend enough time nursing both. It makes me want to vomit.

      • Cobalt
        August 7, 2015 at 1:08 pm #

        Do they honestly think the problem is that the mother could have but just didn’t bother or was too stupid to give the babies more milk?


        • Mel
          August 7, 2015 at 1:37 pm #

          No. I think they literally believe breasts are magical.

          If you put a baby to a breast, the breast will somehow produce milk instantaneously, of high enough quality and in enough quantity to keep any number of babies alive.

          The fact that breasts are the sites of milk production – an incredibly intricate physiological process that has time and caloric limits on it – is beyond their understanding.

          • DelphiniumFalcon
            August 7, 2015 at 1:51 pm #

            I don’t get how they think they can magically produce something from nothing.

            Let’s use me as an example. I got my Vitamin D levels checked as part of a full work up. My level came back as nine. Between 30 and 50 is what’s recommended. I need to take supplements now and make sure I get sun in the evening but not too much because I burn very quickly. I get my levels checked in October to make sure I’m at a healthy level.

            So if I didn’t know I had a Vitamin D deficiency, had a kid, and tried to breastfeed where was the vitamin D supposed to come from? I don’t have enough to even be near the low end of normal. A level of nine split between myself and an infant isn’t going to be anywhere near healthy for either of us.

            And the thing is the doctor who orders the tests said there’s a lot of undiagnosed Vitamin D deficiencies. So it isn’t like this is a rare thing.

            How do they explain breast milk has everything a baby needs when the mother’s body doesn’t have everything it needs?

          • Kelly
            August 7, 2015 at 2:55 pm #

            I pumped enough for twins but it put my body through hell. I had to eat so much food in order to not be queasy and I loved eating fast food because it would fill me up for longer than anything else. My nails were destroyed and I am sure I was deficient in many vitamins. I lost all the baby weight and then some but it was not healthy at all During this pregnancy I have been fighting incredible fatigue and found out my D levels are significantly low and that I am very anaemic. This women’s body would have not have been able to do what I did. She does not live in a situation where she could constantly have high calorie foods, water, and vitamin supplements. Plus, I had all the time that I needed to sleep and keep off my feet. These twins died as a result of her situation, not a result of her not trying enough.

          • Daleth
            August 7, 2015 at 3:55 pm #

            That’s always my point in arguments about this. Breast milk cannot be the perfect food unless the mom’s body has sufficient nutrients to provide the baby with all the nutrients baby needs. Many women of childbearing age even in America, much less in lower-income countries, are deficient in vitamin D and iron, just to name two biggies. Their breastmilk therefore is not the perfect food for their babies.

            The NY Times ran an article on the problem of breastfeeding while vitamin D deficient a few years ago:


          • Mattie
            August 7, 2015 at 5:32 pm #

            Isn’t vitamin D predominantly synthesised by our bodies from sunlight though, is it ‘necessary’ for breastmilk to provide that?

            Evolutionarily what purpose does low vitamin D and iron in breastmilk serve? Or is it a mistake in evolution? (legit interested in this)

          • Sarah
            August 7, 2015 at 5:44 pm #

            Small babies aren’t necessarily in direct sunlight much, though. You probably know that the NHS advice is to keep them out of it. Obviously in hotter countries it’s probably more common, but equally the populations there are less likely than the British to have the optimum skin colour for synthesising it.

          • DelphiniumFalcon
            August 7, 2015 at 5:51 pm #

            You do get most of it for sunlight but I grew up in the Pacific Northwest of the US where in the winter the sun comes up around 7:30 am and starts to set around 4:30 pm in addition to a constantly overcast climate with a lot of rain that forced people indoors. I am also extremely fair skinned and I have had my scalp start to burn within thirty minutes of being outside on a puffy white cloud sunny day. That’s why my doctor suggested sun when it’s closer to setting as there’s less chance of sun burn. I don’t tan either, I just freckle and burn. So it’s a fun balance. Lack of vitamin D with the bone pain, muscle pain, fatigue, and getting exhausted walking across the house or get a lot more sun and up my melanoma risk. I’ve done pretty well on not getting anything more than a little red and I’ve never had a peeling sunburn. I’d like to keep it that way.

            Some people have low vitamin D because of parathyroid disorders. Others have kidney problems. Vegan diets can also be a factor.

            My cause is a hell if we know, try sitting the sunlight and take these supplements. I do have less bone pain and I can walk more than a block without feeling like I wanted to die. I never got it checked out because I thought I was just another out of shape, lazy American and wasn’t being diligent enough to push through the pain to get the gain. Pretty stupid, I know.

          • Poogles
            August 7, 2015 at 7:02 pm #

            “I am also extremely fair skinned and I have had my scalp start to burn within thirty minutes of being outside on a puffy white cloud sunny day. […] I don’t tan either, I just freckle and burn.”

            Are we twins? LOL, that describes me as well (I like to say my skin does 3 colors only – white, pink & red). I also had a vit D deficiency and I think mine was around the same level as yours, I’m thinking 7, but I can’t remember for sure.

            In addition I had B12 & folate deficiencies. Now I take a supplement for each every morning, and all of my numbers are back in normal/healthy ranges 🙂

          • Dr Kitty
            August 7, 2015 at 6:24 pm #

            Actually, the latest advice in the UK is for EVERYONE to take vitamin D tablets, because deficiency is so common and the risks of supplements are low. Prior to that the advice was for at risk populations (breastfed infants, pregnant and breast feeding women, women from high melanin+ high modesty backgrounds and elderly people) to take supplements.

            I work 8am-6pm. Between October and March I’m pretty much going to work in the dark and coming home in the dark. My exposure to sunlight is zero during the working week, and trying to reliably get 75minutes of sunshine, in Ireland, in the winter, on the weekend…nope.

          • Mattie
            August 8, 2015 at 7:25 pm #

            Haha yeh, the UK can be pretty rubbish for sunlight (I just got home from 3 months in Sardinia, lots of lovely vitamin D for me haha). I was just wondering why breastmilk developed to have low vitamin D and iron, as surely that would be an evolutionary change or at least if they were ‘needed’ then it would have evolved over time to contain more of the vitamins required. Obviously if a mother is deficient the breastmilk can’t produce it, but even in healthy mothers BM is low in vitamin D and iron which is odd.

            I read something once (honestly it was likely to have been lactivist propaganda) suggesting that the low iron in breastmilk had developed as a result of bacteria in the gut preferring an iron-rich environment, so BM was low in iron to help prevent bacterial growth. It made sense to me at the time, now realising it was probably a load of rubbish, but still curious as to why BM is low in those vitamins if they are required.

          • Cobalt
            August 8, 2015 at 7:49 pm #

            Required for good health, not necessarily for survival.

          • Angharad
            August 9, 2015 at 11:41 am #

            I assumed that we spend a lot more time indoors now, like in the evolutionary past we wouldn’t have needed dietary vitamin D because when we were evolving everyone would have been in the sun basically as long as there was daylight.

          • Cobalt
            August 8, 2015 at 7:48 pm #

            Not a mistake, and it may be purposeless. Evolution aims not for perfection, but for good enough. And it’s never finished. Sometimes things are they way they are because there was an advantage to a particular trait, and sometimes because the trait wasn’t enough of a disadvantage to wipe out the bloodline.

            Now a genetic mutation may randomly come along and create higher D milk, and if that increases reproductive success (defined in terms of generations of descendants) it may catch on. Skin melanin levels to regulate sunlight dose have worked good enough to keep humans going so far, though.

            Don’t trust evolution to solve for perfect. Nature’s goal is quantity of grandbabies, not quality of life. For example, sickle cell disease, a genetic disorder fairly common in people of African descent is incredibly painful and can be completely debilitating if you have two copies of the gene. One copy reduces the symptoms but is still hard to live with. How would an early onset debilitating genetic disorder become common? It’s also protective against malaria.

            Nature is a bitch.

          • Siri Dennis
            August 15, 2015 at 5:29 am #

            Evolution doesn’t “aim” for anything; it just happens in response to pressures. And nature doesn’t have a “goal”; that’s pure anthropomorphism.

      • Amy M
        August 7, 2015 at 1:20 pm #

        I have twins. If we had no access to formula, my children would have ended up the same way. Twins are only celebrated in places where there are enough resources to support them.

        • DelphiniumFalcon
          August 7, 2015 at 1:29 pm #

          I never thought of it that way. I wonder if that’s why in some cultures twin births were a bad omen?

          • Mel
            August 7, 2015 at 1:34 pm #

            As a twin, that’s what I figured. I mean, the birth and delivery is already runs huge complication risks for the mom and the twins. Once the second baby is here, the family/community needed to make a choice about how to get rid of one or both babies to increase survival chances for the mom.

          • Sarah
            August 7, 2015 at 2:41 pm #


    • Karen in SC
      August 7, 2015 at 1:25 pm #

      Since the midwife went to get powdered milk, presumably there was clean water available in this case.

    • August 7, 2015 at 3:51 pm #

      I’ve heard of the photo used to advance the “breast is best” narrative and implying that the girl was given formula… a different equation in developing countries.

      • nomofear
        August 7, 2015 at 8:02 pm #

        Yes, I have too.

      • sadness
        August 8, 2015 at 10:41 am #

        It’s so strange that they would think that and shows how much they don’t understand the culture. If the family had had formula, surely it would have been given to the boy (as a supplement to breastmilk).

  10. Angharad
    August 7, 2015 at 12:27 pm #

    I knew I shouldn’t have read the comments on babycenter. Here’s a truly evil one:
    “What bull. She could have fed both watered down formula with contaminated water and have them both ill or die. She probably didn’t feed both at the same time due to her chores she needed to get done and as a result her milk supply suffered. It is indeed a man’s world and of course the worth, as in so many countries lies within having a male heir.”

    I can’t believe it. She sees the woman with her starving babies and her reaction is that it’s the mother’s fault for not nursing them enough. In a tragedy her takeaway was that formula is bad and mothers of dead babies deserve their loss.

    • Roadstergal
      August 7, 2015 at 12:45 pm #

      “She could have fed both watered down formula with contaminated water and have them both ill or die.”

      Or you could have spent half the energy you spend shaming FF mothers and patting yourself on the back on initiatives to get clean water to developing nations.

      Selfish twit.

    • Mel
      August 7, 2015 at 1:30 pm #

      The gaps in her logic are pretty telling:
      Gap 1) She could have fed them watered down formula and had them both (become) ill or die.
      Reality – The midwife with a NGO had to travel to get powdered milk – not formula – POWDERED MILK. Formula was not available.

      Gap 2) Her milk supply suffered because she didn’t breastfeed both of them at the same time.
      Reality – Nice try, but breasts only produce a certain amount of milk based on glandular tissue content, maternal calorie intake and the stimulation of having the breasts emptied. Feeding both twins at once would have lead to a more even starvation pattern, but they would have both starved either way.

      Gap 3) Her chores affected her milk production.
      Reality- The total caloric intake of the mother and the amount of available breast tissue to make milk matter way more. The chores matter only in that the extreme poverty increases the amount of work she does each day while dropping her calorie intake.

      One bit of reality: Having a male heir for her could literally be life-or-death. A son gives her a chance at a breadwinner who will outlive her. A daughter does not.

      • Angharad
        August 7, 2015 at 1:53 pm #

        “She could have fed them watered down formula and had them both (become) ill or die” sounds like “The baby would have died in the hospital too.” I mean, yeah, maybe feeding her babies powdered milk or formula wouldn’t have kept them alive. Then again, maybe it would have.

        • Azuran
          August 7, 2015 at 2:07 pm #

          I really don’t get the point that she is trying to make. Two kids are starving to death, A is clearly killing them, but you shouldn’t do B because it ‘might’ kill them?
          That’s like saying you shouldn’t do chest compression on someone because you might kill them more by breaking ribs and causing lung damage.
          Those baby are dying, worst case scenario: They are still dying. Might as well try something else (And I’m sure the mother would have tried if she had access to it)
          Seriously, how can they think that possibly dying of waterborne illness is worst than actually starving to death?

      • Amy
        August 7, 2015 at 2:57 pm #

        This is why I actually defend WBW to a certain extent. It’s not about formula shaming, a huge amount of women in this world do not have access to safe alternatives to breastmilk. It’s that it’s culturally acceptable to let ones daughter die of malnutrition. I HATE that they don’t seem to acknowledge moms who can’t produce. It doesn’t seem to be an easy problem to fix though. Even promoting formula as an alternative to sugar water, coffee or tea carries it’s own risks. It’s a complicated issue for sure.

    • Bystander
      August 7, 2015 at 2:20 pm #

      But the outcome was that they *both* died. Better dead and pure than alive and impure, right? Assholes, the lot of them.

    • Bombshellrisa
      August 7, 2015 at 2:43 pm #

      Sounds like she is saying better dead than formula fed, she is probably the same type that comments better a home birth death than c-section born, Twit basket.

    • Cartman36
      August 7, 2015 at 4:41 pm #

      I just saw that one too. Apparently the poster knows everything about that mom’s situation to fix it from her couch and keyboard.

    • SuperGDZ
      August 8, 2015 at 9:40 am #

      Contaminated water is not a given in developing countries. 70% of Africans have access to clean water – here in South Africa around 95% of the population does, especially in urban areas. And yet, egged on by the WHO, govt promotes EBF in a population where up to 30% of mothers are infected with HIV and has stopped govt funding of formula.

      • Angharad
        August 8, 2015 at 11:28 am #

        I didn’t realize. I guess I just assumed the WHO at least had a reason for their breastfeeding recommendations in developing countries. How appalling that they continue to portray formula as an unsafe alternative even when it isn’t!

  11. An Actual Attorney
    August 7, 2015 at 12:03 pm #

    Well, shit. Now I’m going to spend my lunch hour crying.

  12. wookie130
    August 7, 2015 at 12:03 pm #

    Are there any groups or humanitarian organizations that provide clean, bottled water, washing supplies, and formula to mothers of babies? I have several cans of unused formula in my basement, as my son just made the switch to whole milk this week.

    Such a sad, sad thing for this mother, and other mothers who have only breast milk to rely on, yet can’t breastfeed due to latch, supply, or other issues. I couldn’t imagine the desperation these mothers feel, watching their infants suffer, and slowly starve to death. It’s horrible, and it increases my level of disgust for lactivists who support breastfeeding at all costs.

    • Dr Kitty
      August 7, 2015 at 12:16 pm #

      Ask your local food banks, homeless shelters or women’s shelters if they would like the formula. I bet they would.

      The big international humanitarian organisations tend to source formula in bulk and won’t accept small donations, because it is simply too inconvenient/costly to do so.

      • Cobalt
        August 7, 2015 at 12:24 pm #

        There is also a lot of opposition to international formula donations.

        Because of the WHO code, and “breast is best”.

        • Sarah
          August 7, 2015 at 2:43 pm #

          I’m sure we all remember the breastmilk to Haiti donations.

          • Cobalt
            August 7, 2015 at 7:51 pm #

            Not only did they want to send breast milk (because that’s totally safe and not at all logistically complicated), they tried to block formula donations.

            Of course, what was really needed was money. Pooled funds buys a lot more food/formula with less loss to logistics then sending mishmashed donations of anything a crate at a time.

          • Hannah
            August 8, 2015 at 10:24 am #

            There are complex issues about direct donations of formula in disaster situations. If they’re just dumped on the population and not distributed carefully then it can end up on the black market, and it can undermine what could otherwise have been viable breastfeeding.

            There’s still an amount of unethical marketing in some of these countries, formula feeding can be associated with wealth and success, and their are sometimes unhelpful folk beliefs such as stress causing breast milk to spoil.

            These are countries that don’t necessarily have a secure clean water and sanitation infrastructure in the way we’d take for granted even if they do have sources of water that are “clean enough” in most circumstances, and such that they do have will likely be disrupted in the disaster. Haiti went on to have a cholera epidemic after the earthquake. In addition once breastfeeding is stopped, the family will need to be able to consistently supply formula (which may be expensive) until the baby is weaned, otherwise the temptation to use alternatives or over-dilute feeds may set in.

            Aid agencies are becoming more alive to these issues and if they’re given the money they can source what they need, preferably locally, with labels and instructions in the local language and distribute it in a considered way.

          • Cobalt
            August 8, 2015 at 2:59 pm #

            Sending donated breast milk instead solves none of those problems and introduces pretty intense supply train logistical problems (like narrow range temperature control vastly disparate from the local environment). There is also additional disease control concerns beyond typical food handling issues. Any food can contain E Coli, human milk could also contain HIV, etc. RTF formula avoids all of that.

            Responsible and ethical aid distribution is a concern regardless of the type of donation. That’s why well trained disaster response and relief teams need to handle it, with careful consideration of unintended and downstream effects.

            A baby who has an injured, ill, missing, or dead mother in a disaster zone needs to be fed. Insisting that food is breast milk, blocking the importation of formula, is an unnecessary evil.

          • Sarah
            August 8, 2015 at 3:26 pm #

            I bet sourcing enough premade formula for all the orphaned/separated babies in a wreck of a country that had just experienced an immense natural disaster was incredibly easy. Haiti definitely had both sufficient supplies and the means to transport them.

          • Cobalt
            August 8, 2015 at 7:05 pm #

            And sourcing wet nurses and donated milk is easier? The babies have to eat something.

            That’s why the best individual or small group donation is money to disaster relief organizations that can order, organize, transport, and distribute aid with greater possible efficiency in whatever circumstances.

            Maybe we shouldn’t send any food at all-we wouldn’t want a natural disaster to disrupt farming by giving the people an easy way out. And if they starve, well at least we didn’t encourage dependency on artificial feeding.

    • Karen in SC
      August 7, 2015 at 12:30 pm #

      One way to help is to support clean water efforts. Sandec is a global effort to bring solar water purification to developing countries.

    • KeeperOfTheBooks
      August 7, 2015 at 1:48 pm #

      In addition to the excellent suggestions below, you can also try at your local churches. Ours, for example, keeps a stock of canned/dried/nonperishable goods on hand for people who come in and ask for food; I’m sure they’d love some unopened cans of formula!

  13. Megan
    August 7, 2015 at 12:02 pm #

    That is just so so sad. I am grateful I had formula to nourish my babies when my breasts could not. I feel so bad for this mother. It is so easy for all of us to forget just how good we have it.

  14. Mel
    August 7, 2015 at 11:53 am #

    As a twin, I am deeply grateful for the availability of formula.

    My twin and I were born somewhere between 28.5-30 weeks gestation nearly 34 years ago. We were our parents’ first children. The hospital helped my mom start pumping because we were both far too fragile to breastfeed at first.

    I was eventually able to breastfeed and breastfed from when I was released from the hospital 6 weeks later until my sister was released from the hospital four months after we were born. Mom’s been clear on why she breast fed me before Sis was released: driving 30-45 minutes each way to a hospital during the winter with an infant was hard enough and she didn’t want to have to deal with formula if she could avoid it.

    Mom is also very clear on why she stopped: Trying to breastfeed me while formula feeding Sis – who couldn’t tolerate anything but pre-digested formula for months – and keeping up with all the doctor and therapist visits was insanely hard. Switching to formula and formula allowed her some time to sleep and made it possible for people who came over to help to feed both of us.

    After us, Mom was able to breastfeed both of my singleton brothers successfully (although she “allowed” David to self-wean at 8 months which I guess in NCB circles is frowned on.)

    I love my mom for many, many reasons. My brother David died due to a faulty immune system – which we were unaware of until he died – and Mom believes firmly that breast milk helped prop up his immune system. That belief hasn’t turned her into a lactivist bully; no, it’s made her extremely thoughtful about the actual benefits of breastfeeding for healthy babies.

    So when my twin cousins were born nearly 18 years ago and my aunt was struggling to try and breastfeed both, Mom had sage advice: ” Breast milk and formula both feed babies. Pick the one that makes your life more sane. It’s not like the kids are going to remember which you picked. Oh, yeah, and if you do formula, the kids [referring to Me, Sis and Bro] can take over feedings during their “Anti-teenage pregnancy awareness” weekends.”

    That’s how I learned to make formula with one hand while bouncing a cranky young infant in a front carrier while the adults enjoyed a burger on the deck.

    Thanks, Mom. 🙂

    • KeeperOfTheBooks
      August 7, 2015 at 1:35 pm #

      I like your mom. 😀

    • Daleth
      August 7, 2015 at 1:49 pm #

      Your mom rules! I must steal that page from her playbook.

  15. Neya
    August 7, 2015 at 11:33 am #

    The desperation on the faces of the children is both palpable and devastating. I was in tears before I read the article and sobbing by the end of it. How can we, as a world community, allow for this to still happen? Why did this midwife wait to travel and buy milk, instead of procuring some sugar/electrolytes to give these kids some calories and keeping them hydrated? Where are the blankets to keep them warm? So many questions…

    • Cobalt
      August 7, 2015 at 11:35 am #

      Resource poor environment. Those things are just not ready available.

      This is what living “closer to nature” really looks like.

      • Neya
        August 7, 2015 at 11:42 am #

        I just wonder how, as a midwife, you show up in a resource poor environment without a can of formula of a package of WHO rehydration solution. I have traveled many isolated areas of the world and even many tourists are mindful enough to know that they need to bring few things for the locals. It’s pretty standard to pack extra clothing, a full complement of medications for water-born diseases, re-hydration packages (most people assume that they will get diarrhea), a good water filter, etc. A common practice from travelers I’ve met is to leave the meds/solutions/MREs behind for the locals to use when they are ready to leave.

        • Cobalt
          August 7, 2015 at 12:32 pm #

          It would make sense to do so, if possible.

    • Angharad
      August 7, 2015 at 12:43 pm #

      From reading the article, I didn’t get the impression that she was a midwife at the time, just a photographer. It sounds like they had hygiene supplies, but they probably just didn’t think they’d encounter starving infants.

  16. Trixie
    August 7, 2015 at 11:25 am #

    Throughout history, one or both twins were commonly exposed if they survived labor.

  17. demodocus
    August 7, 2015 at 11:22 am #

    That poor woman and her children. Sometimes life really bites.
    Also, this is proof that going back to our traditional ways is not always best either.

  18. Cobalt
    August 7, 2015 at 10:44 am #


    Always, always, always.

    This is why formula was invented. This is why formula isn’t evil.

    This is why blind promotion of breastfeeding IS evil.

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