Not a single country in the world meets WHO standards for breastfeeding? So what?

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Lactivists are bemoaning the latest breastfeeding report from the World Health Organization.

As USA Today reports:

No country in the world supports breastfeeding moms like they should, according to a new report released Tuesday by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF)…

By comparing breastfeeding rates around the world, the groups found rates nowhere near 100% in its Global Breastfeeding Scorecard, released at the start of World Breastfeeding Week.

So what?

No matter how long and hard professional lactivists bleat about the purported life saving benefits of breastfeeding, very few parents actually believe them, nor should they. The truth, which lactation professionals refuse to acknowledge, is that breastfeeding rates have virtually nothing to do with infant health.

There is literally zero real world evidence that promoting breastfeeding improves infant health.

Don’t believe me? Consider which countries did best and worst on the WHO breastfeeding report card.

Only 23 countries report exclusive breastfeeding rates at 6-months above 60%: Bolivia, Burundi, Cabo Verde, Cambodia, Democratic People’s Republic of Korea, Eritrea, Kenya, Kiribati, Lesotho, Malawi, Micronesia, Federated States of Nauru, Nepal, Peru, Rwanda, São Tome and Principe, Solomon Islands, Sri Lanka, Swaziland, Timor-Leste, Uganda, Vanuatu and Zambia.

By and large, these countries have terrible rates of infant mortality (expressed per 1000 live births):

Bolivia 31
Burundi 54
Cabo Verde 21
Cambodia 25
Democratic People’s Republic of Korea 20
Eritrea 34
Kenya 36
Kiribati 44
Lesotho 69
Malawi 43
Micronesia 29
Federated States of Nauru 29
Nepal 29
Peru 13
Rwanda 31
São Tome and Principe 35
Solomon Islands 24
Sri Lanka 8
Swaziland 45
Timor-Leste 45
Uganda 38
Vanuatu 23
Zambia 43

In contrast:

Laurence Grummer-Strawn, technical officer with the World Health Organization, said the U.S. received “several red lights” or “failing grades” in the report. Rates in the United States were considerably lower than the average. Fewer than 25% of American moms report exclusively breastfeeding for the first six months. The United States has no paid maternity leave, and data showed only 18% of hospitals support recommended breastfeeding practices. Grummer-Strawn also pointed out there’s no regulation on how baby formula is advertised in the U.S., a reason moms could think formula is a substitute for breastmilk.

But the infant mortality rate in the US is 6/1000, a fraction of the rate in any of the countries given the best grades by the WHO.

The United Kingdom, by all accounts, does even worse with a breastfeeding rate at 12 months of 0.5%, reportedly the lowest in the world … and yet the infant mortality rate in the UK is even lower than the US, 4/1000, one of the best rates in the world!

These figures make is nearly impossible to take UNICEF and the World Health Organization seriously when it asks for ever more money to promote breastfeeding:

The groups are asking for lower and middle-income countries to invest $4.70 per newborn ($5.7 billion) in initiatives, such as access to breastfeeding counseling and improving breastfeeding practices in hospitals, to increase the global rate of 6-month exclusive breastfeeding to 50% by 2025. The Global Breastfeeding Collective suggests such an investment could save the lives more than 520,000 children under age five who die of preventable illnesses, annually, and could generate up to $300 billion in economic gains.

All the existing real world evidence suggest that that can’t possibly be true and isn’t even close to reality. So where do such claims come from? They come from mathematical models that assume that when breastfeeding rates are correlated with low infant mortality, they cause low infant mortality. But as anyone with even a passing acquaintance with statistics can tell you, correlation does not equal causation. The figures quoted above demonstrate that definitively.

Nonetheless, the UNICEF and WHO claims, which have no basis in fact, have been widely disseminated and accepted as conventional wisdom.

A piece published yesterday on the Fast Company website is typical:

We really need to act now to fully realize the benefits of breast feeding,” says France Begin, a senior advisor with UNICEF’s infant and young child nutrition division. “Prioritizing breast feeding will save lives, save money, and will lead to better health and economic outcomes for generations to come.

Yet there is literally ZERO real world evidence that prioritizing breastfeeding will do any of those things. In the real world, there is NO correlation between breastfeeding rates and infant mortality rates. Countries with the highest breastfeeding rates have HIGH infant mortality and countries with the lowest breastfeeding rates have LOW infant mortality.

There is NO real world, population based data to indicate increasing breastfeeding promotion or improving breastfeeding rates would have ANY impact on any infant health of term babies.

Indeed, I posted a challenge on Facebook and Twitter yesterday:

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Take the Dr. Amy World Breastfeeding Week Challenge: Please find any example of industrialized countries where promoting breastfeeding reduced infant mortality.

Thousands of people have viewed the challenge but not a single person has offered a single example. That’s not surprising. There are no examples.

Not a single country in the world meets WHO standards for breastfeeding? So what?