What’s for dinner? Food security for babies.

There’s a lot of talk about food security, or food insecurity, plus a correspondingly large volume of writing about this important topic. How people access and afford appropriate, acceptable nutritional and sustainable food is a growing concern along with rising levels of poverty and inequity. It’s a growing social disaster with no end in sight under the current business, ‘economic growth above everything/everyone’ environment.  I searched for New Zealand writing about food insecurity and was startled to note a common theme throughout all the articles I accessed, which was the total invisibility of breastfeeding.  Breastfeeding does not exist in the land of food, milk and honey, nor, it seems, in the land where people can’t easily access food, milk and honey.

Let’s take a quick trip through a few New Zealand documents. Susan Bidwell is the author of a district health board paper entitled, ‘Food Security, a review and synthesis of themes from the literature’, written in 2009.[1] The key points outlined in this review include an estimate of 10% of New Zealand households experiencing low food security, the effects on child health and development/overweight/obesity issues, and that policy change at all levels of government is necessary for any meaningful change. There was one mention of breastfeeding in Bidwell’s paper and that was on page five where it pointed out food insecure households were linked to lower rates of initiation and continuation of breastfeeding. This statement in itself makes the lack of attention to breastfeeding in documents concerned with food insecurity inexplicable.

Carter, Lanumata, Kruse and Gorton looked at the determinants of food insecurity in New Zealand in 2010.[2] Food security was defined as the “assured ability to acquire nutritionally adequate and safe food that meets cultural needs, and has been acquired in a socially acceptable way” (p. 1). Carter et al, estimated that food security was a concern for about 20% of New Zealand households with females being identified as more likely to be affected than males. It was also noted that for Māori, Pacific and low income peoples, income and cost of healthy food are the most pressing issues for these communities (p. 2). Higher rates of poverty and the burden of nutrition related disease within these communities was also highlighted. The lowest documented rates of breastfeeding in New Zealand are to be found in the statistics for Māori, Pacific and families suffering hardship.

In 2011 Stevenson authored a paper for the public health service in the Bay of Plenty about food security policy. This was a literature review and a synthesis of key recommendations for Toi Te Ora – Public Health Service. [3] Stevenson points out in the executive summary that the literature review findings suggest forming a collaborative group is the best approach to address food insecurity issues at a local level, and such a food policy council could advise and promote locally driven work. Again in this document there was reference to the disproportionate representation of Māori and Pacific households in poor health and premature death statistics. Included in the key summary points was a statement about the negative effects of food insecurity on health status and social well-being and how this was damaging for child health and development.

Three well written and valuable papers spanning three years, with two including literature reviews, and still not a mention of how breastfeeding punches above its weight in the food security for infants stakes, even in the most deprived of homes.

Parnell and Smith of Otago University put together a power point presentation (unknown year) which is freely available on the internet. [4]  Parnell and Smith suggest that food security affects health and well-being and it needs to be addressed. Proximity to supermarkets and other food sources was mentioned but the opportunity to mention the proximity of babies to breastfeeding mothers to ensure the optimal food security of our most vulnerable consumers was missed again.

Caritas, Aotearoa New Zealand, a Catholic association, published a booklet in 2012 for Social Justice Week around the topic of food security.[5] The increasing struggle to put food on our tables was examined and unfortunately the sole mention of breastfeeding was found in a section entitled, “who misses out”, where a statement about victims of hunger including “babies whose mothers cannot produce enough milk” was made (p. 10). The comment had no references and no recognition of all the babies who survive globally only because they are breastfed. This omission is a great disappointment, considering how Pope Francis has become a much lauded breastfeeding advocate for encouraging mothers to feed their babies in the Sistine Chapel. [6]  Pope Francis was reported to have said, to the mothers of thirty-two babies, at a Vatican Baptism Ceremony. “If they are hungry, mothers, feed them, without thinking twice, because they are the most important people here.”

The admirable Child Poverty Action Group (CPAG), in New Zealand, prepared a series of documents with part one entitled, ‘Our children, our choice: priorities for policy’ written in 2014. [7] According to the authors there are now 285,000 children, or 27% of all New Zealand children, living under the poverty line. CPAG point out that social policy in New Zealand has been driven by a focus on paid work with limited or no attention being paid to the value of parenting. Along with the undervaluing of parenting comes the lack of awareness of the contribution of breastfeeding to our country and to the health and well-being of our children and mothers. Despite the excellent policy document produced by CPAG with poor child health outcomes due to poverty highlighted, there was no link made to the optimal nutrition and health protection offered by breastfeeding. In a document that speaks of antenatal care and childhood nutrition, breastfeeding was still a silent loss. There are more documents about poverty and food security that also miss breastfeeding. [8]

Added value when used as a tem for food means added economic value for food manufacturers and not the consumer. Added value in the context of infant feeding, when you really think about it, means breastfeeding – exclusive for six months and continued breastfeeding for two years and beyond, after other foods are introduced into the diet at six months. Added value through breastfeeding means a reduction in infant and childhood illnesses and infection, and protection against a number of diseases, including cancer and heart disease in mothers. Unfortunately breastfeeding advocates and breastfeeding women do not have friends at the Ministry of Primary Industries (MPI). By the very definition of ‘primary industry’ [9] breastfeeding women should be counted by the MPI as value added sustainable resources with ‘all’ that would be needed to improve sector productivity, being support and protection. Can you get more primary industry, added value, than breastfeeding? I think not. Unfortunately, as Caroline Walker & Geoffrey Cannon pointed out so well in 1984, ‘An apple a day may keep the Dr away, but a Mars Bar a day helps the directors, shareholders and employees of Mars Ltd work, rest and play’.[10]  Replace apples with breastfeeding and Mars Bars with formula and it’s the same old story.

There is a difference between food security and food sovereignty, “Food sovereignty puts the individuals who produce, distribute and consume food at the centre of decisions on food systems and policies, rather than the corporations and market institutions that currently dominate the global food system.”[11] Breastfeeding puts the individuals who produce and distribute breast milk and home-made food to the smallest consumers at the centre of decision making and not the corporations and market institutions. Therein lies the problem and this is why mothers, infants and breastfeeding are collateral damage in these times of milk wars.

It’s a strange world we live in, where those, with minimal funding, who try to support or mentor breastfeeding women have limited opportunity to have their voices heard. Where those who could pin breastfeeding protection, promotion and support securely to agendas that count for something, do nothing, because they are unaware, unable, misinformed, lobbied, exhausted or disinterested.  Where there are vested interests in short-term ‘economic growth’ agendas that do not count either the contribution of mothers’ breast milk and breastfeeding, nor deduct the huge costs to the environment of intensive dairying from the dairy boosts they claim.[12] Galtry (2013) points out the narrow economic measure of well-being that the NZ dairy industry is based on, and questions whether the industry is undermining global best practice infant feeding. [13]

There are some encouraging signs that may provide comfort. Women are still interested in initiating and establishing breastfeeding, women from diverse backgrounds are interested in providing mother to mother support for breastfeeding, La Leche League continues globally with their mission to provide support, encouragement, information and education, the Baby Friendly Initiative continues to make a difference globally and good people are fighting for the rights of breastfeeding women, parents and maternity protection.

Breastfeeding really is the only sustainable way to feed the babies of the world and as described so well by Pamela Wiggins, “Breastfeeding is a mother’s gift to herself, her baby and the earth.”

(This piece was originally written in August 2014 and published in the La Leche League NZ Communiqué. Reworked in 2015)  

References

[1] Bidwell, S. (2009). Food Security: A review and synthesis of themes from the literature. Christchurch, CDHB Community and Public Health.

[2] Carter, K. N., Lanumata, T., Kruse, K., & Gorton, D. (2010). What are the determinants of food insecurity in New Zealand and does this differ for males and females? Australia and New Zealand Journal of Public Health, 34(5) doi:10.1111/j.1753-6405.2010.00615.x

[3] Stevenson, S. (2011). Edible Impact: Food security policy: A review of literature and synthesis of key recommendations for Toi Te Ora – Public Health Service. Whakatane, BOPDHB.

[4] Parnell, W., & Smith, C. (Year not specified) Food Security: Current research initiatives, globally and in New Zealand. Department of Human Nutrition, University of Otago.

[5] Caritas Aotearoa New Zealand. (2012). Our Daily Bread: Putting Food on the Table, Wellington.

[6] Pope Francis encourages mothers to breastfeed in the Sistine Chapel – accessed at http://www.independent.co.uk/news/people/news/pope-francis-encourages-mothers-to-breastfeed-in-the-sistine-chapel-9055379.html

[7] Child Poverty Action Group. (2014). Our children, our choice: priorities for policy. CPAG.

[8] Agencies for Nutrition Action http://www.ana.org.nz/resources/food-security#subcategory-15

[9] Ministry for Primary Industries. “Our vision is to grow and protect New Zealand. We do this by: maximising export opportunities for the primary industries; improving sector productivity; increasing sustainable resource use; and protecting New Zealand from biological risk” http://www.mpi.govt.nz/home

[10] Walker, C., & Cannon, G. (1984). The Food Scandal: What’s wrong with the British diet and how to put it right. London, Century.

[11] World Development Movement. (2012). Food Sovereignty. Tricky Questions Briefing. London. WDM.

[12] “Dairy’s $14.3b boost to the regions” New Zealand Herald July 2014. http://www.nzherald.co.nz/business/news/article.cfm?c_id=3&objectid=1129285

[13] Galtry, J. A. (2013) Improving the New Zealand dairy industry’s contribution to local and global well-being: the case of infant formula exports. The New Zealand Medical Journal, 126(1386):82-89. http://journal.nzma.org.nz/journal/126-1386/5913/content.pdf

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