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Could milk formula shortages prove a boon for breastfeeding advocates

Lebanon’s economic crisis continues to worsen, parents of young children have found the search for formula milk increasingly challenging.
The challenge of many parents now faces points to a broader underlying issue that is deeply rooted in Lebanese society: the heavy reliance on formula milk. Although health experts agree it’s better for infants to drink breast milk and that formula milk is not necessary for children aged 1 and older, marketing and social norms have pushed parents in Lebanon to rely on formula. Amid the current currency crisis, which has led to shortages of imported goods while the prices of imports that can still be found skyrocket, that reliance has come back to bite parents.

Formula milk for infants younger than 1 is sold only at pharmacies, as it is categorized as a pharmaceutical product, which means formula products for this age bracket are subsidized at the official, LL1,507.5 exchange rate to the US dollar.
Formula milk for children older than 1 is present in supermarkets and was previously subsidized, but now, as support is ended, these products are subject to the parallel market exchange rate.

However, pediatric health experts have pointed out that the current Lebanese reality — apart from relying on expensive imported products — is not ideal for children’s health.
Although formula milk can be a suitable alternative for women unable to breastfeed or in other exceptional cases, breast milk meets infants’ protein needs and is rich in prebiotics and probiotics. It also contains vitamins and minerals needed by babies and is more easily digested than formula milk.

A culture of formula

Despite the evidence in favor of breastfeeding, the breastfeeding rate in Lebanon is very low. The reasons reported include:
  • a lack of support at home,
  • a lack of breastfeeding awareness
  • a lack of education at hospitals, along with misconceptions around breastmilk being insufficient or not good enough.
Most mothers start breastfeeding, but the continuation rate decreases one month after the other, due to the lack of support and education for mothers, in many cases, incorrectly positioning the infant while breastfeeding leads mothers to think their milk supply is insufficient. Mothers’ work schedules can also lead to difficulties in breastfeeding, Hospitals actively push formula feeding. Mothers should also know that some hospitals give babies bottles of milk immediately after they are born and that they have the right to refuse this and insist on breastfeeding their infant instead.
Marketing has also played a role in convincing parents that formula is superior to breast milk. Milk formula manufacturers have a history of marketing their products in the media and in hospitals and pediatricians’ clinics. This phenomenon discourages breastfeeding among many mothers, particularly those residing in developing countries.

Yasmine Haddad said, “Mothers who are having difficulties breastfeeding can resort to formula milk, although there is nothing more superior to breastmilk. These mothers are advised to seek lactation consultants before they call it quits.

Promoting breastfeeding

Some see in the current crisis an opportunity for a societal shift.
Although the formula milk shortages in Lebanon are challenging, it could be an opportunity to encourage new moms [toward] breastfeeding
With support from experienced women, new moms are more likely to breastfeed. This help is especially needed during the initiation phase, within 72 hours of giving birth, when mothers activate or turn on her breast milk production.
Yasmine Haddad, a licensed pediatric dietitian at My Pedia Clinic in Dubai, pointed out that the World Health Organization recommends that infants younger than 6 months old should be exclusively breastfed. After that, food should be introduced to infants’ diets as complementary to breastfeeding, which can go on until 24 months or more.

To encourage breastfeeding, the WHO initiated the Baby Friendly Hospital Initiative, which is applied in 22 public and private hospitals across Lebanon. The hospitals participating in the initiative, which encourages mothers to breastfeed, don’t offer formula, and they place the baby on the mother’s chest upon birth to achieve so-called kangaroo care to promote early initiation of breastfeeding.
Meanwhile the UNICEF is set to launch an infant and young child feeding campaign in line with a Parliament initiative later this month, with the aim of promoting and protecting optimal maternal nutrition,

breastfeeding practices (0-6 months) and complementary feeding (6-23 months).” The initiative will encompass counseling and support on lactation and complementary feeding through the IYCF Hotline and help identify, through robust assessment processes, infants requiring artificial feeding support and [support the provision of] referrals to appropriate service delivery points.”

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