No, Team Trump doesn't question the importance of breastfeeding


As pediatricians, US representatives at this year’s World Health Assembly in Geneva and supporters of breastfeeding throughout our professional careers, we were shocked to read recent headlines, in the New York Times and elsewhere, claiming that the Trump administration has somehow called into question the importance of breastfeeding for infants.

The administration fully endorses breastfeeding, and the agencies where we work — Health and Human Services and USAID — communicate this unequivocally. That’s why the US government supported unanimous consensus on the resolution on breastfeeding at the World Health Assembly, which plainly states that breastfeeding is optimal “for child survival, nutrition and development.”

In this same resolution, we urged countries to do more to promote breastfeeding and requested that the World Health Organization assist countries in mobilizing resources to support nutrition for infants and young children.

We don’t just affirm these priorities in formal conference rooms in Geneva. For years, the US government, under the leadership of both Republicans and Democrats, has invested millions of dollars to promote breastfeeding both at home and abroad. The Trump administration continues this effort.

We know breastfeeding helps children stay healthy. In fact, America gives more than any other nation when it comes to improving nutrition globally. From 1992 to 2015, these investments have helped double exclusive breastfeeding rates in 20 countries.

All of which is to say: Breastfeeding wasn’t in dispute in Geneva. Rather, we raised objections to an early draft of the resolution we eventually supported, which made references to a controversial 2016 guidance document. The underlying policy goal of this guidance is unsupported by US nutrition guidelines and inconsistent with the practice of most families in our country. In 2016, the Obama administration raised the same issues about the guidance, and members of Congress from both parties wrote letters to the Department of Health and Human Services expressing concerns.

In particular, the guidance recommends that countries impose stringent new regulations on the marketing of any commercially produced foods suggested for children between 6 months and 3 years old. Such restrictions, in our view, prevent parents from having access to all the factual information they might need. The guidance even advocates for the prohibition of free samples of formula — including in countries and conflict zones where supplies of formula could help save babies’ lives.

This administration unequivocally supports breastfeeding, and our position at this year’s World Health Assembly did nothing but reaffirm that. But we continued the practice of the previous administration and expressed concerns over the potentially negative public-health consequences of restricting information about safe, appropriate products for children.

Most important, there are good and valid reasons, both medical and personal, why some mothers cannot breastfeed, or choose not to breastfeed exclusively. This is particularly true in situations where displacement, other trauma or malnutrition have made it impossible for mothers to breastfeed their children, and these babies’ lives are at risk without formula or other nutritional supplementation. Parents in these dire situations need all the information and choices available.

Further, gradually introducing complementary foods after 6 months of age matches the guidance offered by the American Academy of Pediatrics. Promoting a range of food choices for young children while emphasizing the importance of breastfeeding is, in other words, the best medical guidance we can offer.

While the US government has been disappointed by the misinformation spread about the events in Geneva, there is also the opportunity for a positive outcome: The controversy has sparked an important conversation about the importance of balancing advocacy for breastfeeding with the fact that many women do need alternatives.

The Trump administration stands with all mothers, here and abroad, and supports them in making the choices that will help their children grow up to be strong and healthy.

Brett Giroir is assistant secretary for health at the Department of Health and Human Services and Alma Golden is a deputy administrator at the United States Agency for International Development.



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