The Ecological Impact of Bottle Feeding

by Andrew Radford, Baby Milk Action

Breastmilk is one of the few foodstuffs which is produced and delivered to the consumer without any pollution, unnecessary packaging or waste. It is the only food which passes on immunisation and other health benefits to the consumer and its production also benefits the health of the producer. It is a valuable renewable resource which is usually overlooked. The idea that breastmilk should be replaced by an artificial substitute has been compared to suggesting that dialysis machines should replace human kidneys. Both dialysis machines and artificial baby milks have a role to play and can save lives, but to use them in place of the natural originals provided by the human body is a waste of resources. Thankfully, nobody has suggested that people's kidneys might not be capable of the task of eliminating wastes from the body. Bottle-feeding, on the other hand, has been promoted as a viable alternative to mothers' milk. Whilst studies clearly show the benefits of breastfeeding (of which over 99% of mothers are capable), artificial milks continue to be promoted. Breastfeeding is good for babies and mothers and breastmilk is an ecologically sound product. Bottle-feeding causes the death of one and a half million babies per year2 and ill health in countless others; this report investigates how ecologically damaging it is.

Toxins in breastmilk

Much concern has been expressed at the presence of toxins in breastmilk, in particular of dioxins and PCBs. It is not my intention to analyse this aspect of the problem in depth, but any study of ecology and infant feeding must recognise its existence.

Dioxins are created and released into the environment through chemical and industrial processes including the production of pesticides and herbicides and the chlorine bleaching of wood pulp. They are also produced by waste incinerators, hazardous waste dumps, smoking, leaded petrol and chemical, plastics and pharmaceutical factories. They have been described as the most toxic compound known and the only effective way of dealing with them is to prevent their production.

Large scale releases leading to numerous casualties include the Bhopal disaster of 1984 and the use of Agent Orange by the US air force during the Vietnam war. Dioxins both promote and enhance cancers as well as causing birth defects. No safe level has been established: a single drop added to the water in an Olympic-sized swimming pool would prevent the hatching of trout eggs, the same concentration fed to a guinea pig would kill it.3

Dioxins are found in the atmosphere, in water and in soil. Once they enter the food chain they are extremely difficult to eradicate. They have a particular affinity for fats (and thus occur in high levels in fatty fish) but also settle on the surface of plants, fruit and vegetables, from where they are ingested by humans and animals. Once ingested, dioxins will accumulate in fat, which explains its presence in breastmilk.

Studies on 48 human milk samples in Denmark, Norway and Sweden showed that the average baby would have a dioxin intake considerably higher than a recommended tolerable weekly intake (TWI). The reliability of any such 'acceptable' level is questionable: if no level has been found which is not toxic, the only acceptable level is zero.

However, toxins are present in the environment and we are all exposed to them. A World Health Organisation Consultation concluded that a safety margin does exist.4 The Nordic TWI was estimated assuming a life-long intake, not the limited time a baby is exposed through breastfeeding. Furthermore, as the baby experiences rapid weight gain during breastfeeding, the concentration of toxins in the baby’s fat does not increase.5

The presence of toxins in breastmilk could frighten mothers away from breastfeeding. However, the role of breastmilk in giving babies the best nutritional start in life, as well as providing vital antibodies, is accepted as outweighing any potential danger from the contaminants. Despite toxins an breastmilk, WHO recommends promotion and continuation of breastfeeding. Furthermore, studies on the effect of PCBs on the intelligence of infants showed that whilst much larger quantities are transferred to the baby through breastmilk, the smaller amount transferred in the womb is responsible for any intelligence deficit.6 Advice to mothers to stop breastfeeding after two or three months is unfounded: the levels of contaminants in breastmilk are greatest immediately after birth and decrease as lactation advances.

Giving up breastfeeding in response to dioxin levels is self-defeating as artificial baby milks contain high levels of aluminium and lead, and many of their common ingredients such as cotton seed oil, sunflower oil and beef tallow are likely to be contaminated with dioxins, pesticides or other toxins. Moreover, a decision in favour of artificial milk will lead to increased pollution and dioxin levels, as this report will show.

Breastfeeding Benefits

When alternatives are compared from an ecological point or view, both options are usually the source of some degree of damage: they must be studies to find the least harmful in order to limit the damage.

The comparison between breastfeeding and bottle is unique: breastfeeding has a positive effect on the environment whilst bottle-feeding has a negative effect. Breastmilk is a natural, renewable resource which is intended to be fed to babies: artificial baby milks are processed, non- renewable substitutes for this resource.

There is no waste from breastmilk as it is produced in quantities according to the baby's needs. Suckling conditions the amount of milk produced, not the mother's food intake. Women need only the smallest amount of extra energy, which is often derived from stored body fats (even malnourished mothers can produce enough quality breastmilk to feed a baby) and the average baby needs no other food for 6 months.

As breastmilk is produced in the right amounts and is tailored to the baby's needs, breastfed babies excrete less and often need fewer nappies. Breastmilk production does not pollute anything and even removes the need for sanitary protection. Breastmilk is free, requires no extra packaging, is ready to use, does not have to be shipped across the world (but is easily transported if necessary), protects against infection and does not need the huge amount of promotional materials produced to sell baby milks. Breastmilk is completely environmentally safe; not to use it is a waste of a valuable resource.

Waste

If every baby in the USA is bottle-fed, almost 86,000 tons of tin plate are used up in the required 550 million discarded babymilk tins.8 If these tins have paper labels, around another 1,230 tons of paper are added to these large amounts of glossy paper used to promote the product. Whilst some of the tins may be reused, the majority of the metal and paper is simply thrown away and rarely recycled. Babymilks are increasingly being sold ready-to-feed in cartons: these containers are made from a mixture of materials and are therefore impossible to recycle.

Bottles, teats and related equipment require plastic, glass, rubber and silicon. These are usually reused but rarely recycled at the end of their lives.  The new idea of selling milks ready-to-feed in a bottle, sometimes complete with teat, means that the equipment will not even be reused. In 1987, 4.5 million feeding bottles were sold in Pakistan alone.9 The number per baby will be much greater in the industrialised countries (most babies in the USA will have at least six).

All these products waste natural resources (tin, paper. glass etc.), cause unnecessary pollution in their manufacture and in that of the packaging, and result is a waste disposal problem.  Plastics are a particular cause for concern as most are made from oil, a key resource, and their manufacture therefore causes pollution.  They are rarely recycled due to lack of facilities and the difficulty in sorting the different types. Plastics are virtually indestructible and remain as a pollutant if dumped (so-called biodegradable plastics are misnamed; they merely have an organic element which biodegrades, leaving very small pieces of plastic as pollutants - at least non-"biodegradable" plastics can be picked up and recycled or disposed of properly).  If burned the fumes may contain dioxins and other toxins.

Most lactating women do not menstruate and, therefore, require no sanitary towels, tampons or cloths. This removes the need for fibres, bleaching, packaging and disposal.  If the baby is unrestrictedly breastfed for 6 months before solids are introduced and if breastfeeding is continued into the second year as a supply of drink and comfort, the average woman will not have a period until her baby is at least 14 months old.10 In the UK, each menstruating woman uses between 286 and 358 towels or tampons per year, 98% of which are flushed down the toilet.  Fifty-two per cent of these are released untreated into the sea where tampons require 6 months to biodegrade, sanitary towels need longer.  The plastic liners on sanitary towels will not biodegrade and remain as a pollutant.11

If every mother in the UK breastfed her baby, 3,000 tonnes of paper alone would be saved every year on sanitary protection products.  The toll on the environment due to pulping, bleaching and other chemical processes, cotton and pesticides applied to it, rayon and the dioxins produced during its manufacture must be added to this, as must the damage caused by packaging, transport and disposal.

All these wasted materials, as they are rarely recycled, must be disposed of.  The most popular form of getting rid of our waste is dumping it in landfill sites.  Most of these are unlined, the theory being that any pollutants will be diluted and dispersed; in practice, this allows the groundwater to be polluted.  Fears have led to some landfill sites being lined: these are better but can still overflow in heavy rain, and any lining will eventually leak.  Another method of waste disposal is municipal incineration. This is the source of half of the UK's airborne dioxins.12 Ironically, a decision not to breastfeed because of dioxins in breastmilk will lead to an increase in environmental dioxin levels.

When a mother makes up artificial babymilk, she has to sterilise the water and the utensils.  Water and the energy to boil it are usually easily available in the industrialised world, but this is no reason to waste them. The energy usually comes from polluting nuclear and conventional power stations.

Water shortages are common in the developed countries but in 1975 The World Health Organisation estimated that 60% of people in less developed countries do not have access to enough water.13  It is not uncommon in some parts of Africa for women to spend 5 hours per day fetching water.14  A three-month old bottle-fed baby needs one litre of water per day for mixing feeds and another two litres for boiling teats and bottles.15  The water for washing and rinsing the equipment must be added to this. Firewood is also a precious resource in the developing countries and is being used up at an alarming rate.  It takes 200g of wood to boil one litre of water, so in one year, an artificially fed child would use up at least an extra 73 kilos of valuable wood.16

Commercial sterilising fluids are commonly used to clean most bottles in many industrialised countries.  Most of these fluids are based on chlorine bleach.  Chlorine production is linked to dioxin emissions.  If the infant is weaned onto commercial weaning foods rather than cheap, locally available produce, more water, fuel and packaging will be wasted.

The Dairy Industry

It would take 135 million lactating cows to replace the milk of the women of India alone.17 Cows need pasture - around 10,000 square metres each.18 This means that to replace the milk of the women of India, 43% of the surface area of the country would have to be devoted to pasture (this is an area 6 times the size of Great Britain). Where cows are reared. wooded land has to be cleared for the pasture, leading to deforestation and thereby depletion and erosion of the soil and an increase in the gases which contribute to the greenhouse effect, not to mention the reduction in flora and fauna species caused by the change in land use. To produce a kilogramme of babymilk in Mexico costs 12.5 square metres of rainforest.19

The gas given of off from cows' flatulence and excretion adds to atmospheric pollution in the form of methane, a significant greenhouse gas. Cattle produce 100 million tonnes of methane per year, 20% of the total annual methane emissions.20 The disposal of the excretion is a problem in itself and often leads to serious river and groundwater pollution.

Rearing of cows also contributes to the problem of acidification or 'acid rain'. Ammonia from open slurry tanks and cow pats reacts with sulphur dioxide (commonly present in the air in developed countries) to produce ammonium sulphate which attacks leaves. When this reaches the earth it converts into sulphuric and nitric acids.21 This problem is exacerbated when the cows are reared intensively, as common in the countries where most artificial babymilk is produced.

The nitrate fertilisers used to grow feed for dairy cows are highly soluble: they leach into rivers and may contaminate the groundwater - 1.5 million people in Great Britain have drinking water with nitrate levels in excess of the levels stipulated by the EEC. Nitrate fertilisers and animal sewage are the two main causes of eutrophication: a lake or stream gets richer in plant nutrients until plants overgrow and their decomposing remains cause de-oxygenation of the water, which in turn becomes foul smelling and virtually lifeless.22 It is estimated that the cost of cleaning the nitrate-polluted waters of just one agricultural region of Britain will be around £200 million.23

Processing and transport

Most artificial babymilk is heat-treated cows' milk which is converted into powder. Skimmed milk is filtered and then heated to 95-105°C for 15-20 seconds, homogenised, cooled and then spray-dried by heating to around 73°C and sprayed into an atmosphere of 160°C. Soya babymilks are manufactured to a similar process.24 The energy required to reach the high temperatures and to create the mechanical procedures required in this process will cause air pollution (acid rain-causing agents and greenhouse gases) as well as requiring natural resources in the form of fuel. Milk or soya is be main ingredient in artificial baby milks, but it is added to a cocktail of factory-processed substances.

The milk often travels considerable distances before processing and the tin, paper, bottles etc. also have to be transported. Once packaged, the milk is transported to the consumer. In Ecuador, for example, the main countries from which babymilks are imported are the USA, Ireland, Switzerland and Holland. Other significant babymiilk exporting counties include Japan, France, Germany, Denmark, the UK and New Zealand; most countries import babymilks from thousands of miles away. No exact data on the pollution caused by such unnecessary transport are available but it will be considerable.

Inappropriate use of land and resources

Milk production is a very uneconomical use of land:  10 acres will support two people if cattle are raised on it, 24 people if it is under wheat and 61 people if soya is grown.27  Development programmes often introduce breeds of cow which are ill-adapted to local conditions.  In such cases, huge spending may be required on feed, shelters, clean water and medical protection from local diseases.

Soya beans are the base of a number of artificial babymilks and are commonly used for cattle fodder.  In Brazil the Cerrado (savannah forest) is cleared and burned and soya bean plantations replace the forests.  Soya beans comprise up to 10% of Brazil's exports.  Soya is also a high input crop, requiring artificial fertilisers and irrigation.

Increased bottle-feeding rates contribute to the debt crisis in the less developed countries.  Most bottles, teats and artificial milks are imported as are the extra resources required by the health system for the treatment of babies who fall ill because they are bottle-fed.  Even when the milk is labelled as manufactured in a developing country, the raw materials are usually from the West.  The country must therefore spend scarce hard currency.  Furthermore, the babymilk market is usually controlled by multinationals from the industrialised world.

The Mozambican Ministry of Health calculated in 1982 that if there were a mere 20% rise in bottle-feeding, this would cost the country US$10 million in just two years, not including the costs of fuel, distribution and damaged health.  It was also calculated that the fuel for boiling the water would use up the entire resources from one of the major forestry projects.29  Indonesian mothers produce 1 billion litres of milk per year; to replace this with imported babymilk in 1982 would have cost over US$400 million.  The country would also have lost another $120 million to make up for the savings in health and fertility reduction provided by breastfeeding.30

In 1987, 28% of Indonesia's export earnings was used to pay interest on foreign debts.  Fortunately 97% of Indonesian mothers breastfeed for at least 6 months (76% for 12 months)31 but the country's economy will suffer if these figures fall - and the babymilk companies are moving in on the market.32,33  In an analysis of breastmilk in relation to the Indonesian economy, Jon Eliot Rohde wrote "Its value exceeds twice the annual national budget for health and roughly equals the cost of imported rice, for which Indonesia has become, unenviably, the world's largest buyer. This great resource is not only renewable, but also equitably distributed, benefits consumer and producer alike and gives far-ranging non-monetary benefits to society."34

Breastfeeding prevents births and passes valuable immunising agents onto the infant and leads to healthier babies.  With increased breastfeeding rates, therefore, child health is improved and fertility lowered, reducing population pressure and dependency on expensive family planning programmes and services, thus benefiting the economy.

Malnutrition caused by over-diluted formula or diarrhoea caused by contamination of feeding bottles can be treated, but at a very high price, and only if the baby is treated soon enough.  Although oral rehydration therapy is cheap and effective, a severely malnourished infant may need intravenous rehydration which can cost as much as US$100.  Even in the wealthy USA, the cost for hospital treatment of bottle-fed infants is 15 times higher than the cost of treating breastfed babies.35  The developing countries are often dependent on the industrialised countries for their health system equipment.

In the developing countries, national governments tear down forests, degrade land, pollute air and water and cut back environment and poverty programmes in an attempt to raise hard currency in order to pay off foreign debts. In such cases, the people of the country suffer as the land where they used to grow food crops for their own consumption is often used for cash crops.

The quick fix solution for governments faced with large foreign debts is to liquidise their natural resources: forests, fisheries, grazing lands and soil.  With few exceptions, this exploitation has been destructive and non-sustainable leading to flooding, drought, erosion, landslides and climatic change.  In Brazil and Bolivia, debt has led to recession with thousands losing their jobs as a result. The unemployed are often forced to invade forests to survive. The economic medicine offered by the lending organisations such as the International Monetary Fund and the World Bank includes encouraging large-scale ranching and soya bean production. This causes deforestation and pushes the landless poor further into the forest.36

It is clear that more factors than the costs of bottle-feeding are responsible for the economic and environmental catastrophe currently being faced by countries such as Brazil. but the above facts demonstrate that increased bottle-feeding rates will damage the economy of any developing country, often leaving the government no choice other than to exploit the country's resources.

Population

Overpopulation in developing countries is sometimes blamed for many of the current environmental problems. In fact overpopulation in the wealthy industrialised world is the real culprit as it is the people there who consume the vast majority of the Earth's resources. A smaller population will mean less ecological destruction, especially if the reduction is in the developed world.

Breastfeeding prevents more births than all other forms of contraception put together (it is also one of the few methods not requiring resources, packaging, health worker time etc). If this protection is removed, the obvious result is more and closer spaced births.  This means that the health of women and of existing children will suffer, especially in regions where other forms of contraception are unavailable or unacceptable.  Babymilk is expensive: in Sierra Leone, for example, to feed a baby for one month with artificial milk costs 90% of the legal minimum monthly wage.37

It is not uncommon for many people in developing countries, especially women, to earn less than the legal minimum wage.  A greater number of children means that the family may suffer as its income has to feed more mouths and meet more doctors' bills.  More natural resources will be needed to support the increased population.  In Africa breastfeeding prevents an average of 4 births per woman, in Bangladesh it prevents an average of 6.5 births.

A study in Chile found that none of the exclusively breastfeeding women had become pregnant within 6 months of birth, compared to 72% of non-breastfeeding women.38  Unfortunately the contraceptive effect of breastfeeding in developed countries is lessened by shorter duration of breastfeeding and, commonly, the custom of restricted feeds and separation of mother and baby.

Conclusion

More bottle-fed babies means more deforestation, soil erosion, pollution (including by dioxins and other toxins) climatic changes and wasted resources.  Breastfeeding has a positive effect by providing a renewable resource and by preventing other forms of damage to the environment in the form of increased population and wasted materials, for example.

Babymilk companies realise that they only have a market if mothers do not breastfeed. To create and maintain a demand for their artificial milks, companies undermine breastfeeding using methods such as free supplies to maternity hospitals, free samples to mothers, misleading information, advertising and promotion to health workers.  There is a WHO/UNICEF International Code of Marketing39 which prohibits these practices but the companies rarely do anything more than pay lip service to it.  The International Code was adopted to protect mothers and babies from unethical and aggressive company practices and to help save the lives of the one and a half million infants who die every year because they are bottle fed, but a natural consequence of its successful implementation would be considerable ecological benefits.  Instead, babymilk companies are contributing to the current global ecological crisis.

The undermining of breastfeeding is the destruction of a natural resource and should therefore be seen in the same light as logging in the rainforests or over-fishing our seas and rivers.   Commercial greed has no respect for ecology.  Companies involved in logging or fishing continually need more wood or fish to maintain their profits.  In order to maintain their markets, babymilk companies need to ensure that more babies are bottle-fed.  Fortunately the majority of the world's babies are still breastfed, a situation which is against the babymilk companies' interests.  The percentage of breastfed babies is in decline.  If the companies continue to be successful in their attempts to increase sales, the problems caused by bottle-feeding today will reach catastrophic proportions.

Clearly, companies which undermine breastfeeding are damaging the environment as surely as the companies which chop down rainforests; it remains for this to be taken on board by green pressure groups, politicians and all consumers.

References:

1.    Campbell CE, Nestle and breast vs bottlefeeding:  mainstream and Marxist perspectives, International Journal of health Services vol 14(4) 1984 pp 547-66.

2.    UNICEF The State of the World's children 1991 OUP Oxford 1991.

3.    Costella A, Vallely B and Young J, The Sanitary Protection Scandal, Women's Environmental Network, London 1984.

4.    WHO regional office for Europe, Consultation on tolerable daily intake from food of PCDDs and PCDFs, summary report, Bikhoven, Netherlands 4-7 December 1990.

5.    Costella A, Vallely B and Young J op cit.

6.    Jacobson JL, Jacobson SW, and Humphrey HEB, Effects of in utero exposure to polychlorinated biphenyls and related contaminants on cognitive functioning in young children, Journal of Pediatrics vol 1116(1) 1990 pp38-45.

7.    Akre J, Infant Feeding, the physiological basis, Bulletin of WHO, supplement to vol 67 1989.

8.    Calculations based on information in Jelliffe DB and Jelliffe P, Human Milk in the Modern World, OUP, Oxford 1978 and in UNICEF op cit.

9.    Bottlefeeding in Pakistan IBFAN Penang 1988.

10.  Stanway P, Green Babies, Random Century, London 1990.

11.  Costello A, Vallely B and Young J op cit.

12.  Goldsmith E, Hildyard N, The Earth Report:  Monitoring the battle for our environment, Michell Beazley, London 1988.

13.  ibid.

14.  Women and Water in the developing world, Water Aid Factsheet 1989.

15.  Bottlefeeding:  a waste of money, a waste of natural resources, a waste of time: fighting for infant survival, IBFAN information kit 1989.

16.  Gilman RH and Skillikorn P, Boiling of drinking water:  can a fuel-scarce community afford it?  Bulletin of WHO vol 63(1) 1985 pp157-63

17.  Calculations based on information in Jelliffe op cit and in UNICEF op cit.

18.  Stanway op cit.

19.  Breastfeeding and ecology workshop report, IBFAN Forum Manilla 1989.

20.  Smail E, Veganism and the greenhouse effect, The Vegan vol 6(2) 1990 pp6-7.

21.  Pearce F, Acid Rain, Penguin books Harmondsworth 1987.

22.  Goldsmith op cit.

23.  Palmer G, The Politics of Breastfeeding, Pandora, London 1988 

24.  Correspondence with Wyeth Laboratories and Crookes Health Care UK February 1991.

25.  Goldsmith op cit.

26.  Breastmillk: a world resource, Baby Milk Action, Cambridge 1989.

27.  Morley D, Lovel H, My Name is Today, MacMillan, London 1986.

28.  Brazil Burns in Earth Matters 5, 1989.

29.  Dept of Nutrition, Ministry of Health, Maputo 1982.

30.  Rodhe JE, Mothers' Milk and the Indonesian economy - a major national resource, Journal of Tropical Paediatrics vol 28 (4) 1982 pp166-74.

31.  UNICEF op cit.

32.  Clement D, Infant Milk Marketing in Indonesia, INFACT Minneapolis 1982.

33.  Baby Milk Action, Companies bide their time in Indonesia, BMAC Update Autumn 1990.

34.  Rohde JE op cit.

35.  Cunningham AS, Letter to Jan McNeil, Action Director of Supplemental Food Programmes Division, Food and Nutrition Service, US Dept. of Agriculture, Washington DC 1979.

36.  Till debt us do part in Earth Matters 4 1989.

37.  The economics of breastfeeding, fighting for infant survival, IBFAN information kit 1989.

38.  Zacharias S et al, Return of fertility in lactating and non-lactating women, Journal of Biosocial Science 19, 1987 pp 163-69.

39   International Code of Marketing of Breastmilk Substitutes, WHO, Geneva 1981.