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No, The Trump Administration Didn’t Oppose Breastfeeding At The World Health Organization


A front-page New York Times article claimed that, at a World Health Assembly in May, the United States opposed a resolution to encourage breastfeeding. “U.S. Opposition to Breast-Feeding Resolution Stuns World Health Officials,” blared the article’s headline.

Other media outlets picked up the story of the Trump administration versus breastfeeding mothers. Here’s a sample.

CNN: “US threatened nations over breastfeeding resolution”
NBC: “Report that U.S. suppressed breastfeeding resolution shocks advocates”
Daily Beast: “U.S. Stuns World Using ‘Blackmail’ to Oppose International Breastfeeding Resolution”
USA Today: “U.S. threatens nation over world breastfeeding resolution, shocking health officials”

The narrative was set. But was it true? President Donald Trump argued it was “fake news.”

The New York Times report mirrored sweeping and unattributed claims from activist groups. According to the Times, an anodyne and scientifically sound pro-breastfeeding resolution was expected to be approved easily. However, American delegates took the side of corporate formula makers over breastfeeding mothers. The delegates opposed governmental support for breastfeeding, as well as restrictions on “food products that many experts say can have deleterious effects on young children.”

We’re told the U.S. threatened Ecuador with punishing trade measures and the removal of military aid. Taking a break from being an all-purpose bogeyman, Russia, we’re told, saved the day and the United States was thwarted. According to the Times, the saga shows how the Trump administration backs corporations over the public good and  how the Trump administration is disrupting the rules-based order.

As with much media coverage of the Trump administration, The New York Times’ extremely negative story elided crucial facts, was based on anonymous sources, and contained false information. Whether or not you call it fake news, at the very least the public was not well served by the story.

What Happened

Every two years the World Health Assembly convenes and discusses public health issues. In 2016, a proposal was discussed that would extend bans on marketing formulas and other supplemental nutrition. Since the 1980s, governments, non-governmental organizations, and corporations have been limited from marketing formula for infants six months of age and younger. The American Academy of Pediatrics (AAP) recommends that infants should be fed breast milk exclusively for the first six months after birth.

The 2016 discussion was about extending the ban of marketing food supplements to children as old as three years of age. The proposal was controversial even in the Obama administration. While the U.S. delegates largely went along with the crowd two years ago, they made sure the resolution was only “welcomed” at the World Health Assembly, as opposed to “endorsed.” This meant that mothers seeking information about how to feed their children could get at least some information on the products being sold and distributed to them.

Cut to 2018, when some delegates wanted to revisit the issue of limiting the marketing of non-breastmilk options for mothers, reopening some of the contentious debates from 2016. While breastfeeding is ideal, anti-formula activists can be a bit radical in their support of the ideal. As Erik Assadourian wrote in his article, “Baby formula has no place in a sustainable future“:

What WHO and UNICEF should do now, after decades of modestly successful efforts to curb the dangerous use of baby formula, is to push for a global treaty: a Framework Convention on Formula Control modeled on WHO’s successful Framework Convention on Tobacco Control (FCTC). This could ban all marketing of formula, such as advertising, free samples and product placements (as the FCTC did with tobacco marketing); require breastfeeding assistance at hospitals; provide paid maternity leave so that women could have the time and security to breastfeed, and so on. It could even make formula a prescription-only product, making formula accessible only as a food of last resort.

Of course, if ratified, the industry would shrink like an unmilked breast (fun fact: the free formula sample bag given in many hospitals includes an ice-pack to help stop milk flow in new mothers). But a sustainable future will require certain industries – not just tobacco and fossil fuels, air travel and automobiles, even baby formula – to become much much smaller to sustain a population of nine billion human beings.

This is not an atypical approach for some anti-formula activists. “Baby Milk Action,” which was favorably quoted in the article, and ran much of the anti-formula marketing part of the assembly, is known for its long-running boycott of Nestlé, which makes and markets baby formula to mothers.

The United States suggested a shorter and more streamlined resolution that encouraged promoting exclusive breastfeeding as well as global initiatives to encourage breastfeeding in hospitals. Delegates from around the world debated for a few days, culminating with all member states in the room reaching consensus on a final draft. On a video available on the World Health Organization web site, the involved parties openly discuss how they reached consensus, emphasize the importance of reaching consensus, and then applaud the passage of the consensus document. The public discussion and applause of the process is a far cry from the “stunned” “shock” alleged in media reports.

The U.S. delegation doesn’t agree with a public health policy of keeping information away from women who are feeding their children. But that doesn’t mean that they oppose exclusive breastfeeding or its encouragement. Describing radical anti-formula efforts as “encouragement of breastfeeding,” as media reports did, is extremely tendentious.

“The Trump Administration believes it’s a public health priority that women and their families have all the information to decide how to appropriately deliver nutrition to their children, whether it is via breastfeeding or other methods,” an HHS spokesman said.

The agency pointed out that the United States has a long history of supporting breastfeeding and breastfeeding programs, and is the largest bilateral donor of foreign assistance programs in this area. Exclusive breastfeeding rates have doubled across 20 of countries where these programs have focused between 1990 and 2014, they say. The U.S. also supports complementary feeding programs and accurate description of the same as a matter of long-standing policy. The original resolution would have made that policy goal difficult, officials said.

Did the U.S. Threaten Small Countries?

The New York Times says the United States threatened Ecuador and other small countries with trade and military repercussions, but it provides no evidence to support the claim outside of anonymous sources. Health and Human Services spokespeople repeatedly denied the allegation, saying theirs was the lead agency in negotiations on the resolution, and at no time were there any such threats regarding trade sanctions in any conversation related to the negotiation of this resolution.