OPINION: Trump Administration’s Position on Breastfeeding Is “Deeply Unsettling”

Puts private interest ahead of the public’s health

Last week, the New York Times reported that the United States tried to block a World Health Assembly resolution encouraging governments to promote breastfeeding among their citizens. The United States also reportedly tried to remove from the resolution language recommending that countries curb the promotion of food products that may undermine the health of young children, threatening the resolution’s would-be sponsor, Ecuador, with economic punishment if the changes were not approved. While the measure was ultimately passed after Russia stepped in to introduce it, the fact that the episode occurred at all is deeply unsettling.

US opposition to the measure came as a surprise to many who had regarded the resolution as singularly uncontentious. Indeed, even in these divided times, it takes work to find what is controversial about breastfeeding. The benefits of the practice are amply supported by decades of research. They include lower risk of infection, obesity, and sudden infant death syndrome (SIDS). A 2016 Lancet study found that universal breastfeeding would save the lives of more than 800,000 children a year, and generate about $300 billion in savings from better economic outcomes and lower associated healthcare costs. The 2011 Surgeon General’s Call to Action to Support Breastfeeding reviewed the data on the practice and concluded: “Breast milk is uniquely suited to the human infant’s nutritional needs and is a live substance with unparalleled immunological and anti-inflammatory properties that protect against a host of illnesses and diseases for both mothers and children.”

The Trump administration’s opposition to breastfeeding would be baffling if it did not fit a broader pattern. This administration has consistently prioritized private interests over the public good. Its actions at the World Health Assembly seem to have emerged from a desire to advance the interests of the infant formula industry, a motive further suggested by the president’s recent tweet in support of formula. If this is the case, it fits with the administration’s earlier steps to roll back environmental regulations, sell off public lands, allow weapons makers to sell any gun to anyone at any time, and other business-friendly moves. With these actions, President Trump has made clear that he regards complete corporate freedom as the only kind worth preserving, even if it comes at the expense of our collective freedom to live safe, healthy lives.

Trump is not the first president to think this way. It was Ronald Reagan who, in many ways, assembled the deregulatory engine Trump has now supercharged. Over the last 30 years, ever since Reagan declared “government is the problem,” we have seen a steady disinvestment in the institutions and policies that promote health, all in the name of placing private enterprise first in our national life. This disinvestment has resulted in poorer health. After decades of attacks on the structures that keep our air and water clean, our workplaces safe, and our economyfair, our health has lagged behind that of our peer countries, even as our healthcare spending has skyrocketed.

This trend reflects more than the triumph of a political ideology. It reflects something fundamental we have lost — a respect for basic public goods in this country. Public goods are common resources that everyone can access without excluding anyone else. Parks, clean air, safe roads, public schools, national security — these are all examples of public goods. Health, too, is a public good. It is a product of our collective investment in improving the social, economic, and environmental conditions in which we live. When we neglect this investment, when we place the profits of some over the well-being of all, we invite poor health for ourselves, our families, and future generations.

If the United States had gotten its way at the World Health Assembly, it would have done much to harm health, making it harder for mothers to make informed decisions about how best to care for their infants. As bad as this episode was in isolation, it pales next to the larger danger it represents. It suggests an administration that reflexively puts the interests of wealth and industry first, heedless of the effect that doing so may have on health, international cooperation, or even its own near-term political interests, to say nothing of the public good. This attitude threatens to accelerate our disinvestment in public goods precisely when we should be reversing it. In an age when unfettered private interests have fueled generation-defining challenges like global inequality and climate change, it is only a commitment to public goods that can truly create a healthier future.

Sandro Galea is the Robert A. Knox Professor and dean of the School of Public Health. He can be reached at sgalea@bu.edu.

Originally published at www.bu.edu.

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