Abstract

PIP: Attention needs to be directed to the disappearance of human milk and to investing as much in terms of both funds and ingenuity in trying to develop programs to cope with this major nutritional retreat as is now invested in other programs designed to improve the problem of childhood malnutrition. Bottle feeding in the type of circumstances existing in rural and urban areas of resource-poor, less developed countries is very difficult to undertake adequately due to small purchasing power, defective environmental hygiene, and low levels of maternal education. Under these circumstances, infants usually receive dilute, contaminated feeds containing homoeopathic doses of nutrients and massive quantities of bacteria. When breastfeeding is replaced by the necessarily inadequate bottle feeding found in developing countries, nutrition deteriorates, infections increase, and pregnancies become more frequent, closely spaced and risky. In order for bottle feeding to be successful in terms of producing satisfactory infant growth and survival, there must be an adequate economic, hygienic, and educational infrastructure. The size of the public health problems associated with the availability or lack of availability of human milk is huge, increasing, and almost totally unappreciated. In less technically developed and resource-poor nations, Bengoa (1974) estimated that there are 9.4 million cases of severe protein-calorie malnutrition annually. It is unknown how many are suffering from kwashiorkor or from marasmus. In the developed countries of the world, there are over 11 million births annually, and the partial or complete preventive effect of breastfeeding can also be very significant in these communities.