Ireland's dairy export boom, is it without consequence?

Enda Kenny feeding a baby milk formula at Glanbia launch

If a picture tells a thousand words what does this one say? It's enraged people. Mostly women, and mostly those women interested in how feeding formula milk is considered "normal" while breastfeeding is seen as "unnormal".

Today was the first day in 31 years that Irish and European farmers were able to produce milk without limit. As part of a series of features by Irish writers on the social and economic impacts of the end of milk quota, I wrote the following piece about baby formula for the Irish Independent.

Baby formula is a huge part of our dairy export boom but is it a product without consequence? Some people think not...

Earlier this week on a farm in Carlow I watched milk splashing into jars as 80 doe-eyed Holstein Freisan ladies took their turn in the milking parlour. The farm, in beautiful well-drained Carlow land had been farmed by its 69 year old farmer and his father before him. This was the perfect place to talk about Irish milk and a brighter, quota-free era.

“Quota was a kind of madness” said the farmer as we shared bread, butter and marmalade in his kitchen after morning milking finished. His college-going daughter, wearing her local GAA team shirt, placed a hot pot of tea and a 2 litre plastic carton of milk on the table.

I’ve sat in many such kitchens of dairy farms in Ireland. Despite the oft-heard view of the dairy farmer swimming in money, few of these farmers want to be rich. All want to educate their children, and work hard at a relentless 365 day a year job. As I poured milk into my tea I wondered if I should ask this man if he felt what he did for a living was putting families in other parts of the world at risk.

Increasingly questions are being asked about the nature of our dairy miracle and its big dependence on milk powder. Is this hugely successful industry which has helped bring Ireland out of recession selling a product to those who have the least money to spend on it - baby formula.

This is relevant both to developing countries and in Ireland where the ESRI named us in a report produced in January as having the lowest breast feeding rate in the world (yes you read that correctly).

Ireland makes 10% of the infant formula fed to babies around the globe. Our food and farming industry presents this as a green, healthy foodstuff and in many ways it is. Ireland is the only country where all our dairy farms are monitored for green credentials and where waste, energy, animal feed and every last input is measured and accounted for.

Yet both the World Health Organisation and HSE policy is for mothers to breastfeed rather than use formula milk in the early months, or in the case of the WHO up to two years of age.

“I was enraged when I saw this picture” says Krisia Lynch from AIMS – the Association for Improvement in Maternity Services talking about the Enda Kenny, Phil Hogan and Jim Bergin from Glanbia feeding three babies infant formula at the launch of Glanbia’s new infant formula plant in Belview earlier this month. “It was outrageous. On one hand you have the department of health saying breast feeding babies is policy then here’s the department of agriculture encouraging and selling this baby formula message. We can guess which of the two is the stronger lobby group.”

Glanbia’s infant formula is fed by parents in West Africa, the Middle East, Asia and central America. Their new factory is the largest single infrastructure investment in Ireland by an Irish company since the construction of Ardnacrusha in 1929. When I contacted the Taoiseach’s office on the above photo their comment was that the plant is expected to contribute an estimated €400m a year to the Irish economy and provide around 1,600 jobs as a result of the extra dairy activity. 

This baby formula boom is hugely valuable in the multiplier effect of income spread in rural areas. To suggest to these workers that what they are making is wrong is incorrect. But are we asking all the questions around to whom and how our infant formula is being sold.

“Our tiny little country manages to feed 10% of  the children of the world with artificial milk” says Krisia Lynch. “While on the other hand professionally here the message on breast milk is being re-written. It’s not now “breast is best” but “normal”. So your baby has a normal response to immuniolgical diseases, gestational diabetes, chrones disease etc... with the underlying message is that if baby is not fed human milk it will have a sub optimal response.”

In the 1970s infant formula companies began to see their first backlash as they began selling product in developing countries. To make up a baby’s bottle you must have a clean bottle, and a clean water supply. Many companies came in for abuse and scrutiny on how health workers and doctors were incentivised to sell baby powder to mothers where breastfeeding was clearly the safest option.

Children died and legislation was changed. In 1981 the UN World Health Assembly ruled that baby formula companies are not allowed influence health professionals on advising mothers.

Unfortunately this doesn't always work. A recent report by Save the Children accused Nestlé in Pakistan, of handing out branded items to health workers and free samples of formula and bottles to maternity facilities.

Ireland gives around 600 million euros to the developing world annually. We aid rural farmers and increasingly women to form micro-businesses that will earn them surplus cash to spend on health or sending their children to school. Some buy baby formula with his cash, thinking it is a better choice for their infant.  Is this a double standard? Is Ireland both playing poacher and gamekeeper?

“The debate on breastfeeding versus infant formula will continue but there is always needs to be choice” says Cormac Healy of the Irish Dairy Industries Association. “We also have to remember that in the scale of things we produce less than 1% of the world’s milk so single handedly we’re not going to change the consumption patterns of any marketplace.”

20% of the milk produced on Ireland’s 18000 dairy farms goes into baby formula. Irish factories produce from milk to finished product in packaged tins but we also export base milk powder for blending in other countries. We are not in control of how this product is sold to third parties or mothers.

“Were not a one trick pony here, infant formula is an important sector but it’s not all we do” says Cormac Healy. “It’s also produced under very strict regimes and has a very valid place in the nutrition area. In terms of the breastfeeding debate, there is the factor of choice and a lot of the time this is about information and support to mothers.”

Closer to home global food giant Danone has plants manufacturing infant formula in Macroom and Wexford, with Macroom producing over 125,000 tonnes of infant formula annually. Danone sponsors the Irish “First 1000 days” baby and toddler nutrition campaign. SMA owned by Pfizer, sponsors Ireland’s Pregnancy and 

Baby Fair in the RDS Dublin and Cork City Hall this April.

In Irish maternity wards, understaffing and the nice lady with trolley of made-up baby formula bottles are also pretty good at undermining the breast is best (or breast is normal) message.

Hospitals pay for the formula and new mums get it for free once they’re admitted to the maternity ward. Like most new mothers I planned on breastfeeding my first baby. Generally it went well but within two months I was back working and baby was wholly bottle-fed from then on.

With my second child I ended up back in hospital having surgery for a C-section complication. I pumped breast milk every four hours even straight after surgery like a demented person but eventually folded and bottle fed. And the brand I chose to continue feeding to my baby once I was discharged was the brand supplied in the hospital, in this case Aptamil. Most mothers do the same thing – if they baby feeds well on what the hospital supplied why fix something if it isn’t broken? 

Women who’ve just given birth, especially with their first baby are exhausted, and if the baby doesn’t latch on and feed they will often take the option of the handily available and free formula milk. Maternity staff are over-stretched and there are not enough bodies on the wards to literally sit with women, help them and motivate them to start or to stay breastfeeding. 

Some women desperately need infant formula, I needed it myself. But the WHO’s position and on wards in Ireland the reality is that most women don’t.

I put the question to twitter -  How do we feel about #babyformula in Irish hospitals? As a mother or parent was it manna from heaven or expensive road to ruin? #nutrition

Siobhan @Smdoyle76 ·  @campbellsuz I think it’s a necessary evil - very little support to establish breastfeeding in hospital and the first few days at home.

  elizabeth macdonnell @yummymummyby4  @campbellsuz it's pushed as the easy option when in fact the opposite is true, the pressure to 'give a bottle/top up' begins in hospital

ShinyPrettyWant @fingalfoodie @campbellsuz if they didn't give it to me my child would have suffered. I can't produce sufficient breast milk due to a hormonal condition.

I found spending 15 euro on a box of formula really expensive and I’m living in a rich country. Imagine how expensive this is in real income terms in Africa or even China? But hang on – if we don’t sell this stuff to them somebody else will. Black market baby formula contaminated with melamine not only killed babies in China but has been found in milk powder sold as baby formula in East Africa. Surely Irish baby formula is the safest option. But is breast milk not the safest option?

Should we be finding other routes for high-quality Irish milk rather than baby-formula? It’s lucrative and valuable to the rural economy but it’s also controversial. The quality of this product is a world beater but Ireland could find itself the future focus of international criticism from NGO’s who work in the fields of infant and mother care.