Dr Susan Shepherd Responds to Nick Kristof’s Editorial, ‘The Breast Milk Cure’

Breast-Feeding in Niger

To the Editor:

Forgive my skepticism at Nicholas D. Kristof’s pronouncement that breast-feeding is the cheap miracle cure for malnutrition and child mortality in Niger (“The Breast Milk Cure,” column, June 23).

Exclusive breast-feeding during a child’s first six months of life is not cheap anywhere. Decisions must be made by women about how to allocate time to earn money to feed the family, tend the fields or nurse a new baby.

As a pediatrician with Doctors Without Borders, I have met plenty of mothers in Niger. They walk for miles or work fields under a broiling desert sky carrying their babies on their backs. When a woman is parched, she suspects that her baby is, too — so she gives the baby some water. Breast milk is the best food for babies, but focusing only on exclusive breast-feeding masks the collective failure to provide safe water.

The severe malnutrition Mr. Kristof describes is far more prevalent in 1-year-old Niger infants — an age when breast milk must be complemented with animal-sourced foods to provide infants the nutritional value they need. The meager plant-based foods typical in the Niger diet are as much a contributor to early childhood deaths as poor water and malaria.

I have seen how combinations of better diagnosis and treatment of malaria, immunization and nutrition supplementation with good-quality foods for 6-to-24-month-olds are saving lives. The only reason these programs work is that mothers are willing partners.

SUSAN SHEPHERD
New York, June 29, 2011

One Response to “Dr Susan Shepherd Responds to Nick Kristof’s Editorial, ‘The Breast Milk Cure’”

  1. Anne says:

    Dear Dr Shepherd,

    could you provide links to peer reviewed up to date research that proves your claim that 12 months is “an age when breast milk must be complemented with animal-sourced foods to provide infants the nutritional value they need”?

    I used to be a donor to MSF giving several thousands of dollars to MSF for the last years, but upon becoming a mother and finding out about MSF’s statements on breastfeeding and infant formula, I have withdrawn my support. I would love to know what scientific evidence the policies described here are based on. I know quite a few exclusively breastfed toddlers who take in minimal additional fruits and veggies with no further milk & cheese and they are the chubbiest babies I have ever seen!!