BEIJING (AFP) — Unregulated, aggressive promotion of formula milk, poor medical advice, short maternity leave and workplaces hostile to nursing mothers mean China has among the lowest breastfeeding rates in the world and is falling well short of its own targets, experts warn.
Just one in five of the nation's babies are exclusively breastfed for the first six months of life, a recommendation set by the World Health Organization. This is less than half the global average, according to UNICEF's 2019 breastfeeding scorecard, and far below the Chinese government's aim to have 50 percent of mothers nursing by this year.
Authorities are now launching a push to promote the practice including building more baby care rooms in public places such as parks and railway stations and teaching doctors and nurses about the benefits of breastfeeding — but experts and mothers say this isn't enough.
Mary Zhang stopped nursing after one month. She developed mastitis -- a painful inflammation of the breast that can lead to fever, infection, and in some cases hospitalization — but doctors gave her inaccurate information on how to treat it, leaving her in agony and struggling to feed her infant.
"Nothing worked. I was in pain and my baby was crying," recalls Zhang.
She adds: "So my mother started giving formula. Once the baby got used to the bottle, he refused to latch. I couldn't breastfeed."
Only 12% of babies in China are born in hospitals where staff have lactation knowledge, according to UNICEF.
But the biggest challenge comes from relentless and misleading formula advertising after the government repealed a code of conduct, set by WHO, regulating its marketing.
'A total lie'
Authorities abandoned the guidelines, which restricted the marketing of substitute milk and prohibited health workers from promoting it, even after brands selling baby food — including Danone — were found to be offering money to doctors to push their products.
Fang Jin, secretary general of government-backed think tank China Development Research Foundation, says there is "intense commercial pressure" from a powerful formula lobby keen to tap the world's biggest market.
China's infant formula market was valued at $27 billion last year and is set to grow 18% to about $32 billion by 2023, according to Euromonitor.
"Infant formula is now advertised as having the same nutrients as breast milk, which is a total lie," Fang adds.
It is also now marketed in hospitals and clinics.
"Most women bring milk powder tins when they come to give birth. They are afraid they might not produce enough milk. It's a myth propagated by the formula lobby," explains Liu Hua, a nurse at Beijing Obstetric and Gynaecology hospital.
Pregnant women rarely get information on breastfeeding during prenatal visits and turn to smartphone apps or websites — often funded by formula firms — for advice, she added.
China's patriarchal structure exacerbates the issue, Liu says, because husbands "rarely help with co-feeding" or other household chores so instead grandparents assist.
But as that generation were the first to get "brainwashed" by formula ad slogans of the 1980s making misleading claims such as "only hungry babies wake up at night" it can exacerbate problems, Fang says.
"In the first few days after giving birth, my mother-in-law blamed me for not having enough milk, and insisted I give formula. It made me doubt myself. I got very depressed. I even thought of committing suicide... I felt so inadequate" recalled Ran Qian, a mother from Suzhou.
The Dairy Association of China, which includes many formula firms, did not respond to requests for comment.
Prevents infant deaths
New mothers must also battle medically unsound traditional customs that can interfere with breastfeeding — including giving brown sugar or sweet rice wine to newborns.
