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The Anatomy of the Infant Formula Controversy

Am J Dis Child. 1981;135(10):889-892. doi:10.1001/archpedi.1981.02130340001001.
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In late May of this year, when the United States became the only nation in the world to vote against the World Health Organization's (WHO's) recommendatory 'International Code of Marketing of Breastmilk Substitutes,' the issue of the causes and consequences of the decline of breast feeding in developing countries received widespread public attention, from the news media, the Congress, and the health professions.

The issue of the relationship between infant formula and increased morbidity and mortality is not a new one. Cecily Williams, the pioneer in study of protein-energy malnutrition, was warning of the dangers of unsanitary and overdiluted artificial feeding in the developing world as early as the late 1930s; in the late 1960s she wrote the following:

. . . a falling-off of breast-feeding is usually found, partly because some mothers may have to work in towns in employment where breast-feeding is taboo by modern convention, but also


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