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Comments on the World Health Organization's 'International Code' of Marketing Breastmilk Substitutes

Am J Dis Child. 1981;135(10):892-894. doi:10.1001/archpedi.1981.02130340004002.
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Few activities are as frustrating as dealing regularly with the problems of the world's poor, particularly those of their children. Progress is slow, difficult to measure, and easily reversed by natural or man-made disasters. Frustration readily leads to anger, particularly among those without the necessary resources or patience. The radicalization of some of our missionaries is a symptom of that anger.

Early weaning of infants in primitive environments leads to increased morbidity and mortality: it did so in this country in the "good old days"1 and it still does in the developing world.2 These and similar studies suffer from an inescapable flaw that tends to exaggerate differences: assignment to breast-feeding or artificial-feeding was not at random. The latter included all the early failures, real or imagined, or breast-feeding plus the many who were never put to the breast because they were sick, premature, orphaned, or abandoned. Most of


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