Yesterday was World Health Day – a World Health Organization (WHO) campaign with a focus, this year, on global food safety. This year, much of the attention is being given to looking at how food safety is affected ‘from farm to plate.’ The WHO feature 10 facts on food safety:

More than 200 diseases are spread through food
Contaminated food can cause long-term health problems
Foodbourne diseases affect vulnerable people harder than other groups
There are many opportunities for food contamination to take place
Globilization makes food safety more complex and essential
Food safety is multisectoral and multidisciplinary
Food contamination also affects the economy and society as a whole
Some harmful bacteria are becoming resistant to drug treatment
Everybody has a role to play in keeping food safe
Consumers must be well informed on food safety practices

As a midwife, my first thought on reading this list, thinking particularly about the third point about food safety issues for vulnerable people, turned to food safety for newborns and infants. The WHO says that ” the great majority of people will experience a food or water-borne disease at some point in their lives.” For most of us adults in high-income countries, this is unlikely to pose a significant threat. But let’s consider a newborn in a low-income and resource-poor country.

In many low-income countries, formula feeding is increasingly becoming the norm. More than 60% of babies globally are given breastmilk substitutes in the first 6 months of life. Safe powdered formula milk relies on a safe, clean water supply. Failure to make up formula milk safely can lead to life-threatening disease in infants, with the increased mortality and morbidity associated with breast milk substitutes in low-income countries well documented.

“Once a woman is regularly and exclusively using formula it is unlikely she will be able to go back to breastfeeding, even if she can no longer afford the substitute or has only dirty water to mix it with.” (Ros Wynne-Jones)

Additionally, millions of infant deaths are associated with malnutrition caused by inappropriate feeding practices including formula feeding. The dilution of formula milk to make it go further restricts the amount of essential calories received by a baby. Furthermore, there have been a number of high profile cases of contamination of formula milk over the past ten years.

It is estimated a staggering 1.5 million children’s lives would be saved every year if all babies and young children are exclusively breastfed for the first 6 months of life and then continued to breastfeed up until 2 years old while being given nutritious complementary foods. Breastfeeding provides the ideal food for newborns and infants, providing them with antibodies that protect against common childhood illnesses, reducing the risk of obesity and type-2 diabetes and triggering an infant’s immune system.

If more babies are to receive these benefits, breastfeeding must be vehemently protected and supported. The WHO International Code for the Marketing of Breastmilk Substitutes attempts to protect against the aggressive marketing campaigns of formula milk companies and the UNICEF Baby Friendly Initiative provides a set of standards for health facilities to ensure mothers receive timely support by skilled workers. This dual approach has made significant strides forward in recent years in ensuring ‘food safety’ for this very vulnerable group, but there is much more still to be done. Let’s start by thinking about food safety for the youngest first.