The Unintended Consequences of Kenya’s Policy Against Substitutes for Breast Milk
Category: Breast milk
By: Debra Mwendwa,
Kenya has always emphasized the importance of infant nutrition by supporting and encouraging breast-feeding of infants as the best start in life. Kenya’s policy intends to provide assistance at each stage of an infant’s development. This includes nutritional counseling and education, as well as encouraging high-quality and nutritious age-appropriate foods. Exclusive breastfeeding of infants is an essential part for achieving relevant Sustainable Development Goals (SDGs), as it improves nutrition (SDG 2), prevents child mortality and reduces the risk of noncommunicable diseases (SDG 3), in addition to supporting cognitive development and education (SDG 4).
Breastfeeding has short-term and long-term benefits for a child. Any amount of breast milk nutrition given to a child is beneficial and the longer a mother breastfeeds her infant, the longer the protection and benefits last for the child. It is claimed that feeding a child with breast milk can help reduce the baby’s risk of developing infections, diarrhoea and vomiting, obesity and cardiovascular disease in adulthood. Breastfeeding infants can prevent up to 12% of all child deaths and 10% of all common illnesses in children under the age of five. Furthermore, optimal breastfeeding is associated with higher educational attainment, individual productivity, and increased national Gross Domestic Product.
A recent WHO report shows that Kenya is moderately aligned with the International Code of Breastmilk Substitutes (the Code). The Government of Kenya’s Breast Milk Substitutes Regulation and Control Act of 2012, prohibits advertisement and promotion of a designated or complementary food product, which is consistent with the 2019 National Policy for Maternal, Infant and Young Child Nutrition (MIYCN), the Act and the Code respectively. According to Kenya’s regulations, cited above, health workers based in Kenya are forbidden from accepting gifts, including financial assistance, or funding for meetings, conferences, seminars or continuing education courses, from manufacturers of infant formula or substitutes for breastmilk, which would otherwise compromise their credibility in enforcing the policy of promoting exclusive breastfeeding for infants for the recommended duration. The intention of active discrimination against the baby formula as an alternative is to favour breastmilk supply, while depressing the demand for infant formula. This well-intended discrimination generates some unintended consequences stated below.
The law of unintended consequences describes how economic decisions can have unanticipated consequences, by distorting consumer or producer behaviour in unexpected ways. For example, a law may be enacted with the best intentions to benefit a group, but if there are unintended consequences, they may be worse off. Kenya’s regulation of substitutes for breast milk, where it is reasoned that the price of baby formula will increase with added taxes, the intention of this fiscal policy is to shift parental preference to benefit children under 6 months of age to be exclusively breastfed. The unintended consequence is on mothers having difficulties breastfeeding or the mothers working in the informal sector who cannot afford nutritious food, enough to exclusively breastfeed, the increase in price of the baby formula makes it difficult as well for these women to afford it.
Prices of goods are relative to another and when the price of baby formula rises, the price of breastmilk as its substitute, increases in relative terms. The negative incentive imposed on purchase of baby formula leads to reduction of the welfare of purchasers of baby formula because they can purchase fewer units of this product. The expected increase in price of baby formula means that mothers purchasing it will have lower buying power, compared to the mothers whose children are exclusively given breast milk. This policy has reduced the welfare of baby formula buyers who have a strong preference or unable to provide infants in their care with breast milk according to the prescription of the policy. There may be a minority of purchasers of infant formula for whom the preference is dictated by health conditions or prolonged absence of a parent capable of providing lactation.
The supply of breast milk may be affected by social factors, health problems and nutrition in addition to employment opportunities available to the lactating mothers. Up to two thirds of workers in Kenya’s labor market are based in the informal sector. When attempting to combine breastfeeding of infants and work, urban women in the informal sector are concerned about their limited opportunities for secure income conditioned by the nature of their employment. They are constantly looking for work and the nature of their daily subsistence militates against maternity leave for extended periods as their need to work on a daily basis affects their overall savings in the period following childbirth. This conditions them to return to work sooner than is ideal for their children and certainly sooner than most would prefer. They also work long hours and in environments that are not conducive for carrying babies or breastfeeding of infants. In these conditions, it is clear that baby formula is an important substitute and not a luxury item of preference by a high-income earner.
Conclusion
The policy preference by the Ministry of Health in Kenya to promote exclusive breastfeeding of infants by increasing the prices of its substitutes is informed by good intentions. However, it appears that it makes the assumption that baby formula, a substitute for breast milk, is a luxury good that only high-income earning mothers want to purchase. It fails to acknowledge that there are mothers who need this substitute to feed their children when they are not able to supply them with breast milk due to health problems, employment conditions or direct economic barriers. To raise the costs of acquisition for this substitute generates unintended consequences that harm a significant number of children based in Kenya’s urban areas.
Key Words: Lactation, Infant nutrition, Breast milk, Food product, Fiscal policy, Child mortality
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The Unintended Consequences of Kenya’s Policy Against Substitutes for Breast Milk
| Post date: Wed, Sep 7, 2022 |
| Category: Breast milk |
| By: Debra Mwendwa, |
Kenya has always emphasized the importance of infant nutrition by supporting and encouraging breast-feeding of infants as the best start in life. Kenya’s policy intends to provide assistance at each stage of an infant’s development. This includes nutritional counseling and education, as well as encouraging high-quality and nutritious age-appropriate foods. Exclusive breastfeeding of infants is an essential part for achieving relevant Sustainable Development Goals (SDGs), as it improves nutrition (SDG 2), prevents child mortality and reduces the risk of noncommunicable diseases (SDG 3), in addition to supporting cognitive development and education (SDG 4).
Breastfeeding has short-term and long-term benefits for a child. Any amount of breast milk nutrition given to a child is beneficial and the longer a mother breastfeeds her infant, the longer the protection and benefits last for the child. It is claimed that feeding a child with breast milk can help reduce the baby’s risk of developing infections, diarrhoea and vomiting, obesity and cardiovascular disease in adulthood. Breastfeeding infants can prevent up to 12% of all child deaths and 10% of all common illnesses in children under the age of five. Furthermore, optimal breastfeeding is associated with higher educational attainment, individual productivity, and increased national Gross Domestic Product.
A recent WHO report shows that Kenya is moderately aligned with the International Code of Breastmilk Substitutes (the Code). The Government of Kenya’s Breast Milk Substitutes Regulation and Control Act of 2012, prohibits advertisement and promotion of a designated or complementary food product, which is consistent with the 2019 National Policy for Maternal, Infant and Young Child Nutrition (MIYCN), the Act and the Code respectively. According to Kenya’s regulations, cited above, health workers based in Kenya are forbidden from accepting gifts, including financial assistance, or funding for meetings, conferences, seminars or continuing education courses, from manufacturers of infant formula or substitutes for breastmilk, which would otherwise compromise their credibility in enforcing the policy of promoting exclusive breastfeeding for infants for the recommended duration. The intention of active discrimination against the baby formula as an alternative is to favour breastmilk supply, while depressing the demand for infant formula. This well-intended discrimination generates some unintended consequences stated below.
The law of unintended consequences describes how economic decisions can have unanticipated consequences, by distorting consumer or producer behaviour in unexpected ways. For example, a law may be enacted with the best intentions to benefit a group, but if there are unintended consequences, they may be worse off. Kenya’s regulation of substitutes for breast milk, where it is reasoned that the price of baby formula will increase with added taxes, the intention of this fiscal policy is to shift parental preference to benefit children under 6 months of age to be exclusively breastfed. The unintended consequence is on mothers having difficulties breastfeeding or the mothers working in the informal sector who cannot afford nutritious food, enough to exclusively breastfeed, the increase in price of the baby formula makes it difficult as well for these women to afford it.
Prices of goods are relative to another and when the price of baby formula rises, the price of breastmilk as its substitute, increases in relative terms. The negative incentive imposed on purchase of baby formula leads to reduction of the welfare of purchasers of baby formula because they can purchase fewer units of this product. The expected increase in price of baby formula means that mothers purchasing it will have lower buying power, compared to the mothers whose children are exclusively given breast milk. This policy has reduced the welfare of baby formula buyers who have a strong preference or unable to provide infants in their care with breast milk according to the prescription of the policy. There may be a minority of purchasers of infant formula for whom the preference is dictated by health conditions or prolonged absence of a parent capable of providing lactation.
The supply of breast milk may be affected by social factors, health problems and nutrition in addition to employment opportunities available to the lactating mothers. Up to two thirds of workers in Kenya’s labor market are based in the informal sector. When attempting to combine breastfeeding of infants and work, urban women in the informal sector are concerned about their limited opportunities for secure income conditioned by the nature of their employment. They are constantly looking for work and the nature of their daily subsistence militates against maternity leave for extended periods as their need to work on a daily basis affects their overall savings in the period following childbirth. This conditions them to return to work sooner than is ideal for their children and certainly sooner than most would prefer. They also work long hours and in environments that are not conducive for carrying babies or breastfeeding of infants. In these conditions, it is clear that baby formula is an important substitute and not a luxury item of preference by a high-income earner.
Conclusion
The policy preference by the Ministry of Health in Kenya to promote exclusive breastfeeding of infants by increasing the prices of its substitutes is informed by good intentions. However, it appears that it makes the assumption that baby formula, a substitute for breast milk, is a luxury good that only high-income earning mothers want to purchase. It fails to acknowledge that there are mothers who need this substitute to feed their children when they are not able to supply them with breast milk due to health problems, employment conditions or direct economic barriers. To raise the costs of acquisition for this substitute generates unintended consequences that harm a significant number of children based in Kenya’s urban areas.
Key Words: Lactation, Infant nutrition, Breast milk, Food product, Fiscal policy, Child mortality
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