Haiti, Hell, Good Intentions, and Breast Milk Donations

by Jake Aryeh Marcus    Find Sustainable Mothering on Facebook and Jake on Twitter.

A few days after the earthquake in Haiti, my Facebook account was flooded with suggestions to become a “Fan” of an organization I do not trust.  I wondered why people who should know which organizations are actually helping breastfeeding women and their children would think I would want to support this particular organization.  And fairly soon I knew: this organization had a heart string pulling photo of Haiti on its home page and a claim it was helping get donated breast milk to Haiti.  My response?   Not a chance.

I was dubious not only because of my distrust of this particular organization but because of the practical realities of transporting and distributing human milk in a country with no electricity, no refrigeration, and no hope of widespread access to either any time soon.  I also knew that the first priority in feeding babies in an emergency is to feed from the breast.  And I knew that the U.S. has a long and shameful history of harming the people of Haiti.

If you live in the United States, chances are good you know little about Haiti. I am no expert but I have some book recommendations.   The Rainy Season: Haiti Since Duvalier by Amy Wilentz is the first book I read about Haiti. I read it the year it was published, 1989, when I was 26 and a year out of law school.  It is a beautiful, horrifying, well-researched book about the history of the country grown out of the first successful slave revolution in the western hemisphere.  By the time Brother, I’m Dying was published I knew a good bit more about Haiti, in part having read all the previous works of that book’s author Edwidge Danticat.  Brother, I’m Dying is the true story of the death of Danticat’s beloved uncle in the custody of the U.S. Department of Homeland Security (DHS).  If you are wondering why there would be any issue about accepting refugees from Haiti, you need to read Brother, I’m Dying, not only because you need to learn more about how the U.S. treats Haitians regardless of whether there has been an earthquake but all of us in the U.S. need to know the nightmare a U.S. citizen of Haitian descent can go through trying to find the truth about the unnecessary death of a loved one who simply disappears into DHS custody while legally entering the U.S.

What you probably do know about Haiti is that on January 12th it was devastated by an earthquake killing hundreds of thousands of people and nearly a month later the death toll is still rising.  You may also, particularly if you are an advocate of breastfeeding, think that getting breast milk to babies orphaned by the quake is urgent.  Well, yes and no.  All international aid organizations know that bringing artificial baby milk (also known as “formula”) to an area without clean water is sure to lead to more dead babies.  Mixing powdered formula with contaminated water is an obvious danger. So what is the problem with liquid formula?  The nipples (teats) and bottles needed to feed babies other than from the breast must be sterilized – impossible without clean water, electricity, refrigeration, and fuel. Well then, donated breast milk becomes all the more important, right?  No. Haiti has no milk banks and even if it had them, without uninterrupted electricity and refrigeration – something it will not have for the foreseeable future – there will be no milk banks.  Donor milk is also not sustainable.  An unknown number of Haitian babies have been orphaned by the earthquake, however they must be fed by Haitian women who can continue to feed them.

Prior to the earthquake Haiti was already the poorest country in the hemisphere.  Its infant mortality rate was the highest in the western hemisphere (nearly 60 out of every 1,000 babies died before the age of one compared to 6 out of every 1,000 in the U.S.) Maternal mortality was also the highest in the hemisphere (670 women out of every 100,000 died of pregnancy-related causes as opposed to 11 out of every 100,000 in the U.S.)  However, breastfeeding rates in Haiti were far better than the U.S.  According to UNICEF, 41% of babies under the age of six months are exclusively breastfed in Haiti compared to 13.6% in the U.S. When considering the availability of breast milk in Haiti, there are some other critical statistics.  The rate of non-exclusive breastfeeding of children between 6 and 9 months is 87% and the percentage of children still breastfeeding at 20-23 months is 35%. What these numbers mean is the one thing that Haiti has a lot of is lactating women.

Still a number of breastfeeding advocacy organizations in the U.S. – the Human Milk Banking Association of North America (HMBANA), United States Breastfeeding Committee (USBC), International Lactation Consultant Association/United States Lactation Consultant Association (ILCA/USLCA), and La Leche League International (LLLI) – issued an “Urgent Call for Human Milk Donations for Haiti Infants” on January 25th.  The U.S. Navy Ship Comfort, a medical vessel currently anchored off the coast of Haiti, had been shipped frozen donated breast milk and the “Urgent Call” urged lactating women in the U.S. to donate more breast milk to HMBANA milk banks, some of which would go to Haiti. Reading this “Urgent Call,” something didn’t feel right to me.  The donor milk was going to the ship NICU and can not be sent to any facility on land as there is no facility that can maintain and distribute it.  So I did some research on the ComfortIt took seconds to discover that the Comfort NICU has two incubators. Yes, two. Any baby born prematurely on the ship will have to be able to breastfeed exclusively before leaving the ship because breast milk from the breast is the only way Haitian babies can survive conditions there.

In short order, it was discovered that there had been no request for donor milk and aid organizations were asking that the milk shipments stop.  The Emergency Nutrition Network explains why: the first priority has to be relactating women not currently nursing and making sure Haitian babies are feeding at the breast. That “stressed or malnourished women cannot breastfeed” is listed as one of the “myths that put babies at risk.”

One organization that is helping women in Haiti breastfeed is Circle of Health International (COHI).  This non-profit – the one that has been getting my donations – has sent midwives, lactation professionals, and birthing supplies to Haiti for the estimated 37,000 women currently pregnant as well as the women and children who survived the quake.

So why did these U.S. breastfeeding organizations send out this “Urgent Call”?  Perhaps it was ignorance.  Perhaps it was well-intentioned.  Perhaps it really did not occur to them that any feeding of babies in Haiti other than from the breast could decrease the total amount of breast milk available in Haiti because it discourages Haitian women from building their own milk supplies by breastfeeding babies (their own or orphaned ones) or relactating.  And perhaps some non-profits see exploitation of the Haitian crisis as an acceptable way to raise funds that will be used elsewhere.  There may be explanations but there is no excuse.  Haitian women and children need our help urgently and we can help by sending money to aid organizations like COHI.


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