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婴幼儿喂养的政治经济学:应对企业权力、克服结构性障碍、加速进展。

The political economy of infant and young child feeding: confronting corporate power, overcoming structural barriers, and accelerating progress.

机构信息

Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.

National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.

出版信息

Lancet. 2023 Feb 11;401(10375):503-524. doi: 10.1016/S0140-6736(22)01933-X. Epub 2023 Feb 7.

Abstract

Despite increasing evidence about the value and importance of breastfeeding, less than half of the world's infants and young children (aged 0-36 months) are breastfed as recommended. This Series paper examines the social, political, and economic reasons for this problem. First, this paper highlights the power of the commercial milk formula (CMF) industry to commodify the feeding of infants and young children; influence policy at both national and international levels in ways that grow and sustain CMF markets; and externalise the social, environmental, and economic costs of CMF. Second, this paper examines how breastfeeding is undermined by economic policies and systems that ignore the value of care work by women, including breastfeeding, and by the inadequacy of maternity rights protection across the world, especially for poorer women. Third, this paper presents three reasons why health systems often do not provide adequate breastfeeding protection, promotion, and support. These reasons are the gendered and biomedical power systems that deny women-centred and culturally appropriate care; the economic and ideological factors that accept, and even encourage, commercial influence and conflicts of interest; and the fiscal and economic policies that leave governments with insufficient funds to adequately protect, promote, and support breastfeeding. We outline six sets of wide-ranging social, political, and economic reforms required to overcome these deeply embedded commercial and structural barriers to breastfeeding.

摘要

尽管越来越多的证据表明母乳喂养的价值和重要性,但全世界仍有不到一半的婴儿和幼儿(0-36 个月龄)接受了建议的母乳喂养。本系列论文探讨了造成这一问题的社会、政治和经济原因。首先,本文强调了商业配方奶粉(CMF)行业将婴儿和幼儿喂养商品化的力量;以促进和维持 CMF 市场增长的方式影响国家和国际层面的政策;并将 CMF 的社会、环境和经济成本外化。其次,本文探讨了经济政策和制度如何破坏母乳喂养,这些政策和制度忽视了女性(包括母乳喂养)的护理工作的价值,以及世界各地的产妇权利保护不足,尤其是对贫困妇女而言。第三,本文提出了卫生系统为何通常不能提供充分的母乳喂养保护、促进和支持的三个原因。这些原因是性别和生物医学权力系统否认以妇女为中心和文化上适当的护理;接受甚至鼓励商业影响和利益冲突的经济和意识形态因素;以及使政府缺乏足够资金来充分保护、促进和支持母乳喂养的财政和经济政策。我们概述了需要进行的六套广泛的社会、政治和经济改革,以克服母乳喂养面临的这些根深蒂固的商业和结构性障碍。

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