A new study published in the leading medical journal The Lancet points out that 40% of the infant formula sold worldwide in 2014 was purchased by China, a market worth $17.78 billion. The researchers believe that demand in China will more than double by 2019, when global formula sales are estimated to reach $70.6 billion, with China accounting for more than half. The study, intended to analyze the levels, trends and benefits of breastfeeding worldwide, is the largest and most detailed analysis of its kind to date. The researchers emphasized that formula cannot replace breast milk. Infants raised on formula grow up to be less healthy and smarter than breastfed children. The researchers calculate that if the majority of infants and toddlers in China under the age of 6 months were breastfed globally, they say that 823,000 fewer children would die each year and 20,000 fewer deaths from breast cancer would occur, saving a total of $300 billion – the amount of money the world spends on cognitive decline in formula-fed children. Cesar Victora, a professor at the Federal University of Pelotas in Brazil, said that the cost of formula consumption for children would be $300 billion. Vidora (Cesar Victora) is the lead author of the study. He said there is a misconception that there is no harm in replacing breast milk with artificial products. But evidence from studies by some of the best experts in the field shows unequivocally that giving up breastfeeding has significant long-term effects on the health, nutrient absorption and development of children, as well as on the health of mothers. The study, published last week, was funded by the Bill & Melinda Gates Foundation and the Wellcome Trust. According to the National Health and Family Planning Commission, less than 16 percent of women in urban areas in China breastfed exclusively for six months after the birth of their children in 2014, in accordance with WHO recommendations. The proportion was higher in rural areas, at about 30%, but breastfeeding rates continued to decline in both urban and rural areas. According to a survey conducted by the Hong Kong Department of Health on babies born in 2012, only 2.3% of Hong Kong mothers breastfed their children exclusively for six months after birth. Overall, one-third of infants aged six months or younger are fully breastfed in low- and middle-income countries, while only 20 percent of infants aged 12 months or younger are breastfed in high-income countries, the study noted. Vidora and colleagues analyzed data from 28 systematic reviews and pooled analyses – 22 of which were commissioned specifically for the Lancet report. The analysis showed that breastfeeding not only has many health benefits for mothers and children, but also contributes to longer life expectancy. For example, in high-income countries, breastfeeding reduces the risk of infant mortality by more than one-third, while in low- and middle-income countries, breastfeeding reduces diarrhea cases by about half and respiratory infections by one-third. In addition, breastfeeding also helps to improve intelligence and may prevent children from developing obesity and diabetes later in life. For mothers, the longer they breastfeed, the lower their chances of developing breast and cervical cancer. The report suggests that there are ways to greatly improve breastfeeding rates and duration. In Brazil, for example, the average time women breastfed their babies increased dramatically from two and a half months in 1974-75 (one of the lowest averages among low- and middle-income countries) to 14 months in 2006-2007, thanks to government policies and health services, the creation of a civil society, and a major media campaign. The authors of the study compared the situation in Brazil and China; two countries with similar economic development, but with very different breastfeeding trends. According to the researchers, the promotion of breastfeeding in China faces unique challenges because of its large population and the number of mother and baby homes (about 600,000). The researchers noted that although the International Code of Marketing of Breast-milk Substitutes was implemented in China in 1995, it has not been updated to match new marketing practices, and enforcement and enforcement have been weak, with the code sometimes being ignored. Independent monitoring results in 2012 showed that about 40% of new mothers reported receiving at least one free formula sample. Of those, 60 percent said the samples were provided by formula company employees, while 37 percent said the samples were sent by health personnel. The report said that although the Ministry of Health actively promotes baby-friendly hospital activities, there is no public information available on how many hospitals in the country have been certified, because there is no centralized process for monitoring and reporting on the implementation of the activities. In addition, government departments can only assess a few hospitals each year, and accreditation is based almost entirely on self-assessment. On the other hand, maternity leave is only 14 weeks, and in 2010, Chinese women had the highest labor force participation among the middle- and high-income countries surveyed (67% compared to 60% in Brazil). The researchers suggest that the lack of a well-coordinated government program, the lack of active participation of civil society, the fact that maternity protection is less than in Brazil, and the unregulated marketing of breast milk substitutes by companies may explain the decline in breastfeeding rates in China. Last April, China announced it was considering a ban on infant formula advertising in an effort to change the country’s worrisome breastfeeding statistics. Nigel Rollins of the WHO’s maternal, newborn, child and adolescent health department, said that the country’s breastfeeding rates have fallen. Nigel Rollins is one of the authors of the Lancet report. He noted that the success of the International Code of Marketing of Breast-milk Substitutes, which was adopted by the 34th World Health Assembly in 1981, depends on how well countries implement the legislation and how well it is monitored and enforced. He said that breastfeeding newborns would have been the best choice, but the marketing practices used by the multi-billion dollar breast milk substitute industry have resulted in breastfeeding failing to become the dominant trend. The report was presented at a stakeholder event in Washington, D.C., on Jan. 29 of this year. Bill and Melinda Gates Foundation Chief Executive Officer Sue K. Desmond-Hellmann, CEO of the Bill & Melinda Gates Foundation, said the evidence presented in the report is clear that breast milk has a significant impact on infant survival and development. Breast milk helps children grow up healthy and allows societies to prosper. She noted that the report inspires action, greater political resolve and more investment in the healthy development of children around the world, and that it should start with breastfeeding. (Original title: Study: Chinese babies too dependent on formula The far-reaching costs far exceed the money of formula The researchers stressed that formula cannot replace breast milk. Babies who grow up drinking formula grow up to be less healthy and smarter than children who are breastfed.