Beijing (AFP)

Aggressive advertising of powdered milk, sometimes hostile employers and abusive mothers-in-law: China has one of the lowest breastfeeding rates in the world and is struggling to reverse the trend.

Only one in five Chinese babies is fed exclusively on breast milk during the first six months of their life, as recommended by the World Health Organization (WHO).

This is half less than the planetary average, according to Unicef. And very far from the government's goal: to reach 50% of babies who are fully or partially breastfed by 2020.

It's not for lack of trying. The authorities are trying to encourage breastfeeding, with rooms reserved in parks or train stations. But without much success.

Only 12% of infants are born in hospitals where staff have been trained in the phenomenon of lactation, according to Unicef.

But the biggest challenge is the ubiquitous advertising for formula milk. Especially since the repeal in 2017 of a law regulating the infant milk market. In particular, it prohibited nursing staff from promoting it.

However, it had by no means prevented certain food groups - including Danone - from paying doctors to place their products with young mothers.

A practice that revolts Fang Jin, secretary general of the China Foundation for Development Research, a state-backed think tank, who denounces "intense commercial pressure".

“Infant formula is advertised as having the same nutritional qualities as breast milk. That's a complete lie,” he says. The powders are now also marketed in hospitals and clinics.

- "A myth" -

According to Euromonitor, the Chinese market represented some 23 billion euros in 2019 and will reach 27 billion in 2023.

"Most women bring powdered milk when they come to give birth," said Liu Hua, a nurse at the Beijing Obstetrics and Gynecology Hospital. "They say they fear not having a rush of milk. It's a myth propagated by the infant milk lobby."

In her hospital, women receive little information about breastfeeding, she explains.

A problem exacerbated by the involvement of grandparents in the education of the baby.

"My mother-in-law reproached me for not producing enough milk. She insisted on using powder. I lost confidence in myself and became depressed," says Ran Qian, a mother from Suzhou (east).

Mothers also have to fight against certain beliefs that can hinder breastfeeding and are not medically valid - like giving brown sugar or rice wine to newborns.

"Pressure from grandparents (...) is one of the main explanations for the low number of women who practice exclusive breastfeeding during the first six months," notes nurse Liu Hua.

The authorities have already tried to improve things.

In the 1990s, they had set the goal of 80% of babies exclusively breastfed by 2000. An ambition then revised to 85% of newborns partially fed on their mother's milk.

- 800,000 lives -

But the numbers have never been reached and neither should they be in 2020, most experts believe.

However, exclusively feeding newborns with breast milk for the first six months would save 800,000 lives and the equivalent of 250 billion euros in medical costs worldwide each year, according to a study published in the scientific journal The Lancet.

The WHO recommends breastfeeding until the age of two, because of the benefits in terms of immunity and nutrition. But only 5% of Chinese mothers do.

According to Unicef, breastfeeding is also beneficial to the mother: it would prevent diabetes, heart disease or post-natal depression.

But the lack of awareness in China leads to some stigma against breastfeeding in public.

While feeding her 4-month-old baby in a restaurant, Wang Chao says she was stopped by a man who found the scene "unsightly".

Chao Anya, another mother who breastfed on a Shanghai bus, says she was called a prostitute by a stranger accusing her of "showing off her nipples".

- "Some are shocked" -

By law, women are allowed in companies to take one hour a day (in addition to their lunch break) to breastfeed or express their milk. But many fear being frowned upon.

"There is some discrimination from older bosses," notes Tang Kun, a public health researcher at Tsinghua University in Beijing.

Maggie Rui, human resources manager in a film studio, says she was forced to express her milk in the toilets of her company.

The Ministry of Health launched a campaign on social media, television and newspapers last month to encourage women to breastfeed.

But for Tang Kun, it is not enough if the medical staff is not sufficiently trained, the practice is not socially accepted and the infant milk producers are not better supervised.

Chao Anya, she does not intend to give up breastfeeding, which she assures even during meetings with clients. "Some are shocked, but others support me. I tell them that my milk is the best thing I can give to my child and that I will not compromise."

© 2020 AFP