Opinion: Supporting mothers who wish to breastfeed is good for public health and could also reduce emissions - By Dr. Kian Mintz (UCC/ERI), Aoife Long (MTU, MaREI Centre/ERI) and Dr. Maeve Anne O'Connell, Fatima College of Health Sciences

Breastfeeding is both a public health issue and an environmental justice issue. In terms of public health, breastfeeding is associated with lower rates of breast and ovarian cancer and lower risk of diabetes in mothers. Benefits for newborns include reduced incidence of ear infection, less diarrhoeal infections and less respiratory infections.

Infant feeding is not purely of nutritional benefit: it also fosters bonding and attachment, brain development and mental health. Worldwide, there are approximately 800,000 deaths of children under the age of five attributed to suboptimal breastfeeding. For these reasons, the World Health Organisation (WHO) recognises the potential benefits and recommends breastfeeding for at least two years.

But breastfeeding can be challenging and lots of mothers stop earlier than they want to. Despite initiatives like the WHO International Code of Marketing, that aim to protect mothers from the commercial interests of formula companies, the aggressive marketing of breastmilk substitutes permeates everyday life and undermines breastfeeding. Providing unbiased, scientific support for infant feeding can ensure high standards of care and the best chance for an infant to thrive whatever their feeding type. When education and professional support is available to women, they can achieve their infant feeding goals and babies can thrive.

An unexpected benefit of breastfeeding is lower emissions compared to producing breast-milk substitutes. Most of the emissions from producing formula are from the dairy farming to make milk, but almost 15% are from the production process which is currently fossil-fuel heavy.

Formula companies are making an effort to reduce the carbon footprint of their products. One way of doing this is by using biomethane as a replacement for fossil natural gas in their processes. Biomethane is made from a process called anaerobic digestion, where bacteria in a giant industrial stomach break down organic materials such as grass or slurry. If the carbon footprint of infant formula is reduced, we can expect that this would be a selling point and make infant formula more socially acceptable.

There is a potential downside to using biomethane and our research considered the ethics of this fuel switch from fossil gas. We applied the ethical principle of 'do no harm’ to the social justice issue of breastfeeding. This principle has roots in medical ethics and asks that we first consider the potential harm caused by our actions.

The first concern is that the current supply of infant formula is greater than the demand, and this demand is fueled by aggressive marketing practices. Examples of these aggressive marketing practices are free samples in hospitals, cross marketing of infant formula and toddler milks and online baby clubs, that claim to be neutral while ensuring that brand recognition remains high. While these may seem benign individually, they create an environment and culture that undermines breastfeeding. If we reduce the carbon footprint of infant formula production, that allows these companies to portray or market themselves as green or sustainable.

The second concern is that using the available biomethane in formula production means we are not using it for other uses. Biomethane has the advantage of being similar to fossil fuels, so it could also be used as a zero-carbon transport fuel.

We argue that hard to decarbonise processes, like transportation, are a much better use for these low-carbon energy sources because these will require alternative energy sources that are powerful and portable. Heavy transport has been particularly difficult to decarbonise, as the current battery technology for electric vehicles is insufficient for long-haul transport. Biomethane is made from energy crops, which will not be available in the same vast quantities as oil and gas reserves, so it is important to use it in a way that it can have the biggest impact.

How would the fuel switch compare with improved support for breastfeeding? The WHO has set a global nutrition target of a minimum 50% breastfeeding rate at 6 months by 2025. In Ireland, the current rate of exclusive breastfeeding at two weeks is approximately 32%, and the rate decreases from here. Using biomethane to reduce the carbon footprint of formula use in Ireland would save 900 tonnes of CO2, There are multiple complex factors that influence individual infant feeding choices.

Conversely, if we reach the 50% minimum target, we could save almost 5000 tonnes of CO2, a fivefold increase in emissions savings. Reaching the minimum target and decarbonizing the remaining production with biomethane will save approximately 5,500 tonnes of CO2.To put these numbers in context, 5000 tonnes of CO2 is the equivalent of 800 mid-range diesel cars driving 20,000 km per year.

Emissions are not the only important thing and we don’t suggest that parents should breastfeed as a means of reducing emissions. There are multiple complex factors that influence individual infant feeding choices. Examining the interaction between public health and environmental concerns, we suggest that when decarbonizing formula with biomethane is on the table, access to social and professional breastfeeding support is a climate justice imperative.

Dr Kian Mintz-Woo is a lecturer at the Department of Philosophy and an affiliate of the Environmental Research Institute at UCC. He is a guest research scholar with the Equity and Justice Group at the International Institute for Applied Systems Analysis. Aoife Long is Cyber Skills Education and Public Engagement Manager at MTU and a PhD candidate studying renewable gas policy at the Environmental Research Institute and MaREI Centre for Energy, Climate and Marine at UCC. Dr Maeve Anne O'Connell is Asst Professor of Midwifery at the School of Nursing, Fatima College of Health Sciences, United Arab Emirates, and a Fellow of the Faculty of Nursing and Midwifery at Royal College of Surgeons Ireland (RCSI).