The headlines just kept getting worse.

The Associated Press reported on September 20 that China's leaders were scrambling to contain public fury over widespread contamination of milk supplies, castigating local officials for negligence and cover-ups, while also moving to minimize criticism of the government's slow response. Officials promised to keep stores supplied with clean milk and set up medical hotlines and a multi-level treatment system for affected babies to help the traumatized Chinese public cope with one of the worst product safety scandals in years.

Originally focused on contaminated milk powder, the poisoned milk crisis worsened when liquid milk was also found to contain melamine, the industrial chemical that has killed four infants so far and initially caused serious illnesses in 6,200 others. By September 22, the number of sick children reported by the government jumped to an astonishing 53,000.

More than 80% of the 12,892 children hospitalized were two years old or younger, and 104 were in serious condition. Another 39,965 children received outpatient treatment and were considered recovered by the end of September, according to the Chinese Health Ministry.  

The company at the heart of the scandal, Sanlu Group Company, apologized for the poisoned products and stated that suppliers who sold the raw milk apparently added the chemical melamine - normally used in plastics, fertilizers, and flame retardants - to make the milk seem higher in protein due to melamine's high nitrogen content. The milk suppliers, in hopes of increasing their profits, watered down their milk to increase volume and then added melamine to fraudulently boost the protein content and bypass safety testing. When ingested, melamine causes kidney stones, which are especially deadly to infants and small children and rapidly induces renal failure. That is what happened to thousands of Chinese infants and toddlers.

This deadly series of events is an embarrassing failure for China's product safety system, which purports to have attempted to institute tighter controls to restore consumer confidence after a series of product safety scares in recent years that involved poisoned medicines, seafood, toothpaste, toys, and pet food ingredients.

These latest incidents represent the second major case in recent years involving shoddy baby formula. In 2004, more than 200 Chinese infants suffered malnutrition and at least 13 died after being fed phony formula that contained no nutrients.

It appears that a well-organized cover-up had been brewing for months before the Sanlu scandal was exposed. Indeed, the problem appears to have gone undetected for months, as the first baby died in May and the second in July. Apparently, Sanlu knew of its product contamination as early as July, and likely even as early as December, but did not go public with the information until September.

So far, eighteen suppliers of melamine and tainted milk have been arrested, with more than 100 others being detained or questioned.

Local government cover-ups, lax regulations, Sanlu's criminal silence, and the failure of the Communist government to guarantee food safety forced the resignation of Li Changjang, the head of the Chinese agency that monitors food and product safety. As head of the General Administration of Quality Supervision, Inspection, and Quarantine, he had promised years ago to overhaul the food and product safety system. However, this is not the failure of one man or one department to transform a deeply corrupt system. The heart-breaking systemic inability to accomplish basic and modern safety reforms indicates that China cannot keep its population safe. Despite its masterful display at a highly complex Olympic Games, China has yet to put transparent and enforceable product safety policies in place. After all, the boss of Sanlu, now in police custody, was a senior party official, as are the leaders of most of the large corporations in China.

Why Not Breast Milk?

Richard Spencer, writing from the UK in September 24's Telegraph, blasts the Chinese government: "Tens of thousands of infants are sick after drinking tainted baby milk. But this isn't an ordinary health disaster - the authorities colluded with the companies who deliberately contaminated their products and failed to warn the public." He asks an even more critical question that is fundamental to the health of women and babies:

Some ask why babies in China drink milk at all: cow's milk is not something the Chinese have traditionally liked, so there was no particular reason for them to follow the worldwide trend towards abandoning the breast. But the question answers itself: China is modernizing, and, to many people, that means doing what the rest of the world does. In present-day industrial China, it also means building your own companies to provide what [the public] and foreigners consume--but cheaper.

Even, apparently, if the price of higher profits is the loss of human life.

As this tainted milk scandal grows and affects other countries, it has forced Chinese women to reconsider breast milk. Breast-feeding in China has declined in recent years, even after the 2004 scandal. The United Nations Development Program says exclusive breastfeeding rates in China at four months of age declined to 48% in urban areas, and 60% in rural areas in 2004, the most recent year for which national statistics are available.

In its September 25 press release, the World Alliance for Breastfeeding Action (WABA) responded to this shocking and growing tragedy, stating that China is not the only country to experience serious problems with ensuring the safety of artificial milk: "There have been 71 occasions in recent years when companies have been forced to recall batches of formula because of dangerous contamination."

Furthermore, WABA declares:

While the most stringent of measures should be taken against unscrupulous and unethical milk companies, WABA calls urgently for renewed support for early, exclusive, and continued breastfeeding, and for additional resources to make this possible.... The widespread use of commercial formula, with all of its risks and side-effects, even when not contaminated [emphasis mine], is a real danger for infants and young children all over the word, even in wealthy countries.

Powerfully true. This is a fundamental lesson from China's tragedy, which has also likely affected milk products in New Zealand, Korea, Hong Kong, Singapore, Myanmar, the Philippines, Indonesia, and throughout Asia, as well as in other parts of the world.

Optimal Young Child Feeding

Optimal infant and young child feeding is defined globally as early and exclusive breastfeeding for the first six months of a child's life, and continued breastfeeding for up to two years or longer, followed by the gradual introduction of age-appropriate, nutrient-rich complementary foods from six months. Yet recently, national and international funding for public education and the training of health workers to support breastfeeding has seriously decreased. There has been a decline in the number of hospitals implementing the WHO/UNICEF Baby-Friendly Hospital Initiative, which incorporates the critical Ten Steps for Successful Breastfeeding, and disallows the unethical promotion of breastfeeding substitutes in health facilities.

In China, for example, at one time, maternity hospitals fully supported breastfeeding and this significant initiative. However, by the high level of formula use reflected in the pandemic, this practice may no longer be in place.

Susan Siew, Co-Director of WABA, states: "A tragedy such as this should not happen again. The majority of mothers, given appropriate support, timely and accurate information, and protection from aggressive marketing of infant formulas, are able to breastfeed. For working mothers, both in the formal and informal sectors, we need to provide an enabling environment with adequate maternity entitlements including maternity leave, flexible work arrangements, and mother-baby-friendly facilities at the workplace."

Even as WABA and numerous other organizations urge all members of the international community concerned with global health to renew and increase their funding and dedication to breastfeeding, it is clear that this demand is the tip of the iceberg for women and children, as it essentially requires a transformation of virtually all societies. Women's and children's needs must truly be respected, honored, and prioritized. Part of this requires a societal milieu where breastfeeding is supported, encouraged, convenient, dignified, safe, and viable for women everywhere.

Regretfully, this is not simple to achieve because this complex dilemma pits the value and welfare of women and children against the might of state-sanctioned corporate greed and endemic governmental corruption. While we should not turn our attention away from solving China's contaminated milk pandemic at this time, it's evident that the struggle for women's and children's rights and health is global.

All of us must stay focused on correcting the institutional milieu that precipitated this tragedy in China. In the process -- as we expose the regulatory shortcomings and recognize the corruption of many governments -- we must urge that each society learns to prevent this pattern from repeating elsewhere.

It is lesson for all of us.

For now, I dread tomorrow's headlines. Where and when will more babies and children die from poisoned milk?