Does this make you want to flop 'em out?

What do you think of this image?

Hint: It's not from a fashion catalogue. 

Let's zoom in:

Why is this child wearing a bathing suit that gives us a weird x-ray view of her kidneys, bladder and colon?

Actually, the picture comes from Tuoi Tre News who have a reasonably good article today about how malnutrition is causing stunted grown in around 30% of Vietnamese children.  The government is blaming this problem on a lack of breastfeeding, and products being sold to Vietnamese parents a nutritional supplements that are very poor quality - specifically: infant formulas.

The image used in the article is odd - but the article itself is good and points at a big problem in the Vietnamese infant feeding market. You might think it strange that I'm talking about infant feeding as a marketplace, but that's exactly what it is.  Every Vietnamese supermarket I've been into has an entire aisle devoted to infant formula products.

Daycare centers and kindergartens are easy to spot, because they all seem to be sponsored by infant formula companies which paint colourful cartoonish murals on the outside walls.

This article from 2009 describes the aggressive push by infant formula companies in Vietnam.  The law here is clear, that breastfeeding should be promoted and that marketing infant formulas in hospitals and the like is forbidden - but it is not well observed. The situation is unchanged now in 2011 - probably worse.


When she heard my mother was coming, my Vietnamese friend asked me to get my mother to bring cans of infant formula for her 2 and a half year old daughter. Vietnamese people are suspicious of the quality of the formulas they are feeding their children, and yet steadfastly believe that they should be feeding their children special formulated foods.  The irony of this is that an adult Vietnamese diet (assuming the family are living somewhere above the poverty line) is rich in vegetables, fruit and fish. Many Asian people cannot easily digest lactose and do well to stay away from milk, cheese, ice-cream and yogurt - and yet still get plenty of protein from tofu and soy-based products, as well as some calcium from fish and small animal bones and other items that are not part of a typical western diet*.  If the toddlers were eating what their parents ate - instead of over-boiled rice mushed with thick infant formula - they would most likely have a much healthier diet.

A further irony is that these formula products are favoured by Vietnam's growing middle classes.  They are very expensive to buy, and have been successfully marketed as somewhat of a luxury item.  This may explain why parents are so willing to pay such a premium for them to feed to children who are well past the age of being needed to be bottle-fed.

If there's something that really astounds me about the problem of breastfeeding in Vietnam, it's that breastfeeding is something that - on the face of it - is well respected here.  There are many many artworks and public monuments depicting breastfeeding mothers. 

The aptly-named "Unfinished Suck" from the second floor of the Southern Women's Museum shows a woman reaching for her gun. She has been interrupted whilst feeding her baby. This is a terribly affecting piece of work - as the expression on the faces of both the woman and her baby make you think that perhaps it is too late.

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The detail in the image below is the central focus of another huge painting on the same floor.  It shows a baby attempting to suckle from a woman who has been killed a battle.

And here is the whole painting (click on it to see a bigger version):

Here is another depiction of a woman soldier breastfeeding, but it is much more tenderly evocative. I look at it and imagine that the artist was drawing a woman and a child he knows and loves - perhaps his wife was the model? This one is in the Fine Arts Museum which is not far from Ben Thanh Market.

Breastfeeding also plays a part in literature any myth, whereas, I can't think of a traditional children's story from the West that talks about breast-feeding.  Take the milk-apple, for example.  According to myth, it is named for breastmilk.  Once upon a time, a naughty boy ran away from home. His mother waited for him to return under the leaves of a tree. When he never returned, she became the tree - and its fruit is the milk-apple - still waiting for him to feed him when he comes home.

Maybe the success of the infant and toddler formula market in Vietnam is a allegorical of the triumph of commercial advertising over art, or over propaganda (or both). But it is heartbreaking to see children who are genuinely loved, and whose parents want only the best for them literally dying from malnutrition - even those children who don't feel hungry.

I don't know what we as expats in Vietnam can do. Surely using all those same strategies to promote breastfeeding that are used all the time in the West is a good idea - breastfeed in public, encourage new mothers to breastfeed, if you are an employer - make sure any breastfeeding mothers on staff have time and space to feed or express milk.  Maybe don't buy formula for your friends' toddlers.

And finally: Don't demonise or ostracise those mothers who do choose to use formula to feed their infants.  Remember that infant formulas save very many more babies than they kill when the mothers can't or won't breastfeed for whatever reason. Breast is best, but I would rather a woman who doesn't breastfeed gives her baby infant formula than rice soaked in cow's milk and porkfat - wouldn't you?  Unless of course you're trying to make zombie babies:

*Soymilk in Vietnam is usually served fresh and therefore not fortified with calcium the way it is in the west.