Land without milk or honey: Lebanese infants ill-fed as subsidies for baby formula withdrawn

Twenty-nine-year-old Mariana Traboulsi was not expecting a second child amid Lebanon's ongoing economic collapse. The stay-at-home mum has two sons, Ali, three years old, and Mahdi, six months old.

After struggling to procure baby formula for her elder son in 2021, Mariana now struggles to obtain it for the youngest.

"We have seen a doubling of prices since subsidies were lifted, and on top of that, not all pharmacies carry them, so we have to order the boxes from other countries," the mother of two explained.

"The decision threatens the health of many impoverished children who will be severely malnourished and could potentially restrict access to childbirth"

Caretaker health minister Firas Al Abiad announced on January 10 that the Lebanese Health Ministry had decided to end subsidies on baby formula due to the lack of "clear solutions to end these shortages."

“We purchased large quantities of subsidised milk that were arriving [in Lebanon] and were almost sufficient for two countries, but they were gone very quickly,” Dr Al Abiad said.

The Central Bank has been struggling to secure payments for subsidies on baby formula since the beginning of the economic crisis in 2019 as the payments for imports – usually in foreign currency – have become increasingly difficult to cover.

“The reason we took the decision to lift subsidies on infant formula is that we wanted to secure milk for children and not for the sake of merchants who take advantage of the product subsidy to smuggle and sell it on the black market,” Dr Al Abiad said.

According to experts, the decision threatens the health of many children who will be severely malnourished and it could also potentially restrict access to childbirth.

For Ahmad Shaar Youssef, a Syrian refugee father of a one-year-old boy, providing baby formula has become a luxury he is unable to provide.

"Since he was born, we have been rationing baby formula, and now we must do it even more," Ahmad told The New Arab. "I now have to feed him smaller portions to make sure he's eating at least something."

The father, who works on a farm and barely makes $100 a month, is forced to buy at least two boxes of baby formula every fifteen days, which is half the amount the baby needs.

"I used to be able to buy seven boxes, now I can only buy five, or even four," the father lamented.

Being malnourished, the baby developed allergies and digestive problems. Ahmad's financial resources are, however, constrained, and he must choose between paying for his child's medical care or buying milk and diapers.

Currently, the only solution is to borrow money from the community.

"It is fortunate that there are still people willing to help, but the additional difficulty is that not all pharmacies have baby milk today," Ahmad added. 

"Some people substitute baby milk for regular milk that adults drink, causing severe gastrointestinal issues and enormous discomfort for the infants"

Mariam*, a pharmacist in the southern town of Saida, told The New Arab that no new batches of baby milk have been delivered since August. She says that pharmacists sometimes refrain from selling their reserves for a fear of running out and to avoid selling them at a low price.

"Since last year, we [pharmacists] were aware that subsidies would be removed, but we did not know when the government would do so," Mariam stated.

The pharmacist adds that even if they attempt to hide reserves in anticipation of the new price, they will nevertheless lose money.

"Our batches cannot be kept for so long due to expiration dates. Even if we set them aside, we still have to sell them for profit or to meet people's urgent needs," she said.

The pharmacist notes that fewer people have been at the pharmacy asking for milk, especially refugees. As undernourished infants grow up, she worries that they will develop illnesses, anaemia, respiratory and even psychological problems without adequate amounts of milk. 

"Some people substitute baby milk for regular milk that adults drink, causing severe gastrointestinal issues and enormous discomfort for the infants," she added.

According to UNICEF, infant formula is falsely promoted in society as the best feeding solution, when it is simply an expensive and artificial substitute for breast milk.

"UNICEF acknowledges that in exceptionally difficult circumstances breastfeeding may be practised but may not always be possible. Towards this end, we fully understand that there are mothers who may need access to infant formula," UNICEF told The New Arab.

In such circumstances, UNICEF notes that breast milk substitutes should be provided solely upon the recommendation of the health personnel after a thorough evaluation of their acceptability, feasibility, affordability, sustainability, and safety.

The World Breastfeeding Trends Initiative ranked Lebanon on the lower end of the spectrum in terms of successful breastfeeding rates compared to other countries in the region and globally. However, the Nutrition SMART survey conducted in 2021, revealed an increase in children 0-6 months of age who are exclusively breastfed to 32%, from 14.8% in 2009, demonstrating that progress is already taking place.

Meanwhile, Jamila Khodor, a social expert and refugee aid worker, told The New Arab that a few refugee families are substituting water and sugar for baby formula, worsening the malnutrition situation.

Jamila believes that baby milk, like everything else that was once subsidised, will be dollarized and made available only to those with dollar wages.

According to her, the country will see a decline in births as newlywed couples will reconsider having children. In this respect, having more than one child, or even being able to have a child at all, will become an exclusive privilege for a small minority of people.

Additionally, smuggling subsidised goods to Syria has made smuggling necessities like baby formula profitable for traders who can buy such items for a low price in Lebanon only to be sold for a higher price in Syria.

"Like everything else that has been smuggled into Syria, traders prioritise their profit over the needs of the people, and this is just one of the many casualties of the crisis," Jamila said.

Dana Hourany is a multimedia journalist based in Beirut.

Follow her on Twitter: @DanaHourany