The interplay of public health and economics in the early development of nutrition policy in Canada

In the 1920s in Canada, the Federal Government’s Division of Child Welfare issued the nation’s first dietary guidelines aimed at encouraging women to breastfeed and also, somewhat ambivalently, encouraging women to feed cow’s milk to babies over nine months of age. The early 1920s was a time of transition in milk processing and distribution. Some cities and provinces had strong sanitary hygiene laws to ensure that milk was free of disease and contamination but others did not so that general national guidelines promoting the use of cow’s milk were problematic. These guidelines were promulgated at a time when many public health officials had begun to shift from vilifying milk, because of its potential to harbour dirt and bacteria and because of its well-known links to infant mortality, to extolling its virtues because of its newly discovered rich vitamin and mineral content. The shift in milk’s status as an unhealthy liquid to the quintessential protective food for children, both in the public’s mind and in the mind of many public health practitioners, particularly those from cities that had managed to clean up their milk supply, was rapid and occurred while much of the nation’s milk supply was in fact not safe. The promulgation of dietary guidelines promoting the consumption of cow’s milk for babies over nine months at this time was inconsistent and probably quite dangerous, particularly as Canada during the 1920s had the highest infant mortality rates among industrialized nations. The guideline was issued at a time of scientific enthusiasm over the new value of milk in protecting against under-nutrition and promoting optimal health. The dairy industry and the Federal Department of Agriculture unabashedly promoted the protective benefits of milk in large national campaigns overwhelming the ability of the Division of Child Welfare to deliver the best possible dietary guidelines for the times. The relatively weak guidelines developed by the Division in the 1920s demonstrate how, in the absence of a strong nutrition policy centre, inappropriate and perhaps unhealthy nutrition advice was too easily modified by the dairy industry and its representative in the federal government, the Department of Agriculture. Correspondence to: Aleck Ostry, Department of Health Care and Epidemiology, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3, Canada. Tel: +1-604-822-5872; email: ostry@interchange. ubc.ca Critical Public Health ISSN 0958-1596 print/ISSN 1469-3682 online 2003 Taylor & Francis Ltd http://www.tandf.co.uk/journals DOI: 10.1080/0958159031000097643 Critical Public Health, Vol. 13, No. 2, 171–185, June 2003