April 2019

Have you ever put ants in milk, just to see what would happen? Have you ever put ants in milk to see if the milk was bad? If you don't think ants are a reasonable way to test the safety of milk, then you're probably not from around here. The fourmi ("ant" in French) test must be pretty reliable--everyone is doing it.

The unfortunate part of the fourmi test is that if an ant dies in a mother's breast milk, then she concludes that her milk must be bad, and therefore unfit for her baby. What do you do when your breast milk is bad? Well, if you're rich then you would buy formula. But most people can't afford formula, so they give the baby water instead. Water has no calories. It has no glucose. It has parasites, which are not as beneficial as the nourishment or the antibodies that the infant would have received from the "bad milk."

I met an infant today whose mother's milk had unfortunately killed an ant--maybe several ants. The baby was thin--her ribs stuck out so that you could count each one. She had tiny upper arms and a thin face.

The nurse explained to the patient in Nangjere why she should breastfeed and not give any water, and she said that the patient agreed. The next morning on rounds we asked about the baby's feeding plan again. "The baby's father says I have to give her water, so I'm giving her water."

It's an ongoing battle here, and always a discussion topic on rounds, to the point that the nurses seem a little tired of trying to drive home the point over and over and over again with each patient. But once in awhile a mom says, "Oh I didn't know! I'll just breastfeed now!" And it seems like she means it, and babies who were previously getting no calories and wasting away actually do gain some weight, at least while they're here in the hospital.

Sometime maybe we'll replicate the ant test in water and see if ants can help us teach the dangers of giving water to babies. I hope our ants aren't good swimmers.