This past spring at an assembly in Geneva, the World Health Organization (WHO) passed an international resolution that would encourage and promote breastfeeding globally. The resolution was expected to pass without opposition—which is why members of WHO as well as health advocates and organizations around the world were shocked when the U.S. decided to oppose it.

Not only that, but there are now accusations that the U.S. delegates used threats and other nefarious tactics to persuade other countries to side with them in standing against the resolution.

So what exactly is the resolution all about and what does this mean? Here, we dive in and try to answer the basic questions surrounding the issue.

What does the international breastfeeding resolution do?

For many mothers around the world, access to reliably clean water can be difficult, making breastfeeding the best, easiest and healthiest way to feed their babies. Both the cost of and ability to safely make formula is out of reach for many families, so the WHO resolution seeks to provide education and help for those who will breastfeed.

The WHO asks those countries who sign to promote and support breastfeeding, as well as take appropriate measures to fight misleading claims spread by formula manufacturers in their marketing and advertising. This is in addition to the already stringent internal code of the World Health Organization, which says that baby formula companies are banned from explicitly targeting mothers and their health care providers.

What does the resolution not do?

The resolution, which relies on decades of studies that prove the multitude of benefits of breastfeeding (to both infant and mother), is not an anti-formula campaign, nor is it looking to shame any mother for whatever method she chooses to feed her baby. In fact, it doesn’t limit access to formula in any way.

Why is the U.S. so against it?

According to the New York Times article, which broke the story, delegates from the U.S. seemed to side with formula company lobbyists, demanding that certain language be stricken from the resolution, “that called on governments to ‘protect, promote and support breastfeeding’ and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.” It is that last line that would impact the current $70 billion baby food/formula industry.

What did the U.S. do in addition to opposing the resolution?

It wasn’t just that the U.S. was opposed to this resolution that shocked and angered people. The New York Times reported that U.S. representatives in Geneva started bullying and threatening other countries in order to prevent them from signing on to the resolution. Delegates from Ecuador claim that U.S. representatives threatened them, saying that if Ecuador backed the resolution, America would “unleash punishing trade measures and withdraw crucial military aid.” Ultimately, Ecuador decided to pull out from backing the resolution.

With Ecuador out, health advocates scrambled to find another country to help sponsor the resolution. At least a dozen countries refused, claiming they feared U.S. retaliation. Most of the countries that said no were ones from developing countries in Latin America or Africa, where populations would certainly benefit from the resolution.

What happened in the end?

The U.S.’s tactics were unsuccessful, and the WHO was able to pass the resolution, mostly due to Russia, who stepped into Ecuador’s place.

While the resolution did indeed pass, it did so while leaving a mark on the U.S. According to statements from many advocates and organizations decrying the US’s behavior in Geneva, this mark will not be easily removed in the eyes of the World Health Organization, and the world, at large.