Credit: katerha, Flickr
By Amy L. Hatch
Some hospitals in New York City will shortly be eliminating the swag bags that nearly all new moms get when they give birth in a medical center — bags of goodies that are generally filled with items sponsored by makers of baby formula, including a sample of the stuff for them to take home.
On top of the bag ban, The New York Post reports that hospital staff will record a medical reason for every bottle of forumla fed to an infant as part of the city’s “Latch On NYC” program, a voluntary initiative in which 27 out of 40 city hospitals have agreed to participate.
Ah, breastfeeding, you offer me such wonderful fodder! Really, this is just too easy, people. This is like shooting fish in a barrel, isn’t it? A municipal government reaching out to monitor how moms choose to feed their newborns?
I mean, really?
Let’s pause for a minute and think about the mom whose best efforts at breastfeeding just aren’t working for her or for her child. Let’s pause for a minute to consider her frustration, her disappointment, her exhaustion, her raging hormones and yes, her shame (because we live in a culture that shames moms for bottle feeding, yes, yes we do). Let’s consider her sense of failure because she can’t make this “natural” and “best” method of feeding work.
And then, imagine that the staff taking care of her has to note her failure in her child’s medical records, with every single bottle that baby eats.
Ridiculous!
I know what it feels like to be unable to breastfeed. By my third day in the hospital my daughter was red-faced and screaming, so hungry was she. I was beyond frustrated and I had to finally tell the lactation consultant — nay, demand — that I get a bottle for her. The nurse pursed up her lips in disapproval, kicking off a year of sideways glances and intrusive questions.
No, I am not exaggerating. And that was almost eight years ago, well before the Lactivist movement reached its full force.
Breast might be best for some people, but as my physician brother-in-law has pointed out to me countless times, formula has driven the infant mortality rates down over the years — because it prevented babies from starving.
Moms vs. moms in this debate is one thing — after all, we have a few things in common, you know, like breasts and wombs. But for a municipal entity to stick its nose in my parental business is something else entirely.
The program is voluntary, and swag bags could be considered an inappropriate marketing push by over-eager brands. But here’s the thing: Parents can choose to leave them behind when they take baby home.
And there’s that rub, the one that keeps showing up again and again — personal choice.
I agree that this is completely ridiculous. I did not breasfeed my 14 year old daughter for many PERSONAL reasons. I was lucky that I did not receive any comments or looks in the hospital – or maybe I was just too tired to notice. I now have a 2 year old and a 2 month old through adoption. I have been given the “breast is best” comments a few too many times in the last 2 years – even at my doctor’s office where it is in the records that I am a foster/adoptive parent. Reality is that you do not know if the person that you are giving dirty looks to even had the option of breastfeeding – and it is none of your business. The government needs to stay out of it.
I gave birth to my oldest in Oregon. Breast is best is definitely the motto there, with every effort to encourage women to CONSIDER breastfeeding and make them comfortable wherever they choose to feed their babies, but it always felt like a choice.
I was made aware of all of the support groups and assistance that was out there and after two horrible weeks of milk just not coming in, my daughter screaming all the time, being up night after night, I was relieved to have such friendly nurses ease my own sense of shame as I turned to formula. When my 3rd was in the NICU here in Champaign, I was never asked if I planned to breastfeed or bottle. With the little he was taking, I was able to actually pump and provide more than enough for his first few weeks. After a month, I actually was able to nurse him directly, never realizing that even if you don’t nurse right out of the womb that it could eventually work.
Having relied on both formula and mommy milk, I see the value in each and would not change how I chose to do things. As for the swag bags – they have ones for both breastfeeding moms and ones for formula feeding moms.
I have to say, it doesn’t surprise me that NY is PUSHING ideas on its residents…
After baseball, scrutinizing and judging moms harshly seems to be our national pastime – regardless of their choices. I had to record every nursing session with both my newborns and submit my journal for scrutiny by hospital staff. I endured quite a lecture from an L&D nurse about how much happier (?) formula-fed babies are compared to breastfed babies. I also had to bring my baby to her pediatrician’s office for weight checks every few days for several weeks to ensure I was nursing her properly. Wish we could ditch the faux Mommy Wars and get people focused on,oh, say meaningful family leave instead?
Wow, this is ridiculous. Can’t we just allow women to be able to choose how to feed their child? Because either way, baby is getting taken care of!
Here is another point of view:
http://www.inquisitr.com/288119/bloombergs-formula-ban-is-the-right-move-heres-why/
There is a lot of evidence that “free” formula reduces breastfeeding rates. The majority of moms want to breastfeed but only about 25% are still nursing at 6 months. This limitation (not ban) is focused on hospitals and has nothing to do with choosing to buy formula on one’s own. Often the “free” formula given in hospitals is the company’s most expensive name brand so if they can get parents hooked on it they can make $1500-4500 per baby per year. It’s pure marketing and no other type of company has that kind of influence over their marketing base at such a vulnerable time.
Thank you so much for writing this Amy. As a mother who was unable to breastfeed I am appalled by this news from NY.
In my opinion, this ban actually gives mothers the choice that so many women claim is being stolen. If formula can damage the chances of a mom successfully breastfeeding who really wants to, she should have the choice not to have her confidence undermined by the many voices (including samples in a bag going home with her) telling her that a little formula won’t hurt (and I’m not saying that there aren’t medical reasons to give formula). If a mom has decided that she wants to formula feed her baby, all she needs to do is bring it to the hospital with her. Banning the samples and forcing hospitals to offer it only when it is medically called for is actually limiting the willy-nilly handing out of formula that has been proven to undermine successful breastfeeding. Bringing formula to the hospital and using it during your stay and afterward has not been proven, however, to undermine other mothers’ breastfeeding success. Furthermore, formula feeding cannot be undermined. A woman can choose to formula feed anytime she wants to, however the window closes very quickly on successful breastfeeding.
Why is it that not receiving 1 can of free formula angers so many of you so much? As a “lactivist” as my job title is called in the above column, I work extremely hard to meet my clients where they are at with the nutrition goals they set for themselves and their babies, whether that means they exclusively breastfeed, feed breastmilk and formula, or exclusively formula feed. It is disturbing to meet that as woman, we can’t support one another- regardless of our personal experiences with the ignorant few. NY is trying to do something good here to help the majority of mothers- yes the majority at 75% (u.s. stat WHO) intend and initiate Breastfeeding in the hospital. This does not take anything away from a mother who prefers to bottle feed formula except 1 can of formula, a bunch of papers full of formula ads, and an unattractive diaper bag that I can comfortably say im sure very few of you would have any intention of using. I formula and breastfed my son and exclusively breastfed my daughter. Both experiences were different, both had good and bad, and both decisions were made for the best reasons for each baby at the time. As more nutrition research accumulates every year in the medical world, recommendation will change and evolve. Just as they evolve, we as a society need to evolve and see that just because our decisions were different “back then” doesn’t mean we get angery or unsupportive for those who are trying to make it better for others. It takes a village to raise a child. Get educated about topics, learn from each other, and support each other. Breastfeeding is a good thing. Just because you couldn’t do it, didn’t want to do it, or had a back experience with a person who wasn’t supporting your needs doesn’t mean you should lower yourself to becoming one of the ignorant and unsupportive people that so many of you seem to dispise
It is not the free can of formula or the ugly diaper bag that bother me. It is having to record a medical reason to forumula feed as if the only reason a mother should formula feed is if it is medically necessary. I am not ignorant or unsupportive. I am completely supportive of the decision that each parent makes but I don’t think I should have to justify my decisions because people like you insist that your way is “best”. It may be best for you but it was not best for me or my baby.
But, Mommy Stein, you miss the bigger point: that by forcing medical professionals to “record a medical reason” for every bottle of formula given, this policy codifies the idea that breastfeeding should be the only choice, and choosing not to should only be a rare-case exception. It frames the decision to not breastfeed as the “lesser of two evils,” rather than an informed choice by the woman.
Of *course* there are benefits to breastfeeding – and possibly, in most cases, it is “best.” But, like anything, there are always more scenarios than one to consider. Many Amy has outlined already. I’ll add a biggie for me (as someone who has worked in poverty-striken regions of the world and our own country): that breastfeeding can transmit HIV from mother to child. So, even if you manage to keep baby safe from transmission during delivery, being forced (or guilted) into breastfeeding can infect him later. I’m not even a mom yet and this still pisses me off on a personal level.
Bottom line: As with any policy designed to control women’s choices, this is completely narrow-minded and reactionary.
i think an HIV infection would count as a medically necessary use of formula.
I have to agree with Not-A-Momma: the fact that the staff would have to “record a medical reason” is the sticking point with me for it screams failure and shame! I don’t want to debate what is best; we make the best decisions we can and as we all know, it takes more than just food nourishment to raise a healthy, confident, happy, and smart child. At the end of the day we all want what’s best for our children – how do we miss that point in our often-discussed “mommy wars”?
There is a lot I would love to say to all of you but I dont want to make anyone feel like I dont value your opinions. There are some good points here that should be explored but there is also some misinformed information that is being spoken about as a fact. I would like to invite all of you to meet with me so we can discuss ways to support all moms without making anyone feel like choices are being made for them. Until women are willing to put themselves out there to help ALL moms, these discussions will be only that- a discussion that does nothing but give people a place to gripe. So I say lets meet! Let’s find a way to support Breastfeeding moms without making formula feeding moms feel guilty or bad for their decision. Lets make a change! If interested, I can be reached at lgholson@c-uphd.org and my name is Linda.
Mommy Stein (Linda),
In the last sentence of your comment I think you make Amy’s point. You state “Let’s find a way to support Breastfeeding moms without making formula feeding moms feel guilty or bad for their decision.” What about finding a way to support ALL moms, not just those who are breastfeeding. As a mother who has both breastfed and formula fed both of my children, I had NO trouble finding support for breastfeeding (ESPECIALLY in Champaign-Urbana). There are breastfeeding clinics, lactation consultants, La Leche League, community support groups, and obgyn support. Conversely, there is a total and utter lack of support groups for those moms who are unable to breastfeed. I think it is a rare exception that not breastfeeding is a choice, typically, because of a factor or combination of factors beyond a mother’s control, it becomes the only option.
I don’t think the “lactation” community realizes just how much mental and emotional damage is done to mothers by conveying the message that they are “choosing” second best for their baby when they are unable to breastfeed. For many women, breastfeeding struggles are a real trigger for crippling PPD and anxiety. For others, the struggles color their first year of motherhood with a given child.
I went to college with a woman that I recently discovered took her own life when her daughter was eight months old after months of crippling PPD. She attempted to breast feed and was unable to help her daughter thrive through that method of feeding. Her inability to continue to do so was a primary trigger for the depression and anxiety that eventually ended her life. Had there been more universal support for all mothers in her community, and a genuine community acknowledgment that it is love and support, not the method in which we feed our children, that truly makes them thrive, she may still be here today.
LIndsay,
Thank you so much for posting this. I don;t think people realize how traumatizing it is to not be able to lactate– the severe depression that is causes. And then on top of that the judgement from other women. I cry even thinking about what I went through. I absolutely hate it when when people use this “choice” language about formula — everyone I know who had to use formula had to do so because they were unable to breastfeed. There is TONS of support for breastfeeding here, but NOTHING for those of us who are unable breastfeed.
We know that hospitals push breast feeding over formula. But, I had an experience here, in Champaign-Urbana, recent;y with my 3rd child. I was in the hospital after a c-section (another story for another time). I was so insistant on keeping my milk production up for this baby because just 18 months earlier I had a hard time with my slow milk production and feeding my 2nd child. But, I managed with tramatized nipples and all (my choice). Now, in the hospital with baby #3who cried a lot and wheneevr she did I put her to breast. I had a nurse actually come in and say to me “you are the human pacifier” Like I was being talked about at the nurses station. I was angry and upset. Yes, I was comforting amy child and keeping my milk supply going by nursing as often as baby wanted. For pushing breastfeeding, the hospital nurses sure had opinions and how to do it!
Even now, I nurse my 1 year old and I feel people give me looks. Breat is best only in the privacy of your home , really?
As far as the hospitals are concerned., mothers need to be clear and strong about their choices and stick to it no matter what.
I do feel that miseducation or lack of eduction regarding breastfeeding is a big factor of choosing formula over breast. Also, some mother’s lifestyles are very different and aren’t the most fitting for time consuming breastfeeding.
I feel like no matter what you do it’s never the right thing. In the end yo uhave to do what’s best for you.
Amy, i completely applaud you for making the best decision for you child. You did the right thing. My understanding of formula is that it is a wonderful invention that saves babies lives, for those babies that couldn’t feed for whatever reason. Your physician brother in law is right there. It also seems to be a very good option for babies where HIV risk is very high – another great reason to use formula.
But that’s it.
The original intention of formula was to save lives not be an alternative to breast milk. That’s why if it is given out at hospitals it is for a medical reason and yours was a good one.
What NYC is trying to do is protect mothers from aggressive corporate marketing. You are right again in saying that this is about personal choice. if you choose to not breast feed your baby then pack some formula in your hospital bag. Women and babies need to be protected from corporate overreach. By including these samples they are normalising formula feeding as a choice not a life saving medical intervention.
The formula companies are not interested in your babies health they are interested in profits, they understand perfectly how hard it is dealing with a newborn and they want to make things easier for us, real easy. That is why they promote formula EVERYWHERE when you are pregnant and about to have a baby. Which is strange when you think about it, because after all only a few babies really need it.
Lindsay,
Please go back to my last post and see that I DID state we all need to support ALL women. I DO on a daily basis. I work in the maternal child health department in WIC at public health. My passion is empowering women with information so that during pregnancy and post partum they will be able to advocate for themselves and their babies to the best of their ability. I regularly counsel woman on breastfeeding AND formula but I do believe that formula companies are out of control. I also believe breast is best but despite my beliefs I WILL support all woman and help them. I encourage us all too. The best way for us to do that is to stand up and do something about the lack of support in our community and make sure our support is based on factual update information from reliable resources. That is why in my last post I encouraged anyone interested in turning this discussion into action to contact me. So again, I challenge us all as a group of women who have obviously had different experiences and possibly differing opinions to come together, learn from one another, and use this as an opportunity to make things better for future moms. I work hard everyday to do what I can to support all moms and I encourage all of you to join me. An easy way to start, check out some of the Breastfeeding events that CUPHD for World Breastfeeding Week that we have put together. These events will teach you a lot about the laws that are in place and why they are in place. While, your there, check out the MANY support services we have for formula feeding moms and events that we have for them too. Again, my email is lgholson@c-uphd.org or you can get info on chambanamoms website too. Think about it!
Linda,
I understand that you previously said that we needed to support all women, but you have to understand that those of us fresh, raw and bloodied from the emotional trauma of not being able to successfully breastfeed read between the lines. While you may say we need to support all women, you specifically advocate to rally community support for Breastfeeding women. Also, while I’m reading between the lines and emotionally over-analyzing, you capitalized your reference to Breastfeeding women, as if they are a group deserving of proper nouns, while not giving the same nod to formula feeding (again, I’m fresh, raw, bloodied, and admittedly, overanalyzing).
I just had my third child 11 weeks ago. As was the case with my first two, I STRUGGLED to breastfeed. Struggled meaning I fed him every two hours, and then pumped for 30 minutes immediately thereafter, and took fenugreek until I oozed maple syrup smell, and ordered drugs from Canada that you cannot get in the U.S., all to try and up my measly supply. All the while, my child continued to fall off of the growth charts. At two months old, he was sporting newborn clothes, and weighed under that which many babies weigh at birth.
We just switched him to formula. He is now packing on the pounds and smiling and giggling, and not constantly starving and crying. While my heart sings to see my baby so happy, it also stings to feel like a failure. I KNOW I am doing what is best for my baby, but on a DAILY basis I am inundated with messages that tell my otherwise.
I am a highly educated attorney with two other children. I should be more confident in myself and the decisions that I make, knowing that they are best for my children and our family. However, the lack of community support for people in my position undermines that confidence, and gives me a perma-lump in my throat. While there may be resources available for those women that you counsel, I am not in that category. Women in my position are conveyed the message that they should no better than to give their babies formula, and that they are either not trying hard enough, or being selfish if they make the decision that breastfeeding is not right for their child (I refuse to refer to it as a choice).
I appreciate your efforts to support the women you interact with in your professional capacities, however, I think we need to be universally aware of how our messages, both those stated and unstated, affect all women out there struggling to give their all to their children.
To correct my own comment, know better, not no better. Sorry, my type A couldn’t let that go!
We read your blog post with interest and want to address some inaccuracies. The initiative does not require hospitals to “hide” or “lock up” formula, nor does it restrict access to it for those who want it. Parents who want formula will not have to convince a nurse to sign it out by giving a medical reason. Parents can and always will be able to simply ask for formula and receive it – no medical necessity required, no written consent. For 3 years, New York State Law has required that mothers be provided accurate information on the benefits of breastfeeding. The City initiative does not require that mothers asking for formula receive a lecture.
The piece erroneously dismisses the positive health impacts of breast feeding for which there is there is overwhelming evidence — supported by national and international health organizations. For mothers, breastfeeding reduces the risk of breast and ovarian cancers. For babies, breastfeeding reduces the risk of ear, respiratory and gastrointestinal infections, as well as asthma.
The American Academy of Pediatrics has just published new guidance to pediatricians in Feb 2012, reaffirming its support for breastfeeding: http://pediatrics.aappublications.org/content/129/3/e827.full.pdf+html
Ultimately, our goal is to support a mother in whatever decision she makes when it comes to nursing her baby and this initiative specifically is designed to support a mother who decides that she wants to breast-feed by asking participating hospital staff to respect her and refrain from automatically supplementing her baby with formula (unless it becomes medically necessary or the mother changes her mind).
Bottom line: It does not restrict the mother’s nursing options in any way – nor does it restrict access to formula for those who want it.
I checked and the previous comment has been posted around the Internet – which is why it does not refer specifically to the piece above. Now it strikes me as a bit odd that they NYC Health Department is so desperate to kill this story the they have gone to the trouble (rather ineptly) of responding to individual blog pieces.
Frankly I think the NY Post piece was accurate and this is a desperate attempt at damage limitation in the wake of other disastrous policies (like the soda ban).
It’s all a bit pathetic but if it stops Bloomberg from initiating another round of “nudge” policies I’m all for it.
Hmmm…maybe such a regulation would have made hospital staff think twice before they gave my son a bottle, against my express wishes, because they thought I “might like some rest.”