My good friend and lactation expert Susan E. Burger, MHS, PhD, IBCLC has strong feelings about World Breastfeeding Week. I have to agree that it's the New York Time's worst time of year for those of us who so strongly support nursing mothers and also think that the infant formula industry is in a constant state of collusion with medical associations and the media. I've asked her permission to publish her thoughts here.
Why the Nanny Debates Make This Lactation Consultant Want to Ban World Breastfeeding Week
My favorite nanny is not one of the dominatrix nannies on reality TV who see children as vile little out of control monsters to be broken by rules that are so strict that pet owners would cringe. My favorite nanny is Mary Poppins who uses sugar to make the medicine go down, implements routines that include moments of magic and wonder, and eventually gets the distant banker dad and socialite mom to pay attention to their own children. Apparently, enough people have experience with the bad dominatrix nannies to turn a perfectly respectable female dominated profession into an insult. Not enough people remember Mary Poppins who brought imagination and merriment into the picture and knew when to leave.
The most recent use of the term nanny as a derogatory term in the news media not only fails to incorporate the possibility of a Mary Poppins-style nanny, but also mistakenly identifies who the children are. The REAL children in the Mary Poppins story were the parents because they were not paying attention to their children. In defense of New York City's so-called Nanny Mayor, the predominant story presented by the news media about the Latch On Campaign has the story upside down and backwards.
The first issue that has been grossly misrepresented is the notion that there is a ban on formula. There is NO ban on using formula in hospitals. Any mother who wants to use formula is free to feed her baby formula. Similarly, her pediatrician can recommend formula if there is a medical need for it. In fact, the World Health Organization (WHO) recommends individual counseling for mothers who cannot fully breastfeed or choose not to breastfeed. What SHOULD happen in hospitals is individually tailored advice about how to do so in the healthiest manner possible after a mother is fully informed about the health implications of her various options. A majority of the mothers I work with as a lactation consultant have had to supplement their own milk with substitutes at some point or another. My experience is that these clients are not yet receiving appropriate counseling about all their options and not counseled in ways that leave them feeling confident about their decisions. These mothers need to be reminded about all the things that they HAVE done for their baby and unfortunately recognition of their efforts often gets lost when they encounter problems.
The second issue is the mistaken notion that promotional samples of formula are free. There is no free lunch. There is no free formula. Formula feeding mothers (whether they do so out of necessity or choice) ultimately pay the price for the huge excesses of promotional samples of the most expensive varieties being dumped into hospitals and foisted upon mothers who don't want or need those samples. The cost of formula includes the cost of aggressive marketing. Do formula feeding mothers want to pay more money because breastfeeding mothers go home with a bag of promotional samples formula that they don't use? It would make about as much sense as insulin dependent diabetics having to pay higher costs because pharmaceutical companies decided that all hospital patients should go home with a bag of needles and insulin just in case they might become diabetic -- or just in case otherwise healthy people might decide that they wanted to make the lifestyle choice to deliberately engage in behaviors that would make them become diabetic. Furthermore, wouldn't parents who can't or choose not to breastfeed prefer that the hospital provided the healthiest array of options from human donor milk to the least expensive formulas? Exclusive contracts between the formula industry and hospitals restricts parental choice to a single high priced brand.
The third misleading notion is that parents are the children who are being "nannied" by locking up the formula. Many supplies including food are locked up in hospitals because of pilfering. Locking up supplies is not directed at parents per se. In the case of formula, the bigger issue is that some hospital employees simply have trouble believing that breastfeeding works. I would say that in about half the cases of the mothers I've seen who were told they had to supplement, it was not a pediatrician who recommended the formula for solid medical reasons; it was a hospital employee who insisted that the baby could not possibly be getting enough without any supportive evidence. To date, I have never ever met a mother who was prevented from feeding formula to her baby in the hospital. On the other hand, I have met many women who were devastated to discover that their babies were given formula without their knowledge or consent. In one case, parents were even sent home with a box of formula that was so far past its expiration date that it had separated into a gluey clump in the bottom of the bottles. In reality, it is hospital employees who unfortunately need to be "nannied" because there are some who doubt breastfeeding so much that they can't suppress the urge to fix it with formula, even when no fixing is needed.
I've really had it with sensationalist attempts to fuel the mommy wars. All mothers are criticized for how they feed their babies no matter what choices they make. I've heard it all. The most severely nasty criticism is reserved for women who nurse their babies beyond a certain age. The most naive criticism is leveled against women who have problems that other women have not experienced and don't understand. I see the moms who muddle through and do their best and come up with pragmatic solutions that are far more creative than the simplistic and rather silly arguments about breast or bottle or human milk or formula portrayed by the news media. There are many varied and nuanced options that are rarely mentioned.
I really hate World Breastfeeding Week because much of the media takes it as an opportunity to attack those who wish to support mothers who breastfeed rather than celebrate their efforts to improve infant feeding. Every year I hope I will not have to read more faux feminist manifestos that denigrate the value of women who enjoy their care-giving roles. I hope I won't have to read more junk science fishing expeditions by journalists who deliberately exclude the wide body of solid research that does show that what infants are fed does matter. This year sets a new low with the addition of outrageously false claims that New York's City's Mayor has imposed a ban on formula that is going to deprive mothers of their rights.
Susan E. Burger, MHS, PhD, IBCLC