Women who don’t breastfeed shouldn’t feel guilty. We have a healthcare system that derails women from their breastfeeding goals, which is the subject of an op-ed I wrote in Newsday. The article about women who don’t breastfeed is a response to New York City Mayor Michael Bloomberg’s Latch On New York Initiative.
If you haven’t heard, Bloomberg announced that, come September 3, New York City hospitals are being asked to keep formula under lock and key voluntarily, just like other medications. If nurses need artificial milk for new moms, they will have to sign it out.
Some feminists, like Slate.com’s Hanna Rosin, have been getting on their high horses about how this initiative is taking choice away from women because it makes it harder for women who don’t breastfeed.
Formula manufacturers celebrate when women don’t breastfeed
We live in a country where health is a profit-driven industry. In all but three states (go Rhode Island! Go Massachusetts! And sort of start to go New York), formula manufacturers are given free reign to cozy up to hospital staff, hospital administrators, and pediatricians. Two of the three formula giants in America are among the top donors to the American Academy of Pediatrics every year.
No one is naive enough to believe this is because formula makers care about infant health. Abbott Nutrition and Mead Johnson both give huge amounts of money and donations in kind to the medical establishment because they have a product to sell and they are cultivating the “halo effect,” as it’s known in the business world. It makes them look good to be associated with the American Academy of Pediatrics. Their goal is to discourage women from breastfeed. When women don’t breastfeed, the formula manufacturers celebrate.
I’d love to be wrong on this and I have invited both companies to communicate with me. Abbott Nutrition did not have the decency to return a single phone call. Mead Johnson agreed to meet with me in person in Chicago and then changed their minds. I went anyway, hoping to persuade the handsome, well spoken, and perhaps well meaning Christopher Perille, to take a few minutes out of his incredibly busy day to explain Mead Johnson’s corporate mission and company history.
This was right at the beginning of my research and I thought I would be writing something about the history of infant formula on the lines of Malcolm Gladwell’s history of diaper innovation. Chris Perille, though he came out of this office twice (the first time angrily until he saw that I was nervous, apologetic, and unthreatening; the second time embarrassedly because he didn’t realize I was still there and still waiting to talk to him) was too busy preparing for a trip to Brazil where, perhaps, he was happy to talk to journalists and encourage women who don’t breastfeed.
The AAP accepts corporate donations from companies that make products to undermine children’s health
Mead Johnson is the luminary that brought our children chocolate-flavored baby drinks, which they then took off the market after a public outcry. However, their equally disgusting sugar-laden vanilla version is still readily available for thirsty toddlers and aggressively promoted to moms. Accepting corporate donations from companies that make products that undermine children’s health cheapens the mission of the American Academy of Pediatrics. Corporate sponsorship makes every member look bad. But it works for big business, making pediatricians feel and act beholden to these multi-million dollar industries. No one bites the hand that feeds him. This is, honestly, a national embarrassment.
This is why so many doctors are against the corporate sponsorship of their professional organizations and are trying—albeit often unsuccessfully—to get the pharmaceutical companies and other corporations out of their offices. Many are, simply speaking, disgusted with a system that both overtly and covertly discourages moms from breastfeeding.
Corporate sponsorship is wrong
“The vast majority of physicians in my Department agree [corporate sponsorship] is wrong,” Dr. Stefan Topolski, M.D., Assistant Professor of Family Medicine and Community Health at University of Massachusetts Medical School, insisted when I met with him while doing research for my book. “It’s embarrassing. The biggest danger is the loss of professional standing with the public and our patients who see us not able to act independently or stand on our own.”
Our breastfeeding rates are ignominious; our infant mortality rates among the highest in the industrialized world. Telemarketers from formula companies actually call new moms to suggest they stop nursing because formula is more convenient. Formula companies give “breastfeeding” advice. I won’t link to it but it’s on the Internet and too easy to find. Their advice is so frightening it would make most women want to bind their breasts. Moms are being belittled in the hospital, told they’re “starving” their babies, and threatened with separation or even criminal charges if they insist medical staff not give their baby formula. Is it any wonder so many American women don’t breastfeed?
Many American women don’t breastfeed, even when they want to
Feminists, wake up. American women want to breastfeed as much as women in every country in Europe and Asia who have more success than we do. But breastfeeding is hard and we need support.
Here’s the Newsday op-ed in its entirety (it’s no longer available on-line):
“Breast-feeding shouldn’t be only for the wealthy who have the luxury to take time off from work without pay,” writes Jennifer Margulis.
New York City Mayor Michael Bloomberg recently announced that come Sept. 3, city hospitals will be asked to keep baby formula under lock and key, with nurses required to sign it out as they would other medication. In July, The Boston Globe reported that hospitals in Massachusetts—following Rhode Island’s lead last fall—have stopped giving gift bags with formula samples to new moms.
America’s public policy on breast-feeding could reach even higher levels. When Massachusetts’ Public Health Council first tried to end the formula giveaways in 2005 with a statewide ban, the decision was overturned by when then-governor, now-presidential-hopeful, Mitt Romney replaced council members in favor of the ban. In stark contrast, first lady Michelle Obama publicly champions breast-feeding as part of an ongoing campaign to reverse childhood obesity.
Science shows the benefits of breast-feeding
Thousands of scientific studies have shown the benefits of breast-feeding. Research has linked breast milk to lower rates of Sudden Infant Death Syndrome, gastrointestinal problems, necrotizing enterocolitis, ear infections, childhood obesity, diabetes, leukemia, and even high cholesterol later in life. A recent study showed that it prompts development of more brain cells. Breast-fed babies score higher on intelligence tests as infants, preschoolers and even at age 10.
These are among the reasons why the World Health Organization promotes breast-feeding babies up to 2 years, and the American Pediatric Association recommends exclusive breast-feeding for an infant’s first six months.
But just because it’s good for moms and babies, doesn’t mean it’s easy. Breast-feeding takes time, patience, sleep and a good support system. For too many new mothers, these are luxuries in short supply. Only 75 percent of American moms even try to breast-feed. And the vast majority give up before their infant is 3 months old.
In Norway, by contrast, 99 percent of moms initiate breast-feeding and the majority of 6-month-olds—80 percent—are still nursing.
There are structures there that support this. In comparison to our meager leave policies, new moms in Norway get 47 weeks of maternity leave at full pay. Or they can take up to 57 weeks at 80 percent of their salary. Fathers, too, get three months of paid paternity leave. In the maternity wards of Norwegian hospitals, formula is available but rarely used. An infant who needs formula is fed with a dropper—so as not to interrupt breast-feeding—and mothers are not shown the brand. Advertising formula is illegal.
American hospitals help the formula industry
In U.S. hospitals, on the other hand, formula is ubiquitous. While researching the influence of corporate interests on baby care, I toured hospitals across the country and interviewed nurses, doctors, hospital administrators, midwives, doulas and dozens of new moms. What I found was dismaying: Hospitals accept free branded formula from manufacturers. Nurseries often use pacifiers, though pacifier use has been shown to interfere with successful nursing, and mothers are usually given formula samples on discharge. Essentially, the hospitals are engaging in product placement — and sending the message that breast milk isn’t enough. There’s often little support for mothers to keep trying to breast-feed. Many hospital neonatal units don’t even have a place for women to nurse.
Meanwhile, formula sales representatives bring pizza and doughnuts to the labor and delivery ward to generate goodwill among the nurses.
Some pediatricians, too, end up discouraging breast-feeding. It’s much easier for a busy doctor to hand a mom some formula samples than to spend half an hour with her evaluating the baby’s latch.
What Bloomberg, Massachusetts and Rhode Island are doing is a good start, but American mothers need stronger public policies to promote breast-feeding. Our government is the nation’s biggest purchaser of infant formula, offering it through the federal Women, Infants and Children program to the most disenfranchised moms—who are also among those who could benefit the most from nursing.
Not only for the wealthy
Breast-feeding shouldn’t be only for the wealthy who have the luxury to take time off from work without pay. It’s time for the American government to stop buying formula. Instead, our government should require employers to provide new moms with a private place to pump. We should mandate and finance paid leave for all new parents. If we prioritized young families over corporate interests, as they do in Scandinavia, we could find the resources to fund this kind of program.
With a system that makes breast-feeding so difficult, women who don’t breastfeed shouldn’t feel guilty—they should feel angry.
Published: August 10, 2012
Last update: January 21, 2020