Sunday, December 19, 2010

America's Sacred Cow - Baby Formula


We in America have a dirty little secret. Our society protects the business of baby formula. It has gotten to the point where those who support and teach breastfeeding have been named in several recent articles as breastfeeding bullies and nipple Nazis. We have been accused of causing new mothers guilt for not choosing to breastfeed, and for judging mothers who choose to formula feed their infants.

I and every other breastfeeding advocate recognize the value of a readily available, affordable and accessible substitute for a mother's own milk when necessary or desired by the mother. My concern is quality and long-term effects on both the mother and her infant(s). Commercially produced baby formulas have never been subjected to independent, randomized, double-blind, controlled studies to establish their safety as a food for babies. Because the companies say they are safe, and our government has deemed them safe, we have all bought into their assumed safe use in infants. This has resulted in a century-long experiment on babies and mothers. Without the benefit of informed consent.

What we have seen a lot of over the years are corporate sponsored studies that compare breastmilk (the experimental substance) against formula (the standard, or control substance). Results are usually predictable, with breastmilk coming out as the "better," "ideal," "perfect," and "optimal" infant milk.

Perfect, ideal, and optimal are hard standards to reach. And "better,"......better than what? Oh, yeah, the norm, the standard, of formula. So, formula is the standard, and if you want to give your kid something better, knock yourself out and breastfeed. But, everyone else is going to formula feed, and we will train our doctors to use formula when breastfeeding becomes difficult or "fails" or falls short in some way. And we will train our judges that breastfeeding is just something extra that only the most committed mothers do and is not all that important to preserve, so that when a nursing mom requests that her infant not go away on weekend visits because it disrupts breastfeeding, the judge often sides with the non-nursing parent.

Formula is the standard that nursing moms must compete with when returning to work. When they request a private place to pump and, gasp, some time to go do it, they are considered to be pests in the workplace asking for special privileges. Oh, and don't bother to travel away from your baby. You will have to pump to preserve your milk supply and provide milk for your baby at home. Good luck getting your precious and hard won milk through the TSA screening. And for heaven's sake don't take your baby out to a restaurant or mall or just about any other public place. You won't know where, you won't know when, but when it happens, you will know why - someone sees you doing it in PUBLIC and complains to the manager to make you stop.

At every turn, breastfeeders are derailed, undermined, harassed, and even accused of child abuse in some cases. If you have your baby in a hospital, you are highly likely to run into formula and its cultural place as king of the baby milks. If your baby gets jaundiced, give formula. If your baby loses weight, give formula. Baby in NICU? Highly likely your baby will get formula while you are struggling to pump those golden droplets of colostrum.

But what is the response when breastfeeding advocates present factual information about the dangers of formula feeding? We are accused of making the mothers who choose formula of feeling guilty. But by focusing on the issue of the ever-present mother-guilt, we ignore the elephant in the room. That is, that commercial baby formulas are made from the cheapest ingredients, not the best ingredients. That the reason formula companies give such lovely "gifts" to new moms is to ensure that a can of formula is in each and every home, in the hands of each and every woman who may be experiencing difficulties or challenges with breastfeeding. They are the ever present saviors of overwhelmed mothers. This is exceptional marketing, not kindness, compassion or support. Marketing. Very effective marketing. Breast is best. But our formula is here for your when the going gets a little rough. We are here for you when you "fail." And, boy do we make money from your failure. Lots of money. Billions of dollars each year.

When we concentrate on not making moms feel guilty, we deny her the opportunity to make informed decisions. We assume that she is too emotional to handle the facts. And we take the choice away from her. I think women can handle making decisions. I think they deserve to have all the information they need to make a decision. Do health care providers refrain from letting a pregnant smoker know the risks of smoking while pregnant? Do they refrain from telling a mom about using car seats and the correct way of using them? How about drugs? Don't women get information about taking OTC, prescription and street drugs during pregnancy? Why then is discussing the risks of commercial formula off the table?

If a mother makes a decision to formula feed for any reason, there should be no need to discuss guilt. I am pretty convinced that mothers make the best decisions for themselves and their babies within the context of their knowledge and life story.

Once a mother finds out that commercial formulas are lacking, her energy would be much better spent being angry at the companies who duped her, not at breastfeeding advocates. If all of us began demanding that human milk be made available to everyone, that milk banks be established in every major city, and that more casual woman-to-woman milk-share programs be promoted, and at the very least that baby formulas be made with the highest quality ingredients available, then we would be on our way to a true solution that does not include guilt or protecting formula and those who manufacture it. It would likely lead to major empowerment of women and mothers.

Sunday, November 14, 2010

Every baby deserves to gestate for as long as they need

Thursday night I taught a breastfeeding class at a university medical center. One of the participants was pregnant with twins. For some reason, obstetricians are very afraid to let labor and birth happen to multiples. So, she said that her doctor had set her c-section date at 38 weeks. I asked her why 38 weeks and she responded that her doc was doing the c/s to prevent overcrowding of her uterus. Overcrowding of the uterus. That's a new diagnosis for me. I hadn't heard that one before. I guess our bodies are just not made to handle a full term pregnancy with twins. Aside from the ridiculous and fake diagnosis that requires surgery, the doctor in question is creating problems that, if she went into natural full-term twin labor, would likely be avoided.

The problems are that one or both twins can (not always) be a wee bit smaller than singletons and sometimes need a bit of growth catch-up in the first weeks. So they need to be able to nurse well from the get-go. At 38 weeks, it's common to see these babies function less like full-termers and more like late pre-term babies, and find suckling more of a challenge. The pediatricians are going to be hovering over them like hawks watching for weight loss or gain. If they don't gain in the first days/weeks the way they "should," it is highly likely that supplementation with formula will be suggested or imposed. Once supplementation has begun, unless the mother has excellent support and information about lactation, there is a downward spiral of events that leads to either overwhelm in the mother who decides it's not worth the effort to continue breastfeeding, or her milk supply gets diminished from the over use of formula.

So, without thinking twice about the effects of surgically extracting babies early just because they are twins, this doctor has created unnecessary problems, difficulties, and hardships for a mother who already has double the work ahead of her in the best of circumstances.

Why do obstetricians do this? What are the evidence-based, scientifically researched data that support the idea that twins shouldn't or can't be born vaginally, or at full-term? If there is some reason they shouldn't be born vaginally, why not wait until labor begins and then do the surgery? Why do obstetricians turn a blind eye to the effects of their actions on the baby and the family after birth?

And they have the audacity to call home birth risky?