June 12, 2006

WHO: Show Us You're Breastfeeding!

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"Breast is Best" is apparently not good enough for the World Health Organization and the Dept. of Health & Human Services, who have instituted a new awareness campaign claiming that not breastfeeding is actually risky, for both a mom and a child.

There's talk of putting warning labels on baby formula, and ads equating bottlefeeding with getting thrown from a mechanical bull while pregnant. Classy. The campaign's goal: bump up the % of kids who get breastfed for 6+ months from 33 to 50.

And just in case you haven't heard every possible benefit, risk, and talking point in the breast vs. formula debate the NY Times article goes through them all. [Except, of course, for any mention of common breastfeeding complications or difficulties like mastitis, or any discussion of why women stop breastfeeding when they do.] Get ready to man the pumps, because there's a guilt wave a-comin'.

Breast-Feed or Else [nytimes]

25 Comments

To equate using formula with being tossed from a mechanical bull while pregnant? WHO is being irresponsible and, in fact, cruel. How can anyone trust an organization who is prone to such hyperbole and meanness.

I would ask that you read the article carefully and see that science supports WHO. They have to attract attention to cut through all the advertisements for formula, doctors who jump to supplement too soon, and lack of support that women in the U.S. get for breastfeeding. It is an important enough health crisis to warrant the means.

[it's definitely a change in tone and approach from the warm, snuggly 'breast is best' campaign. I'd just like to see a bit more acknowledgement of the often-difficult realities of breastfeeding, too. And some efforts that address the reasons women stop (or don't start). Because until that happens, there's going be a lot more guilt and pressure and inadequacy before there's a lot more breastfeeding. -ed.]

Great! Just what American mothers need--more guilt.

It's too bad the guilt won't come with any actual policy changes like paid parental leave, social security benefits for non-employed caregivers, or workplace accommodations for breastfeeding mothers.

WHO may have science on its side, but, as usual, actual parents have nobody on their side.

Sorry, fellow posters, I didn't read the article as negatively as you did. My wife continues to exclusively breast feed our 20 month old son. She has definitely endured the hardships mentioned, but also an unnamed difficulty: Older generational women who criticize her for breast feeding AFTER six months!!!

[After surfing through the HHS breastfeeding campaign site, the risks/negative info is clearly offset by a lot of benefit and upbeat howto information. But there are still links on the front page to some fairly strident and/or poorly argued critiques by breastfeeding activists. I think it's safe and easy to acknowledge the cluelessness of women who raised kids in the breastfeeding-is-for-commie-hippies age, bless their hearts (hi, Mom!), but scaring or browbeating conscientious parents into doing something still bugs, even if it's "good" for the kid. -ed.]

The breastfeeding advocates need to focus their ire on the companies that women work for, rather than guilting the women themselves. If companies did a better job with maternity leave (3 months is nothing!), lactation leave, etc and if insurance companies covered lactation consultants then maybe more women would breast feed.

Also, it's not exactly easy to bf, as the bf advocates imply. Our Dr. Sears book was excellent, except for the fact that they refused to admit how hard it would be to bf, let alone the fact that many modern women who are used to fulfilling and demanding careers find bf-ing for 8+ hrs a day to be a huge challenge. My wife actually began to resent bf time b/c it was so wearisome on her nipples (blisters!), challenging for our colicky-little baby, and took so long that it left little time for bonding with our infant in other ways or even managing simple household tasks. Thankfully, we had a great, supportive doula and a lactation consultant who wasn't a militant, so we've made it to the 7 week mark and my wife has become a champion bf-er.

Until bf advocates like those in the NYTimes article make a more concerted effort to realistically address the challenges of bf-ing in the modern world populated by working women then they can give up hope of increasing bf rates in America.

ps -- there's a LOT of ridiculous assumptions made by the bf advocates re: childhood obesity rates and non-bf babies. For example, high obesity rates correlate equally with poorly-educated families, less-wealthy families, families that rely upon fast food diets, AND with non-bf-ing families. Which one causes the obesity? It's far more complex (and interrelated) than laying the blame on non-bf-ing. Sorry to say it, but bf-ing will NOT save the world. It's harder than that.

I'm really surprised at this idea that just because Breastfeeding is "hard", women shouldn't be encouraged to do it. What part of parenting is easy? It's "hard" and inconvenient to change a diaper in a restroom that has no changing table? I guess that means that we should feel OK about leaving our baby in a dirty diaper instead.
Breastfeeding is a learned skill just like every other parenting skill. There are people all over the world who are trained to help breastfeeding moms for free. If there is pain with breastfeeding, something is wrong and help should be sought. In actuality, the number of women who "cannot" breastfeed is far smaller than the general populus thinks.
Why is this campain to hard to understand? There is nothing risky about breastfeeding? There are an abundance of benefits for moms and babies alike. But it's "hard"? What about children who are allergic to cow's milk or soy? What of those babies? Is it too "hard" for their moms to do what's best for those children? Look at the science and the studies. Why are people coming to the defence of formula companies who go into third world countries and push their imitation breastmilk causing impoverished people to think they can't feed their babies without this product. This is who is being championed?
This campain will raise awareness. Awareness will put pressure on the employers of moms to provide the needed services as well as the moms themselves. Don't think companies aren't going to be pressured as well.
Today expectant moms have access birthing classes and now need access to breastfeeding classes. I am a La Leche League breastfeeding peer counselor and provide classes and couseling and in-hospital or in-home visits to help women breastfeed successfully. This is all free. This is also what should be the norm. Women regaining the confidence to do what's best for their babies with the help of women who've been there. Regardless of income.
Just one more comment about the difficulty of breastfeeding. Imagine it's 3am. Your darling baby is crying to be fed.You can: a. get up, get baby, go to the kitchen, warm some water, mix a bottle (baby still crying-maybe your spouse is up now too), sit, feeding your baby (because letting a baby sleep with a bottle will ruin their teeth), then lay baby down and go rinse the bottle. Now you can go back to sleep.
b. Get up, get your baby, lay down in bed, latch-on baby, go to sleep.
If you don't like co-sleeping you can do what I did with my first. I nursed in a rocker and slept. I woke up a while later and put my sleeping baby back in her crib.
Which is "hard"?
Breast IS best, that has been proven over and over again. Formula companies are raking it in. There is even an ad at the bottom of this page for formula and bottles but none for breastpumps or breastpads. I know we're a society that doesn't want to feel guilty about any of our choices. But this shouldn't be about guilt. It should be about education for women to make informed decisions that provide the best care for their babies. And besides which, is the possible guilt of some moms more important than the health of the children?

[thanks for proving my point by twisting my and several other peoples' comments to make your manipulative argument. Breastfeeding is great, it's best, it's best for kids. But people need to be given all the relevant information to know what they MIGHT be getting into. And conscientious, well-educated parents deserve to have facts presented before them to enable them to make their own decisions without being condescended to and treated like whiny infants. It's not bf or even this campaign about risks that I object to, so much as the rapid reversion to guilting and condescending pressure that lactivists start dealing out at the first equivocation.

I didn't hear the word 'mastitis' uttered ONCE before we ended up in the ER, but once we were 'initiated,' the stories started flowing in from all over. Three months of nursing and pumping and three trips to the ER later, my wife decided to transition the kid to formula. On the advice of two doctors. But we also opted to introduce the kid to a bottle so that I could do nighttime feedings and let her sleep. Sometimes it was breastmilk, sometimes formula.

As for "defending" formula companies, where is that happening? Is anyone here trying to get African moms hooked on formula? No, so keep that straw woman argument out of the discussion, please. When I posted this article, I had no intention of starting a flamewar about bf; it doesn't benefit anyone, least of all babies. I've also given the new campaign credit for providing more balanced info than the NYT made it sound like. But don't go blowing it by throwing LLL shade around. -ed.]

Even up here in socialized-medicine land, we encounter some breastfeeding challenges. I have been incredibly frustrated the last 3 weeks since Throkette was born because all of the information I can find plays down the idea that there are problems that cannot be solved through correcting latch or positioning.

Articles like this accomplish nothing in this household, other than making me us feel like crap when, after breastfeeding and pumping, we have to give Throkette a bottle of formula to top her up, thanks to a true hormone-caused supply issue.

Admittedly, without the free lactation consultant support, home visits, a supportive doctor and family and a midwife who will research the problem to the ends of the earth, i probably wouldn't even have endured these first 3 weeks of attepting to boost a milk supply, so i can understand how difficult it must be for someone with no support.

How about, instead of sinking money into freaking warning labels and ads, they take that money and put it towards more support of nursing mothers so they can attempt to solve the challenges that do come up, especially in those first few sleep-deprived weeks when the biggest challenges do occur. Oh, and some big foam clue bats to thwap people who voice their opinions about which babies are too big to breastfeed. that would be super.

Do we whine about being pressured into strapping kids into carseats, abstaining from smoking while pregnant or around children, drinking during pregnancy, heck, taking aspirin during pregnancy? Why the whining about the proposed advertising being heavy handed?

The bottom line is that breast isn't best, it's the only normal form of infant feeding. Formula is a weak imitation. If women feel guilty when this is pointed out, perhaps they realise that they've made a poor parenting choice? Otherwise, why feel the guilt?

Three months ago I was a hard-core, militant lactivist in-training. I was going to breastfeed for years. I judged anyone who pointed a bottle at their kid's mouth. I seethed at the forumula promotions that popped up in our mailbox throughout my pregnancy. I swallowed anything La Leche League said as gospel. All my friends who were mothers nodded with enthusiasm and cheered me on towards the ultimate expression of motherhood. Then my daughter was born and I came crashing down to earth. I was severely dehydrated after her birth and sick with an infection. My daughter refused to suck. The lactation consultants tried over and over to latch her on, all the while laughing that she was one of the most difficult babies they had ever seen. Meanwhile she was becoming dehydrated and jaundiced. 48hrs and no wet diapers later, even my untrained eye could see that she didn't look well. We tried giving her formula via a catheter tube taped to my breast, then a finger feeder, and the liquid just poured out the sides of her mouth. Much to the disappointment of my lcs, I made the decision to try a bottle and I stand by that decision. My milk finally came in - over a week later (...so what would have happened to my daughter in the meantime if I had refused to give a bottle?)
She has never been able to latch on, and yes we tried hard and met with experts but in the end I was not going to let her starve to satisfy a social agenda. When my milk finally came in I began pumping around the clock everyday. After 2 months, I still only got approx. 20ml of milk per breast every 2 hrs. Now I'm on a Reglan prescription to increase my production.
My daughter gets pumped breastmilk exclusively, no formula supplement. If you think it's bad having old women come up and harass you for nursing a toddler, try pumping every 2 hrs week after week, even overnight, just so that your baby can have the holy breastmilk, and then having militant lactivists lecture you at the mall because they don't realize the bottle you are giving your baby is filled with pumped breastmilk, not evil formula.
A funny thing happened as a result of all these difficulties. One by one, many of my friends began to speak up and share stories of how alone they felt when breastfeeding didn't come naturally. Many of them tried to seek help from LLL, only to be completely alienated by the attitude of "well if you can't make this work then maybe you shouldn't have even had a child!" If you don't think this sentiment is out there and thriving, you're wrong. Moms don't need this kind of mean-spirited negativity.

Man, it must be tough to be a perfect parent and breastfeed and not make any poor parenting decisions...

I also didn't realize that formula feeding could cause death or serious harm (like not using a car seat), or lead to birth defects (like drinking and smoking).

Yeah, sure, some parents just don't feel like breastfeeding, so use formula, but to generalize like you did really pisses off those parents who tried their damnedest, including paying out of pocket (yeah, south of Canada, that's what we sometimes have to do for heathcare) for lactation consultants, to try and try and try to breastfeed. Don't think some parents don't shed many tears when they finally have to decide to stop trying to breastfeed after they've invest so much emotionally, time-wise and, least of all monetarily.

I've never made claims that parents who try hard and don't succeed with breastfeeding are bad parents. I've never claimed to be a perfect parent. But, if you feel guilty about a decision you made, why do you feel guilty? Is it because you made a decision against your better judgement? Is it becasue you know the choice you made was a poor choice?

I know how heartbreaking it is to try and not be successful, and I know how sad it is to have to end a breastfeeding relationship you don't want to end. But, WHO isn't targetting parents who pursued all avenues and still were unable to solve their problems, they are targetting people who think formula is equivalent to breastmilk, people who can't be bothered to even try breastfeeding, people who have been manipulated culturally to think breastfeeding is inferior to formula feeding and people who believe the b.s. written by the advertisers working for formula companies.

And, yes, there actually is a risk of death, sickness and deformity if you choose formula over breastmilk. In the third world, many children are malnourished due to unsanitary water, watering down formula and having free samples dry up when they can't afford to buy formula and alternative food sources are grossly inadequate. But, even though this is prevalent in the third world, does not mean it doesn't happen in North America. The risk may be smaller in the US, but it is still there.

[ugh. first off, I don't breastfeed and never will, because I don't have breasts. And if women feel guilty about giving up br-- never mind. I will only get even more pissed. Throwing up scary "it could happen!" scenarios to make a point is not productive. At some point, people need to get over their urge to be "right" about what other people "should" be doing and just mind their own business. Present the facts, the studies, the data, pro and con, and let people decide for themselves. -ed.]

For the first 6 weeks of breastfeeding, I screamed in pain every time my daughter latched on to my left breast; on day 2, thanks to my day nurse who was "correcting" the latch, my nipple was badly hurt. No one ever told me how hard and painful it could be. But after 6 weeks it did pass. We had a great doula (trained as a lactation consultant), and my husband helped.

Our doula turned me onto a great resource, Dr. Jack Newman. He has a number of books out as well as a website and video. People who have had serious trouble breastfeeding and who have gone to him report that although he is a great activist for breastfeeding, he is no militant, and does not avoid putting babies on supplemental feeding when it is needed. Here is the link to his website: http://www.drjacknewman.com/

Frankly, I was put off by the LLL literature I was given. I am a supporter of breastfeeding, and wound up exclusively breasfeeding my daughter for 18 months (and boy did I get a lot of flack for breastfeeding past 6 months!), but was put off by the position espoused in their literature. It doesn't do a good job of engaging or comforting women; frankly, I found it scary and intimidating!

Fortunately, Dr. Newman is very reassuring.

Please don't take this as a spam post, I think it is very relevant to this thread. Please don't make any judgements until you've read all the information. I'd appreciate any feedback you may wish to offer. Please check out:

www.bottleslingguy.com

especially the "Breast V. Bottle Debate" section.

Holy blowing it out of proportions Batman!!! There are some angry parents out there! What is going on?!?

I have enough trouble trying to do what's best for my own kids. Bf, don't bf - do what works for your family and feel good about making decisions based on your individual family and its individual needs.

yes, quite a spirited discussion. clearly, people should do what they feel is best for themselves and their families. the only creepy thing about the NYT article to me is that the fear of 'feelings of guilt' is a reason to not indicate the potential consequences of formula on the package. not everyone knows the issues. it seems like a 'warning' lablel, or perhaps an 'information' label, with directions to a balanced website (i know, there is no such thing as a balanced website when it comes to parenting) could help informed decisions be made.

We don't feel guilty. We feel a bit sad that we couldn't bf, but not guilty. But the way you word it is as if we SHOULD feel guilty because we made a BAD CHOICE, implying (a) it was totally a choice, and (b) that we ought to feel guilty because we are in some way damaging our child for life.

Personally, I think having militant parents is more damaging to a child's development than whether they were on breast milk or formula for a year.

People will have to make the descision based on what works for their family, but what the government should be doing, is making it easier for women who do want to bf.
I pumped for over a year after I went back to work. I didn't have an office and had to go up and down the hallway 2-3 times a day, begging to borrow an office or a cubicle with a door. The only other option was the disgusting bathroom that didn't even have a plug near a stall or covers on the toilet seats to sit on.
There are still women getting kicked out of stores and public places for nursing. Barbara Walters doesn't want women nursing on airplanes (keeps the kid quiet and pressure on the ears)
Until these thngs change, some women will not be able to nurse or pump after 12 weeks.

People will have to make the descision based on what works for their family, but what the government should be doing, is making it easier for women who do want to bf.
I pumped for over a year after I went back to work. I didn't have an office and had to go up and down the hallway 2-3 times a day, begging to borrow an office or a cubicle with a door. The only other option was the disgusting bathroom that didn't even have a plug near a stall or covers on the toilet seats to sit on.
There are still women getting kicked out of stores and public places for nursing. Barbara Walters doesn't want women nursing on airplanes (keeps the kid quiet and pressure on the ears)
Until these thngs change, some women will not be able to nurse or pump after 12 weeks.

Interesting article. Personally, I can see where a little more aggressive approach is not totally inappropriate, though the mechanical bull thing is a bit over the top. I am still nursing at 11 months, but I have a job where I was able to take off for six months (not paid, but saved to do it)....and came back to a private office for pumping....and work a schedule that enables me to still nurse morning and night. That's not true for all moms by any stretch. And it's STILL hard! I hate to see more pressure and guilt laid on moms where the societal support is just not there. Sucks.

I don't think it is a national law, but at least in Connecticut, I believe companies of a certain size are required to provide a private room for women to use for pumping.

I know we have a couple "Mothering Rooms" in our new building here...

guilting women in a society that just isn't conducive to extended breastfeeding is ludicrous. as GFR said, fix the culture, don't snark at parents! i used to work at a women's TV network. there was no childcare (the promised on-site day care center was instead turned into a computer center--just before the dot-com bust, oops). since only senior management had doors, the producer of the show about motherhood, a new mom, had to pump in the bathroom or lighting closet. (she asked to work from home a couple of days a week but was rebuffed.) once the horndog lighting guy walked in on her, pumping in the closet. finding this hilarious, a junior producer presented a bejewled commemorative breast pump to her on air. hyuk, good times. she quit a few months later.

pumping mom, brava for persevering. i had a similar (tho not so bad) story--baby who couldn't latch, plugged ducts, mastitis, finger-feeding, cup-feeding (no bottle! nipple confusion! aaaah!). i spent over $900 on a lactation consultant, which i fought with my insurance company about for over a year. i took four months off work. not everyone, obviously, has this option, tho the militants simply refuse to see this truth.

two things i felt the article didn't say: 1. it didn't address correlation vs causation. yes, breastfed babies tend to be healthier--they're also more likely to be born to wealthier, more educated, white mothers...all factors also correlated with better health in the USA. there are few good studies on the benefits of breastfeeding, because how can you have good controls? plus, of course, the cost of major longitudinal studies... 2. major change in formula after 2001, the year essential fatty acids were added. a few months ago i interviewed a huge attachment parenting expert (not sears--a scientist) who freely acknowledged that formula today is a whole different deal than formula a decade ago. he, and all the scientists i talked to, agreed: if breastfeeding is painful or a huge source of stress, better to use formula than to have a suffering, sick, depressed parent.

my fave crazy judgmental boob-brownshirt story (sorry to rant, greg) was when my friend took her baby to a conference in another state. she was fortunate that her mother could come with her to care for the baby while she was attending and presenting. she pumped during breaks. one day her mother was feeding the baby in the lobby while my friend gave a speech. a drive-by expert snarled at her, "YOU SHOULD BE BREASTFEEDING THAT BABY!" (my friend's mother looks young, but not THAT young. she's in her 60s.) i know of another woman who was sniped at for not breastfeeding a baby born with a cleft palate. um, NOT PHYSICALLY POSSIBLE. the drive-byers response: "well, you just haven't found the right lactation consultant." feh.

I agree that until this culture can support all parenting choices, be it formula fed or breastfeeding, then we're all lost. Government, employers, health insurance companies don't support woman or families. The last thing Moms should do is create an even more divisive culture, and yet, that's what we do.

Formula has been around since 1900. Doctor's told mothers that it was better, cleaner & healthier and to stop breastfeeding. And woman took to it, so much so that breastfeeding became obsolete until the early 60's and the rebirth to all things groovy. That means in all likely hood your great-grandmother fed your grandmother formula, and she grew up and gave birth to your mother, and fed her formula. Because that was the standard practice in America for 60+ years. You've all grown up healthy.

So stop picking on new Moms and stop supporting woman's groups who use negative ad campaigns to further their cause. Let's support one another, and we'll all move on to other issues. Like better benefits and social security for stay at home parents. Because if we don't no one else will. But if we cannot get over the playground mentality of I'm better then you, we collectively will never get anywhere.

this might have already beed said but babies do not hardly ever exclusively breasfeed past six months- showing a graph of trailing numbers at this age is natural. have you ever had a baby grab for your food? they want everything.

I have to stand up for the WHO after reading the article carefully; it was not the WHO that was guilting mothers into breastfeeding, but rather, U.S. public health authorities. Some U.S. marketing genius gone mad, with a very heavy-handed message is responsible for the mechanical bull, not the WHO.

The WHO was targeting its messaging elsewhere, as there are serious concerns that in developing countries children are dying from infectous diseases because they are not being breastfed. While formula companies may no longer be pushing their product (?), the message that formula is better and more prestigous than breastmilk has somehow managed to spread, cutting breastfeeding rates.

And just to correct the misconceptions about the Canadian healthcare system and what it DOES and DOES NOT pay for: lactation consultants are rarely covered by provincial plans. They are covered while in hospital (if you happen to give birth on a weekend you are usually out of luck) or through extended private health insurance. Most Canadians have to fork out the dough, just like Americans.

Since we have much more supportive maternity benefits in Canada -- national employment insurance premiums cover the majority of mothers for a year at part salary (to a set maximum), and many employers cough up the rest (I was fortunate to have 93% salary for 12 months, which my husband and I split -- he took 2 months), you might assume that the breastfeeding stats here are healthy. You would be wrong, because they are not much different than in the U.S.

While 85% of Canadian women try breastfeeding, by six months, less than 12% still breastfeed at all (and the recommendation is for a full 12 months of breastfeeding). There is a huge drop-off in breastfeeding by the 6 week mark.

If we have so much more support with respect to maternity benefits than in the U.S., what goes wrong?

Well, just like in the U.S., there is little support once you get out of hospital, and if you have severe problems, good luck getting in to see a lactation consultant -- they are few, far between, and heavily booked. We were lucky that our doula was able to help, otherwise, I know that I would have given up on breastfeeding -- the pain was excruciating, and the whole experience horrible. And six weeks of horrible (especially if you are exhausted and recovering from a Caesarian) seems interminable. A friend who had a baby at the same time was just about to give up on it (her baby would only feed on one breast, he had a poor latch, and was not gaining well), but then her husband had a heart attack, and she needed to sneak the baby into the hospital with her, and the only way she could keep him quiet was to keep a nipple in his mouth, and somehow, they got the hang of it. Almost everyone I know wanted to quit by 6 or 8 weeks, and by then, most people had no support left.

Grandmothers for the most part know little about breastfeeding, as the majority bottle fed and were likely bottlefed themselves. So not only are they not able to transfer the skill and provide support, many actually pressure their daughters and daughters-in-law to use formula (they used it, they are comfortable with it, and often are very uncomfortable with breastfeeding). It happened to me with my mother-in-law (and she actually persuaded her own daughter to give supplemental formula and cereal at 2 months, and stop breastfeeding entirely by 6) and all my girlfriends. (funny, come to think, in my circle, only the super-stubborn ones with antagonistic relationships with their mothers stuck it out...) As well, even though my mother actually breastfed me, she really hasseled me to stop after 6 months, when she herself stopped. "Do as I did", and "learn from me" is the pattern.

Get the picture? (no, I am not saying it is Granny's fault, not exactly...) Our culture has unlearned the art of breastfeeding, and most people think it's no big deal. Public health authorities in both the U.S. and Canada want to disabuse people of the notion that formula is equal to breastmilk; although it may be better than it was a decade before, it still cannot compare. And no, all those people who grew up on formula were not healthy, and likely not as healthy as they could have been with breastmilk...penicillin and vacination may have mitigated the spread of infectious diseases, but researchers look to the phenomenon of formula for the incredible rise of allergies in western countries in the modern age...likely not the sole cause, but definately a significant part of the equation. They want formula to be used only by those who cannot breastfeed; and let's face it, the vast majority of those 88% not breastfeeding at 6 months in Canada are not doing so because they cannot breastfeed, but because they don't think it is important to keep breastfeeding, and because they believe that formula is a good alternative.

[thanks for the detail and added perience. I'm counting the days for some HHS ad guy to come up with the "blame grandma" campaign. -ed.]

Ha ha, this whole thread reminds me of why I don't allow breastfeeding conversations on my site! Many people are very passionate either way about BFing vs. FFing.

Anyway, I wish the money being spent towards the marketing campaign was being put towards education during pregnancy on the benefits of BFing for mother and child, at the hospital and then with follow up lactation support.

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