The Call to Action on Breastfeeding: What it means to formula feeding parents

The CDC, Department of Health and Human Services, and Office of the Surgeon General have recently initiated a Call to Action on Breastfeeding. According to the HHS website, “life in America often creates barriers to breastfeeding and makes it hard for women to breastfeed. It is time for our society to get serious about giving families the support they need to be successful with breastfeeding. For this reason, the U.S. Department of Health & Human Services (HHS) would like to open up a national dialogue on how to make breastfeeding easier in this country.”

The rest of the website is committed to suggestions, received through an anonymous online comment form, from people identifying themselves as “concerned citizens”, “health care workers”, “breastfeeding coalition members” and so forth. These suggestions run the gamut; most are excellent, offering concrete and logical ideas, about such things as pumping rights for working moms, on-site daycare options, free lactation consultant home visits, and longer paid maternity leave. There’s also a lot of concern about normalizing breastfeeding in our society, which is so important, in my opinion… some of the crap I see on Twitter, and the whole Facebook debacle (not allowing women to post photos of themselves breastfeeding), let alone the insanity of nursing moms being kicked out of public places like Target…it is truly sickening. So if that is the goal of this “call to action”, I support the initiative fully.

However. (Isn’t there always a “however”?)

Some of the other comments – a large enough number to make me break out in a cold sweat – hint at a not-so-distant future where our rights as formula feeding parents (and I say parents, not moms, because I don’t want to alienate single dads, primary caregiver fathers, or gay partners who adopt, because they are a welcome part of our FFF group too) are in jeopardy. It took me the better part of an hour to just get through the first few pages of comments, but there were a few in that small sample that I want to bring to your attention, along with my take on the inherent dangers in these specific suggestions (all are copied directly from here, so don’t blame me for the grammar or spelling):

Formula supplementation should be treated as a pharmaceutical intervention and should only be allowed under certain medical conditions at the direction of a health care provider who can write orders for pharaceuticals. Formula supplementation should only occur with expressed permission of the mother. 

 I have been involved in lactation since its inception as a clinical area. We would go a long way towards human milk as the only human infant food if infant formulas were available to the general public only by prescription. This forces the HCP as well as the infant’s caregivers to think twice about using infant formulas instead of mother’s milk

I find this concept (expressed by two separate posters) particularly frightening. Formula as a pharmaceutical, available by prescription only? This would mean that your doctor would have to deem your situation “sufficient” for formula. Let’s say a woman was sexually abused and has emotional reasons for not wanting to nurse. Is this a legitimate “medical reason”? What if a woman has postpartum depression and does not want to take the risk of nursing while taking needed antidepressants (and until there is more long-term research done on the effects of certain newer medications on nursing babies, she would have every right to feel that way)? Or what if she just doesn’t feel comfortable sharing her emotional problems with her pediatrician or, for that matter, her insurance company?

Establishing breastfeeding guidelines that would require a home visit within 24 hours to check on the family and breastfeeding by a trained lactation specialist, as well as an increase in post-delivery visits with the pediatrician and a lactation specialist in order to provide the mother, child, and family with continued support in breastfeeding.

I love the idea of more professional support for those who want to breastfeed – but a “mandatory” check on breastfeeding? Umm, sorry, but that seems like a crazy invansion of privacy. Plus, I was a mess when I first came home from the hospital. The last thing I would have wanted was some stranger butting in to my private affairs, especially after having to get my hoo-ha checked by random nurses and doctors every 5 minutes for three days straight.

There is a major disconnect between OBGYNS,Pediatricians, nurses and new mothers in the hospital and before birth. There must be pre-birth dialogue between these practitioners and the patient/client about the benefits of breastfeeding and the shortcomings of formula. The government needs to do more and make these conversations mandatory.

Again, the concept of government intervention in my private medical interactions makes me queasy. (And Dad, if you’re reading this, I know you’ll use that comment against me in a debate about health care reform. Please don’t. 🙂 ) And the “shortcomings of formula”? The science is NOT clear on this. It really isn’t, guys. There are definitely studies proving the benefits of breastfeeding, but as we’ve discussed before, this is all about calculated risks. The benefits of a happy mom outweigh the statistically minimal “shortcomings” of not breastfeeding (and for many of us, there are health benefits to this as well, considering our babies could not tolerate breastmilk, or were unable to nurse).

Companies or the government should offer some sort of pay for maternity leave. If a woman is breastfeeding, FMLA leave should be extended to 6 months (does not all have to be paid) as this is the recommendation by AAP and WHO when babies should have SOLELY breastmilk.

This one is tricky. I would love to see women getting paid maternity leave. But I’m really not sure this would help raise breastfeeding rates.Most of the women I’ve heard from didn’t stop nursing because they went back to work – there were much more specific and troubling issues going on. And on the flip side, I know plenty of women who went back to work after 6 weeks, but have faithfully pumped for the recommended year and enjoyed a wonderful nursing relationship on weekends and in the evenings/mornings. I wish we could support paid and extended maternity leave simply because it is better for all primary caregiver parents and all babies in every respect, not just for feeding. A bottle-fed baby still needs it’s mom or dad around, you know?

Breastfeeding saves employers sick days, saves the parents money, saves the environment because there is nothing that goes into manufacturing it. Breastfeeding mothers should be offered a tax credit by the government.

That’s all well and good, but considering my child has a medical reason why he needs hypoallergenic formula, could I get a tax break too? Breastfeeding is free, at least according to the person who made the above comment… special formula is expensive. I could really use some extra cash from Uncle Sam to pay for it…not to mention the thousands of dollars I spent on lactation consultants, pumps, etc. when I was struggling to nurse.

When doctors give free well baby visits to those who are breastfeeding exclusively, that will increase the rates, too! I knew a doctor who did this in southern California many years ago..

Wow. I’m not even sure what to say about this one. Can we at least include children whose parents had a legitimate reason to feed formula in the mix? Oh yeah… then we’re back to that other sticky wicket: who determines what makes a “legitimate” reason?

A recent journal article showed that more pediatricians now have negative attitudes about BF and a lack of faith in women’s ability to effectively BF than in 2004. Women turn to their baby’s pediatricians for knowledge and support. We must provide better education to them and skills training regarding human lactaion & supporting BF.

Umm… could this be that pediatricians, the EXPERTS on child health, might not be entirely convinced that breastfeeding is the magic elixir it has been made out to be? (Again, I am not saying that breastfeeding doesn’t have many wonderful benefits…but I believe people should do it because they want to, not because they are scared or guilted into it, and I’d bet that a lot of pediatricians feel likewise.) They should support breastfeeding, without a doubt – I know there are doctors out there who make things hard on nursing moms, and that is inexcusable – I would suggest finding another doctor if you’re in this situation – but the fact that many have “negative attitudes and a lack of faith in a women’s ability to nurse” could just be a result of seeing too many women struggle, with negligible results for their children’s health. As my pediatrician said, “Nearly all my patients are or were breastfed for at least a year, and let me tell you, we get PLENTY of sick kids.” She believes that daycare is more a problem than what the kid is eating in that first year.

Using that logic…we’re back to longer, paid maternity leaves for all parents – gay, straight, formula feeding or breastfeeding… wouldn’t it be nice to see that as a “Call to Action”?


Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.

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15 thoughts on “The Call to Action on Breastfeeding: What it means to formula feeding parents

  1. Ack! Those comments are SCARY. I could go point by point, but I agree with you 100%, so there's really no need.

    I'll keep spreading the word about your blog. I think it's important for people to read your thoughts on these things. You really shed some light on these issues. 🙂

  2. As one of the people that have emotional reasons that you mentioned not to nurse… these comments scare the hell out of me.

    Thank god I live in this country.

    And thank god i hav ea public health care system where i don't have to explain stuff like this ti my insurance companies. Infact while im on that subject… thank god i don't have to fork out money for insurance either!

  3. As usual, not a single mention of how difficult breastfeeding can be for some mothers and babies, and not a single mention of how physically and emotionally onerous it can become. No word on how frequently the so-called lactation experts fail to provide any useful, workable advice. Not a single attempt to balance the benefits of breastfeeding against the cost–nope, we just assume that the benefits are exponentially grand and the costs are dreamed up by the evil formula manufacturers and the selfish, worthless mothers who formula feed.

  4. How frightening! I fear I wouldn't have gotten the “medically necessary” approval for formula feeding. Our original pediatrician was not supportive of my stopping, even though I was sitting there sobbing and shaking saying, “I'm just so miserable!” She looked at me with shock and disdain and said, “So, it's just too hard for you, then.” We ended up switching peds eventually, but not until they started blowing off Gabriella's feeding issues, and took forever to accurately diagnose her with the GERD she had been battling since day one. But, most people don't consider my psychological problems a “good” reason to stop breastfeeding. I imagine I would have been given a less effective medication, and told to just continue breastfeeding. How scary. I hate to think of what may have happened in that scenario.

    I think it's great to support breastfeeding, and I do think that most women should try it, but I don't think that supporting breastfeeding should require making formula feeding nearly impossible.

    Also, I do agree that daycare is a much bigger health issue than anything else for our children, and longer paid maternity leave would be nice. I didn't get ANY paid leave, but was fortunate enough that my tiny income didn't effect our finances, so I was able to quit my job and I won't go back until Gabriella is in first grade (and after I get another certification, in hopes of getting a better job) 🙂

  5. I wonder if each of those people making those comments also have the same feelings about the right to choose (abortion). Are we going to have consultants come to the homes every so often during a pregnancy to make sure the woman is still pregnant? NO, because a women has a right to choose what happens to her body, right? So why do they view BF differently? Its still a womens body!! Its still her choice what to do with her breasts just as she can with her uterus.

    I am with you, I don't get it people's logic with this. FFF is NOT detramental to a baby's health. If they are so worried about what kids eat, they should also be petitioning to McDonalds to not allow them to sell their food to children. I am sure many BF moms went on to their their school age children scarf down happy meals at their leisure.


  6. Wow- formula by prescription? Seriously? Could you imagine the millions of dollars spent on parents going to see their doctors to 'renew' their prescription? (Here in Canada the gov would pay for it, but I imagine in the US that cost would be passed on directly to the parents.)

    Also, here in Alberta Canada we do have a system where new Moms are required to either have a nurse visit or go to the public health nurse clinic within 24 hours of getting home from the hospital- mostly for breastfeeding support. I had a TON of support from nurses, lactation consultants and lactation doctors and it still didn't help.

    Also, I might add that in Canada it is very common for women to take a full year maternity leave as we are eligible for 55% of our income for a year from the government. Some employers top that up to close to a full salary for part of the time. And our breastfeeding rates are pretty much the same as the US, I believe. Not that I don't support paid Mat leave in the US- I do!!

    I am not saying I don't support some of the less extreme suggestions for how to increase breastfeeding rates- but I think it needs to be based on why women ACTUALLY stop breastfeeding. I know why I did- but I think there needs to be some serious research in to why most of us do.

  7. I think pediatricians need to get better education on nutrition in general – whether that nutrition is coming from breast milk, formula or solids. While I love my pedi, I was told to just “trust my instincts” when it came to how much and how often to feed my son. While that is great in theory, my instincts were telling me to hand that baby over and run for the hills at that point!

  8. I highly doubt formula would be available through prescription only. I've heard of some moms wishing it were that way. I could just imagine the hiatus it would cause and the protests.

    Anyways, I do like the idea of making home visits with LC's possible. I remember wishing someone were there to help me with night feedings because that was when it was the worst. That was also when I quit because I had no idea what was going on, he just kept screaming and screaming and I had nothing for him and was in horror over the idea of feeding again when it had been 3 hours already and I was in pain. I really wished I could have had an LC come and help me even though it was 3 in the morning.

  9. Great comments, guys!

    Meghan – your point about abortion rights hits home with me. Funnily enough, my husband said the exact same thing when I was telling him about this post. Guess great minds think alike.

    Andrea – I hope you're right (about formula not becoming a pharmaceutical) but this is not the first time I have heard this particular call to arms. The formula companies will certainly fight to make this impossible, and so I also don't think it would ever come to fruition… but I don't know. A few countries have already done this, and I do think that with enough pressure from high-powered government organizations like the ones involved in this Breastfeeding Call to Action, it could come to be reality in our country as well.

  10. I had no idea other countries had done this. I really hope it doesn't happen here and that formula companies fight it. While they have their downside, they also have a good side as well.

  11. What really, really gets me is people focusing on what they're “against” rather than what they are “for.” Why the need to trample others' rights and choices when you could support and nurture your cause (in this case, the promotion of breastfeeding) in a positive way? This approach would lead to the place you arrived, FFF: a focus on issues of paid leave, pumping rights, etc. That is how you enable more women to successfully breastfeed, while not alienating those who can't or choose not to. In fact, all women would benefit, and all women would be more free to make the best choices for them.

    FFF, I think you demonstrate my point. You are championing formula-feeding rather than attacking breastfeeding. Lactivists could learn so much from you.

  12. Formula by prescription would be an absolute disaster… We would end up with people Dr. shopping, people making homemade formula, a formula underground perhaps? Who knows… Ironically a big winner would be Nestle and their evaporated milk…

    I know my area has a very high rate of breastfeeding for Canada, but yeah, I know of many Canadian women who change or choose to formula feed.

    As for mat leaves, wow, I guess those formula feeding women should head back to work right away since obviously there is no other benefits to have a parent home for the first year :roll eyes: .

    I guess I probably shouldn't have another kid according to some of these women since I will start back with my SNRIs once I give birth.

    Sigh… I so support breastfeeding rights, why do a vocal few feel they need to take away my right to decide how I feed and raise my child(ren).


  13. While I absolutely appreciate each and every mother's individual situation, I feel that I must stress that there are not mere benefits to breastfeeding. There are risks to not breastfeeding. I think that every woman should ALWAYS have the right to choose what to do with her body, no matter what — so I am just as horrified as everyone else about the idea of formula by prescription and invasion of privacy. However, I want to point out that the Call to Action is not about individual mothers and their individual choices, but about reducing barriers in all aspects of today's society. That includes cultural ideas about the breast as a sex object, inappropriate advertising of formula products, and the completely horrific maternity leave and pumping rights policies in America. By the way, America is one of only FOUR countries in the ENTIRE WORLD (developed and developing countries) that has no mandated paid maternity leave. It's disgusting. And I agree that paid maternity (or parental in general, preferably) leave should be for everyone, not just breastfeeding mothers.
    I support you all, but I hope you don't think that the Call to Action is about anything but societal barriers. It's not about individual choices.

  14. First of all, formula is FOOD, it's not a drug. Not only is the suggestion nothing but a publicity stunt, it's a political one as well.

    Removing the obstacles to allow women to breastfeed is a smokescreen for advocation of the continuation of a larger, universal care model (be it right, wrong or indifferent). Our country doesn't give 1 year of maternity leave or mandatory paid maternity leave because we are working people who still enjoy take home of over half our income, even in the midst of it shrinking. In order to sustain an ideal breastfeeding intervention policy, we would have to drastically change our American lifestyles, even within the confines of this economy. You can try to put a bow on it, or wrap it in pink cellophane, but that's the truth. And even with all that stated, with the supposed obstacles that many breastfeeding mothers claim that the general mothering population is victimized by, we still have an impressive breastfeeding rate in this country. Maybe not as high as other countries, but a significant amount of women do breastfeed and furthermore, have support, eduction and lactation consultant support through their hospital. Breastfeeding advocacy and support is out there, just because a woman KNOWS the benefits of breastfeeding and still opts to formula feed is her decision, and it's a good decision that doesn't deserve the punitive measures that bfing advocates want to impose upon it.

    It's time for breastfeeding advocates to be confident enough in THEIR OWN decisions that they don't need the “approval” or acknowledgment of those who choose a different path. Formula is a safe and healthy alternative, so to create obstacles to it would be so oppressive and cruel, it would set womens rights back hundreds of years and turn breastfeeding advocacy into a heinous monster. It would start a political firestorm that would permeate every branch of government. We would have to resign ourselves to a dictatorship and a forfeiture of our unalienable rights.

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