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”?


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