Latch On, Latch Off

In the “Mommy Wars” – nobody ever wins. There’s too much judgement and defensiveness going around, and too many personal feelings and pride at stake for there to ever be a clear winner. And yet, despite the fact that nobody wins, the same battles continue on, rarely flagging in heat, passion, and at times, vitriol.

The latest round comes courtesy of NYC’s Mayor Bloomberg and his “Latch-On” initiative. The initiative will change the current protocol surrounding formula use in NYC hospitals, requiring new mothers who want to use formula while in the hospital to sign it out like medication. Nobody will be denied formula, but if a mother requests some, they’ll receive a mandated talk from staff on why breast is best.

The push behind this initiative is to promote breastfeeding, yet many critics feel that instead of encouraging breastfeeding, all this initiative succeeds in doing is alienating and shaming mothers who need or simply choose to formula feed. Blogger Deborah Cruz, who  wrote about Bloomberg’s initiative for The Stir, feels that the mayor went one step too far in attempting to promote breastfeeding:

This is just one more instance of government getting into mom’s business and women’s reproductive rights. You may very well be right, Mayor Bloomberg, breast milk may be best. I agree. But for those of who can’t produce, should our children be punished because our bodies don’t function effectively? Should we mothers be made to feel like criminals because for whatever reason we choose or need to give our babies formula?

Before I get into this debate, I’ll make my position on this emphatically clear (again): I believe that breast is best, and I breastfed my son for 3 years. However, I also am able to understand that not every situation is the same, and I can certainly understand Cruz’s (and others) concern over this initiative.

While Bloomberg’s intent may have been progressive, the way he went about encouraging breastfeeding seems anything but. Instead of supporting breastfeeding, it seems like hospitals will be limiting formula. I’ve written before about breastfeeding and formula, specifically about the formula “swag bags” many hospitals across the country still give out to new mothers. I still feel that corporations that are only attempting to squeeze more money from you once you’re back home have no place giving out free swag at hospitals.

Mothers can’t win. They’ll be vilified for choosing formula in the hospital, or, if they choose to nurse and dare to breastfeed in public, they’ll find plenty of judgment on that end (and heaven forbid you nurse longer than a year).

If Bloomberg really wants to encourage mothers to breastfeed, why doesn’t he work on the supportive end, rather than locking up the formula out of reach like it’s some sort of evil drug? As it stands right now – just like the majority of other Mommy War battles – nobody is winning with this new initiative. Not the mothers who want to nurse, or the ones who want/need to formula feed.

If Mayor Bloomberg, or any other well-intentioned politician, wants some feedback on what actually might create a playing field where there is true, legitimate choice? Read on…

1. Educate: Find a way to let folks know the differences between formula and breast milk in a way that doesn’t belittle, confuse, or judge. If we ensure that parents-to-be have a basic understanding of these two options, so they can make truly informed decisions, than we’re already half-way to success. Even G.I. Joe knows this. 

2. Create an everybody wins swag bag for new moms: Let’s find whatever money is going into this initiative, and use it in a way that actually helps folks. Create a bag that provides free quality breast pads (not the disposable ones that inevitable stick to your nipples and get all gross), a breast pump/bottles, and the numbers/information for local LLL and lactation consultants. It can also have coupons for formula. This way, we’re closer to providing an actual choice.

3. Mandate some Maternity/Paternity leave, yo: This one is pretty self-explanatory. I know I’ve repeated this stat till I’m, blue in the face, but until it changes, here we go – we are only 1 of 4 countries IN THE WORLD with no mandated maternity leave. But if you’re so concerned with women breastfeeding their baby, why not provide them with some maternity leave that actually counts. When women have the time and ability to just *be* with their newborns, it makes the breastfeeding relationship that much easier to maintain and sustain. If her partner also has the ability to be home during the first few weeks, providing support and help when needed? Even better.

4. Provide actual support: One reason many women stop nursing their babies isn’t because they have unfettered access to formula while at the hospital. It’s because once they return to the workforce, they rarely have any support when it comes to pumping for their infants. Instead of locking away formula and lecturing mothers, why not lecture employers and encourage them to provide both the time and the space for mothers who would like to pump so they don’t feel torn between work and their babies. Of course, this is not the magic solution for every family, but it would probably be helpful for many women who have the desire to try and make it work.

5. Remember that women are smart, responsible, capable people: With access to information and true choice, we can actually make the right decisions that work for our families. Trust.

Think of this as my attempt at a Mommy Wars’ détente, at least when it comes to how we feed our children from birth. Is there anything I missed? Share with me below!

 

20 thoughts on “Latch On, Latch Off

  1. I love your idea about providing a swag bag that everyone can use. I am one of those women who was not able to produce enough breast milk and had to supplement with formula from day 1. The only thing I would add to your list is for the nurses to better communicate with each other why some women may not be breast feeding so the new mommy doesn’t have to explain it every time there is a shift change.

    • Absolutely. It made me feel like a loser every time I got that scrunched-up, “another dumb woman who doesn’t love her baby enough to breastfeed” look from a nurse. This still happened when I was on baby #3, so by that time I was pretty aware of what my body would and would not do!

  2. Yes, yes and yes. At my midwife appointment today, she sort of asked, sort of stated “And you’ll be breastfeeding?” I said “No, the risks of my medication outweigh the benefits.” And I felt sad, so my husband had to add the part about us using donor milk. She didn’t bat an eyelash, though, when I told her my reasoning, in just one sentence. Because she respects my ability to make smart, responsible choices! And my choice is a responsible one! (For those of you who don’t know me–even Dr. Hale at InfantRisk agrees that it’s really risky for me to consider breastfeeding.) Oh, and she wrote herself a note to call someone at the hospital to ask about protocol re: donor breastmilk, so that was just awesome and validating.

    So I think that this is dead on because the problem isn’t a lack of freaking information. For almost a year of our lives, pregnant women are bombarded with information. What we need are people with real expertise who are willing to have real conversations with us about *our* lives. If we actually took the time to consider individual families’ situations, I strongly believe that there would be no Mommy Wars!

  3. I’m not a mom, as you know, but I have been DYING for a place to rant about this so… you win.🙂 It’s stuff like this that makes me terrified to have a child in the first place. Breast is best? OK, that makes sense. You should breastfeed for at least a year? Sure. But how am I supposed to do that? I can’t stay at home, nor do I want to. I love my job, we can’t afford for me to leave it, and it is one that would allow me to “have it all” – I get summers and all holidays off and I will be home well before 4:00. Once that kid gets into school, I’ll be home when s/he is. Breastfeeding as a teacher, though, would be extremely difficult. What am I supposed to do, give up my one 55-minute plan time to pump? Lock my classroom door and pull all the blinds and hide in a corner away from the windows and hope some unsuspecting student doesn’t try to wander in? Schedule all meetings before or after school because that’s my pumping time and I can’t meet then? And then take all that grading home because I won’t be able to do the grading during my prep time? No thanks. I get a 6-week maternity leave, and apparently I’m supposed to be grateful for that because “at least it’s paid.” Well, then I’m going to have to breastfeed for 6 weeks (if I even can), and use formula after that because I have to go back to work. You want me to breastfeed, government dudes? Then give me a year off to do it.

    These men in these offices have no clue. They don’t know how gut-wrenching it is to have to make these decisions, and this is just the first of MANY difficult decisions moms have to make for their children. I get the argument that giving formula samples to new moms makes it easy for them not to breastfeed, and that the marketing surrounding formula often stretches the truth, but come on. We are women. We’ve been raising healthy kids for millennia; if we hadn’t, the human race would be extinct. We know what we’re doing. Just trust us to make a decision, don’t guilt us into it.

    • There are a bunch of issues here and I want to address them all. I totally agree with you re:the message vs the reality. If the gov’t wants to promote breastfeeding they have a hell of a long way to go beyond locking up formula. When I posted this yesterday, somebody alerted me to a part in the new Affordable Care Act (aka Obamacare) that “requires an employer to provide a reasonable break time for a woman to express breast milk for her nursing child. The employer must also provide a private space for her to do so—a space that is not a bathroom.” http://www.forbes.com/sites/erikamorphy/2012/05/13/obamacares-mothers-day-gift-space-and-time-to-breastfeed-at-work/

      Now, how enforceable this actually will be? That’s left to be seen. But it will definitely be interesting to see how it plays out in the workforce. As a former teacher, I’ve known many teachers who pump (they just have phone conferences, grade, lesson plan, etc… while pumping). Then again, it’s the hands-free pumps that work the best and are, of course, the most pricy.

      The 2nd point I need to make – it’s totally true that we’ve been raising healthy kids for millennia, however, what we haven’t had to contend with is marketing to the extent it occurs now by the formula companies. This is an excellent post that really gets into the nitty gritty of formula marketing and how it makes it less of a true choice: http://www.phdinparenting.com/2011/12/01/why-do-moms-quit-breastfeeding/#.UBfXtPXEVvA

      • RE: Obamacare – That’s awesome. However, for teachers, I bet they can say that your classroom is private and not a bathroom, and that between prep and lunch, there is reasonable break time. In reality, my classroom is on the first floor and people walk by outside all the time, and students are ALWAYS in and out, even during my prep. I could lock the door, but anyone with a key to the school also has a key to my classroom. There just seems to be a discrepancy between the law and real life.

        I know teachers who do it, too. I’m just not sure if I’d be able to. BUT that remains to be seen; my priorities will probably change if I have a kid, and, knowing myself, I’ll definitely be an advocate for my rights.

        Also, marketing always sucks. Marketing NEVER allows ANYTHING to be a true choice. Whether it’s about breastfeeding or preschool or whatever other decisions parents have to make, we can’t win, and we’re usually set up to fail.

  4. I haven’t studied the initiative in-depth, but one positive effect might be to change the behaviors of doctors and nurses on hospital maternity floor. I recently gave birth at the busiest NYC L&D ward, and had to fight tooth & nail to stop nurses from giving my *slightly* jaundiced baby formula, despite the fact that he was latching on well and I was producing obscenely copious quantities of colostrum. (I know, because they made me pump and syringe feed to “prove” it was enough.) My roommate was also pressured by the hospitsl pediatrican to supplement with formula, even though her baby’s weight was fine. A less determined mama, or one one less fluent in English, or one more tired from a traumatic delivery, or one less comfortable being a “difficult” patient for any reason could have easily been swayed into formula feeding from day 1, which can have negative impacts on ultimate milk supply. If this initiative changes the attitudes and behaviors of hospital staff to stop pushing formula, it’s a positive step.

    • I agree with you that the one benefit I hope comes out of this initiative is that hospital staff is more educated on breastfeeding and all that it entails, especially in the 1st few days. It’s amazing to me the number of inaccurate statements I hear re:breastfeeding from women who didn’t have the support and knowledge from those who knew what they were talking about (i.e. qualified LC’s or doctors/midwives/doulas with a strong background in breastfeeding). I am so sorry you had to deal with that right after giving birth:/

  5. I think Liz’s experience is the norm across North America. Two of my friends and my sister all gave birth at different hospitals (in Canada) in the span of a month and all three of them were pressured into giving formula in the first 24 hours for various (unfounded and medically unnecessary) reasons, even though they had specifically expressed their decisions to breastfeed. I truly think that this initiative is a step in the right direction (although Bloomberg’s delivery of it may not be the most tactful). Hopefully it is just the first step of many to come.

    I am not sure the “mommy wars” will ever end, but it might be nice to get some of the big corporate backers (formula manufacturers) out of the fight!!

    • While I’m thrilled that Bloomberg is taking on this issue, I just feel that his efforts need to expand beyond the hospital into true shifts in policy. Why can’t hospital employees be educated/mandates to promote breastfeeding w/o having to lock up formula? I am all for banning formula companies from stepping foot into hospitals with any of their free samples and swag bags, but to go from that to locking up formula? The implicit message that sends, in and of itself, only furthers the divide between women. Why not take the desire to help promote breastfeeding and instead of locking up formula, provide more well-trained, highly-qualified LCs per maternity ward? Penalize and shame the companies preying on new moms, not the mothers themselves imo. Instead of locking up formula, why not create affordable milk banks within the hospital? or work on getting insurance to cover donated milk? These all sound like better steps in the right direction that would have longer-lasting results down the road.

      • So here is when my deep dark past is exposed. I used to work for a large pharmaceutical company and a lot of the education that health care workers (including physicians) get comes from pharma. All those glossy pamphlets are not just for the public, there is a whole department just for educating medical professionals and let me tell you, it is BIG money! I am also married to a physician, so I also have some knowledge of what med. students and residents are taught about breastfeeding…. pretty much NOTHING! And then these are the doctors that we listen to and go to for help with breastfeeding?? It is no wonder they just shove a can of formula across the desk… it’s what they know and have been taught (by the pharma companies).

        As for why hospital employees can’t be educated without having to lock up the formula? It goes way beyond just the formula. It is the printed material that bombards you from every corner of the L&D units. It is the mail outs that come to your house because you filled out a form AT THE HOSPITAL! It is the swag bags, filled with “your gonna fail anyways” not so subliminal messages.

        I am sure the answer is somewhere in the middle, providing moms with true choice in the matter and giving them equal access to education and support for breastfeeding or formula-feeding. The problem is that breastfeeding is not a billion-dollar industry with high-powered marketing teams. For breastfeeding to even get on an even playing field it either needs that kind of $$$ and marketing or we need to severely limit what the formula manufacturers can do with theirs.

        What Bloomberg is doing is a start. And change is tough for everyone to accept. If he is willing to do this, then perhaps the conversation is opening for, like you said, a greater shift in policy nation wide.

  6. Pingback: Now Bloomberg Wants to Legislate Women’s Bodies « Clarissa's Blog

  7. We read your blog posting with interest and wanted to respond and address several inaccuracies.

    The piece states “the initiative will change the current protocol surrounding formula use in NYC hospitals, requiring new mothers who want to use formula while in the hospital to sign it out like medication. Nobody will be denied formula, but if a mother requests some, they’ll receive a mandated talk from staff on why breast is best.”

    This is actually not the case:

    • In fact, the initiative does not require hospitals to “hide” or “lock up” formula, nor does it restrict access to it for those who want it.

    • Parents who want formula will not have to convince a nurse to sign it out by giving a medical reason. Parents can and always will be able to simply ask for formula and receive it – no medical necessity required, no written consent.

    • For 3 years, New York State Law has required that mothers be provided accurate information on the benefits of breastfeeding. The City initiative does not require that mothers asking for formula receive a lecture.

    The piece does not highlight the positive health impacts of breast feeding for which there is there is overwhelming evidence — supported by national and international health organizations. For mothers, breastfeeding reduces the risk of breast and ovarian cancers. For babies, breastfeeding reduces the risk of ear, respiratory and gastrointestinal infections, as well as asthma.

    The American Academy of Pediatrics has just published new guidance to pediatricians in Feb 2012, reaffirming its support for breastfeeding: http://pediatrics.aappublications.org/content/129/3/e827.full.pdf+html

    Ultimately, our goal is to support a mother in whatever decision she makes when it comes to nursing her baby and this initiative specifically is designed to support a mother who decides that she wants to breast-feed by asking participating hospital staff to respect her and refrain from automatically supplementing her baby with formula (unless it becomes medically necessary or the mother changes her mind).

    Bottom line: It does not restrict the mother’s nursing options in any way – nor does it restrict access to formula for those who want it.

    • Hi Jean – I really appreciate you taking the time to read my blog and clarify parts of the initiative.

      I’m glad to hear that mothers do not need to have formula signed out if requested. (I believe I got that information from a Washington Post article)

      The point of my piece, however, is more about how to level the playing field so that mothers actually have a true choice, and how to then foster/promote that bf-ing relationship once out of the hospital. If Mayor Bloomberg truly wants to promote breastfeeding, there are many other options (which I highlight above) that would raise the number of women who not only choose to breastfeed but continue to do so. The real drop in numbers come once women leave the hospital, so it would be wonderful to find ways to keep fostering that relationship once they’ve checked out and are back home.

      Thank you for pointing out the myriad of benefits to breast-feeding. I’m well aware of them (hence why I nursed my son for 3 years), but since my point was more about how we can better educate/support women and not about breast-feeding vs. formula, I didn’t feel I needed to veer off like that.

      I appreciate the fact that this initiative includes having hospital personal not push formula on mothers who are committed to breastfeeding. Clearly that hasn’t been the case as a few commenters have noted. I wonder if the Mayor would go a step further and consider things like ensuring there is a well qualified LC or 2 for every maternity ward, or that nurses/OBGYNS/midwives take training from a LC. Ideally, it would be great if there was also a milk bank option, to provide more of a choice from women who would like to breastfeed but cannot for medical reasons.

      Again, I do appreciate the time you took to comment, and while I’m glad that NYC hospitals will be more breastfeeding friendly, I simply wish that the promotion of breastfeeding extended into other arenas like providing pumps, quality LCs, donor milk if needed, and even policy issues like mandated maternity leave.

      • They left an almost identical response on my post about this issue. I don’t think they are taking the time to listen to what we are all saying. It’s frustrating, because the health dept could learn a hell of a lot from women like you.

  8. I’m going to post this piece on my Facebook page, as soon as I finish leaving my comment. This is BRILLIANT. You have no idea how happy it makes me to see such a measured and realistic take on an issue that has inspired mass hysteria (and I am including myself in that mass).

    I think the point so many people are missing in this debate is that our anger isn’t about promoting breastfeeding. Supporting women in their breastfeeding goals is a wonderful, positive thing. But initiatives like this aren’t helping anyone, as you so clearly point out. Treating formula like a shameful entity, or a controlled substance, only puts more pressure on women to breastfeed successfully – which, like it or not, can be a difficult thing in our society. Our breastfeeding rates take a nose dive AFTER the hospital stay, not during. The energy spent on making and implementing policies such as this one could be better used in providing real, on-the-ground support for moms after they return home. How about sending LCs for free home visits, 3-5 days postpartum? Or maybe being a bit less dogmatic about the formula, and instead making the goal for the dyad to have a positive, happy breastfeeding relationship – even if that means some formula supplementation via SNS, if that will help a woman get through the first 48 hours physically and/or emotionally? And what about providing good information to formula feeding parents, so that we can avoid the common formula feeding mistakes new parents make that lead to health issues (ie, improper storage or handling; uneven ratios of water to powder, etc)?

    This initiative has clearly missed the mark, as evidenced by the immense backlash against it. This is not helping the cause of breastfeeding promotion. It’s time we took a step back and realized that we need to approach infant feeding in a way that works for the society we live in. We aren’t Norway, or Canada, or even the UK. What has worked there will not necessarily work here – and frankly, talking to women who bottle feed in the aforementioned countries, I’m not so sure these policies are working all that well over there, either.

    • Thank you so much for your kind words, and thanks for posting it on your FB page – I really appreciate it.

      And yes – there needs to be a way to promote breastfeeding while not alienating those who don’t/can’t. Even if that wasn’t the intention of the campaign – as many people continually remind us – does that matter when so many people are clearly taking it to heart?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s