I'm not the only one wondering what's up with Mayor Michael Bloomberg's Latch On NYC. Mothers including ones who've breastfeed, haven't or somewhere in between have emailed me, commented here and called to vent their frustration, concerns and sometimes confusion.
KJ Dell'Antonia over at Motherlode, whom I briefly met at BlogHer12 in NYC this weekend (as if she remembers it) fortunately took time out last Thursday to try to clear up some rather hazy details that have been floating through the media over the last few weeks. You know, messy details like whether mothers (i.e. those who don't breastfeed) will get a good talking to about the benefits of breast milk and also whether formula will be locked up as if it's a dangerous narcotic. Here's what KJ learned from Bloomberg's press peep:
"There is not a mandated talk every time formula is given,” Samantha Levine, deputy press secretary, told me by e-mail. “That said, already existing NYS Law (Breastfeeding Mothers Bill of Rights) … requires that mothers be provided accurate information on the benefits of breastfeeding.”Okay so no mandated lecture for every bottle requested, phew but just before the first and no mandated lock-down though it's clearly up to the discretion of the Baby Friendly Hospital (as opposed to Mother Friendly or Formula Friendly ones) to decide whether they secure it beside the narcotics.
According to Ms. Levine, there’s no actual requirement that hospitals “lock up” formula, either. But that is how at least one hospital has structured the program it has actually put in place in the name of being “baby-friendly.” Why the Backlash on Bloomberg’s Breastfeeding Initiative?, New York Times, August 2
Excuse me. It's easy to get the impression formula would be locked up from the press release the New York City health department issued outlining the goals of Latch On NYC. Does this sound like the proper respect accorded new mothers or the containment of a public health enemy? Here's what hospitals will be expected to perform:
Restrict access to infant formula by hospital staff, tracking infant formula distribution and sharing data on formula distribution with the Health Department.Nurses must sign out the bottles of formula as if they have nothing better to do than comply with unnecessary policies. Yes at at time when the country is trying to reduce unnecessary health costs and one imagines unnecessary procedures required by unnecessary policies.
As coincidence would have it Momma Data received a comment from Jean Weinberg who works with Bloomberg's Public Health Department. She reported it was inaccurate to say women who don't breastfeed will have to watch a series of informational videos. Reassuring but it's also inaccurate at this time to say that the sale of formula will be banned within a half-mile of a medical facility or on weekends as I also speculated on my previous post with no small bit of sarcasm. So now I must forsake sarcasm to tend to some other matters involving as it turns out accuracy.
As for the lecture or talk or whatever it's called, Bloomberg's Latch On doesn't have to mandate it because the state of New York already has already done so according to Ms. Weinberg:
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.So we cannot blame this authoritarian health initiative on Bloomberg. Blame the state.
So new moms already get the lecture so what's this new breastfeeding business accomplishing? The point, according to Ms. Weinberg is to support all mothers in their parenting decisions:
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).So technically and legally new moms can have all the formula they want.
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.
As for the rest, let's cut the ruse here and now.
Latch On NYC is not about about helping mothers who choose to breastfeed. It's not simply about preventing nurses from feeding supplemental bottles (or more accurately not irritating/respecting the wishes of mothers who don't want/fear/worry their babies will sip formula). If that were the case new moms wouldn't be treated to a lecture, talk, information speech or whatever the PR people call it. The government certainly wouldn't request to monitor and track the distribution of infant formula.
Latch On NYC is certainly not about "supporting a mother in whatever decision she makes when it comes to nursing." If it were simply about supporting all mothers, including those that cannot or do not for whatever reasons (and there are a multitude of very good ones) then formula feeding wouldn't merit a good talking to and I wouldn't have to report formula doesn't have to be under lock and key though nurses do have to sign it out.
If Latch On NYC were about providing accurate information then new moms would be informed that despite the stringent breastfeeding recommendations and policies the empirical evidence shows very moderate benefits from breastfeeding, most quite short-term. Benefits that do not justify the pressure or burden on new mothers taking place across the country. Benefits, by the way, that might also largely be explained by the differences between mothers who do and do not breastfeed.
If solid, accurate information were the goal in public health then we'd hear about the studies that find no differences between breast-fed and formula-fed kids. We certainly wouldn't have to hear that 900 babies die each year because they weren't breastfed enough and no, I'm not ever going to get over that Harvard study. If accuracy were the goal there'd be a discussion of both the benefits and the costs associated with breastfeeding. Yes, costs. Did you hear that my researcher friends? Anyone going to gather that data? Ever? Hello?
If public health departments were really concerned with the well-being of new moms and babies they would attend to not just the slight short-term benefits of breastfeeding and instead attend to the whole range of emotional health and physical health of new mothers and their babies, paying attention to the many conditions and circumstances that sometimes make formula the best option.
Focusing on how and what new mothers feed their babies in the first months of life at the expense of other often significant factors does not help mothers or their children. If well-being were the goals public health authorities would consider the psychological aspects of not only breastfeeding and thus being the sole provider of food for another human being but the psychological consequences of pressuring mothers to do so while recovering from pregnancy and childbirth, sleep deprivation, caring for other children, going back to work and the host of other real-world obstacles to breastfeeding.
If public health officials had any intention of helping mothers choose what's best for them and their babies then their public service announcements and lectures or whatever we call them would mention the numerous range of factors that complicate the first months if not years of motherhood and complicate the issue of what's best for each individual mother and child. Their initiatives would recognize that what's best for each family encompasses many variables other than how much breast milk a child sucks down. Maybe they'd actually focus on parenting decisions and behaviors that we know impact children to a far greater degree for far longer than breast milk.
But that's not the case in New York or really any where else right now.
Don't even try, New York City, to portray the current breastfeeding initiative as simply about providing accurate information or helping mothers who choose to breastfeed or worse yet supporting all mothers.
Bunk, bunk and more bunk.
For that matter, ditto the above to all the public health folks promoting the current pro-breastfeeding/anti-formula climate at the expense of the well-being of women (and their children) who for a variety of valid reasons can't or don't choose to breastfeed. Acting as if infant formula is a danger to be contained and tracked like a contagious disease or criminal? You should be embarrassed.
When not breastfeeding is compared to smoking or riding a mechanical bull during pregnancy than accuracy is not a goal. When new mothers are made to feel guilty, anxious, inadequate, conflicted, incompetent or selfish over what amounts to less than stellar, moderate and short-lived benefits culled from a body of one-sided correlational data then we have left any smattering of accuracy, balance, parental choice not to mention the well-being of moms and kids far behind.
Personal Disclaimer: I breastfed all 3 of my kids and yes I sometimes supplemented with formula especially with my later babies because I realized it wouldn't compromise the breastfeeding. I don't have a strong opinion on the ban of formula gift bags in the hospital but then again I didn't really love the plethora of lactation materials or consultants either.
Update: The Skeptical Ob has collected some evidence of the Bloomberg people backtracking.