Monday, August 06, 2012

Backlash on Bloomberg's Breastfeeding-Friendly Latch On NYC? You Bet


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.”

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
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.

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).

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.
So technically and legally new moms can have all the formula they want.

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.

16 comments:

Awesome Mom said...

Well said!

Sarah PH said...

Great post. I wrote about Latch On NYC on my blog a few days ago, and have been less than impressed by the defenses and clarifications that have been coming out about it. You really hit the nail on the head with your descriptions of why so many things about the initiative ring disingenuous. The women of New York deserve better.

Polly Palumbo, Ph.D. said...

Great post back to you, Sarah! Thanks for stopping by and thanks for sharing your breastfeeding story, the challenges therein, on your blog. FYI, I moved into a new old house a month before my second child was born and haven't completely recovered...cheers!

Erica said...

Thank you for this:

"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, 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."

This is exactly how I feel. I am still breastfeeding my 16 month old but had to supplement throughout. All the time and energy in trying to get my supply up and the guilt I felt about not fully breastfeeding my daughter was far more harmful than any of the formula I fed her. I wish people could get some perspective on this.

Katie Spencer White said...

Great post and thanks for the analysis - common sense is always appreciated. I just wonder who comes up with initiatives like this?

Anonymous said...

From one post partum woman to another I thank you. My son is 15 months old now so I've moved passed this stage. My hope is that the desperate post partum new mommy finds your blog when she is crying her eyes out at 3 in the morning and she sees that there are sane people in Mommyworld, even if it doesn't always seem like it. Best to you!

KR said...

Thank you so much for posting this!

I am one of the moms out there who chose not to breastfeed. I didn't have a medical reason for not doing so, but I just didn't feel like it was the right choice for me and my child. My daughter did very well on formula, we have an amazing bond, and she couldn't BE anymore intelligent.

What makes me the most upset and angry about the formula vs. bf debate is when people focus on the "why" factor. I can't count how many times I've heard people say that formula is fine for babies whose mothers have a medical reason for not breastfeeding. But you chose not to? You didn't even try? Well, formula is the devil and so are you for not giving breastmilk. It's so ignorant. The "why" factor should be irrelevant because it's nobody's business why my daughter is consuming formula. If formula is acceptable for babies to consume (and that assumption is made when someone says that it's okay for babies whose mothers are unable to brastfeed for medical reasons), and has proper nutrition, etc... then it doesn't matter WHY it's being consumed.

This isn't about supporting ALL moms. It's about the untrue assumption that women who are not breastfeeding are uneducated and are not goodenough parents to make choices in the best interet of their children and families.

Polly Palumbo, Ph.D. said...

Howdy, Erica, impressive! So I'm assuming you wouldn't have been able to make it to 16 months without supplementing with formula, right? Thanks for sharing.

Polly Palumbo, Ph.D. said...

Hi Katie, yes, I'd love to know who worked out the actual terms (i.e. tracking the distribution of infant formula??). If you ever hear that interview please let me know. I wonder why this and not say the rising incidence of HIV? Or school luch programs that apparently need a bit of a rework in the city.

Hi Anony, thanks for referencing what had to be a common parenting phenomenon- the 3am crying fit (mom's) along side's baby's. My husband remembers it all too vividly...speaking of which, can you imagine if health authorities told men to attach their babies to their breasts and feed them round the clock for months at a time?

Polly Palumbo, Ph.D. said...

Howdy, KR, thanks for stepping out into the spotlight. It's unfortuate that we've come to the point that women are asked to justify a perfectly reasonable parental choice. We don't generally hassle mothers who give birth beyond their prime childbearing decade (20s). We don't have public health authorities recommending women pop out their progeny before their eggs get too old. Or frankly telling men to get on with it before their genetic contribution starts to deteriorate. Most of us recognize it's a personal decision based on numerous factors.

Anonymous said...

"What makes me the most upset and angry about the formula vs. bf debate is when people focus on the "why" factor. I can't count how many times I've heard people say that formula is fine for babies whose mothers have a medical reason for not breastfeeding. But you chose not to? You didn't even try?" I would add, KR, that to many women, it wouldn't even matter if you had a medical reason...because no "reason" is good enough. They are all just excuses. I've been basically called a liar for saying nursing contributed to my PPD, with both kids. Excuse me, but shouldnt I know best what does and does not help my recovery? So, you see, no matter what you say, to some people it's still lies, misinformation, or rationalization. Sigh.

Polly Palumbo, Ph.D. said...

Anony, sorry you had to endure that terrible treatment as you dealt with a difficult time. Postpartum depression is one clear condition that makes breastfeeding difficult. In fact as you most likely know all too well breastfeeding has been linked to worsening symptoms. Thanks for reminding us. I trust you're over the worst of it. Take care.

Anonymous said...

I am, thank you. Weaning has helped me immensely, with both kids. I still hear, "but nursing PREVENTS PPD." just simply pointing out that really, no matter what, no reason is good enough to some people. But I know better, and I'm glad I did what was right for me.

Polly Palumbo, Ph.D. said...

Good to hear weaning helped...not surprised people think breastfeeding helps depression as its the new wonder drug of sorts.

Erica said...

Polly,
Formula absolutely helped me to continue breastfeeding. I never had a full supply and I just could keep up my crazy pumping routine the lactation consultant put me on for longer than six weeks. I moved on from trying to supplement with my own milk (always had to use a little formula) and supplemented with formula. It helped me to enjoy breastfeeding and have a life. So yes, formula can help with breastfeeding success.

Polly Palumbo, Ph.D. said...

Erica, so in other words you couldn't have breastfed without formula and a good breast pump!