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Wednesday, August 1, 2012

Understanding Mayor Bloomberg's "formula ban" in NYC hospitals

World Breastfeeding Week 2012 logo: "Understanding the past,"
and how it's negatively influenced the breastfeeding relationship
for countless mothers over literally decades, is key to
understanding initiatives like Bloomberg's in NYC. 
The internet is in a tizzy over the recent decision of NYC mayor Michael Bloomberg to "ban" infant formula and 'keep it under lock and key' in the city's hospitals.

Many people exhibited a typical knee-jerk reaction - ranging from mumblings about 'breastfeeding Nazis' to a woman's choice on how to feed her child. While it should be her choice, it's clear that we understand how that choice can be heavily influenced by a variety of factors, including the media's influence. First of all, it's not a ban. That would mean that all cans have been removed, that there isn't a drop of infant formula to be found anywhere within New York City hospitals.

I think for the staunchest of breastfeeding supporters, or mothers who fully know the benefits and intend to nurse their babies, this ruling means little - because they're already doing all that (or intend to, at any rate). There are those who make the decision based on all the facts and say, "You know what - this isn't for me," mothers who plan on returning to work full time, have stressful situations at home or little support in their efforts, or a variety of reasons - which include just not wanting to. If you don't want to, I doubt this move is going to stop you and no hospital employee should have a right to refuse you infant formula that you know you want to use.

But I do believe there are many women who are on the fence about their decision - whether it's really right for them, whether it will be hard or easy, or who just don't know enough to make a truly informed decision. These ambivalent feelings might run deeper than we realize - and no doubt stem from an upbringing in a culture with 'ubiquitous bottle feeding,' as one of my readers put it. Plainly put, if you are a mom-to-be who, like many other women, was never raised around anyone who nursed a baby, never saw it done anywhere, anyplace, then you are probably more likely to not give a crap and say 'Why not choose formula? It's there, why not use it?'

If you are surrounded by mothers who never nursed, friends who say things like 'it hurts too much, it's too difficult,' etc. etc. you have to wonder what kind of support they were getting. The further back in our society you go, you hear tales of women unwittingly given medication to dry up their breast milk, because nursing was just not en vogue in those days (of which we are not that far removed). Women who were told (and still are, depressingly) that 'their nipples were too big/too small,' 'formula is the same thing as breast milk' and a host of other inanities. Couple that with the overt sexualization of breasts in our culture, because no one has been actually used to seeing them do their primary job on a regular basis for at least the past 40 years or so, and it's a wonder any woman ever has a successful breastfeeding relationship.

I can see where Mayor Bloomberg is going with this - and why he seems adamantly nutso to those who don't understand or see the big picture. If you don't realize the history in this big debate, you're going to think the man is trying to strip women of their freedoms and force those inferior formula feeders to give birth in the hospital's janitor's closet.

Reading reports about it in the media don't help, either. Usually by the tone of the piece, you can tell there is some alarmism that says "How dare they!" Before we freak out and assume the worst when reading these articles, we have to ask ourselves: "Is this even true? How accurate is this piece, and how much do they understand the full history behind this problem?" If they're using sensationalist language, screaming headlines and defensive words meant to do nothing but get your hackles up, then perhaps it's best to move on.

Some examples: (from The New American, in a piece written by Michael Tennant)
Now New York Mayor Michael Bloomberg wants to take formula out of the mouths of babies.....In addition, any mother asking for formula for her baby will get a side order: a lecture on the benefits of breastfeeding....A mother’s choice not to breastfeed, on the other hand, will not be supported.
“The key to getting more moms to breast-feed,” Lisa Paladino of Staten Island University Hospital told the Post, “is making the formula less accessible.” In Bloomberg’s Big Apple, adults cannot be trusted to make wise decisions; the government must do that for them.
Lectured? I hope not. I think if a woman really knows the benefits and still doesn't want to, hey, that's great. Perhaps using the word 'lectured' is a bit harsh - and I'm sure she'll be no more lectured than a woman who is struggling with nursing and really wants to continue, who often hears, "Oh, that'll never work - just use formula." "Why don't you let us feed your baby formula? You need your rest." "Your baby's too big for you to breastfeed. Why don't you just use formula? It's right there. Besides, it might not work out."

Michael, do you have any idea how heavily these products have been marketed, pushed and sometimes given without the mother's permission, sometimes against, for decades?

This article, from The, gets in your face and pretty bombastic from the get-go:
Mayor Michael Bloomberg has devised a new and cunning way to force new citizens of New York to suck at the teat of the State by insisting that they suck at their mother’s.
Seriously? Grow up.

Keeping tabs on the amount of infant formula that flies out the door is probably not such a bad idea - after all, it's rather expensive stuff. I wonder if the author of this article realizes also that the US government subsidizes half of infant formula consumed in this country?

Of course, the first thing this does is stir up even more tension and derision in the mommy wars, without offering any thought or insight into the debate, nor its history in why we get so freaking defensive about what breasts are for in the first place.

Comments on one article (read it here) actually included "Breastfeeding is overrated," peppered with "My milk didn't come in after four days!" and "I supplemented with formula samples and then my milk dried up" are why these initiatives need to take place. There is just as much fervency and lack of support on the other side of the fence, coupled with myths and untrue "advice," that hopefully such a program can be helpful to those who need it. No one should make a mom feel guilty if she can't or doesn't want to breastfeed, certainly; but if you know nothing of it - as one writer admits - then what? Is that really an informed choice?
"I’ve never had a deeper understanding or appreciation of my breasts as feeding mechanisms. I’ve grown up thinking of them as sex objects and not as nourishment." 
It's the long-term influence of these companies, starting with our grandmothers and trickling down to us, that has played a tremendous role in our thinking today. Some argue that one bag of freebies isn't going to sway even the most determined mom - but it's amazing how fast that determination crumbles when you're surrounded by "booby traps:" unsupportive spouses, ill-informed but well-meaning girlfriends, aunts, sisters, mothers and yes, even doctors and nurses. The very people who could be making your journey easier are actually making it harder.

The resolution needs some tweaking, I think; but it's definitely a step in the right direction. And before you give yourself a heart attack after reading countless ill-informed, panic stricken headlines, realize that the measure hasn't even passed yet - which doesn't even mean it will. I've read that those hospitals seeking a "mother-baby friendly" rating are scrambling to put their own initiative into practice, which is great - and which will likely lead countless women to think all hospitals are that great and supportive when it comes to a mother's choice on how to feed her baby. They will likely not understand how, in one person's words, some hospitals in this country are "positively draconian" in their labor and delivery practices, extending to the breastfeeding relationship (think immediate, often completely unnecessary separation of mother and baby after birth, and so it begins).

Lastly, when you scan the headlines and read "Michael Bloomberg wants to ban formula," you must realize that no, it's not being "banned." If anything it saves resources for those who really do want to formula feed, instead of handing out expensive cans of the stuff to women who will likely throw it out or let it expire on kitchen cupboards somewhere. And it could cut down on the unscrupulous tactics of hospital staff shoving cans of it in your face the minute it appears the baby is having trouble latching, passes excessive gas or has to audacity to spit up. (See, that train goes both ways, ladies.) Considering that advocates decry the media's poor grasp of all things pregnancy, childbirth and breastfeeding, do you really expect them to get this right?


TracyKM said...

Good post, as always. I just have one comment on this line: "no hospital employee should have a right to refuse you infant formula that you know you want to use".
Why SHOULD hospitals provide you with formula you've already decided to use? They don't provide clothes, and often not even diapers anymore. If you want to feed with formula, then you SHOULD be expected to come prepared.

The Deranged Housewife said...

I've read that hospitals will accept formula from manufacturers in exchange for medical supplies for preemies and high-needs babies, for one. And I guess if there is a reason why breast milk is not available from the mother, even despite her best intents and purposes, what would the baby eat if the hospital didn't provide at least an initial start? There is that.

When my first was born, I was determined to breastfeed but obviously inexperienced. I had nurses and lactation consultants helping, but we hadn't fully mastered a good latch until sometime after the second day in the hospital. I wasn't going to give up, but it was very frustrating for me and the baby, and they were giving him droppers from daddy's gloved finger in the meantime because he hadn't latched on properly yet. They were "warning" me that if it didn't happen soon, they'd give him formula. :/

I'm not sure I totally agree with documenting a 'medical reason' for giving it out - which invites all kinds of dubious diagnoses in order to justify it, much like, say, the practice of 'medical inductions.' Suddenly things that can be easily fixed and are not as problematic as we're led to believe are reasons to not even try, and while I respect the mother's wishes to not do so if she truly doesn't want to, without a laundry list of explanations, sometimes I think much of the perceived "problems" encountered *might* not be as bad as we once thought. Then again, they might. People need to realize that care providers can just as much undermine a mom's efforts as they can support it, something I think some people have a hard time believing.

Trbobitch said...

I am a "libertarian", for lack of a more succinct way to describe my views... And while I will promise you that most of my "libertarian" friends would disagree with this (mother's choice, blah blah) - they'd be going at it all wrong. I am no fan of Bloomberg and he may or may not be doing this for the right reasons (I'll bet it has more to do with cutting subsidization than it does with encouraging breastfeeding, not that this is a bad reason either). I think ALL AROUND this is good - hopefully it will save the taxpayers' money having to subsidize sub-standard, genetically modified, sugar laden sorry excuse for breastmilk substitute. You don't have a RIGHT to free formula, especially when your own boobs make something even BETTER for FREE.