WBW ’12: Thoughts on NYC and formula-marketing

 (Have you seen this cute meme yet? I didn’t create it, but I have adopted it for the week)

Yesterday (July 30,) news broke that NYC mayor, Michael Bloomberg, has decided to ban formula from hospitals. This, of course, led to cheers and jeers, especially in light of the recent “Big Glup-gate,” but before we jump to any conclusions, why don’t we take a look at what the NYC mayor is really doing (and it’s really not that bad.)

Latch On: NYC” is a citywide initiative to better support mothers who choose to breastfeed. It proposes doing so by:

  • Enforcing the New York State hospital regulation to not supplement breastfeeding infants with formula unless medically indicated and documented on the infant’s
    medical chart
  • Limiting access to infant formula by hospital staff
  • Discontinuing the distribution of promotional or free
    infant formula
  • Prohibiting the display and distribution of infant formula advertising or promotional materials in any hospital location

If you are familiar with the WHO-code and/or efforts to make hospitals “breastfeeding-friendly” these guidelines should be of no surprise. Breastfeeding advocates and experts for years have remarked on the correlation between aggressive formula-marketing and decreased breastfeeding rates, despite the formula cans stating “breastfeeding is best.”

For example, in 2006, the US Government Accountability Office (GAO) issued a report in which they found that:

  • the U.S. would save a minimum of $3.6 billion in health care costs and indirect costs, such as parents’ lost wages, if breastfeeding increased to meet these Healthy People* goals.
  • Breastfeeding rates are particularly low among infants who participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
  • WIC and non-WIC breastfeeding rates fell short of most national goals, but rates were substantially lower for WIC infants.
  • Infant formula marketing targets non-WIC mothers and also reaches WIC mothers. Some of these marketing efforts use the trademarked WIC acronym in promotional materials.
  • A majority of studies [we] reviewed that examine giving free formula samples to mothers at hospital discharge found lower breastfeeding rates among both WIC and non-WIC mothers.

So, some of you may be thinking: What’s the big deal with formula being marketed/ available to moms in the hospital? Not every woman wants to breastfeed.

True.

Not every woman wants to breastfeed, but for those ones who DO want to, the elimination of in-your-face-formula can only help. How?

If you have given birth, you know how it is. If you haven’t let me paint you a picture. Labor is hard work. In fact, it’s not called “labor” for nothing, and it could go on for hours. Some hospitals won’t let you eat. And you are tired. Medicated or non-medicated; Vaginal or C-section, you are still working and the work doesn’t stop once you have the baby in your arms. If you choose to breastfeed, you have more work ahead of you… especially within the first few hours post-delivery. So, you are tired, the adrenaline has most likely worn off, you’ve been up for hours and now you have to try to figure out how to get a squalling, wiggly infant to latch on and take a few drops of colostrum. Depending on where you are and who is with you, you might hear:

  • “Let me get the LC and let’s figure out what’s happening”
  • “I saw a picture of breastfeeding in nursing school. You just have to get baby on!” (this was said to me after having DD1 by my recovery nurse.)
  • “It’s OK that you tried, but you are tired. We’ll give your baby some sugar water and a pacifier and you can try again in a few hours.”
  • “Nice job trying, but we’ll just give the baby a few ounces of formula to tide him over”
If you want to breastfeed, you want to hear option #1 and NOTHING ELSE. This is because of the mechanics of breastfeeding. And this is where the formula-marketing issue comes to play.
Breastfeeding is strictly supply and demand. If the colostrum/ milk is not removed from the breast, the body will stop making it. For every feed that is replaced by a bottle of formula, that is one fewer feed in the body’s feedback loop. Eventually, if the trend continues, the body will stop making the colostrum/ milk, there will be none for the baby and the family will be a formula family.
Depending on the type of formula required, that simple “offer” of free formula could cost a family as much as $3100 in the first year of the child’s life. Yes, they say that breast is best, but for a breastfeeding mom, FREE formula in a hospital could be the kiss of death to her breastfeeding goal because the nourishment for her baby is coming externally rather than internally. 
And what about WIC? I don’t know much about WIC and formula, but every state has different formula limits for WIC. Some states are more generous than others, and this has lead to the trend of some mothers further diluting their baby’s formula to stretch until the next round of WIC money.
So what about the mom who wants to formula-feed? The only change that it appears she will have make is to make her request to formula-feed known. If you have ever been in a hospital, you know that you have to ask for EVERYTHING while you are there: water, juice, food, to go to the bathroom, everything. Will the requirement that mothers ask for formula hinder mothers who have chosen to formula-feed? In my opinion, No. Will it hurt the bottom-line of formula companies… maybe?
But there is one piece that seems to be missing from Mayor Bloomberg’s plan: Support. I mentioned support briefly earlier and I can tell you from personal experience, support can really affect a breastfeeding relationship. A CDC report from 2010 put breastfeeding initation rates at 75%, but exclusive breastfeeding rates at 3 or 6 months drop to 33% and 15%, respectively. Breastfeeding can be hard and if you don’t have people around you to support you, it is too easy to throw in the towel. I would love to see easier access to IBCLCs and more promotion of true peer breastfeeding programs, such as La Leche League (rather than ones that masquerade as breastfeeding support but are quick to offer up formula as a stop-gap.)
http://edwardsvilleregionbreastfeeding.org/
So, time will only tell if the NYC “Latch On” campaign will lead to long-term breastfeeding. It’s a great first step, but what about the follow through?
Have an opinion? Share it below!
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Coming up this week:

Thursday: ACA, breastfeeding and work

Friday: Seven Quick Takes: Breastfeeding in Social Situations

Saturday: Bad Medical Advice

Sunday: Breastfeeding in the Bible

Monday: Modesty and Breastfeeding (Guest Post over at Imperfect Kate)

Tuesday: Avoiding Bottle-feeding guilt

 

*Healthy People 2010 Targets
Objective 16-19 – Increase the proportion of mothers who breastfeed their babies:

In early postpartum to 75%
At 6 months to 50%
At 12 months to 25%
Exclusively through 3 months to 40%

Exclusively through 6 months to 17%

 

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