Quick Hit: On teets, tots and spats

Our own Jessica Valenti has a must-read about how shaming women who can’t or don’t want to breastfeed — and choose to use formula — is really fucking problematic (something she’s experienced recently):

I support breastfeeding women – long before I had my daughter I was blogging about the heinous lack of resources for breastfeeding mothers and the various ways they are discriminated against. I think we need mandated paid maternity leave, insurance that pays for lactation consultants and breast pumps, employers who are required to have a space and breaks for pumping moms, hospital- and state-funded breastfeeding support groups and more. But I also believe that formula feeding your child is just as valid and healthy a choice as breastfeeding – it’s not something women should have to justify or be denied resources for or access to. If that makes me less of a feminist or a mother to some people, well – they can just suck my left one.

PREACH. Also read her follow-up post on feminist anger and solidarity.

Join the Conversation

  • http://cabaretic.blogspot.com nazza

    My own attitudes have trended towards the “let’s just all get along”, because that’s something my own religion advances. But I recognize that nothing gets Quakers riled up quite like politics and those arguments have been decidedly hot blooded in the past. I think I’m a bit gun-shy because what often happens is not a discourse or a dialogue, but a very selfish display of self-righteousness.

    If we can in our anger not stray from the purpose, then I see no issue. Women have had a tradition of being told that they could not be angry and could not respond forcefully on their own behalf. But I would just sound a word of caution that it takes discipline to channel this anger in responsible ways.

  • ecape2

    My aunt researched and wrote a book about how non-breast-fed babies are more likely to develop allergies and other kinds of low-level health problems. Because of that, I tend to believe there’s some truth in it. Many doctors recommend that babies be breastfed for 1-3 years to receive the antibodies in their mother’s milk, in addition to the proper proportion of nutrients.

    Women who are unable to breastfeed can substitute, but it doesn’t just have to be with formula. Wet-nursing is an ancient practice that has something of a stigma these days, but I’ve heard of women who do it. (Or more accurately, who partner with another woman to collect milk in a bottle to feed their baby.) I happen to think that makes plenty of sense given the circumstances.

    • http://feministing.com/members/stellarose/ Stella

      There are also TONS of techniques to increase your milk production and increase the chances of breastfeeding working for you. Unfortunately, most are not taught by our maternity care system here is the grand old USA.

  • http://feministing.com/members/amandakh/ Amanda

    I am a long time reader of this site (thought I never comment) and a long time fan of Jessica’s. She is a feminist I respect and I have read, own and enjoyed her books. I read Layla’s birth story in tears while holding my own newborn son who was born healthy with no problems and I can’t imagine what kind of hell she went through and I can in no way say what I would have done in her situation, especially both of us being first time mothers.


    I have followed this debate closely because it is between two feminists I deeply respect and admire. I have been following (and had the privilege to meet a few months ago at a nurse in) Gina at The Feminist Breeder throughout my pregnancy and have been enjoying her posts about natural parenting (the sting Jessica made on her about being a “natural” parent means she follows the natural parenting movement i.e. cloth diapering, breastfeeding, etc. – just to clarify) as I have a similar parenting style.

    I have to say -Jessica, I completely agree with everything TFB has pointed out in this debate and really think that you have handled the entire thing poorly. The fact is that breastfeeding is healthier for mother and baby (science proves it) and that Jessica should be a strong advocate for anything that makes women and babies healthier. It breaks my heart that she was not able to have the breastfeeding bond with her daughter and I don’t judge or blame her for using formula (I probably would have done the same thing in her situation). Do you know you were arguing with a woman who formula fed her first child? Jessica, use your experience to work for more access to donor milk in the NICU. Work through the pain and advocate, REALLY advocate to make it easier for women to breastfeed their babies and don’t play into the formula companies tricks to make money. Work against formula companies who are looking to make a dollar at the expense of women and baby’s health. As a respected and famous modern feminist, I expect nothing less.

    Feministing (Vanessa), obviously this is a blog Jessica started and Vanessa is her sister but you need to link to TFB website so everyone can have a clear picture of what this argument was really about and they don’t just see one side. She wrote some great posts, I feel a one sided argument is not beneficial to your wide readership. Honestly, I am interested on Miriam’s opinion, considering she is a doula.

    I have to say, as a reader, I feel a bit attacked. I am a lactivist and Jessica had some very harsh words about mother’s like me. By making blanket statements about women who work to educate mother’s about breastfeeding, you have basically told me that I do not care to educate but just judge, which is not the case. Jessica, I am sad to have to do this, but I will not be following you closely anymore. As a feminist mother, I don’t feel that you can bring any more ideas that are relevant to my life and cause, considering the recent statements you have made. I do agree with you on one point, we should be arguing over this. This is a big, big deal. Every reader of yours should read both Jessica and Gina’s posts to see the entire picture.

    Also, please read this, a great article by a doctor: http://bfmed.wordpress.com/2010/06/12/what-does-feminism-have-to-do-with-breastfeeding/

    and for anyone interested: http://thefeministbreeder.com/

    • http://feministing.com/members/vanessa/ Vanessa

      Jessica linked to several folks in her post, including TFB, where they can get the full picture. And just so you know, “Quick Hits” generally mean linking to one piece that an editor/blogger would like to recommend, which is what I did. And if YOU read the convo closely, you’ll see that Jessica wasn’t insulting women who support breastfeeding or lactivists for that matter, but was speaking to a larger issue behind some of these folks who shame women who decide to use formula. Also, to imply that it was a tragedy she wasn’t able to have a breastfeeding “bond” with her daughter (is that therefore not as strong of a bond otherwise?) and to tell her she needs to work through “the pain” of not breastfeeding IS making assumptions and judgments about her experience.

      • http://feministing.com/members/amandakh/ Amanda

        I said, breastfeeding bond, which is a specific bond I don’t think anyone can have unless you breastfeed. That is not to say that there are not other wonderful, more meaningful ways to bond with your child – my partner cannot breastfeed but he bonds with his son. I didn’t mean to put words in her mouth but from what I have read, that is what it seemed like to me, that it caused her pain and guilt. She wrote “I was devastated; I became depressed, ashamed that I couldn’t give my daughter the one “natural” thing I could provide while she was hooked up to so many wires and tubes. ”

        The article I linked too discusses the guilt many women feel when they aren’t able to breastfeed because of societal pressures, I think she makes a good point (the link to the doctor’s article, not TFB). I don’t want any woman to feel that way, I am aware that there are many women who aren’t able to breastfeed. I think that we work to better alternatives – a big one is donor milk – and NOT allow women to be at the whim of formula companies. Let’s start women out with better options, more education and support – more paid time off of work, better access to donor milk, more lactation support, no formula samples in the hospital, restrictions on contracts the formula companies have with hospitals, etc. – I think that every feminist should be working for that (again, breastmilk is proven to be better, please don’t dispute that) or at least get out of our way and don’t assume we are judging you, because most likely we are not.

        As far as me reading more closely, I get the “you’re judging me for formula feeding argument” constantly. It has gotten to the point that I rarely bring up the subject. As a lactivist, I felt attacked. Either way, I don’t see myself reading as often.

        • http://feministing.com/members/amandakh/ Amanda

          And for the record, I really don’t want to bring Jessica’s personal experience into this very much (though I think it is important and plays a part in how she forms her argument). She clearly went through hell and back and made the best decision for her and her daughter.

          What I have an issue with and what I am criticizing ( I just realized I don’t think I have made that clear) is her public position on breastfeeding vs. formula – in spite of all of the research that breastfeeding is the best choice and the obvious unscrupulous tactics used by formula companies to sell formula. Women and new mothers do not make decisions in a vacuum, they are heavily influenced by culture, medical necessity (or feigned medical necessity), how much support and education you have and unfortunately influence from formula and other companies. It is not patronizing to promote what science says is best and work to find better options for women who cannot or do not want to breastfeed.

          Feministing has a wide readership and I feel only highlighting Jessica’s side of this argument is doing your readership a disservice.

      • http://feministing.com/members/cnelson/ Cecily Nelson

        Thank you, Vanessa for your comment. I would also like to add a few things to what you have said. The first is that this notion of guilt that FF mothers feel always comes up in conversation. As a mother who formula-fed her first, the only guilt I felt was from breastfeeding women who raked me over the coals for my choices. Secondly, many women who are “natural” parents fail to see their privilege. I agree that breastfeeding, cloth diapers, organic foods, etc. are wonderful things for your baby to have, but not all women have access to these (expensive) items. I was a sophomore in a college and single when I gave birth to my daughter. I had finals the week after I gave birth. Breastfeeding was not in the cards for me. However, I’ve had stay at home moms who are married to wealthy men judge me and expect me to make the same choices as them, without the same resources. Lastly, I would like to second your point that Jessica linked to the articles on breastfeeding and has been an advocate for lactivists all along. I, too, have done what I can to break down the societal barriers that face many breastfeeding women. However, it seems that when FF moms want that same support back…it’s nowhere to be found. The best that a mother who uses formula gets is “I respect your decision, but here’s a bunch of facts that say I’m better than you”. Without that person recognizing their privilege and access to the resources necessary to breastfeed, including time.

    • http://feministing.com/members/evelyn/ Evelyn

      TheFeministBreeder raises many good points in her article You Think Women Aren’t Vulnerable to Marketing? Check Your Privilege, but she is still at fault for using patronizing rhetoric to promote breastfeeding. While I agree that “to even suggest that all women have equal access to information and support in the decision-making process is to completely ignore classism, racism, sexism, and privilege,” TheFeministBreeder really does expose her privilege (and her belittling attitude towards formula feeding mothers) in the comment section.

      She says:
      “I think the reason many women feel that they need to ‘stockpile’ formula ‘just-in-case’ is because our culture has led them to believe that we’ll all need formula at some point. It’s inevitable, right? But do you know what I have in my house ‘in-case-of-emergency’? Frozen breastmilk. That’s my backup if I were to get into an accident or something. And if I needed a long term solution? I’d try to get free donor milk from Eats on Feats [sic]. But most women have no idea these are even options. We’re all so convinced that formula is the only backup.”

      (Oh yeah, I forgot…every woman has the ability to pump extra milk, every woman has the time to pump extra breast milk, every woman has a safe space to pump extra milk, and every woman has access to free breast milk.)

      She also says:
      “When formula is necessary, it’s readily available just about anywhere. But when it’s hanging around, so many women…resort to it too quickly, instead of using other options (like pumped milk.) That’s why breastfeeding advocates tell women who are committed to breastfeeding to put formula out of their minds, unless it actually becomes necessary. There are things happening around the time of childbirth that stress and tax our systems, and really do make us susceptible to things we would not normally be.”

      (Implying, of course, that women have poor self control and that they shouldn’t listen to their bodies when their bodies are telling them: STOP PUMPING ME FOR MILK!! Is it just me, or does this sound a lot like disordered-eating talk? “If you just hide the candy bar or throw it away, you won’t feel tempted to eat it.”)

      Ultimately, I think TheFeministBreeder is on to something, but she has serious rhetoric issues on top of good-ol-fashioned privilege-awareness issues.

  • http://feministing.com/members/wilg1/ Robin

    The arguments advanced by the breastfeeding supremacists remind me of the ones advanced by the anti-choice lot: “We want to make sure women are truly educated about abortion (including our lies about mental illness and breast cancer) and can make a truly ‘informed’ decision. So we’re going to insist there be a waiting period, that women undergo a sonogram and counseling by people devoted to eradicating reproductive choice, and all sorts of other restrictions to ensure that they make the ‘right’ decision not to have an abortion.”

    I’m all for making parents aware of their choices in childbirth and childrearing, but patronizing them is never okay.

  • http://feministing.com/members/hoosierfem/ Kay

    As a fellow feminist, I respect your decision to formula feed and believe that you should not have to justify your decision. It is a personal choice that each mother must make for herself. However, your statement that bottle feeding is just as healthy is untrue. The American Academy of Pediatrics states that “breastfeeding ensures the best possible health as well as the best developmental and psychological outcomes for the infant.” The American Medical Association, World Health Organization, and American Dietetic Association also reccomend breastfeeding as the best for babies. The American Academy of Pediatrics states that there is evidence that breastfeeding reduces the occurrence of infectious disease for infants, reduces post-neonatal infant mortality rates by 21%, reduces the chance of type 2 diabetes, reduces the chance of leukemia, reduces the chance of asthma, slightly enhances cognitive development, and decreases the risk of breast cancer and ovarian cancer for the mother. The Journal of the American Medical Association also concluded that young adults who were breastfed scored higher on intelligence tests, independent of possible confounding factors.

    • http://feministing.com/members/stellarose/ Stella

      Just to preface, I breastfed two babies and it was the best thing in the world for me and them, and I am a huge advocate of it. I must say, though, these authorities have certainly not taken into account the costs of breastfeeding to some women. The most obvious would be some women cannot combine breastfeeding with work (not all of us can pump), and need to earn money in order to keep a roof over their child’s head. Other women need to take medication not compatible with breastfeeding. Some might subjectively experience breastfeeding in adverse way, and we all know that a depressed or upset mother is probably not her best self for her baby.

      I also take everything the AMA says with a grain of salt, considering that their policies on maternity care generally are a complete outlier vis-a-vis the rest of the developed world, and in many cases they directly support policies proven to make breastfeeding difficult. Its not clear that they are always the most evidence-based organization (although I do think the studies you cite hold up and are corroborated by organizations internationally). Personally, I could not have breastfed if I did not have a wonderful partner who shouldered 50% of the responsibility for babycare, an employer who gave me 6 months paid leave, midwives supportive of breastfeeding and a non-clinical birth and afterbirth environment, and the money and knowledge to hire a lactation consultant. And I was pretty motivated. As far as I can tell, the AMA and AAP are doing nothing to create these conditions for women, and in some cases are actively opposing them.

    • http://feministing.com/members/evelyn/ Evelyn

      Joan Wolf, author of Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood, explains in an interview that “Compelling science tells us that breastfeeding provides babies some protection against gastrointestinal infections. Doctors and public health practitioners tell us that breastfeeding makes babies happier and smarter and prevents ear and respiratory infections, diabetes, obesity, childhood cancer, asthma, allergies, leukemia, heart disease and scores of other illnesses and diseases. So I wouldn’t say there’s a divide between what the science says and what pregnant women and new mothers are hearing; I’d say there’s a chasm.” The reason why there seems to be so much evidence pointing to the virtues of breastfeeding is that breastfeeding is CORRELATED to healthier babies. However, Wolf outlines an alternative (and often overlooked) hypothesis: breastfeeding mothers might “behave in all sorts of ways that promote health, and these behaviors could be responsible for the better health outcomes that we now attribute to breastfeeding.” And sadly, even though The American Academy of Pediatrics currently states that breastfeeding is in every way better than formula, “science is no closer to distinguishing the effects of breastfeeding from behavior surrounding breastfeeding.”

      I am with Wolf. “The absence of any demonstrable causal link, outside of the gastrointestinal tract, between breastfeeding and better health” is worrisome, and I think we should be more critical of the popular information we are given. Yay science!

      link to the full (awesome) interview here http://www.fearlessformulafeeder.com/2011/02/q-with-joan-wolf-author-of-is-breast.html

  • http://feministing.com/members/stellarose/ Stella

    I’m not sure its correct to say that not breastfeeding is “just as valid and healthy a choice.” Everything depends on the circumstances. The question is who should be the judge of what is best for a particular woman and her baby. And my answer would be, the woman (not random observers, well-meaning or not). The fact is, whether to breastfeed is based on thousands of complicated factors…no one should make that choice for you, regardless of what the “experts” say about its relative healthiness or validness at any particular time in history.

    This is all complicated by the fact breastfeeding has been so totally problematized in our country (meaning the USA). Women are often forced back to work before they are ready because they need to pay the bills or retain their job (vs government mandated and subsidized maternity leave in almost every other country in the world). Many women are subjected to a level of technocratic maternity care that is totally inappropriate (33% c-section rate vs fraction of that in countries with the best maternity care measured by infant and maternal mortality, limited or no access to midwifery care or lactation consultants). Many of us think that more women would choose to breastfeed given better circumstances. That’s why sometimes we seem a little crabby about women formula feeding.

  • http://feministing.com/members/praminthehall/ Caitlin

    Formula is a lifesaving substance for babies who need it. However, Jessica is wrong in her piece to imply that Baby Friendly status would mean that formula would not have been available to Layla in the NICU when pumping milk ceased to be a viable/desirable option. Baby Friendly standards say that formula should only be offered to breastfeeding infants if medically necessary (the word medically is emphasized in the printed guidelines). This does NOT mean that mothers may not use formula if they choose it, and it certainly doesn’t mean they can’t get it if they need it. Baby Friendly guidelines do say that the formula must be purchased by the hospital (as are other foods and supplies), as receiving it gratis is usually contingent on giving out bags with formula promotions and samples to all mothers upon discharge. These bags have been shown to impact breastfeeding practices and to encourage mothers to purchase expensive, name brand formulas (as thetype in the bag appears to be a hopsital endorsement). I firmly believe that infant feeding is a very personal choice, as are food choices and parenting practices in general. When parents are given appropriate support, they will general make choices in line with the best evidence available. Sometimes supplementing with or choosing formula is the best choice. However, our current system shames mothers for breastfeeding (in public! she had teeth! isn’t he kind of old?) and for not. We can work to eliminate shame without allowing the corporate promotion of formula through healthcare facilities.

  • http://feministing.com/members/steveo/ Steven Olson

    Its a shame that people are shaming mothers for their choice of whether to breastfeed or not. I think only a mother has enough information to make that choice and we shouldn’t pass judgement.

    That being said, Jessica’s statement “But I also believe that formula feeding your child is just as valid and healthy a choice as breastfeeding…” is problematic because it assigns belief to a scientific question. The question does have an answer, and, as current research suggests, breastfeeding is the healthier option. With that being said, formula, although not as good, still allows babies to be properly nourished and grow into healthy human beings. Formula wouldn’t have become so widely used if it was not reasonably close to as healthy as breastfeeding.

    So, I would agree that formula feeding is just as valid, but it is not just as healthy (how marginally less healthy is the question, and it doesn’t seem to be that much). A quick look at the stat Kay provided illustrates this. Formula feeding increases the post-neonatal mortality rate by 21%. From wikipedia, the infant mortality rate in the US is about 6.3 deaths per 1000 live births (I know, not exactly the same, but for illustrative purposes, its close enough). Increasing that by 21% brings it up to 7.6 deaths per 1000 live births. Its measurable, but on such a small quantity, marginal enough that the decision, based on personal circumstance should NOT be judged. Not breast feeding increases the chance of infant mortality by about 0.1%. There are so many other factors that put people at risk, that the choice to breastfeed or not is pretty unimportant.

    As other commenters have said, we should strive for a world that accommodates all mothers better and leave this decision up to mothers without judgement.

  • http://feministing.com/members/apology/ McKenzie

    I really hate that people are getting hung up on Valenti’s mention of the health of formula feeding: that’s missing the point completely. The POINT is that mothers should not be shamed for not breastfeeding, should not be thought as “bad mothers” or looked down upon for not doing what YOU do.

    If you formula feed your child, she will not die of starvation or malnutrition or disease. She won’t grow up to be dumber or “worse” than a breast fed baby. She will be just as wonderful as any other baby. If you formula feed your baby, you are not harming her. Breastfeeding might have more benefits yes, but it is not as if formula is poison: if you feed your baby your own milk or formula, she will survive and thrive either way!

    I’ve heard from a lot of feminists how wicked formula feeding is, and maybe I’m being overly sensitive here, but I really don’t like the implication that my mother, who worked her ever-loving ass off to provide for me, to take care of me, and to raise me somehow “didn’t do enough” or “didn’t care enough” about me.

    Breastfeed if you want. Formula feed if you want. Your baby will survive and thrive either way: love, after all, is all you need.

  • http://feministing.com/members/tashabunny/ natasha

    This is a complex issue, and I hope that discussions on breastfeeding vs. formula become less divisive. I agree with Jessica that it’s important for hospitals to provide free formula as well as breastfeeding support. The notion that this hospital would be more baby-friendly without formula is ridiculous, since many have no choice, they aren’t physically able to breastfeed. What would happen to those babies at that hospital?

    I believe that it’s up to the individual mother to decide what she will do. I do believe that breastfeeding is the healthier choice, if it’s possible, but I don’t want to imply that i’m for shaming and coercing mothers who choose formula.

    I think feminists should try to unite on this subject instead of fighting. We should look at the things we have in common, and work together without judgment and preconceived notions. We can find middle ground here. I think lactivists should take caution and stay away from arguments like all women should breastfeed (which isn’t even possible), and that giving your baby formula is akin to smoking. Formula isn’t inherently bad for an infant, it’s just not as good.

    I think the pro formula side should refrain from terms like breastfeeding supremacists. It’s unclear what’s being implied, at least to me. Does it mean that you’re aware that breastfeeding is healthier? Because if it does, that’s unfair. You can realize that it’s just a fact that breastfeeding is better for an infant, and hope that a mother is able to and chooses to breastfeed without shaming all the mothers who don’t or can’t. That’s how I feel about it.

    It’s important to discuss the fixation on women’s looks involved in this. I know several women who have told me the number one reason they chose not to breastfeed was because they were afraid of their breasts sagging. I’ve also heard people tell pregnant women that they should breastfeed because it will help them lose the baby weight they gained during pregnancy. I’m trying to avoid generalization, but it does happen, sometimes. I find this to be a significant detail, especially in feminist discussion, and I feel it’s often overlooked.

    Mothers are also shamed on both sides, if they breastfeed or if they don’t. My mother breastfed me, and she was shamed a lot by her family (she’s the only one who breastfed her child), and still is sometimes even now, nineteen years later. They’ve told her it’s gross, and how could she do that with her breasts ( the sexualization of breasts comes into play here), and how could she dare to breastfeed in public. Mothers can’t win, ever. There’s always someone who shames them.

  • http://feministing.com/members/kalidrea/ Andrea

    in my life I’ve been called a lot of things that have hurt my feelings (tomboy, bitch, slut, flower child, etc ) most of these I actually like now and find them funny — I bet the other readers of this blog have been called these names too.

    I know that feminists often get endearing names as well: Militant feminists, feminazis, dykes (I’ve been called these things too — and again I’m sure you have too)

    but I guess now you can call me a breastfeeding supremacist too
    (I actually prefer “breastfeeding nazi”. A coworker called me that after I told her I went to a Le Leche League meeting while I was pregnant and was looking for another way to get support for my plan and choice to breastfeed)

    Thing is I’m gonna keep fighting for myself and other women who deserve better in all parts of their lives (including lactation rights and promotion) regardless of what I’m called. Is that unfeminist?

  • http://feministing.com/members/megs528/ Megan

    I want to say that I agree with Robin, that a lot of the rhetoric coming from Breast Feeding Activists seem to sound like anti-choicers…that “if only they were more informed”

    What women do with their bodies is their business and no one else. Women should absolutely be able to breastfeed and encouraged to do so, if it is what THEY want, but it shouldn’t be pushed on them. Just like formula feeding shouldn’t be pushed on them. Breastfeeding is every woman’s right, and hospitals and medical peoples should make that available and an option for women, but if a mother chooses not to breastfeed, hospitals and the like have no say in that personal decision.

    Women who formula feed their children have no reason to justify their decision, and no one should assume that the choice was made out of ignorance. Women can choose not to breastfeed because they simply don’t want to, and that is their decision. They shouldn’t be shamed or bullied or patronized because they are doing what is best for them, and what is right for their bodies.

  • http://feministing.com/members/ahodges/ Adrienne Hodges

    I agree with almost everything Jessica had to say in her post, and I’m frustrated with the self-righteous posturing of the people over on The Feminist Breeder’s FB page. They simply refuse to bend or try to understand where others are coming from. When I brought up the point that I think women are intelligent and resourceful enough to make their own informed decisions about how to feed their babies I got called privileged (and I was called a troll for disagreeing). I find that ironic considering it’s upper middle class women who seem to be the ones telling everyone else how they should birth and parent. There are comments over there stating that formula should be outlawed unless it is medically necessary.

    Seriously, these are women who will defend a woman’s right to choose abortion until they are out of breath, but they would happily take away choice when it comes to feeding a baby. And the funny thing is they don’t see how hypocritical that is. IMO, the Feminist Breeder is as white and privileged as they come, talking about how women should use donor milk if they can’t breastfeed, as if that’s even close to feasible for most people. And the thing is, she knows how difficult and time consuming it can be to breastfeed, and that many workplaces are not very accommodating when it comes to letting women take breaks to pump, etc. not to mention the pumps themselves are crazy expensive, among other things. But no, she’s convinced she’s on the “right” side of this issue, which makes the rest of us on the wrong side, in her fucked up opinion.

  • http://feministing.com/members/kalidrea/ Andrea

    Let’s check out what exactly UNICEF and WHO are supporting, here’s a link to their Baby Friendly Hospital Initiative


    I have worked in health care (in different arenas) throughout my adult life.
    These experiences include a very busy private psychiatric practice as well as a world famous medical center. Pharmaceutical companies know that the more they get “free” samples into a practice or hospital as well as all the other “free” gifts with their branding on them — the more prescriptions for that product get written and the higher their profits go. Health care providers and patients can be persuaded and marketed to. I won’t get into the other forms of advertisement like print, TV, and now internet.

    The private practice I worked in overhauled their policy on interactions with drug representatives and on the use of free samples while I was working there. This was an important practice and ethical decision prompted by all of our staff (front desk, counselors, and prescribers). The basic things we did were to remove any branded posters/flyers/handouts from our practice (including yes even coloring books with “focalin XR” in the corner & even if some of these things were helpful like free copies of questionnaires PHQ-9 which is used to screen for depression). No longer would we accept “lunches” with food and a speaker to “learn” about a new product. Samples were kept in my office and were not displayed — and were not routinely used (I guess you could say we used our discretion to figure out when the use of them was “medically necessary” and was decided based on the individual relationships we had with the patients).

    The medical center I worked at also has an incredibly strict policy on any interactions with representatives as well as conflict of interest disclosures. Within the hospital there is absolutely nothing displayed with a pharmaceutical brand name or company on it — no flyers, pens, handouts, etc. This is true of the clinical areas as well.

    Here’s a link to download the WHO international code of marketing of breast-milk substitutes that has 18 pages in which frequently asked questions are addressed:

    I believe the goal of WHO and UNICEF is to provide hospitals with some guidelines on their relationships with these pharmaceutical (yes, formula companies are part of big Pharma) companies. By not allowing “free” samples in diaper bags with coupons and other promotional items, these hospitals are giving themselves some much needed distance between themselves and the pharmaceutical industry.

    As a health care provider I am always looking for more ways in which I am able to act as the care provider and not as a salesperson for a particular product.

    • http://feministing.com/members/kalidrea/ Andrea

      oh and as a patient — I’m always looking for an individualized relationship with my provider in which options are discussed and I am not being marketed to

  • http://feministing.com/members/limelightqueen/ Zoe

    I am an advocate of breastfeeding whenever possible, but I know that it is just not an option for many women. Although I am not a mother, if I were to get pregnant tomorrow I would most likely end up formula feeding as I am on medication that can pass through the milk to the baby. Although there are other medications, due to having been to hell and back finding the right one, I know my doctor would be reluctant to have me switch.

    That being said, when it comes to almost all things mothering, I look to my closest and most dear example: my own mother. My mom breastfed her myself (number 3) and my oldest sister but chose formula for her second and fourth daughters. With my little sister it was a lack of milk supply but with my older it was based on external constraints- she was in her last year of medical residency and just did not have the time to breastfeed or even pump. All four of us turned out fine, both physically and mentally, and have fantastic relationships with my mother.

    While I believe that “breast is best” I understand that often it is just not an option. I detest women who make split second judgments against women who choose formula. A friend of mine was accosted at the mall for formula feeding. Her response was amazing, “Oh, hi Dr. Soandso, I didn’t recognize you there.” When the woman responded with confusion my friend shot back “Oh, I assumed you had to be my doctor since she is the only woman with the authority to tell me what is and is not best for me and my baby.” Cue embarrassed drive-byer.

  • http://feministing.com/members/limelightqueen/ Zoe

    And just one more point: I dislike any group who chooses to liken their opponents to Nazis, Socialist or any other despicable widely known group. Calling lactivists “supremacists” makes me disinclined to trust Jessica’s views. Whether or not there is truth to it is not even the point. The word “supremacy” is steeped in historical connotation, connotation that I am sure Jessica knows of. When one hears the word the first image that pops into one’s head is almost always white supremacy and the KKK. If you truly believe that lactivists see themselves as unrightly better than those who choose formula, than you need to pick another word instead of using one that is almost always used to describe hateful people.

  • http://feministing.com/members/praminthehall/ Caitlin

    Jessica has somethings right and some wrong in this statement: “But I also believe that formula feeding your child is just as valid and healthy a choice as breastfeeding – it’s not something women should have to justify or be denied resources for or access to.”

    Formula can actually be HEALTHIER than breastfeeding for individual mother-infant pairs. It’s healthier if the mother is HIV positive. It’s healthier (as it was in Jessica’s case) when breastfeeding is going so badly that the mother is unable to effectively mother or even live her own life.

    It is absolutely true that no mother (or father) should have to justify feeding choices or be refused access to formula if they choose it (as far as I know, this is not happening, despite the provocative proposals of some zealous advocates). This does not mean that formula marketing is okay.

    Safe, nutritionally sound formula should be available to whoever needs or chooses it. But as much as we would like to believe we are not influences by advertising, science assures us that we are. Formula companies spend BILLIONS of dollars a year advertising their products, whereas breastfeeding, which has no sale value, has almost no “marketing” budget at all (and US PSAs supposedly supporting breastfeeding have been badly conceived, influenced by formula companies, and notoriously ineffective).

    The US should follow the WHO Code for marketing breast milk substitutes, which is designed to protect and promote public health from commercial interests. The code specifies that safe formula should be available when needed or desired and that caregivers should be shown how to prepare it properly. It also specifies that there is no need whatsoever to market formula in any way. The US is one of only 8 countries world wide that has not implemented any aspect of the Code.