I know -- as a parent first of all, then as a physician, and finally as a public health practitioner -- that "breast is best." Breast milk, absent some very compelling contraindication such as a transmissible infection, is the ideal food for a newborn. Nothing else we've got confers the many unique benefits of breast milk.
These benefits, very well chronicled in the scientific literature, are stunningly comprehensive. They range from the psychological effects of such close bonding between mother and baby, to enhancements to both skeletal and cognitive development, to the transmission of protective maternal antibodies as the newborn immune system and GI tract slowly mature, to an apparently lifelong defense against obesity we don't even fully understand.
While in general we really can't say for sure which specific diet is best for older kids and adults, the first year of life is a clear exception. Breast is unequivocally, unambiguously, and altogether conclusively best.
And so, the promotion of breastfeeding is a World Health Organization priority, and breastfeeding figures among the objectives for Healthy People 2020. Objectives, by the way, we are still a long way from meeting.
None of the above was surprising to me, and I bet nothing so far has been terribly surprising to you. So here's the surprise: One of the reasons we are so far from national objectives for routine reliance on breast milk as the safest, cheapest, healthiest, and just plain best way to feed a newborn is... food marketing. Yep: food marketing to neonates.
I am among those who feel that food marketing to children is a serious problem, in need of substantial reform through voluntary restraint (I advise against holding your breath!) or regulation. Foods marketed most aggressively are unfailingly -- as innumerable studies show -- of fairly poor nutritional quality. The foods kids are coaxed into loving, in other words, are the least likely to love them back -- and will instead accelerate their progress toward obesity, and even diabetes. And the contest between a 6-year-old and a highly-paid advertising executive is unfair by any standard.
But despite my devotion to this topic, I had no idea that even neonates were in the crosshairs of food marketers.
They are. According to Elizabeth Ben-Ishai, Ph.D., the campaign coordinator for Public Citizen's Commercial Alert Project, roughly two-thirds of ALL HOSPITALS nationwide allow food and pharmaceutical companies access to their maternity wards. The companies use this hallowed real estate to hand out "discharge bags" of free infant formula to new moms. The bags are, of course, decorated with company insignia and formula names -- and are accompanied by discount coupons for subsequent purchases of the same formula.
My friend and colleague Karla Shepard Rubinger, executive director of the Academy of Breastfeeding Medicine, had this to say:
Although the formula companies all give lip service to "breast is best," their aggressive advertising and marketing do everything to undermine it. And there is a significant amount of research to show that where formula is provided at no cost, breastfeeding rates are lowest. Our goal is to better educate physicians, hospitals, and other healthcare providers to understand why breastfeeding is so very important: It is universally available, free, evidence-based, supported in all cultures throughout time, shows documented benefits for mother and baby, and is "green" into the bargain.
What she said!
I spoke with Dr. Ben-Ishai, who confirmed that simply distributing formula and coupons substantially reduces breastfeeding rates. She noted that the practice extends at times from the hospital to the offices of both gynecologists and pediatricians.
Public Citizen is sponsoring a petition to end food marketing to neonates. Dr. Ben-Ishai noted, "This is not about setting any limits on mothers' choices; it's about opportunistic marketing by the formula companies, and the ethics of the hospitals that allow this marketing to take place on their turf." A formula industry valued at well over $3.5 billion and an exhausted new mother with a newborn in her arms looking to a ward full of health professionals for guidance seems a very unfair match-up indeed. By distributing their goodies on maternity wards, the formula companies are getting a "halo effect" -- making it seem as if the hospitals and health professionals are recommending formula.
And for that reason, the marketing works -- even when lactation counselors encourage breastfeeding, according to Dr. Ben-Ishai. The counselors do provide a first line of defense, but it's not enough against a marketing campaign valued at many, many millions of dollars.
If we want more children to get the benefits of breastfeeding -- and anyone with any reason to care about any child, should -- we need to un-muddle the message being delivered on the rarefied terrain of the nation's maternity wards. "Breast is best" needs to be uncoupled from "but here's a free bag of formula and some swell coupons!" And the fact that no one gets paid when a mother provides her baby the best nutrition there is? Too bad! We all profit in the ways that matter most if healthier babies abound.
I remain hopeful about curtailing food marketing to kids in general. But for now, let's at least end exploitative food marketing to neonates. Mothers who truly prefer or need formula should get it. Mothers who don't should not be talked into it.
Ideally, formula companies should simply abandon the practice. If they don't, hospitals should defend their turf against it.
The best possible start in life is every baby's birthright. For the vast majority of babies, breastfeeding is an important part of THAT formula. The marketing of other formulas to neonates as an alternative to breast milk... most certainly is not!
-fin
Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org
Sign the Public Citizen petition here:
http://action.citizen.org/p/dia/action/public/?action_KEY=10062
Learn more about breastfeeding, and formula marketing, here:
http://www.bfmed.org/Default.aspx
http://www.citizen.org/infant-formula
For more by David Katz, M.D., click here.
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FAQs about Baby Formula, Bottle Feeding and Infant Nutrition ...
Women can make their own choices. A woman's body is her own. It is her right to make her own choices about birthing, nursing, contraception, pregnancy. Free formula and free help with nursing can both be provided. She owes no explanation or apology to anyone about her choice.
pharmaceutical companies provide all kinds of free products for all kinds of patients. it is paternalistic to focus on this specific one. how about a campaign against viagra samples to stave off heart attacks?
We have epidemics of diabetes, asthma, cancer, etc, and we don't think baby's diet, when there is only 1 thing baby eats--this isn't one fruit roll up instead of fresh grapes--is gonna matter? Our babies are born practically fetuses. They are born to have breast milk to complete their brain development, their digestive track, to nurse in order to complete their neurological development, their oral motor development, etc. To deny our babies this when their bodies count on it to complete their development is to risk consequences.
We all make decisions for our children every day, but let's not make them with "I didn't wear a seat belt as a kid and I'm fine" mentality. If we can look at the risks and say honestly that for us, this is best, risks and all, then fine. But don't get mad at ppl for stating facts.
Hospitals & doctors should not be marketing any product but especially one that has known health risks.
If this is a war on women, it's not a war on human women- it's a war on female mammals of all species. And if it's being waged, it's not being waged by men, or other women, or me- it's being waged by biology, anatomy, physiology, and natural selection. Those are not good forces with which to be at war in my opinion.
Equality does not mean equivalence. I would line up with those willing to wage war in defense of the first- but am still willing to acknowledge that men and women are not the same. It's not an ideology- it's just a fact.
I suppose pregnancy, or the actual gestational period, is anti-woman as well, because it's a burden that only falls on the female during the reproduction process (that seems to be your implicit argument here)? These things naturally come with children. They are part of the natural process. That's really the end of it.
How insanely silly can one be to assume that a man-made product which has orders of magnitude less nutritional diversity than the natural, biological thing (this is demonstrably and objectively true of all human technology by the way... we just don't design with natural levels of complexity. We don't design to a bell curve in organic compound variations, yet that's the way nature works) could approach the same organic and biological benefit.
Formula feeding certainly can be a medical necessity for a particular woman here and there, but to eschew it on principle is really unnecessary.
I don't see what the big deal is, frankly. I was bottle fed, as was my brother, my husband, his sister, and probably 90% of everyone I grew up with as that was the norm in the late 50's/early 60's. Both my children were bottle fed. We were all healthy children and are now relatively healthy, productive adults. It's not like this is a developing country with an uncertain water supply which would make mixing formula risky for the child.
Breast feed if you want, bottle feed if you want, and allow others the right to make their own choices without condemnation.
Yes, there are some women that don't want to breastfeed, and that is their choice. But, I really think it is ridiculous for any hospital or doctor to actively discourage it or attempt to sabotage it and it immediately colors my opinion of them. Doctors and nurses (at least in my area) need to be more educated about breastfeeding and they should be the first line of support for mothers that want to learn and do it, because it isn't easy for everyone and can be incredibly stressful.
With my first child, I very strongly wanted to breastfeed. At the hospital after he was born I was ridiculed for my choice. I asked for help from a nurse experienced with lactation and they told me she was on vacation. They actually laughed at me and asked me why I was "so afraid" to give my baby formula. They gave me BAGS - I mean brown paper grocery store bags - of free formula because I obviously was incapable of breastfeeding. I felt harassed, I felt under a microscope, they were telling me if I didn't get my baby to latch or feed him and he lost any more weight they wouldn't let me leave with him. It was ridiculous. I was so stressed out and had such a lack of support I was sobbing and he was crying every time I tried to feed him. Even his pediatrician (who I replaced immediately) laughed at me for refusing to use the free formula! I ended up not being able to get him to latch properly, but he never had any formula. I pumped for him for 14 months, and I am really proud of myself that even with the complete lack of support I received I still made sure I fed my son what I wanted to. He is now a happy, healthy toddler and he eats everything we give him. Cont...