Margulis: Government should do more to promote breast-feeding
New York City Mayor Michael Bloomberg recently announced that come Sept. 3, city hospitals will be asked to keep baby formula under lock and key, with nurses required to sign it out as they would other medication. In July, The Boston Globe reported that hospitals in Massachusetts -- following Rhode Island's lead last fall -- have stopped giving gift bags with formula samples to new moms.
America's public policy on breast-feeding could reach even higher levels. When Massachusetts' Public Health Council first tried to end the formula giveaways in 2005 with a statewide ban, the decision was overturned by when then-governor, now-presidential-hopeful, Mitt Romney replaced council members in favor of the ban. In stark contrast, first lady Michelle Obama publicly champions breast-feeding as part of an ongoing campaign to reverse childhood obesity.
Thousands of scientific studies have shown the benefits of breast-feeding. Research has linked breast milk to lower rates of Sudden Infant Death Syndrome, gastrointestinal problems, necrotizing enterocolitis, ear infections, childhood obesity, diabetes, leukemia, and even high cholesterol later in life. A recent study showed that it prompts development of more brain cells; breast-fed babies have been shown to score higher on intelligence tests as infants, preschoolers and even at age 10.
These are among the reasons why the World Health Organization promotes breast-feeding babies up to 2 years, and the American Pediatric Association recommends exclusive breast-feeding for an infant's first six months.
But just because it's good for moms and babies, doesn't mean it's easy. Breast-feeding takes time, patience, sleep and a good support system. For too many new mothers, these are luxuries in short supply. Only 75 percent of American moms even try to breast-feed, and the vast majority give up before their infant is 3 months old.
In Norway, by contrast, 99 percent of moms initiate breast-feeding and the majority of 6-month-olds -- 80 percent -- are still nursing.
There are structures there that support this. In comparison to our meager leave policies, new moms in Norway get 47 weeks of maternity leave at full pay, or they can take up to 57 weeks at 80 percent of their salary. Fathers, too, get three months of paid paternity leave. In the maternity wards of Norwegian hospitals, formula is available but rarely used. An infant who needs formula is fed with a dropper -- so as not to interrupt breast-feeding -- and mothers are not shown the brand. Advertising formula is illegal.
In U.S. hospitals, on the other hand, formula is ubiquitous. While researching the influence of corporate interests on baby care, I toured hospitals across the country and interviewed nurses, doctors, hospital administrators, midwives, doulas and dozens of new moms. What I found was dismaying: Hospitals accept free branded formula from manufacturers. Nurseries often use pacifiers, though pacifier use has been shown to interfere with successful nursing, and mothers are usually given formula samples on discharge. Essentially, the hospitals are engaging in product placement -- and sending the message that breast milk isn't enough. There's often little support for mothers to keep trying to breast-feed. Many hospital neonatal units don't even have a place for women to nurse.
Meanwhile, formula sales representatives bring pizza and doughnuts to the labor and delivery ward to generate goodwill among the nurses.
Some pediatricians, too, end up discouraging breast-feeding. It's much easier for a busy doctor to hand a mom some formula samples than to spend half an hour with her evaluating the baby's latch.
What Bloomberg, Massachusetts and Rhode Island are doing is a good start, but American mothers need stronger public policies to promote breast-feeding. Our government is the nation's biggest purchaser of infant formula, offering it through the federal Women, Infants and Children program to the most disenfranchised moms -- who are also among those who could benefit the most from nursing.
Breast-feeding shouldn't be only for the wealthy who have the luxury to take time off from work without pay. It's time for the American government to stop buying formula and instead require employers to provide new moms with a private place to pump. It should mandate and finance paid leave for all new parents. If we prioritized young families over corporate interests, as is done in Scandinavia, we could find the resources to fund this kind of program.
With a system that makes breast-feeding so difficult, women who don't nurse shouldn't feel guilty -- they should feel angry.
Jennifer Margulis, a senior fellow at the Schuster Institute of Investigative Journalism at Brandeis University, is author of the forthcoming book, "The Business of Baby: What Doctors Don't Tell You, What Corporations Try to Sell You, and How to Put Your Baby Before Their Bottom Line."