Hospitals limiting baby formula, stirring breast-feeding debate

The debate over how mothers feed their newborns is back in the news, with World Breastfeeding Week starting Wednesday.

The designation commemorates the Innocenti Declaration made by the World Health Organization and UNICEF policy makers in August 1990 to protect, promote and support breast-feeding. According to UNICEF's State of the World's Children Report 2011, 136.7 million babies are born worldwide and only 32.6 percent of them are breast-fed exclusively in the first six months.

In May, the New York City Department of Health and Mental Hygiene launched Latch On NYC, a hospital-based initiative to support a mother's decision to breast-feed — that includes enforcing the New York State hospital regulation not to supplement breast-feeding infants with formula unless medically necessary, limiting access to infant formula by hospital staff and discontinuing the distribution of promotional or free formula products.

Of the city's 40 hospitals, 27 have agreed to give up the free formula gift bags, according to the DHMH.

Starting Sept. 3, the city will keep tabs on the number of bottles that participating hospitals use and document a medical reason for every bottle a newborn receives, according to the New York Post, which also reports that new mothers will not be denied formula, but if it's requested, they'll receive a mandated talk from staffers and nurses on why they should opt out.

On Long Island, many hospitals have been limiting formula, providing it to infants only if it is medically necessary. North Shore-Long Island Jewish Health System in New Hyde Park said it hasn't distributed formula bags in about a year. “We offer prenatal classes and breast-feeding support groups twice a month for new moms and we also have lactation specialists on staff to support moms who are having difficulties,” said Linda Faller, assistant director of perinatal services at LIJ.

Nassau University Medical Center in East Meadow stopped distributing formula bags and removed formula information from their literature racks about a year and a half ago. “At that time, it was about 50 percent of moms who breast-fed,” said Shelley Lotenberg, a spokeswoman for NUMC. “Now, it has increased -- about 90 percent of all moms exclusively breast-feed or use a combination of breast and bottle.”

While four Catholic Health Services of Long Island hospitals that offer maternity services, which include St. Catherine of Siena Medical Center in Smithtown, Mercy Medical Center in Rockville Centre, Good Samaritan Hospital Medical Center in West Islip and St. Charles Hospital in Port Jefferson, do not distribute formula samples to new moms, the staff is respectful and supportive of parents' feeding decisions, said Chris Hendriks, CHS vice president of public and external affairs.

“We encourage breast-feeding for the promotion of the best health of newborns in our care and the bonding support breast-feeding affords our moms and babies,” Hendriks said. “Whenever breast-feeding is not possible, we support our patients with the best alternatives.”

Recently, Stony Brook University Hospital was selected to participate in “Best Fed Beginnings,” a first-of-its-kind national effort to increase the number of U.S. hospitals implementing a proven model for maternity services that better support a new mother's choice to breast-feed. In fact, at Stony Brook, 82 percent of mothers breast-feed while in the hospital and 32 percent of moms use breast-feeding exclusively, according to Kathleen Van Deventer, clinical nurse specialist and lactation coordinator. The hospital's rate of exclusive breast-feeding has nearly tripled over the past two years.

Comments on the North Shore Mamas Meet-Up message boards reflect the range of personal experience and depth of emotion surrounding the breast-feeding vs. formula debate.

Maria Gonzalez-Prescod, mother of two from Bay Shore, breast-fed her children for a year. “I remember at both hospitals where I delivered a few years ago they actually tried to encourage formula,” she said. “Formula was always brought to my room but I chose to breast-feed only. So if they start to encourage breast-feeding that would be wonderful.”

Tiffany Macartney, mother of two of East Northport, feels it's a new mom's choice about what to feed her baby. “I nursed both my boys for a year,” she said. “When I was asked by the labor and delivery nurse if I was going to nurse or bottle feed, I said I'd like to breast-feed given that all goes well. She answered me with 'good girl,' as if I answered the question right. I don't think it's fair to put that pressure on a mom and to hide the formula as if it's some sort of contraband and to have to ask permission to feed it to your own baby is over the top. It's the mother's right to decide what's best for her baby.”

Macartney's comments reflect the emotional nature of this debate, and how personal experience can impact a mother's view.

When I was pregnant with my now 16-month-old daughter, I intended to breast-feed. I bought a pump and all the accessories — I even took a breast-feeding class.

When Maggie was born, she latched on the first day. By the second night, she wanted no part of it. I pumped and kept trying to get her to latch on as nurses came by to support me, but it wasn't working.

So I asked for formula. It created such a stir that I felt I was doing Maggie a disservice. One of the nurses finally asked me if I was sure because she had to document that the hospital tried everything it could to get me to breast-feed.

When I brought Maggie home, I continued to pump with the hope of breast-feeding full time. But after a week, she lost more weight. Maggie's pediatrician directed me to switch to formula.

I felt I made the best decision for my daughter, but I'll never shake the feeling that I failed, in part because of the pressure I was under.

Feeding babies — whether with breast or formula — is a huge commitment. I applaud all these efforts to increase breast-feeding, but such initiatives should be about educating women and supporting the choices they make.

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