Mother Talkers

The Politics of Breastfeeding

Fri Oct 26, 2007 at 08:45:27 AM PDT

I’ve been an avid reader of the attachment parenting resource Mothering Magazine since my son was an infant.  Mothering’s editor, Peggy O’Mara has written a very interesting editorial about how she feels breastfeeding is in trouble.   According to O’Mara, breastfeeding initiation rates dropped when infant formula companies began to advertise to consumers in 1989 via magazine and television.  At the same time, she says that breastfeeding advocates became more active to actually increase the initiation rate to an all time high of 70.1% in 2002.  Then, in 2003 she says the unthinkable happened.  The rate drops 4% to 66%.  

And, the numbers themselves might be somewhat skewed as they are compiled by formula manufacturer Abbott-Ross.  And, you might be surprised to find out that breastfeeding initiation rates are defined as “one breastfeeding during one day”.  So, if breastfeeding is just “tried”, that counts as “breastfeeding initiation”.  It may not even be exclusive breastfeeding... but mixed feeding including formula.  

As we’ve discussed many times before, this country does nothing to help moms exclusively breastfeed.  Lack of paid maternity leave and lack of support to moms who choose to pump at work present major obstacles to successful breastfeeding.  O’Mara describes how it affects mothers from different socioeconomic backgrounds:

...because the six weeks of unpaid leave that we do get—if we can afford to take it—barely give us enough time to establish breastfeeding, much less figure out how to combine it with working. In addition, white-collar workers have greater access to lactation support in the workplace than do blue-collar workers. We need laws that protect every woman's right to breastfeed or pump in the workplace, and provide training for employers about breastfeeding's advantages. Numerous studies have shown that the many benefits include lower health care costs, less absenteeism, improved staff productivity, and lower employee turnover.

And, how about this?  Some websites that appear to be breastfeeding advocacy sites are actually just “mouthpieces for the formula industry”.   MomsFeedingFreedom tells moms they need to stop the Ban The Bags campaign.  Here’s where the politics comes into play:

One such website, www.momsfeedingfreedom.com, is registered to eNilsson, an international Web consulting firm whose clients include Romney for President. Republican candidate Mitt Romney, as governor of Massachusetts, pressured his state's Public Health Council to rescind a ban on the bags of free formula given by hospitals to new mothers and paid for by formula companies. The website states that "the opinions and views expressed on this website are of Kate Kahn," a corporate communications strategist based in Boston. A sister site, www.babyfeedingchoice.org, is licensed to Kellen Communications, a public relations firm whose clients include the International Formula Council.

As you may recall, Massachusetts was the first state to institute the “Ban the Bag” policy.   Governor Romney pressured the Public Health department to put a hold on the ban in May of 2006.  The result?

Less than two weeks later, Romney announced a deal with Bristol-Myers Squibb, the world's largest formula manufacturer, to build a $66 million pharmaceutical plant in Devens, Massachusetts.

So, it’s not about choice.  It’s about corporate profits.  Take a look at the abysmal breastfeeding rates in some developing countries:

Sub-Saharan Africa has a rate of 32 percent; Asia, overall, 35 percent; Indonesia, 39 percent. In Vietnam, only 19 percent breastfeed, and in Thailand, only 5 percent.

If the majority of babies in those countries are formula fed, you can imagine the enourmous profits for US formula companies.

In the Philippines, the government tried to do something about raising their 16% breastfeeding initiation rate.  When they did, the infant formula industry stepped in and sued the Philippine Health Department from new rules like stricter labeling and accurate health claims from being enacted.  

In July 2006, the Philippine Supreme Court denied the formula companies a restraining order, but on August 15 it overturned its earlier decision and granted the restraining order to PHAP. This action was taken just four days after Thomas Donohue, president of the US Chamber of Commerce, wrote a letter to President Gloria Arroyo in which he threatened the Philippines with loss of international investment (www.babymilkaction.org).

No, breastfeeding advocates aren’t crazy like Bill Maher would have us believe.  I think sometimes advocates are portrayed as nutjobs trying to push an agenda.  On the contrary... I think it’s just retaliation to the corporate greed of the formula industry.  As long as there’s profit to be made by pharmaceutical companies, breastfeeding can and will be compromised.  

Tags: Mitt Romney, Breastfeeding, Formula, Ban the Bag, Philippines, Mothering, Peggy O'Mara (all tags)

Permalink | 20 comments

  • The trend is up (0 / 0)

    Ross Labs does a mail survey with low response rates.  According to what I think is a better response rate, the breastfeeding trend is upward.  It's still not high enough, but it is positive, not negative.

    MMWR link

    Among infants born in 2000, breastfeeding rates for the early postpartum period,* 6 months, and 12 months were 70.9% (95% confidence interval [CI] = 69.0%--72.8%), 34.2% (CI = 32.2%--36.2%), and 15.7% (CI = 14.2%--17.2%), respectively. For infants born in 2004, these rates had consistently increased to 73.8% (CI = 72.8%--74.8%), 41.5% (CI = 40.4%--42.6%), and 20.9% (CI = 20.0%--21.8%), respectively (Figure). Based on the revised questions, rates for exclusive breastfeeding through ages 3 and 6 months were 30.5% and 11.3%, respectively, among infants born in 2004 (Table 2).

  • Wow re: developing country rates (0 / 0)

    Those are just amazing!  Do you know of efforts by US NGOs to help increase those rates?

  • Where is the developing country info from? (0 / 0)

    According to one source mentioned in the editorial, rates at initiation are much higher than what you cite.  Are your numbers at 4-6 months?

    • Very good point... (0 / 0)

      And one I plan on following up on.  After searching around different sites, I could not figure out where she got those stats.  So, I'm going to e-mail her to find out.  

    • I did (0 / 0)

      fire off an e-mail to Mothering... but it being a weekend and all it may be a while before she gets back to me.  She must have gotten the statistics from somewhere.  

      BTW, my SIL is Filipino.  And, when she had her daughter in the Philippines 5 1/2 years ago, she was instructed to feed the baby formula before her milk came in.  Maybe they are counting only "exclusive breastfeeding" and not just "breastfeeding initiation"?  

    • I just received an e-mail from Peggy O'Mara.. (0 / 0)

      Dear Hilary:
      Thank you for your kind words about my editorial. You know, I did use the LLL stats for most of my numbers, but the numbers
      "Sub-Saharan Africa has a rate of 32 percent; Asia, overall, 35 percent; Indonesia, 39 percent. In Vietnam, only 19 percent breastfeed, and in Thailand, only 5 percent."

      are from an article from the Philippines:

      link

      Peggy

  • It Doesn't Surprise Me If Rates Are Down (0 / 0)

    It seems like no one gets real about breastfeeding until you're actually sitting there with your hungry newborn, trying to figure out how to make her stop crying, wondering why nobody told you breastfeeding meant your baby wouldn't really have anything substantial to eat for about 2 days.

    The fact is, it's kinda hard.  OK, for me it was really hard.  That doesn't mean it's not very worthwhile, but there are a lot of logistical difficulties that make it hard in the modern world.  It's a supply and demand system, which means either you keep up with breastfeeding on demand and do it in public, you stay at home so as not to endanger sensitive Bill Maher types, or you end up bottle feeding for at least a portion of your baby's day.

    And it isn't like this is just a problem while you're sitting in a cafe enjoying yourself, most women have to work and pumping just doesn't work for everyone.  Assuming it does work, it requires time and dedication and a private place to do it.  

    I think that too often we sugar coat these realities in order to promote nursing, and we shoot ourselves in the foot when we do so.  I think that if lactivists really want to increase breastfeeding success rates, it's important to promote the benefits of nursing while acknowledging the difficulties.  Idiots like Bill Maher become idiots (on this issue, anyway) because there's zero awareness of what it takes to successfully breastfeed in the long term.

    http://www.tacomamama.com

    by jenyum on Sat Oct 27, 2007 at 02:49:30 PM PDT

  • Do you think... (0 / 0)

    there could also be a link between these dropping rates and the rise in scheduled c sections? I know that the doc who delivered me - although her office sponsors breastfeeding classes and natural birth - was also under peer review for a high rate of scheduled c sections/inducements. I was induced and ended up with an emergency c section resulting in other complications making breastfeeding one of the most difficult experiences of my life. My milk didn't come in fully for weeks. Our first ped told us "... are you going to wait for your baby to die...." to use formula. On and on... my husband and I were terrified - the pumping wasn't working... I felt like everyone was yelling at me and I shut down completely. While I know my experience was unique... I cannot help but wonder if more women who come thru c section don't have more issues with this. I was eventually able to combo feed my darling red head for 10 months when she quit on her own. I can't help wondering if it would have been easier without that "forced" birth - as I have come to call it.

    Since the house is on fire - let us warm ourselves.

    by michgs on Sun Oct 28, 2007 at 07:03:20 AM PDT

    • I think this has a lot to do with it. (0 / 0)

      I had both of my girls in Alameda County, CA, one of the most liberal places in the United States.  I was completely floored at how much the whole birth experience seemed to be designed to make bonding and breastfeeding as difficult as possible.  

      My first birth was very stressful and I do think that lead to big problems with nursing.  I also got terrible, terrible advice from pediatricians with no education on the subject that made our problems much worse.  (Like, is the baby nursing too much?  Schedule her, and take her off the breast after 10 minutes.)

      My second daughter's birth went fine, but the hospital fought to keep her there and pump her full of IV antibiotics for totally bogus reasons.  If I had let that happen I don't think we could have nursed at all, since milk production and my body don't always get along so well.  If I hadn't researched group B strep before the birth and didn't have confidence that they were being ridiculous, I would have let them put my newborn baby through 4 completely unnecessary days hooked up to an IV in a nursery.  I'd been on IV antibiotics for 12 hours before the birth, and 48 hours a few weeks before during false labor.  There's no way she was sick , and their only evidence that she was was a .5 over normal temperature reading that was back down 15 minutes later.  They kept sending more people in to quote old (and incorrect, even for the old ones) statistics based on women who didn't get IV antibiotics.  They had my pediatrician call me and bully me, generally treated me like a five year old, and tried to tell me that if I didn't do what they said the insurance company wouldn't pay for her birth.

      I stuck to my guns and got out of there a day early with my happy little baby, we got off to a great start and nursed for about two years.  At her first three or four doctor's visits her pediatrician would say "who would have thought she'd be such a healthy baby?"  I would.  

      http://www.tacomamama.com

      by jenyum on Sun Oct 28, 2007 at 09:34:19 AM PDT

      [ Parent ]

      • I had so hoped it was getting better. (0 / 0)

        I thought it was horrible 17 years ago when the nurse and supposed "lactation" support person came into the room I was briefly sharing with another young woman and told her the same....and that her newborn, six pound baby would only need to nurse every four hours!

        I'm not sold on the whole Strep B thing, either.  I had several children before anyone even heard of it, and honestly, I know of no one who ever heard of a newborn baby being infected.  And even when it first was becoming recognized, babies were not given anti-biotics, they were just observed for signs of infection.  In fact, when my 17 year old son was born, I supposedly had the strep b...and I asked about taking him home on a dose of antibiotics and was told that it was totally unnecessary and that it was not shown to prevent an infection.  I was also told that the chances of a baby getting this infection, even though the mother was carrying it, were very, very slim...less than one percent, I believe, and of that one percent, few developed serious consequences.  

        • IV antibiotics for mom good (0 / 0)

          From what I know of the research, IV antibiotics for mom are good at preventing transmission to baby.  It's not a common infection, by any means, but certainly caused (preventable) death for a small number of newborns.  In WA state midwives can give IV antibiotics at home births for Group B strep positive women, which I think is great.

          • Well, considering I had (0 / 0)

            him about 10 minutes after arriving at the hospital and pretty much delivered him myself, that wouldn't have helped!  

            Doctors were not testing mothers for this at this time...it was actually after he was born and I was ready to take him home in the morning (after about a 8 hour hospital stay)that it was mentioned.  I asked about giving him a round of antibiotics, and they told me it was unnecessary and would probably be ineffective in preventing him from getting sick.  I was told to watch him for fever or other signs of illness and to take him to our family doctor the next day.  I followed those instructions, but you know, as I sat there with a day old baby in the doctor's office, I thought how crazy this was...I was exposing my newborn, who in all probability was completely healthy, to God knows what...

          • I was fine with me getting them (0 / 0)

            especially since my water broke about 6 hours before labor was induced, I was glad they started them as soon as I got to the hospital.  (Right after my water broke.)  It gave me piece of mind to know that infection would be highly unlikely, I just wished that mattered on the post-partum end of things.  The whole point to dealing with the IV and the subsequent nuking of my intestinal flora was for my daughter to be safe.  Which she was.  

             

            http://www.tacomamama.com

            by jenyum on Tue Oct 30, 2007 at 11:48:48 AM PDT

            [ Parent ]

      • Beta strep... (0 / 0)

        I had that too, though neither of my children were administered antibiotics after the birth.  I had antibiotics during labor though... and what followed after both my births was a nasty bout of thrush that was really hard to get rid of.  

    • From the Mothering article... (0 / 0)

      In addition to obstacles in the workplace, there can be no doubt that our country's soaring cesarean rate adversely affects breastfeeding, as it did in the 1980s. A 2005 study in Greece showed that cesarean section and information disseminated through the mass media have a negative impact on exclusive breastfeeding. (Fani Pechlivani, "Prevalence and Determinants of Exclusive Breastfeeding During Hospital Stay in the Area of Athens, Greece," Acta Paediatrica 94, no. 7 [2005]: 928-934.) In the US, mainstream media coverage of breastfeeding, particularly on ABC, is sensational, provocative, and undermines breastfeeding success.

      As a former LLL Leader (and I'm sure your from LLL Leader MIL would agree too) we are told that c-sections can make breastfeeding more challenging.  

  • I keep Getting Distracted by Talking About Myself (0 / 0)

    It's really hard not to do that, since this is an emotional issue for me.

    I think there's a larger point that I've been trying to make, though, that despite any gains we've made due to the efforts of lactivists and natural birth advocates, the health care situation in the US just continues to get worse. As long as it does, medical handling of birth is going to make breastfeeding rates go down.  If doctors are too fearful of liability and insurance regulations to make decisions based on actual need, unnecessary C-sections, invasive procedures, and separation of mothers and newborns will happen regardless of their effect on breastfeeding rates.

    Add to that poor maternal health care and increasing poverty (and the public health problems that go along with poverty), and you have a recipe for more mothers receiving more interventions, with more negative impact on breastfeeding rates.

     

    http://www.tacomamama.com

    by jenyum on Sun Oct 28, 2007 at 09:48:40 AM PDT

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