Tuesday, October 20, 2009

What exactly do we have to gain from telling the truth about formula?

An article has been popping up in Canadian newspapers this month, with the dubious headline "Prepare a backup plan for feeding baby: Moms should learn about formulas as a nutritious option to breast milk." It reads as a thinly veiled ad for infant formula, heavily quoting an Ottawa pediatrician (pregnant with her first, of course, & due any day) who recommends that parents plan for breastfeeding failure by having formula at the ready before baby is born. Let that sink in. A pediatrician & mother to be is suggesting that you have at the ready a product that will increase your baby's chance of death in his first year by 30% *

So, really, who benefits from this arrangement? It certainly is not the baby and it is rarely the mother. It has been well-documented that the free promotional formula & coupons handed out by doctors, hospitals etc decreases the likelyhood of successful breastfeeding. It is obvious that the formula (read, pharmaceutical) industry benefits when women don't breastfeed. It is also well-established that parents are apt to continue to buy the brand of formula recommended by their doctor.

So how do doctors acquire the information needed to recommend one brand of formula over another? Not in med school- the amount of education on either breastfeeding or formula feeding is negligent, if at all existent. They receive virtually all of their education on infant feeding from pharmaceutical companies, ie, the makers of formula. It is a drug & it is marketed as such. The pharmaceutical industry is a huge one, with vast marketing & advertising budgets. Chances are you know a drug sales rep- ask them what their job is like! A typical sales rep is expected to build & maintain positive relationships with the MDs in their territory. This is accomplished by spending time- appointments in the doctors' offices, lunches out, golf games. The entertainment is covered by the drug reps' expense account. During the time spent, the focus is on educating the doctor about your product- be it the latest anti-erectile dysfunction pill, or the newest infant formula. How it is different from competitors. How it is used. Swag- pens, notepads, measuring tapes are left (with the product logo on them), as are samples for the doctor to hand out to patients who might use the product.

Consider this when, as a new parent, you walk into your doctors office hoping for help with your breastfeeding questions. While a small industry around breastfeeding has cropped up (nursing pillows, breast pumps, other products) it is a tiny fraction of that of the formula industry. Frankly, the people selling those products are probably not the ones considered to be the Zealots, the Lactivists. The Nazis.

What on earth do the so called breastfeeding bitches(lactivists, nazis, whatever) have to gain? I was inspired by this quote from Edmonton doula Victoria Powell, in response to a "friends" complaint about a link she posted on her Facebook page:

"I don't agree whatsoever. Breast isn't best-it's just normal!!
To make the choice to use formula is absurd. I never know how to respond when I hear that a woman was made to feel guilty because she didn't/wouldn't breastfeed. The first I think is: what exactly do these breastfeeding "zealots" have to gain from telling the truth about formula?
Nothing. We don't spread the truth because we want women who formula fed to feel bad, we want them to rethink what they did, and do it differently with their next baby. And if they medically cannot breastfeed, I want them to still encourage breastfeeding for others. Because the mother who genuinely couldn't breastfeed uses formula to keep her baby from starving, that doesn't mean formula is a safe choice for women who can breastfeed. It is to be used in an emergency situation only. No one has anything to gain from a woman breastfeeding- except for that mother and her baby."

I ask you to consider this. We have nothing to gain. Ostensibly, there is the potential for reduced public health care costs, but that exists with any public health initiative. Frankly, it doesn't impact my bottom line as a taxpayer.
Those of us who speak out against the unethical marketing of formula, the misinformation, lies & spin that the industry perpetuates, have nothing to gain from it. Only one group stands to lose from our efforts- the formula industry itself. We know what happens when it feels threatened. Employees are assigned to stir up Mommy Wars in parenting forums. Companies attempt to bribe bloggers . Babies are lost in the shuffle as the disussion focuses not on how formula should be marketed, or on how it's safety can be improved for those reliant on it, but on the "lactivist agenda".

We have nothing to gain. Mothers & babies have everything to lose when they are not able to access accurate information about the risks of formula feeding.

"No one has anything to gain from a woman breastfeeding- except for that mother and her baby."

*This statistic was quoted by Teresa Pitman at the 2009 Birthing Breastfeeding & Bonding conference in Lethbridge Alberta. It is based on meta-analysis of the combined risks of infection & disease caused by not breastfeeding.


  1. I love the way you've expressed yourself! Thank you for this blog, I think I'm going to enjoy it very much. And thank you for supporting mothers.

  2. While making women who cannot breast feed feel badly about themselves as mothers, or as you put it, "rethink" their decisions, you gain a feeling of superiority... so don't say you have nothing to gain. Otherwise I cannot imagine why you would relish making someone feel badly. Education is one thing, shaming someone is entirely another. If you care so much about mothers and their babies, maybe you should think about the undue pressure you are putting on women who may be suffering from post-partum already. Educate responsibly please... not everything is black and white.

  3. I'm a mom of four, three of which were breastfed, the second had an undiagnosed tongue tie, and so I was under the impression that I was too stressed out to produce milk for her and finally gave her formula. I don't think formula is bad in as you put it, an emergency situation, but I agree that the doctor was too quick to recommend formula, rather then find the real problem. I should have known, being an expienced breastfeeding mom that it was not me that had the problem. The doctors and nurses failed both me and my child. Thank you for stating what we've all known for years, the pharmiceuticals love making money off the insecurities of all who rely too heavily on their doctors advice. Trusting yourself first, then your doctor, is a wiser policy.

  4. I don't feel superior in anyway to a mother who cannot or will not breastfeed. I have family members and friends who fall into that category and yet I am a militant breastfeeder. The guilt story has been played a long time, but telling the truith about formula is NOT about guilt tripping but about telling the truth and helping mothers and babies, not catering to the whims of the formula companies.

    I support and love all my friends and family for their attempts and KNOW that they ALL love their babies and want what is best for them. This is not about the mothers. It is about debunking the dangerous myths that have been prevalent for so long and helping the babies.

  5. Actually, in a Nationalized Health situation, the governemtn benefit from mothers breastfeeding, as do tax payers. Because it makes for fewer sick kids and reduced medical expenses.

  6. Niecey, she does refer to that fact, however she points out that spreading the truth about formula has no immediate, personal benefit for her. I'm not seeing thousands of dollars, nor even $2 coming back to me when I tell people about the true differences between milk and formula.

    Lueida, to the contrary, as a mom who breastfed and is very passionate about moms having the best support and information in order to be successful breastfeeding, I do not feel superior to formula feeding moms in any way. I do, however, feel lucky that I had a really easy go of it. I have enough close friends and family who have struggled with breastfeeding and would not be so callous as to then look down on them and add insult to injury.

  7. Beautifully put. That's all I can even say about it...

  8. thank you for this. im posting a link on my facebook. this is EXCELLENT!!!

  9. Great post, but a different take: There is another option of doing both as I did with my first. I honestly wanted to breastfeed my first, and I did everything I could to do so, even saw a lactation consultant one on one outside of the hospital. But when my daughter was crying hard for days clearly due to hunger, my nipples were cracked and bleeding, I was crying from the stress, I was glad to have a little bit of formula sample that came with my free hospital bag. It gave me a couple days for the milk to come in, and she was able to feed from me and the bottle and then mixed when I was at work (found out breastmilk gets rid of all foam from formula mixing) as I realized I couldn't produce enough for my baracuda. Once you use formula it takes a lot to get your supply back. With my 2nd, I did all breast as I learned.

    Looking back now, I see things we could do differently: 1) Better educated lactation consultants, 2) Community of experienced mothers, 3) No condemnation but education.

  10. I wanted to post that I completely agree with this blog post, and that I am absolutely an advocate for breastfeeding, however I want to ask what is the alternative? We *know* formula is not desirable, and all the health concerns that go with it, but lets say that the mom does not get the support she needs to establish a good supply, and formula is the only option...or the only available option, how do we not make her feel guilty? I just feel by demonizing the formula itself (not the companies) that we are not supporting those women. Unless you have actually had issues with establishing nursing yourself, seems like its a no brainer, but as a mother with a slow weight gaining baby, and an LC in Calgary tell me that I was being stubborn by not supplementing and that I would be the cause of my son's mental issues (due to lack of nutrition), I would have loved and Welcomed an alternative with open arms....however, my alternatives were Soy, Whey or Corn. :(
    We need to find the alternative an educate the mothers on THAT if they seem to have issues nursing, or have lack of support, or need to supplement for a couple feeds the first week, and leave the breast vs. formula debate, and consider it done.

  11. My body produced WAY too much milk once my milk came in. It upset and overwhelmed my son, and took him four hours to eat because he would get one drop and then jump off screaming and crying. It was horrible. I reduced my feedings to a couple times a day and gave formula in between because I needed to reduce my supply to an amount that was manageable for him. In less than a week my supply has adjusted to his needs, and I've been breastfeeding him for 3 months now. He still has formula once a day when his dad is taking care of him in the mornings, and that is the right choice for our family. When I read the stat that giving him formula increased his chance of death by 30% I was appalled. It was stated in a very misleading way (as in formula CAUSES death, not that breastfeeding reduces it), and the information you cited to back it up was definitely lacking. I was looking for an article, and you had just quoted something you heard someone say and linked to a conference. I'm all for breastfeeding, but please don't go around telling women that formula leads to death. Fear mongering is not really the way to prove your point.

  12. The 30% statistic is accurate. Teresa Pitman is a well-respected expert & author in Canada & the quote was from a recent conference for health care professionals. There are hundreds upon hundreds of studies clearly demonstrating that not breastfeeding causes infection & illness, which sometimes lead to death. Search PubMed, you will find them. Breastfeeding, being the biological norm, does not decrease the chance of morbidity & death- not doing so increases it.
    Additionally, the formula itself can & does cause illness & death. In its powdered form, it is not sterile. As with all manufactured products, it is prone to bacterial & other forms of contamination, mis-production etc.

    Formula certainly can lead to death. That is not fear mongering, it is fact.

  13. Alisha- I think we need a few things happening to provide safer alternatives. The UN heirarchy lists:

    1-breastfeeding with mother
    2-mothers pumped milk
    3-donor milk
    4-infant formula

    First, we need to be working on getting factual information about infant formula to the public.
    Second, we need to re-establish human milk banks.
    Third, we need to improve the quality of formulas- they are currently made with the lowest quality, least expensive ingredients available. Higher quality proteins, oils, etc, along with stricter manufacturing laws would be a start.

  14. I agree with a lot of what was written, but I take exception to this: "that doesn't mean formula is a safe choice for women who can breastfeed. " That is completely inaccurate.

    Is it as GOOD a choice as breastfeeding? No. Can problems occur as a result of formula feeding? Yes. But is it GENERALLY safe? Absolutely.

    It's not like there are never any problems associated with breastfeeding...for example, my sister's baby almost choked to death because blood in the breastmilk - which was not visible - irriated her stomach and caused her vomit to thicken to the point where she couldn't cough it out. So would it be fair to say that breastfeeding isn't safe because problems CAN happen? No. So why use that as a reason to say that formula isn't safe?

    Plus, there is evidence to suggest that the "30% increase of death" is more related to parenting styles than actual content in breastmilk or formula.

    By the way, I breastfed my baby.

  15. I love this blog! I must say, even if I don't agree with every statement, it nonetheless informs me.
    If I would have known then what I know now with my first, I likely would have breastfed past 3 months. I have 4 children and breastfeeding has ALWAYS been a challenge. My first, I misread her tired cries and assumed she was hungry. I fed her nonstop, or at least tried and she would scream, she wasn't hungry, she was sleepy. I then misinterpreted that for a lack of milk. I began supplementing, which decreased my milk and so on.
    My 2nd, was a big boy, he clusterfed then slept through the night which wreaked havoc on my milk supply. He then began to lose weight. Was a good night's sleep more important than breastfeeding? I didn't think one had anything to do with another. My doctor suggested I supplement at 3 months, I followed his orders.
    My 3rd would scream with my let-down. I hated to nurse in public because she would refuse my breast, even after 5 hours. Concerned people would look at me, I could tell they were judging. I spoke with a lactation consultant. I didn't believe anything she said. Finally I went on a medication to increase my milk, I was certain that it was a lack of milk again. This time I was able to nurse for 7 months. Although I am not proud of the idea of using medication.
    I have now learned that my birth experience is directly related to my breastfeeding experience.
    With my fourth baby, I had an incredible birth experience and other than a bout of thrush, we are coping beautifully. I am much more informed now and able to make better decisions, and in turn I am more confident. I think confidence plays a major role in successful breastfeeding. I am honored to have know Arie and be a part of this blog. It is difficult to think what kind of birth I would have chosen due to my lack of information and the likelihood of trusting the medical community rather than myself.

  16. I agree that breastfeeding is the way to go. But for me I was only able to breastfeed for 7 weeks. I was surrounded by friends and family that acted like formula was from the devil and that I should never use it. When I read this article I cried. I miss so much the times I breastfed with my lo, even though it was a constant battle. Little did I know that I was basically starving my lo because I wasn't making enough milk due to stress and axniety. And the pressure to continue breastfeeding added to it. I have found an alternative to formula that is A LOT healthier but WAY more expensive. We are a low-income family and I'm on WIC to help provide the food needed to help my precious one grow, including formula. I agree that doctors need to look deeper into why a baby and mother is/are having problems breastfeeding and to not push formula so quick. I also agree that women NEED to have support and be informed about the skills of breastfeeding BEFORE they give birth. The fact that I had no other choice than to use formula was hard to accept. But reading this article was a knife in my heart. All women that use formula whether because they have to or want to are secretly judged when they feed in public. They are thought to be vain or lazy in deciding to use formula. I used to be one of them. But in the end we don't know the circumstances why they formula feed. I'm glad that it's there but agree with you in the thought of making formula about the health of the babies and not about the money the drug rep,'s are making.

  17. You know - I wish I would have had formula on had for my first daughter - I was a wanna be boob-nazi and thought enfamil was the devil.

    Little did I know I had insufficient glandular tissue and my daughter was dehydrating and her kidneys were shutting down. I was literally starving her to death until a lactation consulant heard pure terror in my voice because my little girl was peeing red brick dust and was GREY - she brought me in and we poured enfamil down her throat and she got some color and actually started to respond.. I went to the LC every day for 2 weeks and my supply never did come around (despite spending thousands on herbs, pumps, lactaids, etc) - I pumped around the clock for 7 months and got droplets and my baby never got more than 5 cc's at a feed (1 teaspoon). It about destroyed my marriage.

    My second daughter - I knew better and she was exclusively breastfed through donor milk from birth through her first year. I took milk with me to the hospital.

    Now... my three year old -who was my first daughter - I look at her and I will never forgive myself for starving her. NEVER. I put her through failure to thrive and starved her into being unresponsive because I wanted to be a proud mamma who exclusively breastfed. And now- she has mild autism (very mild/very high functioning) and I wonder if because she learned from day one that it was safer to be under responsive and not fight for her right to be fed - if that is why she has so many sesnory issues and is so stuck in her own world.

    What a crock -formula is there for a reason.

  18. Pumping exclusively is an option too. I've had trouble BFing both of my kids and am now pumping exclusively for my second child, just like I did my first. It takes dedication, but it can work.