Thursday, August 2, 2012

Latch On NYC

I was an exclusively formula-fed baby. I didn't even get the "first milk" (colostrum) from my mom, because at Brooklyn Hospital in the 1970s, that's not what was done. I think they gave her a shot to "dry up" her milk. It's all rather Brave New World.

Nevertheless, I have (knock on wood) always been healthy. I've never been hospitalized. My blood pressure is low; my cholesterol is normal. I've never even had strep throat.

As a baby, I didn't have pneumonia, ear infections or diarrhea. So what to make of the subway posters for the NYC Department of Health's latest campaign, Latch On NYC?

The Latch On NYC campaign's subway poster.

The DOH's breastfeeding brochure goes further:
Breast-fed babies are less likely to have asthma, ear infections, allergies, and diabetes. They’re also less likely to become obese.
I don't have asthma. I have mild seasonal allergies. I am not diabetic. And although I sometimes throw, much to Rayne's dismay, screaming "fat parties" in my bedroom, wherein I basically try on everything I own and thrust it on to the bed in tears when it doesn't fit right, I am not obese.

The point? Formula is just one part of the equation.

But it is part of the equation. And we know now (or rather, again, since I'm pretty sure we knew it before and convinced ourselves otherwise) that breastfeeding is best.

Breastfeeding is a fraught issue. It's way more difficult than you want it to be, and there is a ton of angst, especially in New York, about giving your child the best shot at...I'm not even sure what. And there is a lot of loud, unhelpful judgmental behavior out there by uber-boobers, a term I just made up which I'm sure needs no explanation.

It is natural in this environment for women who fed their infants formula to feel defensive and attacked. As a result, they're out there carrying on about "choice" and the "nanny state," as in this article from the Christian Science Monitor. They're focused on the formula being locked up, as if it's any different from anything else in a hospital. When you ask for Tylenol for pain, the nurse goes to the locked Pyxis machine to retrieve the medication. This is done, in part, to keep track of what and how much each patient is getting. No one is outraged that this otherwise easily attainable over-the-counter medicine needs to be requested and is held under lock and key.

Listen up, naysayers:

1) Contrary to popular outrage, the Latch On NYC campaign (whose stated purpose, by the way, is to "support mothers who choose to breastfeed and limit practices that interfere with that choice") provides mothers with more choice than we had before; and

2) The initiative is not about you. You are free to formula feed exclusively if you so choose. All you have to do is ask. The campaign is aimed, rather, at hospitals and the formula industry.

Today, everyone, including the American Academy of Pediatrics, agrees that breastfeeding is preferable when possible. Some nurses, however, have not gotten the message. At Mt. Sinai Medical Center, where I gave birth, a few nurses preemptively and pointlessly alarmed me with the news that I was "going to have to supplement" if Henry's glucose numbers were "too low." I emphatically stated that no, they did not have permission to give my son a bottle of any sort. They tsked tsked and sighed and gave each other knowing glances, as if to say, Here we go again with this crazy talk.

Henry's numbers were fine. But I admit to having been worried. What if they had been a little low? If I were not (a) a hospital administrator who is unafraid of questioning medical authority and (b) an educated, well informed consumer, I might have freaked out at their alarmist behavior and given Henry formula. And despite (a) and (b), I might have been too tired to resist.

And who, under the current system, chooses which formula nurses provide or which freebies moms take home in their goody bags? The formula makers, of course, some of the biggest of whom are global pharmaceutical companies. These big companies provide free samples to hospitals hoping that mothers will stick with whatever worked in the nursery or will use whatever is given to them in the goody bag instead of shelling out more money.

When someone can't (for any of the hundreds of completely legitimate reasons) or doesn't want to breastfeed, well, formula is the next best thing. But that's no reason for hospitals to be the conduit for the marketing strategies of Johnson & Johnson (Enfamil) or Nestle (Gerber) or Abbott (Similac).

Indeed, part of Latch On NYC's plan is to:
- Discontinue the distribution of promotional or free infant formula [and]
- Prohibit the display and distribution of infant formula advertising or promotional materials in any hospital location

You see, Latch On NYC actually puts choice back into our hands by giving us the right to request formula, instead of having it foisted upon us by behind-the-curve hospital providers or marketing directors at multi-national corporations.

Hallelujah! The choice is ours!

One other thing. According to the Centers for Disease Control's report, the women least likely to breastfeed are the poor:
Breastfeeding rates in 1999-2006 were significantly higher among those with higher income (74%) compared with those who had lower income (57%).
Those are the very people who can't afford the education and prenatal care from which women in my own over-privileged cohort -- who seem to be the loudest in decrying the new initiative -- benefit. Low-income families in New York may have the most to gain from the city's new initiative.

Formula is not poison. I, along with hundreds of thousands of healthy human beings, am alive to disprove conspiracy theories of uber-boobers everywhere. But breastfeeding is better when possible. And as the head of a public health system that is straining under high rates of obesity, diabetes, asthma and other chronic diseases, Bloomberg is right to put choice back into the hands of mothers by asking hospitals to educate patients about the benefits of breastfeeding, reduce the influence of corporate marketing and track subsequent formula use and health outcomes.