New York City Mayor Michael Bloomberg is right to want to promote breastfeeding, but his administration’s “Latch On NYC” campaign is an exercise in excess. First announced in May, the campaign is asking maternity hospitals to 1. ban formula feeding of newborn infants unless medically indicated; 2. restrict access to formula for hospital staff by locking it up and reporting its distribution to the New York City Health Department.
Lock up infant formula and track it as if it were a controlled substance? That’s not only unnecessary, but is both demeaning and disrespectful of a woman’s right to make her own choice about how to feed her infant. It’s also based on an awful lot of wrongheaded assumptions.
“Human breast milk is best for babies and mothers,” said New York City Health Commissioner Thomas Farley, one of the four city officials — all male — quoted in the campaign’s press release. “When babies receive supplementary formula in the hospital or mothers receive promotional baby formula on hospital discharge it can impede the establishment of an adequate milk supply and can undermine women’s confidence in breastfeeding.” It’s true that breastfeeding has real health benefits over formula feeding, but the benefits are actually relatively small. As a hospital poster for the program acknowledges, there is only solid scientific evidence for the claims that breastfeeding decreases the risk of ear infections, diarrhea and pneumonia. But all that other stuff you may have heard about — such as breastfeeding raises a child’s IQ — is based on conflicting evidence that is often plagued by confounding variables.
But more problematic is the fact that the “Latch On NYC” campaign does not acknowledge that in addition to the benefits, breastfeeding also has substantial costs. For many women, breastfeeding is difficult, painful (especially at the beginning), and may be inconvenient for those who need to return to work. That doesn’t even take into account the fact that some women have serious breastfeeding difficulties that result in infants who fail to thrive. And these are the problems for women who want to breastfeed. Many women don’t want to breastfeed at all.
The “Latch On NYC” campaign explicitly attempts to prevent the use of formula even though many mothers successfully feed their babies with breast and bottle combined. A bottle of formula can soothe a frantic infant before a mother’s milk comes in, can spare a mother another painful nursing session during the early days when breastfeeding can bring blisters and soreness, and can allow a mother to get desperately needed sleep while someone else feeds the baby.
Moreover, there is simply no evidence that the “Latch On NYC” policies will have any impact on breastfeeding rates. Most mothers give a great deal of consideration to feeding methods before they have their children — their decisions are not based on their ability to access formula in the hospital. The most likely outcome of storing formula in locked cabinets is shame for mothers who ask for it, and extra, unnecessary work for nurses who have to retrieve it, monitor it and record it. Breastfeeding activists also fail to acknowledge that women who ask for baby formula have made their choice already. It may not be the choice that activists want for them, but that doesn’t mean it’s okay to make it harder for women who have made that choice.
The idea of locking up formula is disturbingly similar to the idea of mandating ultrasounds for women who want to terminate a pregnancy. Just as anti-choice activists justify mandatory ultrasounds by claiming that a woman can still choose abortion, Mayor Bloomberg insists that women will still be able to choose formula feeding, and that there is no harm to providing them with more information. But in both cases, it’s about creating obstacles (and shame) for women. When it comes to breastfeeding, Mr. Mayor, here’s a good rule of thumb: Her baby, her body, her breasts, her choice.