Yikes. After the announcement came out that Mayor Bloomberg had plans for a proposal to make changes to how formula is offered in hospitals came out, some amazing headlines popped up:
With headlines like that, it’s no wonder that people are freaking out, talking about how mothers have a right to choose what they feed their babies, and getting angry. I’ve seen a lot of discussions going around about this initiative. A New York Post article states:
With each bottle a mother requests and receives, she’ll also get a talking-to. Staffers will explain why she should offer the breast instead.
Lectures? With every single bottle? Wouldn’t that be awful? I agree, getting a lecture every time your baby wanted to eat would be tiresome and disrespectful of the mother’s choice.
So, let’s look at the reality of this proposition, first off, addressing the concern above.
What do we tell our staff to do when mothers (families) request infant formula?
While breastfeeding is healthier for both mothers and babies, staff must respect a mother’s infant feeding choice. Educating mothers and families about breastfeeding and providing encouragement and support, both prenatally and after birth, is the best way to ensure breastfeeding success in your hospital.
While in the hospital your staff can:
• Assess if breastfeeding is going well and encourage the mother to keep trying.
• Provide education and support to mothers who are experiencing difficulties.
• If the mother still insists on receiving formula, document it in the chart along with the
reason and distribute only the amount of formula needed for the feeding.
• Train staff in breastfeeding support (CLC, IBCLC) who can be available to assist new
mothers at all times regardless of day, night or weekends.
Huh. See, let’s look at that carefully. Unlike all the articles saying “a lecture with each bottle”, the proposition says nothing of the sort, and in fact says you must respect a mother’s choice, and that for those who want to breastfeeding, they should be encouraged and have help provided at all times. It’s also worth pointing out that it is specifically addressed that “free formula” means formula for a mother who has no medical indications that she she is unable to breastfeed. So moms with medical issues? It’s okay hun, they did think about you and see your formula as a necessary medical cost, not a freebie. It does say, “When the decision to supplement is not medically indicated, efforts to educate the mother should be documented as well by the nursing and/or medical staff.” So yes, they may say something to you if you choose to use formula, but by no means is it indicated anywhere that you should receive a lecture with each bottle.
As medical professionals, it should be expected that they are required to make at least one statement about a topic that is health-related for you and your newborn. After all, while you may find it irritating and came to your decision in an educated fashion, there are some moms out there who still believe things like colostrum isn’t good for the baby/isn’t enough for the baby, or that because their mother is unable to breastfeed, they will be too. If it helps one mom who thought she couldn’t breastfeed be able to, it’s worth them saying a small something to everyone, since you never know who that mother who only chose formula because she thought she had no choice will be.
A big concern that lead to this decision as well was this:
Babies born in New York City are far more likely to receive supplementation in the first 2 days of life than in 56 out of 64 United States jurisdictions. This may help explain why, while 90% of NYC mothers initiate breastfeeding at birth, over 50% stop breastfeeding exclusively within the first week.
While breastfeeding rates do drop quickly, New York City especially has a very big problem right now in their hospitals, and they’re looking to fix it.
If you’ve only exclusively formula fed before, you may not be aware that breastfeeding moms are given a sheet of paper where they are required to track how long the baby nurses for on each side, marking times, which breast, when they started and stopped, and are supposed to keep this list up the entire time they’re there. In fact, I was given a sheet I was supposed to take home and fill out for three MORE days to bring back (I didn’t). This is simply a way of tracking feeds for both formula and breastfed babies, and noting reasons for bottles given, so they can see if it’s because a mother asked, or because it was needed. It would be a good way to see which hospitals are having more success with breastfeeding initiation and support as well.
If you’re a breastfeeding mom, there’s a big concern with giving birth in a hospital… often, nurses and doctors are known to try to push you to use formula. Nurses are also known to sometimes feed your baby while you’re sleeping, or if they’re in the nursery, without your permission. One bottle of formula can interfere with 2-3 breastfeeding sessions immediately, and when your supply is so sensitive with a newborn, that can cause some major problems. This proposition makes sure that breastfed babies are NEVER given bottles unless the mother, specifically, asks for one, and in that case, they make sure that if your reason is you’re struggling, that they try to provide you with often much-needed encouragement and support and help from professionals.
But if you choose to formula feed, this doesn’t stop you one bit.
This proposal also includes rule such as:
[A mother] has a right to:
a. Have the baby not receive any bottle feeding or pacifiers.
b. Have someone trained to help with breastfeeding, provide information and assist
c. Know about and refuse any drugs that may dry up milk.
d. Have the baby in the room with her 24 hours a day.
e. Breastfeed the baby at any time day or night.
Believe it or not, these are huge problems breastfeeding moms are facing right now. A friend of mine desperately needed help from the on-call lactation consultant, but never saw her until they’d filled out her discharge papers and she was getting ready to leave, already feeling defeated and upset. Making sure we prevent things that harm a mother’s breastfeeding relationship in the first days, first hours after birth is incredibly important. Please note these also cover glucose water, plain water and formula. Sometimes nurses think it’s okay to give a breastfed baby glucose water if mom is sleeping because hey, it’s not formula, right? But that form of supplementation is also a big problem.
One comment stuck out to me from some of the articles I read:
“They make formula for a reason, and the FDA makes sure it’s safe,” said Roxanne Schmidt, whose 14-month-old twins were fed with formula from birth. “Locking it up is just wrong.”
Thing is, vaccines and other medications like the acetiminophen you’re often given for pain after birth is also FDA-approved. And it’s also locked up. One of the biggest PROS here to formula feeding mommies to this is that if they are tracking formula given to your baby, and there is a recall of that formula for any reason, they will be able to notify YOU so you can make sure your infant wasn’t harmed. Wouldn’t you be happy to be able to know without a doubt that the recalled batch of formula wasn’t the one you gave your baby in the hospital? That’s a major safety precaution we DON’T take right now.
There’s too much for me to cover here, but those were some of the major concerns I saw going around as I read comments. Before engaging in further debates, I hope people take the time to read the FAQs that have been assembled by the New York City government. This isn’t anything designed to punish or stress out moms who choose formula. It’s a way to help women who want to breastfeed be able to do so successfully, and get the help they need, while also making sure formula is tracked like it should be, so they have better information about your baby’s intake, and what it is they were fed, just like they do anything else given to any patient.
Oh, and it also says you should be able to take home free formula from them too — as long as you ask for it.