Is Breastfeeding a Legal Right? Civil Right? Or a Social Responsibility?

“What kind of a society raises its children on food that will shorten their lives?” I dug this quote up one day while looking for examples of other public health crises that have benefited from celebrity leadership.  Turns out they were words first spoken in connection with Farm Aid, but they so perfectly capture the reason why we need a popular cause for healthy infant feeding, that it’s now plastered to my wall.

We are what we eat.  The food we are given as infants, children and adults, can do one of three things:  (1) help us to thrive, (2) sustain us or (3) jeopardize our health.  Unfortunately, most of the commercial food supply in the U.S., including infant formula, falls into the latter two categories.  And the consequences are horrendous — America spends $2.7 trillion each year on health care costs trying to stop a rising tide of epidemic noncommunicable illness — diabetes, obesity, cancer, heart disease,  Crohn’s disease just to name a few.  And we are no healthier for it; our mortality rank is 50th in the world, our Infant Mortality rate is 41st, and our Maternal Mortality rate is 50th -WAY behind other developed nations.  For many Americans who don’t die, living with disease and chronic suffering has become the NORM.  We are one of the unhealthiest populations on the planet despite our spectacular spending on “health care.” READ: Americans Under 50.  Read: The Cracks in the Foundation & The First Food. 

Call me crazy, but the goal last time I checked, was not just to grow or survive, but to flourish and thrive.  What parent doesn’t want the latter option — for their babies to reach their optimal potential health, physically and emotionally, for a lifetime?

None.  That’s right.  None.  Show me the right-minded mother who wants to see her child’s health compromised by the food she puts in its mouth.  She doesn’t exist.  But show me the mother who makes feeding decisions based on inaccurate or incomplete information, or the mother who chooses breastfeeding but is Booby-Trapped by poor care, advice and support from the medical and legal system and her community and employer and is forced to formula feed by default, or the mother who doesn’t want to, or can’t breastfeed, but is not given the option of using the next best substitute, donor human milk — she exists, by the millions each year.

savethechildrenbfreportWhich is why ‘What your infant is having for dinner’ is not a topic over which moms, businesses or even politicians should be arguing.  The debate is over and the evidence is clear:  Breastfeeding, followed next in order of preference by pumping or donor milk, is the undisputed “first food” and the foundation of human health and thriving.   Yes, infant formula has a place and purpose when breastfeeding or donor milk is not feasible (and believe us, sometimes it really is not and we understand!  Read: It’s Not Just About Breastfeeding.) But breastfeeding (and human milk) is first on the list because it is a highly cost-effective way to help PREVENT illness - in both baby and mother, long and short term. Period. If more mothers were supported to reach their personal breastfeeding goals, it would slash billions from the nation’s health care burden, (Read:  $13 Billion for Breastfeeding), and it would save and improves lives.  Read: Save the Children’s  Report.

Given our poor collective health and economy, the only question on the table should be how can we as a society pull together to see to it that as many moms as possible are no longer being Booby-Trapped and get the full panoply of support that is required to help them succeed at breastfeeding- at birth, at home, in the workplace, and in public?   We should be rolling out the red carpet for moms for paying it forward for us all, we should be throwing open every door for them and thanking them, definitely not shaming them.  

To be sure, we need a national law that protects a woman’s right to breastfeed and have access to donor milk.  This law could be passed as an amendment to existing federal law e.g., the Civil Rights Act, the Pregnancy Discrimination Act, or the American With Disabilities Act, or as a stand-alone. Pipedream?  Maybe.  But worth fighting for.   It is extremely time-consuming to fight to protect mothers and babies on a state level, 50 times over.  Moms across the country are organizing under our Take Action wing and other groups to amend laws to make this a reality.  Read:  Texas Moms Fight for Better Breastfeeding Law.

But it’s going to take more than laws to change consumer attitudes and create the kind of total sea change in the way we view and support breastfeeding and moms that we so desperately need. If that’s all that it took, then decades after being told about the health benefits of eating more vegetables, most Americans would be heeding that standard — we still don’t eat enough.  And legislation making sexual harassment a form of discrimination would have sufficed to eradicate it from our work spaces — it still takes oodles of employee training, education, and cultural indoctrination to reset behavioral norms.

Since we entered the breastfeeding conversation in 2007, Best for Babes has consistently framed breastfeeding as more than a question of the legal right to nurse in public or even as a reproductive right.  As a behavior that benefits our collective and individual welfare, breastfeeding is also a shared responsibility, and as such, a human and a civil right.  Looking at breastfeeding through the human rights lens helps us go beyond the “legal” issue and get to the moral issue that will drive systemic and cultural change:  human milk is so precious and beneficial to us all, that helping moms to breastfeed or have access to donor milk, if needed, is more appropriately a question of social responsibility -like preventing forest fires, educating children, or fighting poverty, hunger and disease.  

By definition, human rights (and its subclass of civil rights) protect our inalienable rights to dignity, safety, health and life, and to be treated fairly and as equals.  Protecting a mom’s basic human right to nourish her baby optimally, and a baby’s basic human right to be nourished optimally, falls squarely within those parameters.  Seeing breastfeeding as a human rights issue for children is not a novel concept.  The Convention on the Rights of the Child is an international treaty declaring eating a human right for a child.  Not surprisingly, the U.S. along with Somalia, are the only countries who have not signed on.

Our mother’s and babies should not be discriminated against for exercising their human and instinctive right to breastfeed.  And yet, as our Nursing In Public Harassment Hotline proves, daily and in droves, moms are being harassed and discriminated against for following an innate and prescribed behavior that will help ensure their and her baby’s best health. 

Civil rights are also intended to guard against infringements by both government and the private sector that compromise an individual’s freedom of thought and choice.  In the current climate, that freedom is being severely compromised.   The infant feeding industry has been hijacked by big business (Big Formula) for the benefit of profit and shareholders. Their predatory and unfair marketing practices rob moms of the freedom to make an informed feeding decision and are largely responsible for the inordinate number of breastfeeding failures. Study after study points to the corrosive effect of formula marketing on breastfeeding initiation and success. Read: the Save the Children Report citing unfair formula marketing as a major barrier to breastfeeding.  Read: What is the WHO-Code?  And we will emphasize here again, that it is not formula per se, but the aggressive marketing of formula that subverts and sabotages breastfeeding that is the problem.

Getting back to framing breastfeeding as a civil liberty, formula manufacturers love to ring the Freedom of Choice bell and co-opt that argument to fit their bill.  Big Formula spends billions per year to perpetuate a marketing fiction to convince moms that choosing their product is a testimony to the exercise of that freedom.  Read: Defeating the Formula Death Star. They want moms to believe that formula-feeding is about exercising personal choice, about which a new mom shouldn’t feel guilty, and over which they emerge as her new “BFF” and “savior.” Nothing could be farther from the truth.  True “friends” don’t wreck your chances of succeeding at something, throw their arm around you when you predictably fail, tell you not to feel guilty — “after all you tried Sweetie,” then take your money with the other.  The formula industry plays the guilt card  like Yo Yo Ma plays a Bach Cello Suite and their rewards are equally grand.  The “we are here for you mom” campaign yields approximately $8-$10 billion per year profit.  Breastfeeding advocates, educators, scientists, and practitioners, make next to nothing when moms achieve their personal goals.  We can attest to that personally.

So what kind of a society are we?  America is a country that prides itself on liberty and freedom and change and great reversals of course to fulfill those promises -cue the Women’s Suffrage and the Civil Rights Movements.  We can do this!  Let’s make healthy food for infants, children and adults top of our national priority list — a shared responsibility for the betterment of our individual and collective health -and precipitate our laws, policies, and norms to shift to accommodate our shared goal.  Let’s no longer seek to ostracize mothers who breastfeed but rather embrace, cheer and celebrate them!  Let’s no longer longer tolerate infringements on our personal freedoms and on our personal health for the benefit of big business.  Imagine the laws and the infrastructure that might follow that paradigm shift — paid parental leave?  On-site daycare? Routine post-partum home visits by qualified lactation professionals covered by all insurance?  Greater access to breastfeeding care for low-income and minority women? More affordable and accessible healthy foods?  These practices are already standard in many countries that score high on health indices and on quality of life indices.  Reframing breastfeeding as a social responsibility — not just a right — will help to deliver the change we need. What are we waiting for? 

Do you think breastfeeding is a social responsibility and a human right?

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To learn more about how you can get involved or support the Mother of All Causes visit www.bestforbabes.org/take-action.



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47 Comments | Last revised on 04/03/2013


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47 Responses to Is Breastfeeding a Legal Right? Civil Right? Or a Social Responsibility?

  1. Beautiful post! Sharing widely!!!

  2. Leslie P. says:

    This is so perfectly stated. This is why I am training to be a Le Leche League leader. All women deserve to be successful a breastfeeding!

  3. This post troubles me. I am 100% on board with breastfeeding being a civil right and a legal right for the mother… but the moment you make it a civil or human right issue for the baby, you are veering into dangerous territory- and the rhetoric sounds awfully familiar to those of us acquainted with the abortion debate.

    Additionally, I’m curious where these billions of dollars in marketing money from Big Forma trying to perpetuate the “choice” concept are going. Because the people I see shouting about choice are people like me, Hanna Rosin, Joan Wolf, Jessica Valenti, the women of Bottle Babies, and a growing number of other journalists, writers, and mommy bloggers. None of us are being paid by the formula industry, and I can’t speak for the others on this list but I know for a fact that me and the Bottle Babies team are LOSING money on our efforts to stand up for combo-feeding and formula feeding mothers. I agree with you that formula companies do many bad things. I think their ad campaigns suck donkey eggs, for the most part. But just b/c they have jumped on the choice bandwagon does not mean they invented it, or that it isn’t a very real concept. They are simply capitalizing on it. This is an important distinction, b/c groups like BFB who have the potential to do so much good need to understand where the women I represent are coming from. When you dismiss our thoughtful, emotional, and researched opinions as merely a byproduct of malicious marketing, it simply widens the divide between us. And that’s a shame, when we could be working together (even if we have to grit our teeth while doing it) to make things better for breastfeeding and formula feeding moms, alike.

    • Bettina Forbes, CLC says:

      Thank you for commenting, Suzanne. We agree that we should be working together, which is precisely why we have charged the entire breastfeeding advocacy community and the media to broaden the dialogue and to support informed decision making and to support and protect ALL moms, whether they breastfeed for 2 days, 2 months, 2 years or not at all, without pressure, judgment or guilt . . . our ground-breaking language and messaging now permeates the breastfeeding, bottle-feeding, donor-milk feeding and formula-feeding communities, even the FFF and Bottle Babies websites, books, blogs and Facebook pages! We are very proud of our work to change the conversation and to take the pressure off moms and put it on the barriers that keep moms from making an informed decision-regardless of what that is-and carrying it out. However, it is hard to have a constructive dialogue when you start your Facebook post with “Not sure if they will publish our comments”, which is inflammatory, dismissive and disrespectful of our work and our standards. We would be more than happy to have a conversation if we can start from a mutually respective place.

      • Bettina, there have been comments made by me and some of my readers which have been removed in the past, which is why I made that comment. I don’t think it was disrespectful; you have every right to monitor your comments and uphold a comment policy, as we all do. I’m sorry if you found that to be disrespectful. As I’m sure you saw, I also encouraged my readers to be respectful in their dialogue with you, as I know we can all get a bit fired up about these issues.

        • Bettina Forbes, CLC says:

          Yes, everyone gets fired up about this issue, and I am sad that you chose to fire up your followers who are now making inaccurate assumptions and mischaracterizing our position, when we have done more to bridge the divide on this issue than any other advocacy organization. Danielle’s blog post addresses one aspect of the larger infant feeding conversation, does not reflect the depth and complexity of the issue, and of course can not encompass all of the work we have done to support formula feeding moms-our posts about IGT, bottle-feeding tips, letting go of guilt etc.-posts that you will be hard-pressed to find on any other breastfeeding site. It is very discouraging that commenters here are throwing back at us the very language that we created and disseminated to re-frame the debate, heal the divide, and advocate for greater support for ALL mothers. It is disappointing to see advocates turn their precious energy to attacking those who are trying to create a better maternal and infant health landscape for everyone . . . when we all should be working together to take the wind out of the sails of the very vocal extremists on both sides of the fence who are ruining it for us all. None of us-neither FFF nor BfB-is getting paid more than peanuts for what we do out of love for mothers and babies. What I really wish you appreciated is that Danielle and I, and many of the volunteers and IBCLCs we collaborate with, advocate tirelessly at breastfeeding conferences and behind closed doors that bottle-feeding and formula-feeding mothers deserve better information and support, in fact that none of us will succeed until ALL of us succeed. As you know I combo-fed because IT WORKED FOR ME IN MY PARTICULAR SITUATION, and I will continue to fight for the rights of mothers to do what is best for their families and themselves.

          • Elizabeth says:

            Well … that doesn’t account for the comments you previously deleted. You can’t say you are calling for “unity” if you are deleting the perspectives that don’t buttress your position. You made your bed. To now call FFF’s warning about deleted comments “inflammatory, dismissive and disrespectful” is to ignore reality.

          • Bettina,

            I don’t think it’s quite fair to say I got my readers “fired up” and (as I think your response implies) on the attack. In fact, I urged them to be respectful, as I’ve seen you do on numerous posts on the BfB Facebook page (even on one recently about a piece written by a friend of mine about her desire to nurse her second baby - which struck me as very sad, that there even needed to BE a disclaimer, because who could possibly slam Kim for her beautiful sentiments and understandable emotions?? But of course, FB is an open, public forum, so I fully understand why you’d have to add that caveat).

            I did not post the link to cause drama; rather, I was thinking that it would be important for you to hear from people who are hurt by these sorts of posts - because I DO believe that you are trying to improve maternal and fetal care; and I DO believe that your heart is in an admirable place. This post scared the heck out of me, quite frankly, as someone who has a lot of hope for what BfB can do for the greater conversation… and my hope was that by hearing from other moms (and not just me, who could be seen as having some sort of nefarious agenda) you would listen and hopefully reassess. Considering many of our readers actually intersect (as there are plenty of women who believe BF support and FF support can go hand in hand), I didn’t see it as confrontational.

            I think it’s possible to discuss these issues without taking it so personally, and I’m sorry if some commenters took it a bit too far. I don’t have control over my readers - in fact, I tend to piss them off on a daily basis myself. They tend to be extremely opinionated folks… I have a feeling most were all on their high school debate teams. :)

            I hope you can understand that this article was quite triggering for those of us who use formula, for whatever reason, as many people have explained in this thread. Regardless of whether it was intended as such, I think it’s fair for women to express concern over these ideas and to speak up for what they believe.

            I’ve posted things before that struck the wrong chord with people, and their responses can be quite unnerving. I get that. But in many cases, I’ve ended up changing my opinions on the given subject, because I realize I was only looking at it from one perspective. I know criticism can be hard, and I’m sorry if you feel any of these responses have been antagonizing - but I think that the majority of the women posting here see you as an organization that has the potential to do a lot of good, and are therefore here urging you to consider their feelings and proceed accordingly.

          • Melody says:

            I am one of those followers that the FFF supposedly riled up who is accused of making inaccurate assumptions about your position and mission. I consider myself to be a level-headed critical thinker most of the time, and what I got from reading this article are the following points: formula is inherently a substandard product that is only capable of keeping a child alive, but not at all capable of keeping a child both alive AND thriving, and indeed can *harm* a child. Also, the companies who make this less-than substance are unethical for *gasp* advertising their product to the one portion of society who would actually care that their product exists - moms. Also it is stated that breastfeeding is on the level of social responsibility, meaning that I owe it to the rest of society to not only breastfeed, but to pump some extra for those mothers who would have otherwise used formula, the less-than substance. It is stated that not only is breastfeeding a social responsibility, it is a human right. This implies that to choose to give a child anything else is to deny them one of their human rights, which are usually something worth starting wars over and launching worldwide campaigns asking for donations and immediate help for because people are literally dying from a lack of access to their human rights. It was these ideas in the article that got me riled up, not the FFF.

            BFB claims to support formula feeding moms. You can’t support them while saying that the food they chose for their children is so below breastmilk that it can’t help them thrive, and can also hurt them, and that their babies have a human right to the milk they can’t provide or choose not to provide for their children. Real support is truthful and uplifting, and if you tell formula feeding moms what has been said in this article, you are being neither. This article attacks the formula companies for daring to say anything about choice. Talking about choice is one major way to support moms, and when you say that “choice” is just a way for formula companies to make money, you insult a lot of mothers who have made the informed choice to feed their babies formula.

            Getting upset at the FFF for daring to question some of the points that are made here and expressing those concerns to her facebook followers, does you no favors. Seeing how BFB and the FFF both desire good things for the infant feeding future, it would be wise if you both learned from each other.

  4. “By definition, human rights (and its subclass of civil rights) protect our inalienable rights to dignity, safety, health and life, and to be treated fairly and as equals. Protecting a mom’s basic human right to nourish her baby optimally, and a baby’s basic human right to be nourished optimally, falls squarely within those parameters.”

    Absolutely. I agree with you. However, respecting a a mum’s basic human right to feed her baby with a bottle, formula OR expressed milk also falls within those parameters, yet is consistently ignored. Bottle Babies hears stories every single day of women shunned, ignored, belittled and told that they didn’t breastfeed because they weren’t educated enough, they weren’t supported enough and that the big bad formula companies got to them and somehow influenced them.

    Around 5% of women can’t breastfeed. That’s a LOT of women! For an organisation who claims to support all women you have certainly played your hand with this one. Very disappointing.

    • CLC In Training says:

      I have done a lot of research on this 5% statistic, and have yet to find any scientific study done that reflects this statistic. All I can find are other individuals looking for the source of this same statistic, seems like if existed I would be able to find something legitimate about it. I have even searched the university library at UNC and can find nothing even remotely related to this ‘fact’.

      But, let’s just ignore that. Let us consider the implications of 5% of the human population being unable to nurse. In nature, the offspring of that 5% would either have to nurse off someone else, or they would die. What caused this inability to nurse? It’s certainly not evolutionarily advantageous. Supposing this statistic is true, and human lactation dysfunction was at some point an evolutionary advantage, it would only be so of the infant perished. The only time an infant death would be beneficial is if the infant was sick, deformed or disabled in some manner which would cause the child to be more of a burden on their tribe than a blessing. That would mean today, human lactation dysfunction would be a sign of a sickly or defected infant in some manner.

      Due to the few studies on human lactation dysfunction, it is far more likely that a woman’s inability to nurse is a direct result of their socio-economic status, support, education, competently of medical staff, the difficulty of their birth, as well as their marital status and relationship with father, employment situation and support, and whether or not they experienced postpartum depression, etc.

      If you can provide the source of your information, I would be more than happy to review it and perhaps change my view. But until I have hard science to back that, I cannot take it seriously.

      • Lisa says:

        I don’t quite understand what you are saying here. Are you saying that all breasts function perfectly and that while it is very well know that all other parts of the human body (including reproductive anatomy) can at times be dysfunctional, that all breasts will Lactate? That is a very naive view which even without studies just goes beyond common sense…

      • Mother of Boys says:

        Ah yes, because of ALL the parts of the human anatomy, breasts are the one that never fail. That kind of logic is akin to saying diabetics just aren’t trying hard enough to break down sugars or that hemophiliacs aren’t educated enough to form clots over wounds.

        From an evolutionary viewpoint, the inability to feed one’s young could be seen as a way of weeding out the particular genetic make-up that leads to that or other associated health problems (e.g. mastitis and the subsequent risk of blood poisoning or other breast related illnesses) - thereby enhancing the race of that species. In simple terms, those who can’t eat, can’t live so can’t reproduce. I don’t know any parent who would consider that logic and go ‘ah yes, well in that case by all means let’s ban formula - for the good of the human race and all.’

        • In biology it is an assumed fact that if in a species population more than 3% of primary reproductive functions (lactation being one of those) is dysfunctional, that population will soon be extinct. If in natural conditions a female that birthed cannot lactate the offspring will die and the malfunction will not be inherited. If, however, the offspring will be nurtured by other females, the offspring will survive and in the females a possibly genetic form of lactation inability may be forwarded. So it is possible that in humans 5% of females are not able to lactate. However, that does not mean 5% of those conceiving naturally and giving birth. Problems in reproductive function tend to be correlated to each other. still, it is possible to conceive and to give birth ans still not be able to lactate. That is not the same as not being able to feed at breast, using human milk. Being nourished and nurtured in a species specific way is the human right and the birthright of each child, and in my book the rights of the most vulnerable override the rights of adults.

          • Becky says:

            “In biology it is an assumed fact that if in a species population more than 3% of primary reproductive functions (lactation being one of those) is dysfunctional, that population will soon be extinct.”

            What? Absolutely not! Reproduction in nature often involves LARGE amount of wastage. In many animals, think schools of fish, the majority of offspring perish before reproducing. This 3% number is absolutely not based in reality or science.

      • Becky says:

        The 5% number is based on evidence and estimates by Neifert, a fairly prominent breastmilk researcher. http://bfmed.wordpress.com/2012/10/15/how-often-does-breastfeeding-just-not-work/

  5. This article troubles me because it artificially raises the future potential of an infant over the very reality of raising the infant. We hear daily from women who are struggling, often on their own (marriages sadly dissolve quite often in the first few months of a newborn period), financially strapped and emotionally barren. Breastfeeding doesn’t happen naturally for all women. Some women have been subjected to incest, rape, sodemy, molestation as children and young women — breastfeeding then becomes quite triggering. As much as we want to offer women the very best start to a nursing relationship, we also have to realise it is a duality.

    While I want the very best for all babies, I also want them raised by sane, competent, invested and emotionally available women. If that means supplementing then I am 100% on board with that. I breastfed through a very ill baby (failure to thrive, allergies, hospitalisation, surgery, etc) to 21 months ONLY because I supplemented feeds. Otherwise I would have thrown the towel in and never tried again.

    Why is it a this or that, tit for tat sort of affair? Why can’t we praise women for the good work they DO every damn day and give them validation for acknowledging their own limitations? Why can’t we just accept that sometimes help isn’t available, every situation is different and that this picture perfect ideal outcome isn’t possible.

    I invite your readers to visit the bottlebabies.org website and read some of the stories. These women are very real; your mothers, your sisters, your friends, possibly the mirror image of someone reading this article and suddenly terrified they have completely and irrevocably f’d thinkgs up beyond repair.

  6. Melody says:

    Couldn’t help but notice the “Shop in Our Store” link on the right. One might say that articles like this use shaming to guilt mothers into buying those products. I don’t see why saying this would be considered more offensive than basically implying that formula companies are evil and are only trying to make money off uneducated, naive mothers, under the guise of “choice”.

    “We should be rolling out the red carpet for moms for paying it forward for us all…” Am I right in understanding this line to mean that breastfeeding moms are doing all the rest of us a public service by breastfeeding their babies, and moms who choose to or have to formula feed are just riding on the health coat tails of those women who breastfeed? That formula feeding mothers are, *sigh* again, being portrayed as less than? I formula fed my daughter from about 3 months on, and I am planning to formula feed my second child due in August. But before I happily give my newborn baby a bottle for the first time, don’t let me forget to take a moment of silence out of respect for all the moms who are inherently better than I am. Thank you, breastfeeding mothers, for picking up my slack.

    I unashamedly support infant feeding choice, and not because the formula companies told me to. I felt like a terrible, confused mother for too long when my daughter was very little, and I feel like my first few months with her were robbed from me because I absolutely was guilted and shamed into continuing trying to pump and breastfeed. There is supporting a woman’s choice to breastfeed, and then there is pointing fingers and implying unnecessarily negative things about her character and parenting in order to keep her breastfeeding.

  7. Mother of Boys says:

    “What kind of a society raises its children on food that will shorten their lives?” Seriously? THIS is how you hope to start a reasoned and serious discourse on infant feeding – by implying parents are feeding their babies what amounts to poison?
    Your story troubles me in so many ways – I am all for supporting breastfeeding mothers in all ways possible, but this doesn’t equate to insulting and demeaning formula feeding mothers like you have done multiple times . Contrary to your belief, formula feeding parents are not uneducated imbeciles whose desire to do best by their children is surpassed only by their desire to buy everything that they see advertised. The choice they make IS in their children’s best interests. The choice they make IS to feed their child in the best way available to them. What they want IS the best for their children – and as you mentioned, all babies have the right to optimal nutrition. Sometimes, that means formula.

    Inflammatory comments such as your opening sentence do nothing to help improve the support for breastfeeding mothers, and do a whole lot to create a culture of Them vs. Us. A real shame for a website that purports to support mothers without judgement, pressure or guilt. Shame on you, BFB.

  8. Kiwi Mama says:

    Umm… anyone else see the irony in an article condemning formula companies for advertising being listed directly beside an ad encouraging readers to ‘shop in our store’ ???

  9. Kati says:

    I read this article linked on FFF and I while I agree that all mothers should have the right to feed their baby wherever they need to, I draw the line at many of the other things that were stated. It is a baby’s right to be fed, however it’s the mother’s choice how that baby should be fed. There is no right to breastmilk and frankly there shouldn’t be. I am currently a formula feeding mother. I was formally a breastfeeding mother. I made the choices that I made with regards to my family, home, and work situations. I was not booby-trapped by a formula company. I am not uneducated. I don’t see formula companies as my savior or BFF and I don’t know anyone who does.

    The article also mentioned donor milk as the next best thing to breastfeeding. Now it’s hard enough for many women to be able to exclusively breastfeed their own babies. Isn’t that pressuring women to spend even more of their time and energy trying to produce extra to feed all these failure to thrive babies that are out there as a result of America’s poor choices? Not to mention that breastmilk is a body fluid and thus is a carrier for harmful diseases or even common allergens. Donor milk will never replace formula because in many instances it just can’t meet the needs of all the infants out there.

    In short, I feel the article is so full of hyperbole that it’s good points are lost in the breast is best rhetoric that is so pervasive on the internet.

    • Beth says:

      One thing I want to point out regarding donor milk- in some areas, that is simply just not possible. I live in rural Montana - there are NO donor milk facilities anywhere. The only options are breast feeding or formula feeding.

    • Gabriela says:

      Hola! I just want to comment on what you said whether donor milk would put more pressure on women who are having a hard enough time breastfeeding. I am currently a regular donor of milk to the first (and unfortunately the only one so far) human milk bank in Peru (I’m Peruvian). I found out about this because I had built up a stock for my baby when he was barely six months old and I had to travel - I built it week by week for four months. While away I pumped to keep up my milk supply and stored the milk I had. The place I was staying had no milk bank I could donate the milk I had expressed so I shipped it back home and then I had all this breast milk that I was not going to use. That is how I initially contacted the human milk bank and started donating.
      It has not put any extra pressure on my regular activities. Basically I just pump regularly as I would at work for my baby and whatever I have extra (1, 2, 3 ounces) I save for the human milk bank. They come to my house regularly (before it was weekly, now every two weeks, it has varied due to the amount of milk I can provide, and it has decreased because my baby has also decreased the amount of milk he drinks himself) and provide with sterile containers where I write my name and the date when the milk was expressed. Regarding the risk for disease, at least in Peru it is mandatory to have several tests taken when you are pregnant, including HIV. So you know your health status and you have a card with all those results that you can provide the health personnel if you want to be a donor. Also, as they come to pick up the milk every week or so, they checkup on my baby, to make sure he is well nourished as well. Like I said before, it is not hard at all. I have not been the super milk producer that you may think, in fact I spent the first two months when my baby was born supplementing with formula, convinced that I did not have enough milk. Luckily I built up my confidence and my milk supply and it has helped me, my baby and I hope some other babies who receive some milk that I can tell you has been expressed with lots of love :)

  10. Lara says:

    I fully support the idea of ensuring that women have the encouragement and support they need to breastfeed. I fully support a woman’s right to breastfeed in public.

    BUT I also support a woman’s right to choose to formula feed her child, and your article makes it sound like those women don’t exist. Women who choose less “natural” options are often excluded from feminist debates, but this exclusion doesn’t mean they don’t exist. Yes, there are women who choose to formula feed. Yes, there are women who choose c-sections. Yes, there are women who choose epidurals. These are not always women who need your “education”, pity or worse still judgement. They also need your support.

    My body, my choice? Yes. My boobies, my choice. If I want to breastfeed then that is my right. If I make an informed decision NOT to breastfeed, that it also my right, my autonomy over my body. I also need your support in that choice, not just your judgement.

    • Bettina Forbes, CLC says:

      Best for Babes absolutely supports a woman’s right to formula feed her child, and that is reflected in our language and messaging. In fact, in our presentations to the Academy of Breastfeeding Medicine, the US Breastfeeding Committee, ILCA, USLCA, BMBFA and elsewhere, we have charged the entire breastfeeding community and leadership to broaden the conversation to include ALL moms, and to defend the rights of mothers to make an informed decision, whether that is to breastfeed, use donor milk, or formula feed. What concerns us is the predatory marketing practices of some formula companies (and some breastpump and bottle companies!) that make it harder for mothers to make a truly informed decision and to carry that decision out.

  11. Becky says:

    I don’t understand how you can imply that formula is dangerous and unsafe, when the AAP says quite the opposite. From their parent page on choosing breast or bottle, “Before your baby arrives, you’ll want to consider whether you’re going to breastfeed or use formula. The American Academy of Pediatrics advocates breastfeeding as the optimal form of infant feeding. Even though formula feeding is not identical to breastfeeding, formulas do provide appropriate nutrition. Both approaches are safe and healthy for your baby, and each has its advantages.” http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Should-I-Breastfeed-or-Bottlefeed.aspx

    Formula feeding’s link to the chronic health issues you mention is tenuous at best. There is actually a correlation between breastfeeding and an increased risk of mortality from cardiovascular disease in adulthood, although it is low.

    And while the US has an epidemic of chronic diseases, sure, not all the countries doing better than us in that regard have significantly better breastfeeding rates. Some have worse rates. Do you have any evidence of a correlation between a country’s breastfeeding rate and their rate of chronic disease in adulthood? The larger problem is with the US health care infrastructure and access to health care. Blaming this all on infant feeding is extremely simplistic.

    And donor milk is NOT a preferable choice to commercial formula for health full term babies, according to any public health agency I’ve seen. Even the WHO seems to be moving away from it as an option. The Facts for Life booklet it publishes with UNICEF was edited between the third and fourth editions to remove ALL references to “milk from another healthy mother” as an option, except in the case of premature and low birth weight babies.

    More on the cardiovascular disease issue: “Similar analyses were also performed to examine the association between prolonged breastfeeding (> 1 year duration) and the risk of all-cause, CVD, and ischemic heart disease mortality in later life. There was little evidence that prolonged breastfeeding was associated with all-cause mortality (pooled rate ratio: 0.94; 95% CI 0.71 – 1.24), although there was moderate statistical evidence of heterogeneity. There was some evidence that prolonged breastfeeding was associated with a 16 percent increase (95% CI 0.99 – 1.36; P = 0.06) in CVD mortality, and no evidence of inconsistency in estimates. There was little evidence that prolonged breastfeeding was associated with ischemic heart disease mortality (rate ratio: 1.08; 95% CI 0.88 – 1.31; P = 0.5) and there was no heterogeneity.” from http://www.ncbi.nlm.nih.gov/books/NBK38333/#B106835

  12. Supermouse says:

    Hello-
    I have to agree with Becky above. Even though there are studies that correlate or associate breastfeeding with reduced illnesses and conditions, that is by no means proof that breastmilk directly causes or prevents any of them. As Becky pointed out the healthcare system in the US is not adequate to cover our huge and diverse population. We have a large population of people living in poverty, and they and their children don’t have access to health care. It is the poverty rate in the US that is more closely associated with infant mortality than how infants are fed.

    This article takes these associations (from the media, notorious for misinterpreting scientific studies) and exaggerates and extrapolates to a ridiculous extreme. A vast majority of the American babies born from the 30s-70s were formula fed. Yet, these people are living longer than ever…why haven’t they all been affected by all of the diseases you mention and died years ago? I’ll agree that diet has an effect, but adult life-long diet of less than optimal foods, not what was eaten the first year of life.

    Anyway, I’m all for breastfeeding. I agree that it is the best way to feed an infant IF you can and want to (and same goes for the baby). I think breastfeeding advocates would get farther in their cause if they stop exaggerating everything, stop trying to use scaremongering, guilt and shame and if they stop insisting that it is all or nothing. If breastmilk is liquid gold, any amount is good, and there are women out there desperately wanting to BF their babies, having difficulty and unable to find real support that doesn’t continue to insist that they are failing as mothers.

  13. Gijohnnysgal says:

    I think that what children are fed outside their first years affects them far more than what they receive the first year or two! Fast food, processed foods, red dyes, pesticide-laden procedure, hormone-laden dairy, etc. are the more likely the culprits that may “shorten” their lives rather than Enfamil or Similac. It’s rare that folks with illnesses whose lifestyle choices included fatty foods, lack of exercise, smoking, etc. blame Enfamil for their health woes…

  14. Kathy says:

    We need a lot less finger pointing in our culture and a whole lot more support. I appreciate the passion that BFB has in championing the rights to breastfeed, I fully support that as well. However, we do each other a huge disservice though to assert or assume that mothers are choosing to use formula because inadequate education or by predatory marketing. We are completely losing the forest in the trees.

    The real issue that we’re facing is not one of formula vs. breastmilk. The issue that we’re really facing is a far more insidious one and that’s the fact that, as a country, we do not support families. We have some of the lowest support rates for post-partum leave in the world. If we’re really going to have a conversation, we need to look at the fact that the support for new mothers and for babies in this country is almost non-existent or challenging and expensive at best.

    As far as choice goes, a woman should be supported for her feeding choices, period. Like so many, I, an educated woman with a good job, chose to breastfeed. Then when I was physically unable to, I chose to formula feed, but truly, this is where the argument breaks down. Let’s talk about choices. I chose to formula feed, because I chose to have my baby live, he would have starved to death had I not. Still, I suppose it’s a choice, and I’m ALWAYS treated as if I chose the less than ideal option available, regardless of reason (the reasons shouldn’t matter, but they do). I also chose to go back to work after eight weeks of leave, two of those being unpaid. I chose to go back to work after an excrutiating battle to get my milk to come in, spending much of my short leave pumping and not holding my child, or even better, in the hospital (all true). So, I chose to go back to work to support my family, and to not have my house foreclosed upon, to help put food on the table. Yes, I guess I chose that too.

    Life is full of choices. When we’re treated like second class citizens for making choices, choices that actually make our lives better (food on the table, a stable roof of my child’s head, and yes, food in his tummy in the form of formula, not breastmilk), how is that supportive? How are you supporting me?

    Women need support. Reading an article that starts with an assertion that formula will shorten a child’s life is, frankly, cruel. You start an article, that could easily be a battle cry for women everywhere, not just breastfeeders, with a statement that is patented fearmongering. You just lost half your audience.

    You claim to support women, and to want to have a civil discourse about the state of infant feeding in this country. I would caution you to not start your discourse with statements such as this, and with making women feel as if they didn’t understand the choices they were faced with. Passion and ardor can be conveyed without putting fear into the hearts of women who actually do want (and NEED) your support. A great many women who come to this site are likely supplementing, and need to know more about how to do so safely and properly. Not be told that they are doing grave harm to their children.

    That helps no one.

    Put your passion behind positive support for all women, regardless of their feeding choices or circumstances.

  15. Beth says:

    How much money goes to WIC for formula? Shouldn’t poor mothers be focusing more on breast feeding and shouldn’t more go to helping women be able to breast feed? I know formula is expensive - it was a part of the deciding factor for me to breast feed and why I try very hard to keep my supply up and keep feeding my lil that way.

    • Keeley says:

      Actual WIC does focus a lot of their efforts on breastfeeding, they are very good about making sure that women are making informed decisions

    • Kate says:

      A lot of poorer mothers make the choice to formula feed because they haveno choice to go back to work to feed their families- all of them not just the youngest. A lot of employers frown on the time taken away from work to allow pumping. So how do you breastfeed in the case? If you cant afford the time off and your boss wont give you the time to pump- what do you do?

      the actual price you pay for a tin of formula can sometimes be the smallest fiscal burden.

  16. Bria says:

    Breastfeeding is one of the most expensive things you can do. I happen to like expensive things, but it is by no means “free” not for poor women or rich women.

    • Megan says:

      Breast feeding is only as expensive as you make it. I do not use nursing tops or bras. My only expense has been pads to prevent leaking. And personally I did not choose to formula feed bc I am way to damn lazy to wash bottles when I don’t have to. I don’t know how formula feeding is said to be for lazy mothers. Some of the hardest working smartest women I know bottle feed by choice or not it doesn’t matter.. But from the comments what I am seeing is everyone attacking this group for posting a pro breast feeding article when they have also provided articles at other times supporting choice and formula. Regardless if you agree with every tiny detail of this article the main point is right, we need to stick together and share information and stop being against each other.

      I am pro breast feeding that is my choice.

  17. American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months and to continue for at least one year or longer, adding appropriate solid food. There are very few conta-indications to breastfeeding and those are galactosemia and HIV. World Health Organization recommends breastfeeding for 2 years and the outcome data show that there is a linear relationship between IQ and future earning and length of breastfeeding. Your comments about “WE ARE WHAT WE EAT” has been scientifically proven. It is called Nutriepigenomics, or the effect of nutrients on our health and longevity. Some of these effects are mediated by cow’s milk ingredients, or infant formulas, to affect DNA methylation or histone de-acetylation which would inactivate a number of infant’s genes. There are sufficient data now that show an association between formula feeding and autism spectrum disorders. Breast milk ingredients act like messengers that regulate the infant’s metabolic pathways. Breastfeeding and not breast milk feeding is an investment in your child’s future. This will be an investment not only in economic productivity and effective social functioning but also in our overall nation’s health.

    • Kati says:

      Considering I only found 3 studies PubMed for formula feeding and autism and two of them were not looking at formula feeding as causation, I’m going to say that the jury is still out on that one. The one study was only done on 90 infants and was about development during the first year. If you are truly an MD, you’d know that children develop at different rates and a delay in motor skills is not necessarily indicative of ASD.

      • An abstract was published in Breastfeeding Medicine, November 2011. I am a board-certified pediatrician with 40 years of pediatric practice and research. I see many children with autism who have been formula fed from day one or weaned after a couple of weeks. There is convincing evidence that increased oxytocin levels in the central nervous system in infants which results from breastfeeding ( an enriched environment) will prevent autism. Dr. Thomas Insel, the director of National Institute of Mental Health, is one of the researchers who discovered the connection between autism and low oxytocin level. There is a serious lack of information about the brain development in medical literature. You will have to dig real deep into basic science journals and specially the work by Drs. Thomas Insel,Sue Carter, Unvas-Meeberg, Grewen, Champagne and Bartel. There is strong and convincing evidence that brain development is compromized in the absence of breastfeeding and an enriched environment.

        • Mina says:

          Dr. Shafai,
          I don’t match your level of education but if you don’t mind I just have a few questions:
          Has anyone been speaking to parents who are on the autism spectrum about how they fed their babies? Isn’t being sensory defensive one of the symptoms of ASD? Could it be possible that some ASD mothers find breastfeeding more difficult (emotionally, physically etc.) or that babies born with autism issues could have more latching problems or find that close contact upsetting so the mother adjusted accordingly? Wouldn’t it be more helpful to have more research on why people with children on the autism spectrum used formula in the first place before deciding that it’s the formula itself?

        • SarahR says:

          I smell a ‘wakefield’ moment. Im surprised that as an MD you are seriously suggesting there is ‘convincing evidence’ on the link between autism and formula feeding. As the previous blunders in autism related research have shown - this is a highly complex area with numerous confounding variables. You mention the patients you treat who have symptoms of autism who have been formula feed. How about those who were breastfed? Correlation does not mean causation. Oh and by the way - whats the Impact Factor of ‘Breastfeeding Medicine’ again?

          I sincerely hope that this is not the approach you use with your patients who are formula feeding.

  18. Penny says:

    Thank you for this. I work in a hospital, and I often felt angry at the lack of support that people who I felt should know better- health care workers— gave me when I tried to keep my lactation going after I went back to work. Some people were great but others were just mean and nasty and actually tried to actively sabotage my efforts. The worst one was the head nurse in the NICU. My best supporters were other women who had been part of the sisterhood of breastfeeding women. Having breasts that were ready to explode and being denied the right to feed your baby or pump which happened to me on several occasions really does feel an awful lot like a human rights violation…..because it is. And both my baby and I suffered. Those who feel otherwise and try to silence this debate by thinking it’s valid to compare the choice to maintain lactation and the choice to have an abortion absolutely need to go and check their privilege.

  19. Chris says:

    I fully support a woman’s right to feed their child however they decide is best. I’m not going to reiterate all the galvanizing points, but want to point out that the depth of thought on both sides of the discussion in these comments illustrates how many educated, articulate women there are on both sides of the issue. Educated women who make an active choice how best to handle their baby’s development. This article starts pushing into that dangerous area where the woman is losing the right to choose, because the medical establishment “knows best”. Although the article presses the freedoms of women to breastfeed in public (important personal rights I do defend), it fosters further animosity towards the freedom to choose formula instead. The article can be seen as intimating that formula feeders willfully harm children or are sucked in by the formula industry. I chose forumla feeding, not because “choosing their product is a testimony to the exercise of that freedom”, but because of real medical complications that I won’t detail. Women often make decisions not fueled by propaganda. Most bottle-feeding moms I know had medical issues otherwise. Formula Feeding or mixed-feeding moms do get the guilt the article referenced, but mostly in the forms of articles and comments from breastfeeding extremists. I have heard of hospital wards that say they are “out of formula” and the kids will “starve” if you don’t breastfeed. That’s a pretty scary infrigement on patient rights. There are critical rights everyone deserves (breastfeeding in public, choice of how to feed), but until we realize that there are intelligent women on both sides of the issue and present balanced dialogue, all we are going to do is argue and never progress.

  20. This is in response to Mina’s questions regarding breastfeeding problems of genetically susceptible infants. There is no convincing evidence that genetically susceptible infants have breastfeeding problems. The majority of babies who develop ASDs lack autistic symptoms until they are about a year old. Most experts agree with me that it is difficult to diagnose a younger than one year old with autism with the exception of Rett syndrome or Dravet syndrome, which start with seizures and developmental delay as early as 6 months. Of course breastfed babies at any age are more advsnced in their deveopment than formula-fed infants.

  21. This is in response to Sara R’s question regarding the validity of my hypothesis that extended breastfeeding is associated with a decline in prevalence of ASDs. You are only right about one thing and I agree with you that ASDs are very complex disorders. However there is now a vast knowledge regarding the etiology, that is the causation and possible treatments, than 30 years ago.In 2003 Dr.Thomas Insel, who is now the director of National Institute of Mental Health discovered that adults and children with ASDs have lower oxytocin levels than normal adults and children. He then noted that infusion of oxytocin to these individuals resulted in temporary improvements in some of their symptoms. He then proceeded to use oxytocin nose spray, which crosses the blood brain barrier better than intravenous infusion. Now there is a 100 million dollar grants for first phase human trials. You may ask what is the connection between oxytocin and breastfeeding. There is strong and convincing evidence that there is higher concentration of oxytocin in breastfed babies as well as breastfeeding mothers. My hypothesis is that oxytocin up-regulates the oxytocin receptor’s gene expression. Furthermore there are some other articles regarding the higher incidence of autism associated with formula feeding and early weaning.

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