29 August 2012

When Did Breastfeeding Support Become Fat-Hate?

Many states seem to be adopting policies regarding those pesky formula samples at hospitals. I won't belabor the point here since odds are if you are breathing and have ever had a kid you know all about this. No need to rehash the gory details.  Ignoring for a second that I find it highly unlikely that the biggest public heath issue facing most states in this fine union is breastfeeding rates, I find these policies both god and bad.

They are bad for all the classic reasons:
  •  lack of autonomy for women over their own bodies 
  • disrespect for the fact that infant feeding is a highly personal choice
  •  ignoring that sometimes breast is not best for each baby/mom/family unit
  • the often not-so-subtle insinuation that all it will take is the mere presence of a can of formula to render the tiny female brain incapable of making a healthy choice
  • the idea that there is only one "right" choice anyway
  • that implication that it is OK to shame women for making any choice other that the "right one"
  • the propagandized benefits of breastfeeding  (it is great, but maybe not as great as the die-hards might have you believe)
  • promoting the idea that any suggestion of formula usage is just "big pharma" conspiring to lower breastfeeding rates* (see Side Note Below)
  • ignoring the fact that actual physiological inability to breastfeed is most-likely under-reported and/or not well understood
I could go on and on and hundreds of bloggers have covered all those bases far better than I ever could so moving on.

*Side Note:  I think that health care providers may actually push formula, but not because they want to see women "fail" at breastfeeding.  I hypothesize that formula supplementation is suggested not as a wholesale change in feeding plan, but as a medical intervention.  If a baby is not gaining well, or dehydrated, or struggling to clear up a case of jaundice then a few ounces of formula now and then may be recommended.  However, since health care providers don't always take the time to explain formula use as a treatment vs a shift in feeding paradigm all new mothers hear is "RED ALERT!  Bad doctor telling you to formula feed just like your LLL consultant said they would!!!!" and well, no one walks away happy there.  Since ideas of temporary supplementation and/or combo feeding never really seem to come up, we all get trapped in this breast vs. bottle dichotomy.  So yes, the health care system may often suggest some formula, but not because "the man" wants us all to up the stock price of Similac.  Before we all start pointing fingers, lets just have some perspective on just why formula can be helpful even when the end goal is EBF babies. *

However, on some level these policies are an OK idea.  Women who do want to try breastfeeding do not need some nurse sending them home with a formula sample and a smug "just in case" smile.  We do have to respect the choices of all parents and sending home an Enfamil bag full of powder samples with someone trying to EBF is a bit unhelpful.   By making the formula samples something that is offered and/or given when requested but not automatically presented is probably a good idea.  Sure, lots of people wind up being glad those samples are floating around at some point in time, but it is the parents who should make that choice, not hospital administrators. 

The real problem I have with these policies is that they are often backed-up by all those, lets say for the sake of diplomacy, misleading statistics.  The cost of breastfeeding can equal that of formula feeding and formula-fed babies are no more likely to die of SIDS than breastfed ones. (Good try with the fear culture plan though, points for effort Medela.) All the breastfeeding in the world won't fix a genetic predisposition to ear infections and three IQ points are not going to be the difference between Yale and  Wossamotta U.  I have to believe that there are many other public health and education related interventions that will help kids more than berating women about they chose to use their breasts.  All this being said, the part that really grinds my gears is that almost all of these policies tout higher breastfeeding rates as a veritable cure for obesity.  The fundamental idea is that if we could just stop being stupid/lazy/ignorant and breastfeed (at all costs, no matter what) then the obesity epidemic would just disappear**. Even ignoring for the fact that weight/BMI has little correlation with actual health this may be the stupidest conclusion I have ever seen drawn by public health officials.

So really, this might just be fat hate cleverly disguised as "thinking of the children" with an added anti-feminist twist.  Are we, as a culture, actually so offended by the idea that not everyone looks perfect that we will regulate the very survival of newborns?  Apparently maternal child health only counts if it makes us all fit into the neat little boxes of BMI.   Just when you thought we had reached the zenith of shaming women in this country, it turns out we can blame women for making us all fat too.  Awesome.  Todd Akin must be positively wetting himself with excitement right now.

The whole thing just sickens me. Not only is it totally OK to regulate yet another part of the female body, but if you disagree, or merely make a different, but equally safe choice, you are making us all die from obesity.  Sure the "war on women" is totally just in our heads.  

**Personal anecdote that does NOT equal scientific research: I only know two kids diagnosed as having "childhood obesity" and both were EBF with all organic/natural/crunchy diets.  Go figure right?   Can you even win at this game?  I think not.