NYC Hospitals to Limit New Moms’ Access To Baby Formula

by Bettina Elias Siegel on July 30, 2012

Turning to the tiniest kids in “kids and food,” the office of New York City mayor Michael Bloomberg has announced a new initiative under which participating city hospitals will restrict access to infant formula in an effort to encourage breast feeding by new moms.

Launched back in May under the auspices of the city’s Department of Health and Mental Hygiene, Latch On NYC promotes breast feeding by seeking to:

  • Enforce the New York State hospital regulation to not supplement breastfeeding infants with formula unless medically indicated and documented on the infant’s
    medical chart
  • Limit access to infant formula by hospital staff
  • Discontinue the distribution of promotional or free
    infant formula
  • Prohibit the display and distribution of infant formula advertising or promotional materials in any hospital location

As far as I can tell, the two-month old initiative appears to be making news today because of a new requirement, starting September 3rd, that will “keep tabs on the number of bottles that participating hospitals stock and use — the most restrictive pro-breast-milk program in the nation.”

Not surprisingly, conservative commentators are having a “nanny state” field day, especially since this news breaks so soon after Bloomberg’s proposed ban on sodas sold in large containers (with one wag facetiously worrying about babies requiring more than 16 ounces of formula.)

But of course, the banning of formula manufacturer “swag” like free diaper bags is nothing new, and certainly not confined to New York City hospitals.  And participation in programs like Latch On NYC does seem to work; one hospital quoted in the New York Post reports that breastfeeding rates there have climbed from 39 to 68 percent under the program.

My feeling is that encouraging new moms to breastfeed is a very good thing, and so is banning from the maternity ward the shameless profit-seeking of formula manufacturers.  But browbeating moms who can’t or don’t want to breastfeed is definitely not a good thing, and that creates a fine line for hospitals to walk.

What do you think about all this?

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{ 45 comments… read them below or add one }

Michelle July 30, 2012 at 8:32 am

“My feeling is that encouraging new moms to breastfeed is a very good thing, and so is banning from the maternity ward the shameless profit-seeking of formula manufacturers. But browbeating moms who can’t or don’t want to breastfeed is definitely not a good thing, and that creates a fine line for hospitals to walk.”

I am so far on the “women should breastfeed” side of this line that I will admit that I can’t even see the other side clearly. I know so many people, even personally, who do not breastfeed because they “just don’t want to” or because “it’s too much trouble.” I don’t get it. It has been proven repeatedly and without question that breast milk is, by far, the best way for a baby to receive nutrients. Perhaps more mothers will even TRY to breastfeed if, at least at first, the hospital provides few other options.

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Bettina Elias Siegel July 30, 2012 at 9:39 am

Michelle: I know — as someone who breastfed my own two kids, I, too, support breastfeeding whenever possible and I applaud efforts and support systems that make it easier for women to try it. But we all know moms who, despite their best intentions, have real problems physically or logistically that make it very hard. And yes, there are those women who just make an informed choice not to breastfeed, and I think we have to respect that decision, even if we disagree with it.

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mommm!!! July 30, 2012 at 8:51 am

I think that breast feeding is a personal choice. I think that if a mom chooses to feed her child formula then that is also her choice. I think it’s terrible that women get beat up over choosing to breast feed, so I think it’s equally terrible to beat up women who choose to use formula. I don’t know why people feel the need to dictate to women rather than just letting them make their own choices.

I feel sorry for the new mom that can’t, for whatever reason, breast feed. Giving birth should be a happy occasion. But I know I’m not alone about feeling insecure as a new mom when my child was first born. I can’t imagine adding a new layer of insecurity to that by making such an issue over formula in the hospital. Again, a woman should be free to choose.

And for the woman who simply doesn’t WANT to breast feed? Is she going to be made to feel like a heel now after giving birth? What a way to crap on someone’s day. The day you give birth to a child is not the same as having say….an anniversary. Especially for new moms.

Women need to stop allowing themselves to be dictated to by men in the government. We are perfectly capable of deciding when and if we want children and we are perfectly capable of feeding our babies, whether that be by breast or by bottle. We really are capable. I know this may surprise some people, but women can actually make their own decisions.

I breast fed my child, but I received a huge amount of flack for it, both from the nurses and from my family. I actually busted the nurse sneaking my child formula after he was done breast feeding and the formula would make him throw up everything he had just eaten. I became suspicious after my child continued to lose weight seven days after being born. Then eight days. And nine. It was his nurse that insisted I keep to a 4 hour feeding schedule, which is contradictory to breast feeding. I had to literally fight with the hospital just to feed my child properly and I had to keep my eye on that cagey nurse and not let my child out of my sight for 5 seconds for fear that she would sneak him formula against my wishes and ultimately sabotage his health and my efforts. I know there are other crazy stories out there about breast feeding moms like me. It doesn’t make sense to swing the pendulum all the way to the other extreme.

I’m not opposed to swag. Especially good swag that is useful because it’s free. Lots of moms really NEED free stuff. Rather than ban formula swag, they need to encourage beast feeding swag. I would have loved some extra tubes and BP free bottles to go with my outrageously expensive medela double pump. That thing cost as much as a crib for gawd’s sake. In fact, I think there should be more swag. Breast feeding moms use more diapers (I think) and they are danged expensive! Free ones are always appreciated.

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Bettina Elias Siegel July 30, 2012 at 9:33 am

Mommm!!! I’ve seen that some hospitals now do give out pro-breastfeeding “swag,” just FYI.

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Justin July 30, 2012 at 10:09 am

“What a way to crap on someone’s day.”

Love that statement… :-) And the breasfeeding swag is a great idea. You should get whichever swag maps to what you’re doing when you leave the hospital. That should encourage breastfeeding Moms to keep at it and still let the bottle-feeding moms have the financial leg-up.

Your story about the nurse sneaking your baby additional formlua reminded me of yet another “pressure” we felt when we had our daughter very recently. Most hospitals now are pushing “Rooming-In” programs, which amount to encouraging Dad to stay overnight in the hospital room (with varying degrees of creature comforts) and encouraging–sometimes more or less forcing the parents to also have the baby in the room so they can learn to care for him or her.

While I love the rooming-in concept for lots of reasons, it’s also sometimes just necessary to send your child to the nursery for his or her own safety and your own sanity and you shouldn’t be made to feel guilty about that either. My wife and I were awake for 36-hours straight during a difficult labor and then ended-up with an emergency C-section. As much as I wanted to, I couldn’t care for her until I’d had a few hours sleep and my wife was still bedridden and on pain-killers. I literally cried and felt guilty that I had to send her to the nursery, but I couldn’t keep my eyes open and was afraid to drop her.

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mommm!!! July 31, 2012 at 12:48 am

Exactly. The day your child is born is intense. I don’t see the point in making women feel “less than” for choosing formula.

One of the things that people don’t tell you about breast feeding is that your child will be physically attached to you for as long as you choose to be so and there is a mental drain that comes with that no one ever talks about. I mean, you carry this baby around IN your body for 9 months and then it’s attached to your boob for however many months after that, and frankly, its hard giving up that kind of personal space for that long. And I know because I did it for a year.

I also had a c-section. So, my child’s birth was….a bit stressful LOL! (an understatement) I didn’t get to go home and recover. I had to go to the hospital my child was transferred to and then fight with his nurse for the next several days. Fun! I actually had no intentions of breast feeding. But I never got to hold my son or anything because he had to be whisked off to a hospital with an infant ICU. So, I made the decision to breast feed as a last ditch effort to recreate the bonding we missed out on at his birth. Man, was I in for an eye opener! My parents were pissed, the nurse was hellbent on sabotage, and I knew not a single person that had any knowledge of breast feeding of any kind whatsoever.

The point is, stick to your guns. Listen to your gut. You’ll have plenty of things to feel guilty about later, trust me LOL! A sleep deprived parent is not a great parent. Stay informed, do what feels right for YOU, and remember to take care of you because unhappy parents are also not great parents. You’ll be fine! Don’t let the snobs that think they are the ultimate authorities on all things parenting make you feel guilty about anything that you may or may not be doing that they may or may not disapprove of in all of their self righteous glory. And congrats and good luck! :)

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Justin July 31, 2012 at 8:34 am

I have to admit…I’m quite surprised at all the stories about “fighting with the nurses” and nurses supposedly sneaking formula to the infant in the nursery. Sounds to me like that’s a MUCH bigger problem if it’s happening than the manufacturers giving away free formula…and a correctable one. Any healthcare professional that doesn’t respect a patient’s wishes should not be in that job.

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Justin July 31, 2012 at 8:51 am

“One of the things that people don’t tell you about breast feeding is that your child will be physically attached to you for as long as you choose to be so…”

A side-effect of this, BTW, is that Dad more or less can’t help you out with the middle-of-the-night feedings (unless you’re pumping and the baby takes to the bottle).

I’m probably going to get shot for suggesting this, but I’ve also noticed that it’s easier to train your baby to keep to a schedule and sleep through the night when you use a bottle because you know how much they’re getting and you can focus on scheduling it more like meal-times. When the baby is simply nursing from the breast, there’s a lot of “snacking” going on at whatever time the baby sees fit. Many say this is better for the baby, but sooner or later, the kid does need to learn what meal times are and I like to set good habits from the beginning rather than try to fix them after the fact. Personal parenting preference.

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mommm!!! August 1, 2012 at 9:12 am

I think the not being able to help issue was what really ticked my parents off. Luckily, I started pumping right away because I wanted my child to take breast milk both from bottle and breast so that weaning him would be easier later. My child is their only grandchild so they wanted to do everything (ok well only the fun stuff lol!)

A word about “snacking”….breast fed babies eat more often than formula fed babies do because breast milk is more easily digestible. So it may appear to be “snacking” it’s really not. Also, there is a growth spurt that happens around 3 months old (it’s been a long time so it could be 2 months old, I don’t remember) where the baby eats nonstop for as long as 3 or 4 days. This period can be a make it or break it for a lot of breast feeding moms because they panic or they aren’t prepared and can’t keep up with the milk production demands and don’t know how to boost their production, etc. Also, I opted to feed on demand while I breast fed rather than stick to a scheduled regimen about food. I feel that a scheduled regimen regarding meals works better with solid food and an older child rather than a milk eating infant. I had to accept that I could not control when my child should or would be hungry as an infant and it was important to me that his little body not be denied important nutrients at such a critical time in his life and his development. Free feeding kept him remarkably healthy and he was a pretty happy baby, never fussed, rarely cried, and slept through the night.

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mommm!!! August 1, 2012 at 9:33 am

I want to add that dads actually can be a tremendous help to breast feeding moms by being really supportive of the mother and her needs during such a demanding time.

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Amy July 30, 2012 at 2:42 pm

“It doesn’t make sense to swing the pendulum all the way to the other extreme.”

I honestly don’t see that this is the intent at all. Babies who need formula for whatever reason will still get it. Moms can still choose to feed their child formula once they take them home. I don’t see anywhere in here or any other articles where the law mandates hospital staff to make moms feel bad if they choose not to breastfeed.

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mommm!!! July 31, 2012 at 1:05 am

It seems counter productive to limit or deny free formula and baby items to women that actually need them to prove a point about breast feeding. Of course the mandate doesn’t SAY “make all new mothers feel like crap for not breast feeding”. However, pressuring people at such a poignant moment is going to be met with some backlash and it’s going to make people who can’t or don’t want to meet that standard feel like crap. (I know from personal experience…you can even call my nurse and ask her about the backlash I unleashed on her trifling self) And I think that’s pretty…well…shitty, to be honest. Pushing an entire human being out of your crotch is stressful enough. The last thing I, personally (and this is from my ME place), would want to follow that experience up with is some nurse shoving whatever politically correct method of feeding children is at the time down my throat. And I say that from personal experience as someone who chose to breast fed when it was the absolute NOT cool thing to do.

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Uly August 7, 2012 at 12:52 pm

Formula companies don’t provide free formula in hospitals because they’re nice. They do it because they know that if they do, you’ll end up using their formula instead of a competitor’s – and yes, that’s how they view breastmilk, as a competitor.

You’re right. It’s a very vulnerable time for parents. So instead of tanking their ability to do what’s best for the kid, why not support them and the baby? Nobody is going to stop you from simply buying your own formula… and if you’re that poor, I promise you, WIC gives it out for free.

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Justin July 30, 2012 at 9:45 am

I have to respectfully disagree with this policy and one or two of your points on it. Quite frankly, as a new dad of a formula-fed infant (by our own educated choice), these policies make my blood boil, for the following reasons:

- As you pointed out, many moms can’t or don’t feel comfortable breastfeeding. For those who can’t, I know many who have tried and were heartbroken/frustrated that they could not–as if it were some personal failure. The LAST thing they need is additional guilt or difficulty obtaining formula.
- While it’s perfectly within the hospital’s duty to encourage breastfeeding and educate the patient on the virtues of it, it should *not* be their job to police who does and does not have access to formula nor make our choices for us. We pay enough to have children in hospitals (our bill was over $40k)–we should get whatever we want/need to care for that child without having to fight for it.
- New Moms and Dads should not have to feel ashamed for the nutritional choices we make for our child in the first days of life. Those few short days are emotional and tiring enough without getting a “guilt trip”. That’s especially true with difficult births such as a C-section or other medical complication.
- If you’ve ever purchased formula, you know that brand-name formulas are outrageously expensive (because they’re developed and marketed by the pharmaceutical industry). The two leading brands cost around $25 for a one-week’s supply of the powder. To make matters worse, you get whatever they happen to give you for the first feeding and most doctors don’t recommend switching brands unless your child has a problem with it. As a result, you feel obligated to maintain brand-name loyalty in the name of your kid’s health at a huge financial strain. Any “free stuff” the manufacturer is willing to give away is an entitlement, IMHO. If they’re going to screw us on the price, the least they can do is give us some free stuff. If the hospitals really want to help, they’d offer the parents the choice of brand up-front before giving the kid the first bottle.
- With regards to the free stuff (which you refer to as “swag”), it’s often $100 to $200 worth of free formula. I can’t tell you how helpful that is to have on-hand during the first week, both financially and as a matter of convenience. If you don’t want to give it to breastfeeding Moms in order to encourage them to continue, fine. For those of us who *are* formula feeding when we leave the hospital, you’re just screwing us over by witholiding it.

I’m so very tired of activists who push for a one-size-fits-all solution when the situation is really not that simple. As a parent, I’m increasingly frustrated with standards organizations like the AAP who are so ultra conservative and prescriptive that sometimes, their recommendations (which people truly believe are hard-fast rules) often lack plain old common sense.

Instead of taking away peoples’ choices and what few free things we have in life, instead, let’s make it about education and personal choice.

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Bettina Elias Siegel July 30, 2012 at 10:08 am

Justin: Really glad to get this perspective. Thanks for sharing here. You’ll find similar views expressed over on TLT’s Facebook page where a lively debate is happening right now.

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mommm!!! July 31, 2012 at 1:09 am

Justin…..you said it better than me. Thank you :)

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Chic Mummy July 30, 2012 at 9:47 am

Australia pretty much has this law already. No infant formula ads, including magazine, tv, Internet, etc (or swag) is allowed for formula intended for under 12 month olds. The majority of hospitals (and all public hospitals) will only provide formula when medically indicated.

What this means in practice is that formula companies heavily promote toddler formulas, but with copy such as “when you choose to stop breast feeding, or you want to mix feed…” that is just as applicable to mums of infants. The result is that while 92% of babies are breastfed at birth, this has already dropped to 80% by 1 week, 71% by 1 month, 56% at 3 months and just 14% at 6 months. Don’t forget that here in Oz we also have 1 year of maternity leave, of which 18 weeks is paid leave.

IMO, it just shows that while you can legislate and make it difficult for women to be exposed to formula in the hospital environ, unless you really educate, and more importantly, SUPPORT, women’s breast feeding, then all you are doing is delaying formula by a matter of weeks, if not days.

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mommm!!! July 31, 2012 at 1:10 am

Excellent point. As an American woman, I never even considered this because the idea of the kind of maternity leave that you enjoy is something I could only fantasize about so therefore this perspective never even entered my mind. It’s SO true, though.

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Christine July 30, 2012 at 9:50 am

Feeding your child formula is not the end of the world. Yes. Hospitals need to dial back on the shameless self-promotion of formula-makers, but we also need to remember that formula serves its purpose. It feeds and nourishes babies when mothers cannot. My daughter was in the hospital for ten days after she was born and I had great difficulty nursing her. I did nurse for as long as I could, but ultimately formula is what helped her gain weight.

Formula has its place, and choosing to give your child formula does not mean that you love your child less, but the choice is often made for you because of lactation difficulties or because your workplace might not support you by giving you space or time to pump. So though I do agree that hospitals should dial back on the formula giveaways, I think we should remember that formula is a viable and healthy choice for mothers.

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mommm!!! August 1, 2012 at 9:23 am

Just a thought on the formula give aways…..I was sent home with three giant cans of formula, even though I was breast feeding. I was given the option to take them or leave them. I took them with me. (hey I grew up poor and us poorfolk don’t turn down free anything) Then I took those cans down to the food pantry where I know they would be used by a grateful mom or two. Just a thought.

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Justin July 30, 2012 at 9:51 am

One more thing of related interest. Did you know that, for the purposes of health insurance and healthcare flexible spending accounts, breast pumps and related pieces are considered “medical equipment” but formula is not considered “medication?” That means that breast pumps are often free (under insurance) or tax-free (under the FSA). Formula and regular feeding equipment (bottles, etc.) don’t enjoy this same classification .

(Admittedly, formula is considered food and is non-taxable in most states.)

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mommm!!! July 31, 2012 at 1:13 am

This must be new because there was no way in heck that my insurance was ever going to cover my breast pump and if they did it surely was not going to cover the pump I chose, which was crazy expensive, yet the only one that was going to work if I was going to attempt breast feeding AND employment simultaneously.

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Justin July 31, 2012 at 8:44 am

Sorry…I should have been clearer. Obviously, not all health insurances are going to cover the cost of the pump. Some might…I’m not really sure. Sometimes, it’s covered under the prescription plan and people don’t even think to ask. I remember being surprised when my wife’s blood sugar meter was covered at the cost of a prescription co-pay. All you needed was a “prescription” from the doctor.

The FSA eligibility (the ability to pay for the pump with pre-taxed dollars) is a federal law. If your employer offers an FSA as part of your benefits program, all you need to do is “elect” that dollars from your paycheck be put into the account pre-taxed and you can use it to pay for the pump. Not sure about the bottling and storage kits that go with the pump. The same may be true for companies that offer HRA’s or HSA’s, but I’m not sure.

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Bri July 30, 2012 at 9:52 am

I’m going to come at this from a devil’s advocate position.
Free formula in hospitals can be a very, very good thing for low-income mothers. Yes, ideally, we would all probably LOVE to see those mothers breastfeeding their children; but let’s think about what that mom’s day might look like.
Get up after exhausting, sleep-deprived night with new baby. Take new baby to childcare of SOME description, somewhere, with enough food to get baby through the day while mom goes and works one, two, or even three low-wage jobs. Come back, pick baby up from childcare, take baby home, deal with the overwhelming exhaustion that is the life of a new parent — especially a resource-poor new parent who has to work.
Somewhere in there, she’s supposed to…what? Pump in the bathroom? Store the milk…where? This is probably not a new mom who is working in an office building with mom-friendly policies and plenty of space for milk refrigeration for her. She probably has to account for every second she’s away from her workstation, as a matter of fact. Pumping takes a long time. Pumping regularly and getting enough milk for the baby takes even longer.
My point is: Until we have overall policies that will ensure every mom is able to take plenty of maternity leave, pump as needed, etc., etc., I don’t think I really want to see free formula taken away entirely. It’s comfortable to have the debate from where I, and probably many other TLT commenters, sit; but I can imagine a life in which those formula samples would get me and my new baby through the first few weeks, or the first month, or whatever, and that’s a lot of money saved and a lot of support given at a challenging time.
Just another way to think about things.

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Bettina Elias Siegel July 30, 2012 at 10:07 am

Bri: So glad you brought up this angle. I was so fortunate to be able to stay home with my babies, which made it immeasurably easier to breastfeed. When I encountered some problems nursing my first, I was also able to pay for a helpful session with a “lactation consultant.” And even among my working-mom friends, they all were in offices or settings which allowed for pumping in privacy and for the cold storage of breast milk. Sadly, for vast swaths of American women, none of those things are true.

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Bri July 30, 2012 at 11:14 am

Maternity leave isn’t even true for many women in this country, and that — right there — is going to keep breastfeeding rates low. Can you imagine having to get right back to your job after a week? Two weeks? Maybe not even? It happens all the time. Nobody can tackle the huge challenge that is establishing a breastfeeding relationship under those conditions.

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mommm!!! July 31, 2012 at 1:20 am

Bri…..exactly! I don’t know many convenience store clerks, bank tellers, ice cream servers, waitresses, grocery store cashiers, farm hands, vegetable canners, cocktail waitresses (the list could go on for days) that can leave their job post every other hour to go pump breast milk. Just sayin’ folks.

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Timmi July 30, 2012 at 11:15 am

This sounds like the policy at the hospital where I had my girls. They do not hand out formula swag, but do give you anything that you need to make breastfeeding successful. I was given a diaper bag and baby blanket and I was also given (if asked) nipple shields, and larger pump cups for my pump, I could have gotten a free manual pump but I already had one. You can come in any time to get help with breastfeeding FREE of charge. They won’t give the baby formula if you are nursing. If you are going to opt out of nursing they tell you ahead of time to bring your own formula otherwise you will be charged for it. My sister who works in labor and delivery says this is a wonderful program, and at least encourages new mothers to think about nursing, the staff is very knowledgeable if you have any questions. They won’t look down on you if you choose formula but all the education is given for both sides.

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Kirby July 30, 2012 at 11:23 am

Yeah, not gonna lie here. I think a mother should have a choice. When I had my daughter, she would not breast feed at all. I had 3 differant people come in and try to help me, but to no avail. She simply refused. Are you going to continue to force an infant to latch on or starve? NO! We put her on formula her second day and she did great. I pumped for the first 2 weeks and gave that to her, but after that, my body just stopped producing breast milk.
And putting your infant on formula is not evil. Sometimes it’s a life saver. And thats exactly what happened to me as an infant. The doctors kept telling my mother to breast feed me, but I wasn’t getting the nutrients I needed. I was starving to death and ended up malnourished, and needed to stay in the hospital for 3 weeks hooked up to IVs. Tell me that is perferable to formula.
In the end, it’s the mother who knows best, not for the government to tell us what we can and can’t do. They say what we can and can’t feed our kids, and I say stay the hell away from my dinner table, you wern’t invited.

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Amy July 30, 2012 at 2:47 pm

“Are you going to continue to force an infant to latch on or starve?” This is a bit melodramtic… nowhere does it imply this is the policy. In fact, if it becomes medically necessary the baby will get formula. If the situation is really as dire as this, the baby will get the formula.

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Timmi July 30, 2012 at 12:32 pm

Bri I don’t know where you live but we have programs here in Nebraska that allow low income families to receive free formula. So formula isn’t being taken away completely its just not handed out in the hospital, but you can still get those awesome formula swag bags from the Dr’s office you just have to ask or bring in the coupon to receive it

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Bri July 30, 2012 at 3:16 pm

Some states have that, others don’t, but also, WIC benefits will only apply to one specific type of formula. I’ve known many young mothers who did not have the ability to breastfeed, for all the reasons I stated above, and whose babies didn’t respond well to the WIC-approved formula. They’re pretty much stuck. It’s great if they could still get the formula bags from the doctor’s office, but it seems to me that many may not have the foresight, or indeed the knowledge of the program’s existence, to be able to plan ahead and say “Oh, I’m going to need to feed my baby, and the hospital isn’t going to help…”

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Alissa July 30, 2012 at 1:49 pm

I don’t think the point of this policy is to shame moms and starve babies, I think it’s to try to turn the tables on existing policies that undermine breastfeeding efforts and make it MORE difficult for even the most motivated moms to begin a successful breastfeeding relationship. The fact is that pretty much every study looking at this issue has come to the conclusion that breastfeeding IS best for mom and baby and the first hours and days of a baby’s life are critical in establishing a latch and the mom’s milk supply. But right now, despite the best research available, many hospitals are biased towards pushing formula.

As one example, I had my first baby in a birthing center within a NYC hospital, and even in this unit which was dedicated to natural birth, I had to fight a nurse in the middle of the night who insisted that my baby was starving because I was exclusively breastfeeding. Fortunately I was very committed and had done my homework in advance, but I should have NEVER been put in the position where a nurse was giving me misinformation that, if I had listened, could have made it harder for my baby to learn to breastfeed and potentially slowed down my milk coming in.

That being said I absolutely think there are many legitimate reasons why families may use formula. Just because breastmilk is best does not mean formula is bad, and certainly hospital staff should be able to help parents learn how to properly formula feed infants. But the fact is right now there are so many societal factors that get in the way of successful breastfeeding, starting in the hospital. This conversation reminds me of a recent NYTimes article (http://well.blogs.nytimes.com/2012/07/23/the-ideal-and-the-real-of-breast-feeding/) which was basically arguing that since breastfeeding is hard for many, it’s unfair that the AAP recommends it so strongly. The answer to something being challenging is NOT to change the recommendation, it’s to help people work through the challenges as much as possible! On this blog we have a lot of conversations about stacking the deck in favor of other healthy choices. I see this as the same thing – let’s stack the deck in favor of breastfeeding. That means no nurses pushing formula, lactation support in the hospital, support for moms in the workplace, cultural norms that allow women to breastfeed in public places without being shamed, and more support among women for dealing with the challenges. Those challenges may just turn out to be too much for some to overcome either initially or over the course of weeks or months, and some people may just feel that the benefits of breastfeeding are not worth the trade-off. Which is fine. Parents are certainly entitled to make their own decisions regarding what’s best for their babies. But hospitals should facilitate what research says is best, and they CERTAINLY should not undermine health recommendations through policies that send mixed messages and misinformation to new parents.

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Amy July 30, 2012 at 2:49 pm

Right on Alissa!

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Jenn July 30, 2012 at 3:25 pm

My question would be, if a new mother has chosen to breastfeed will receiving free formula samples and things like diaper bags really change her mind? I would think not so I don’t see the harm in giving away free things to new mothers. I do see the point in restricting giving formula to babies who are being breastfed, unless there is a medical reason for it.

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Emma July 30, 2012 at 4:14 pm

This knee-jerk nanny state-ism is getting really old. What, you have some kind of civil right to 72-ounce colas and free baby formula? Furthermore, nobody’s actually talking about forbidding either of these things. You can still buy a 12-pack of Mountain Dew and drink it all. You can still buy baby formula– though, I must note that, except in instances of specific health issues, our boobs have done a more-than-adequate job of making baby formula for, you know, all of human history.

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Tina B July 30, 2012 at 6:57 pm

I suffer from Rhuematoid Arthritis and my disease did not go into remission during my first pregnancy. My labor was induced three weeks early for the express purpose of allowing me to go back on my meds because I was reaching a critical state by 37 weeks. After delivery I was attacked by the boob nazi’s who literally yelled at me and made it sound like I was a bad mother because I was choosing to begin taking my much needed medicine which would turn my milk to poison for my new infant. When I gave birth to my second child at the same hospital I literally had it written on my charts that NO lacticians were to enter my room under ANY circumstances.

I support breast feeding and if it had been possible for me to do so I would have if for no other reason than formula is really, really expensive. BUT, I will never give a woman greif for choosing not to breast feed. You don’t know why she made the decision she’s made. Even if she did choose formula because she was too lazy to be bothered to do it, at least she is feeding the baby a nutricious substitute.

My boys only had formula, both are very intelligent, healthy, the proper weight for their age and height and don’t seem to be suffering any ill effects from my inability to breast feed.

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mommm!!! July 31, 2012 at 1:26 am

This is what I’m talking about. This is why women should be supported in either choice regardless of what it is. We shouldn’t create a formula VS breast milk environment. Both should be accepted and supported equally.

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anne July 31, 2012 at 8:58 am

Mothers have enough pressure and decisions to make after giving birth. This reminds me of the working moms vs. stay at home moms debate. When Mayor Bloomberg gives birth, then he can tell moms to breastfeed. Till then he should stay out of it. It’s none of his business. Then End!

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heartsmart July 31, 2012 at 2:32 pm

I am so glad that people are pro choice…..As someone mentioned, there are reasons why women cannot breastfeed, even if they had wanted to….it is not right to make anyone feel guilty for going one way or another as long as it is not harming the baby and to my knowledge, there has been no proof that a formula fed baby is any worse off then a breastfed one…..if we take choice away with things like this, what else are we opening ourselves up to….

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mommm!!! August 1, 2012 at 8:58 am

While I agree that it should be a choice, there are definite benefits breast feeding enjoys over formula feeding. One is cost, because breast milk is free. The other is that there are health benefits to the child and mother involved in breast feeding that do not exist in formula. Lastly, by nature of being a processed product, formula and the containers that formula come in can contain chemical contaminants, which have cropped up in the news in recent years. I’m only pointing these things out for the benefit of the lesser informed that might be reading this blog.

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Elizabeth August 2, 2012 at 8:14 am

I’m commenting from my phone, so I’ll be brief. The LACTATION CONSULTANT recommended that I supplement with a little formula when I was in the hospital after the birth of my second. Thankfully, I had a wonderful experience nursing my 1st, and knew this lady was confused about her job description. Hopefully new policies like this eliminate needless formula for families who really don’t even want it in the first place but don’t know enough to say, no thanks.

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NYCHealthDept August 2, 2012 at 5:54 pm

We read your blog posting with interest and wanted to respond and address several inaccuracies. The piece states “So starting September 3, the city will urge hospitals to put formula under lock-and-key. Parents who want to bottle-feed their infants will have to convince a nurse to sign out formula for them by giving a medical reason for every bottle. They’ll also have to endure a lecture about why they really should be breastfeeding instead.”

This is actually not the case:

• In fact, the initiative does not require hospitals to “hide” or “lock up” formula, nor does it restrict access to it for those who want it. Parents who want formula will not have to convince a nurse to sign it out by giving a medical reason. Parents can and always will be able to simply ask for formula and receive it – no medical necessity required, no written consent.

For 3 years, New York State Law has required that mothers be provided accurate information on the benefits of breastfeeding. The City initiative does not require that mothers asking for formula receive a lecture.

The piece erroneously dismisses the positive health impacts of breast feeding for which there is there is overwhelming evidence — supported by national and international health organizations. For mothers, breastfeeding reduces the risk of breast and ovarian cancers. For babies, breastfeeding reduces the risk of ear, respiratory and gastrointestinal infections, as well as asthma.

The American Academy of Pediatrics has just published new guidance to pediatricians in Feb 2012, reaffirming its support for breastfeeding: http://pediatrics.aappublications.org/content/129/3/e827.full.pdf+html

Ultimately, our goal is to support a mother in whatever decision she makes when it comes to nursing her baby and this initiative specifically is designed to support a mother who decides that she wants to breast-feed by asking participating hospital staff to respect her and refrain from automatically supplementing her baby with formula (unless it becomes medically necessary or the mother changes her mind).

Bottom line: It does not restrict the mother’s nursing options in any way – nor does it restrict access to formula for those who want it.

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Bettina Elias Siegel August 3, 2012 at 7:52 am

Hi, and thanks for stopping by The Lunch Tray.

Your comment has me scratching my head a little bit since not one of the offending sentences which you rebut  above are contained anywhere in my blog post.  I get the feeling your comment is actually a blanket statement  drafted your office to rebut some widespread, negative publicity about Latch On NYC, and you’re now blanketing the Internet with that statement as fast as you can — without paying much attention to its recipients.

So allow me to introduce myself:  I’m the mother of two children, both of whom I breastfed for a little over a year.  In fact, my oldest child simply would not take a bottle from anyone, under any circumstances (stubborn little thing), so I think I more than amply demonstrated my commitment to breastfeeding that year — not to mention my stamina and patience.  My belief in the merits of breastfeeding is precisely why I wrote in my post about Latch On NYC: “encouraging new moms to breastfeed is a very good thing, and so is banning from the maternity ward the shameless profit-seeking of formula manufacturers.”  So for you to say that my piece “erroneously dismisses the positive health impacts of breast feeding” only confirms that you never actually took the time to read my piece before leaving your comment.  Frankly, I find that annoying.

Because I was already supportive of your program in principle (and am all the more so now that you’ve provided more information about how it works in practice), I’d normally be inclined to brush off this mix-up.  But your leaving this rather high-handed and utterly inapt comment on my blog points up a larger issue:  the dismal job your press office has done in promoting this program and addressing inaccuracies about it in a timely fashion.

When the New York Post story broke on July 29, the very first thing I did was visit your Latch On NYC web page to try to verify the Post’s description of the program.  Unfortunately, the most recent document posted on your website that day was a press release from May, 2012.  That was still true twenty-four hours later when I was ready to post my story on The Lunch Tray.  For that reason, I made clear to Lunch Tray readers that I wasn’t quite sure why Latch On was suddenly even in the New York Post, since nothing on your website indicated a change to the program since May.

When, in the days that followed, my Lunch Tray post garnered a lot of attention and discussion both on the blog and on Facebook and Twitter, I continued to visit your site periodically for any newer information you might provide, but none was available.  Amazingly, despite the quite negative PR the program has garnered in some quarters in the last week, that is still the case as of my writing this reply on August 2.   So instead of leaving comments on blog posts without taking the time to read them, perhaps someone in your press office could take a few minutes to actually put the helpful information you’ve shared here on Latch On NYC’s website for all to see?  Just a thought.

The bottom line is that you and I are on the same side.  I wholeheartedly support breastfeeding whenever possible, as its advantages for the baby are solidly documented, and I abhor the practice of allowing formula manufacturers to market heavily inside maternity wards.  But as a blogger who is privileged to hear the personal stories of many readers, I also know that lots of well-intentioned women find out in the hospital that they can’t breastfeed for a variety of reasons, or they feel (or are advised) that formula supplementation is needed.  Some of these readers expressed fear that this program will cause other women in their situation to be pressured or shamed, and I’m very glad to learn from your comment that this shouldn’t be the case.

Thanks for getting in touch and I hope you take my criticism of your press office’s performance in the spirit in which it was intended.  I enthusiastically support efforts to increase breastfeeding in New York City hospitals and I’d like to see your department garner widespread support, not criticism, of this worthy goal.

Regards,

Bettina Siegel

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anne August 8, 2012 at 2:52 pm

I think it”s wonderful if you can breastfeed. I got a 102 degree fever three days after I delivered my son, so they bottlefed him while they decided if I should even touch him, since nobody knew exactly what I had. (It was later determined that I must have picked up an infection because my water broke around midnight and I didn’t give birth until just after 3 p.m.) I didn’t feel well for a few days and was on an anti-biotic when we were discharged.

If I had it to do over again, I’d probably try harder to breastfeed, but I felt overwhelmed at giving birth and taking care of a newborn.
When my daughter came along two and a half years later, breastfeeding was the furthest thing from my mind.

Fortunately, they both have grown up into healthy and happy young adults. Come to think of it though, my father-in-law and his sister were both breastfed and they had/have terrible allergies, so I don’t know whether things would have been worse if they had taken a bottle.

I guess you just have to have the confidence to do what you think is right and not to beat yourself up if you weren’t a perfect mom. My pediatrician used to tell me that the mothers who knew that they weren’t perfect were the better moms because they were flexible with their children. I’m not sure if he didn’t just say that to make me feel better, but it always did!

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