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Latch On, NYC–OR ELSE (Updated 8/1)

Starting September 3, baby formula will be a controlled substance at some New York City hospitals. Under the health department’s voluntary Latch On NYC program, 27 hospitals are literally hiding the baby formula under lock and key, tucking it away in distant storerooms and locked dispensaries like legitimate medications that need to be tracked.* Nurses will be expected to document a medical reason for every bottle a newborn receives, and mothers will get a breastfeeding lecture every time they ask for a bottle of formula.

The NYC health department describes Latch On NYC as “a citywide initiative to support mothers who choose to breastfeed and limit practices that interfere with that choice.” (Just a note, health department: If a woman is breastfeeding mostly just because the doctor won’t let her have a bottle, it’s not exactly a choice.) Participating hospitals agree “to not supplement breastfeeding infants with formula unless medically indicated and documented on the infant’s medical chart” and to note on the chart whenever a mother chooses to bottle-feed her baby despite instruction to the contrary from hospital staff.

With each bottle a mother requests and receives, she’ll also get a talking-to. Staffers will explain why should offer the breast instead.

“It’s the patient’s choice,” said Allison Walsh, of Beth Israel Medical Center. “But it’s our job to educate them on the best option.”

Lisa Paladino, of Staten Island University Hospital, said: “The key to getting more moms to breast-feed is making the formula less accessible. This way, the RN has to sign out the formula like any other medication. The nurse’s aide can’t just go grab another bottle.”

The key to encouraging breastfeeding is to withhold any other option from new mothers. And to remind them every time they request a baby bottle that really, they’re depriving their baby of a healthy start at life and should probably feel guilty about that.

*Update 8/1, 6:30 p.m. According to Samantha Levine, deputy press secretary in Mayor Bloomberg’s office, the information on the Latch On NYC site was wrong, and hospitals will not be expected to keep formula locked away (although they’re free to do so). She says they’re correcting the FAQs to reflect that. It seems like a rather a strange thing to get so diametrically incorrect, but removing the lock-and-key element of the Latch On NYC initiative does help things immeasurably.


120 thoughts on Latch On, NYC–OR ELSE (Updated 8/1)

  1. Actually, this brings to mind Pheeno’s (and others, I’m not 100% sure I remember their usernames) comments on another thread about how poor WOC are being shamed/forced into nursing because welfare money doesn’t cover baby formula. I’d be really interested in follow-up studies on the race breakdown of who ACTUALLY gets these talkings-to, and which hospitals really enforce these rules and why.

  2. Nurses will be expected to document a medical reason for every bottle a newborn receives

    “The baby required food.”

  3. As an adopting parent whose children depended on formula from the moment they were born, it saddens me to see this. I ‘get’ that formula is manufactured by nasty big-ag corporations and that breast feeding is healthy and beneficial. I don’t ‘get’ the need for a hospital to stigmatize formula, and I worry that by subjecting it to these kinds of controls, a clumsy hospital bureaucracy could wind up denying vital nourishment to babies who need it.

  4. Huh. So, first public health officials (and, of course, formula manufacturers) told women that the best thing for their babies was formula, and shamed and harassed women who chose to breastfeed by telling them how primitive and barbaric it was. And now public health officials are telling mothers that it’s bad for their babies to use formula, because it’s not natural.

    And yet I know people in public health who wonder why there’s a confidence gap.

  5. The NY Post is known for its sensationalism and not so much for its journalistic integrity. That article, as often is the case, takes a good deal of dramatic license.

    Here are the pertinent points from the NYC Health Department:

    Hospitals joining Latch On NYC have agreed 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

    bolding mine

    All of these points are about making sure that hospital staffers are following proper protocol for dispensing formula and to keep formula manufacturers from trying to promote their products in hospitals. Nothing there about forcing mothers to undergo breastfeeding lectures if they formula feed or anything of the sort.
    I’m not in NY, but I had all sorts of problems when my twins were born 7 years ago with nurses trying to sneak them formula behind by back and against my express instructions while we were still in the hospital (Oh, we need to administer hearing checks, and we topped him off with a bottle while he was there. We need to check baby’s weight, we might have topped him off again, he seemed hungry. etc) These sorts of regulations are far more necessary than one might think.

    Btw, charting bottles/nursing sessions is standard of care anyway for newborn babies to make sure their input and output are on track. If nurses are giving bottles to babies who are supposed to be breastfed, that needs to be charted so that input is on the record and so that the parent(s) know what’s up.

  6. This is all flat out wrong. It is NOT about shaming, it is about formula marketing taking over. Breastfeeding fails because hospitals don’t have educators on staff. I am SO disappointed to see this formula company PR BS here. Do your research.

  7. This is total bullshit, you try breastfeeding a baby the day after a C-section, 3 epidurals and an 18 hour labor. I’m glad we both got some rest the first couple nights before Ms. H decided to breastfeed. Also happy St. Barnabas provides information without pressure and that they are across the river in the land of freedom & democracy (New Jersey). Parents should bring their own formula in to the hospital also in protest. Sorry NYC, but the nanny-state you are creating does not equate with liberal values. Next up social services will visit mothers who decline to breast feed and charge them with endangerment.

    These policies are being forced on everyone by people who have it easy – people with paid maternity leave, who can afford lactation consultants, classes etc. It smacks of a certain class of wealthy “pretend liberals” forcing everyone else to do what they think is best. (according to our Dr. you should not pump breast milk for the first 2 weeks for example, which means Mommy needs to be around, and awake every 3 hours before she can start trying to stockpile and then have family help on the feedings) Try doing that with a job that produces the income you need immediately. If Bloomberg wants to do something he can mandate paid maternity leave in the city. Then more people could choose on their own.

  8. Right now corporations can pay to have their samples placed in the hospital rooms. Even if you state you will be nursing the formula is pushed on you.

    Asking for formula doesn’t create an undue burden for formula feeding parents, but the ever-presence of formula does undermine nursing for parents who want to nurse.

    I’m personally sick of getting formula in the mail, from the hospital, and the pediatrician’s office – I had six cans by the time my little one was 4 weeks old! And they all knew we were exclusively nursing, congratulated me for it, then gave (usually my husband) formula in case “I needed a break.” WTF? These practices undermine nursing, which has been shown to provide better health outcomes for the child and nursing parent.

    Very few parents meet their breastfeeding goals, most people use formula. I can’t remember the last time a bottle feeding parent was kicked out of a restaurant, pool, mall, school, courthouse, or off an airplane for giving a bottle.

  9. Did anyone see the Law and Order years ago where the mother couldn’t get the baby to latch on and was terrified of formula so the baby starved to death? In the end I think she went to jail for murder or something like that. Don’t know if it was ripped from the headlines or just made up, but this thread sure reminded me of it. (Though there was plenty of culpability to go around in that episode.)

  10. All of these points are about making sure that hospital staffers are following proper protocol for dispensing formula and to keep formula manufacturers from trying to promote their products in hospitals. Nothing there about forcing mothers to undergo breastfeeding lectures if they formula feed or anything of the sort.

    …did you read the same regulations I did? Look, I fully support bars on formula companies advertising in hospitals. Fine. But “Limit access to infant formula by hospital staff”? And if you read the FAQs at the Latch On website, it is very clear that hospital staff have an obligation to strongly discourage bottle feeding, and “educate” women who say they want to bottle feed.

  11. When my wife and I heard this story, her response was “well, are they now going to allow women to breastfeed in public without being targetted for harrassment? are they going to provide free cover-ups for women to assist in public breastfeeding?”

    I figured Bloomberg must think every woman can afford a breast-pump and will have the time and energy to pump enough milk to keep the baby fed all day when she’s at work. Or maybe that Bloomberg figures every new mother has enough financial resources to take 2+ years off of work while the baby breast feeds. My wife figured that Bloomberg must think that every woman can afford a wet nurse.

    As adoptive parents ourselves, my wife and I also noted what archie said. BTW, I was an extremely milk allergic baby who (for what turned out to be obvious reasons, once we figured out the milk allergy) didn’t really suckle, and my mom wasn’t really able to produce milk. How would she have been treated? FWIW, my mom felt that La Leche league was offensive to her and, when she was trying to nurse my younger brother, they blamed her for my milk allergy (“you should have tried harder”) when it was likely the reason why nursing didn’t work out was because of my milk allergy. And my mom is mega-pro-nursing (to the point where she was suggesting that my wife take the medications necessary so she could start producing milk for our daughter).

    Of course, what Lolagirl said may very well be correct; and it isn’t just the NY Post reporting this. The media are all too keen to paint Bloomberg as the key proponant of the “nanny state” (and we could have a whole thread about the racism and sexism involved with that term), and this just feeds right into the media’s (I must admit largely correct) narrative about Bloomberg being an out of touch proponant of unnecessarily interventionist government.

    Still, I do worry about how those who are unable to nurse will be treated …

  12. according to our Dr. you should not pump breast milk for the first 2 weeks for example, which means Mommy needs to be around, and awake every 3 hours before she can start trying to stockpile and then have family help on the feedings

    I’m honestly not trying to be sarcastic here, but you got some bad, or at least mistaken, medical advice if that is what your wife/baby’s doctor instructed.

    The issue isn’t with pumping, because parents of NICU babies do it all the time immediately postpartum. The only caveat being that pumping often doesn’t get as much milk as direct nursing as babies are generally more efficient than pumps. The issue that will come into play in the first 2 weeks postpartum is supplementing with formula if one wishes to breastfeed. The first few weeks are critical for building one’s milk supply, and that process is hampered significantly if formula is given in place of nursing. If the nursing session is replaced with a pumping session, then it shouldn’t be a problem.

    Look, I’m not some strident lactivist. But I am a woman with 4 kids who has been given a great deal of bad advice about breastfeeding over the years and been treated like crap with a great deal of judgment and disgust by others who oppose my breastfeeding my kids. If not for a great deal of personal research and flat out persistence I would have given up before the game was even started because of all of those obstacles.

  13. If you make formula sign out mothers will be forced to wait 30 minutes or more, possibly hours to get the formula. Anything in a hospital that needs to be signed out by the RN goes in a queue, ever wait an hour or more for pain medication – that’s quite common. You can bet food for a baby where breast is available will be the lowest priority on our understaffed wards list of things to do, especially if they need to spend time reading a formula warning to the mother. And that is the intent of the law – we won’t force you to do it, we’ll just make it impossible not to.

    Relevant quotes from the hospitals interviewed by the Post:

    With each bottle a mother requests and receives, she’ll also get a talking-to. Staffers will explain why she should offer the breast instead.

    “It’s the patient’s choice,” said Allison Walsh, of Beth Israel Medical Center. “But it’s our job to educate them on the best option.”

    Lisa Paladino, of Staten Island University Hospital, said: “The key to getting more moms to breast-feed is making the formula less accessible. This way, the RN has to sign out the formula like any other medication. The nurse’s aide can’t just go grab another bottle.”

  14. Lola thanks, to add more – the advice was “shouldn’t” not “cannot”, in that it’s better to feed directly the first two weeks to (1) build up milk supply – according to the consultants something about the baby’s presence on the breast increases milk supply, and (2) there’s no point if the baby is around you to do so because you’re not making enough to have extra to store so mom will need to be up at 3AM anyways. (they did note the NICU thing and said that pumping was recommended in those cases)

  15. All of these points are about making sure that hospital staffers are following proper protocol for dispensing formula and to keep formula manufacturers from trying to promote their products in hospitals.

    All fair points.

    All kinds of products are promoted in hospitals, including medical services, pharmaceuticals, food, candy, prosthetics, nearly countless products and services under one roof in order to serve medical needs, not all of which are controlled or require “proof” of medical necessity. Singling out formula is stigmatizing for new mothers that choose not to breastfeed, and it’s made even more difficult for families and babies when baby food is stored under lock and key.

    The actual implementation of the policy is what is going to make or break the initiative. If the purpose is to track what parent chooses what feeding method and why, that’s pretty innocuous and it makes sense from a data-capturing and scientific/sociological perspective. If the purpose is to coerce parents into breastfeeding by shaming mothers and “educating” them into making the desired choices, that’s bad news, bad policy, and we need to protest this loudly. Hungry babies are designed to inspire anxiety and urgency in parents. Making them wait while the nurse walks to the pharmacy and signs out a bottle of formula while the baby is crying is unconscionable.

  16. My baby was mostly formula fed even though I did not want her to be. I firmly believe that if they had not pushed formula on us right after my c-section while I was dazed and out of it I would have at least made it to 6 months or more of breastfeeding. Hospitals waste no time in making you feel like a loser and a bad parent if you don’t give into formula. In fact hospitals take a lot away from you as a new parent in those first couple of days. I know I really felt like everything was out of control. And formula was a huge part of it.

  17. “Lisa Paladino, of Staten Island University Hospital, said: “The key to getting more moms to breast-feed is making the formula less accessible. This way, the RN has to sign out the formula like any other medication. The nurse’s aide can’t just go grab another bottle.”

    WTF? Formula isn’t medication! It’s nutrition. And the idea that a hungry, crying infant will be made to wait one moment longer than necessary, so that a nurse can sign out a bottle of formula, is absolutely unconsionable.

  18. I can absolutely understand encouraging hospitals to get rid of promotional materials from formula companies and I am definitely on board with ensuring that mothers are not pressured to bottle feed (and that no one bottle feeds their infant without their permission, wtf). But this goes way beyond that. This is from the program’s FAQ in response to the question of what hospitals should do when a mother requests formula:

    • Assess if breastfeeding is going well and encourage the mother to keep trying.
    • Provide education and support to mothers who are experiencing difficulties.
    • If the mother still insists on receiving formula, document it in the chart along with the reason and distribute only the amount of formula needed for the feeding.
    • Train staff in breastfeeding support (CLC, IBCLC) who can be available to assist new mothers at all times regardless of day, night or weekends.

    So a mother asks for a bottle, and the recommended response is to first encourage her to breastfeed, then educate her on why breastfeeding is a better choice, and then if she “still insists” distribute enough formula for one feeding. And then repeat that every time the infant needs another bottle. That’s not supporting the choice to breastfeed, that’s shaming mothers for bottlefeeding.

  19. The part that unnerves me is the part about forcing the staff to account for a medical reason for each bottle. My son was born in a baby-friendly hospital with such a policy. I had abstained from my mental health drugs for a long time but wanted to take them immediately after the birth given that I did not know the state I was in. When I requested formula for medical reasons, the nurse kept insisting that I needed to tell her why, exactly. You can understand that I did not want to announce my mental illness to a room with others in it, but she kept saying she needed a valid medical reason for the formula. I finally just told her that under HIPPA, I did not have to disclose the reason and that yes, I am a lawyer and yes, if she does not want a lawsuit, she’d provide the formula.

    Here’s what gets me. Nationally, something like 75% of women nurse in the hospital. In NYC, it’s close to 90%. 3 months after birth, around 30% are still at it. Well, has it dawned on anybody that around 2-3 months is when lots of mothers go back to work? And that work isn’t exactly an easy place to nurse? Do they also realize that the nations with higher nursing rates provide paid maternity leave, longer leave, cover nursing expenses 100% and all that? But its easier to say “educate and encourage!” Because then, nobody talks about the actual biggest barriers to nursing.

    1. Here’s what gets me. Nationally, something like 75% of women nurse in the hospital. In NYC, it’s close to 90%. 3 months after birth, around 30% are still at it. Well, has it dawned on anybody that around 2-3 months is when lots of mothers go back to work? And that work isn’t exactly an easy place to nurse? Do they also realize that the nations with higher nursing rates provide paid maternity leave, longer leave, cover nursing expenses 100% and all that? But its easier to say “educate and encourage!” Because then, nobody talks about the actual biggest barriers to nursing.

      Exactly this.

  20. So, refer back to the soda thread. Annnnnd can we get an “I told you so,” mmm? First soda, now formula. I just loooove it when the left gets as far up in my ladybusiness as the far right. Anyone else feeling some uncomfortable parallels between the forced counseling sessions pre-abortion and the “talks” from the nurse before you’re allowed to use formula?

    Look, I’m a fan of certain part of this initiative. I think it’s a dandy idea to limit free advertising for formula companies–we’ve done it with other medical supplies and its high time doctors stopped getting free pens/lanyards/steak dinners from these people. Give mothers formula, fine, but not eight million doodads with a brand pasted on. Maybe a generic label for all hospital formulas?

    But this doesn’t seem to be about that as much as it is about shaming women in order to score some low-hanging public health fruit. Want to increase breastfeeding rates, Bloomberg? Go after paid maternity leave, or require pumping space and time be available for ALL jobs. But no, THAT would be nanny-stateism. Argh.

  21. If hospitals weren’t so shitty about ignoring women who say “please don’t formula feed my baby” none of this would be needed. And what’s needed isn’t this new policy of making formula “less accessible,” what’s needed is doctors and nurses who actually pay attention to the wishes of the parents, whatever those wishes may be. This all just means hospital staff gets to keep being disrespectful to parents, it’s just now they’ll be pressuring for breasts instead of bottles.
    Any policy that is intended to make FOOD less accessible to INFANTS is a shitty policy, in my book.

    I’m personally sick of getting formula in the mail, from the hospital, and the pediatrician’s office – I had six cans by the time my little one was 4 weeks old!

    Meghan– I was annoyed, too, but ended up donating the free formula to the food bank. I hate to see food go to waste.
    Be prepared for another 2 years of formula samples!

    poor WOC are being shamed/forced into nursing because welfare money doesn’t cover baby formula

    Mac, it’s WIC that shames women into nursing, but will provide formula if you choose not to. (They’ll just belittle you every time, is all, which is stupid, because once you’re already not nursing for awhile you can’t actually just up and start doing it).

    Foodstamps (which you get on welfare) does cover formula, and unless the clerk at the grocery store is a jerk, you won’t get shamed for your feeding choices. (At least it does in CA, because even though I nursed my son there were a few occasions where I picked up formula, paid for with my foodstamps, for my nephew, since WIC didn’t cover the allergen-free brand his doctor recommended. And yeah, the tribal WIC office was super shame-y about his mom’s decision to formula feed)

  22. Mac, it’s WIC that shames women into nursing, but will provide formula if you choose not to. (They’ll just belittle you every time, is all, which is stupid, because once you’re already not nursing for awhile you can’t actually just up and start doing it)….And yeah, the tribal WIC office was super shame-y about his mom’s decision to formula feed)

    In my experience, WIC is super-shamey, period. Before I could get my vouchers, I had to take anger-management classes on how not to beat my children (among other courses). These were mandated regardless of our parenting methods, history with children, record of violence or lack thereof, etc. It’s really nice to be assumed to be an abusive piece of shit because you need help paying for food.

  23. Oh, for Pete’s sake.

    First, they are only banning the FREE SAMPLES given out by the formula companies. There are already a couple of states that have banned the “swag bags” and the breastfeeding rates increased. http://www.kgw.com/lifestyle/Hospitals-halt-free-formula-tout-breast-feeding-163114166.html

    Why? Because breastfeeding is hard, even for moms who WANT to do it. If they get discouraged and worried it is easier to just use the free formula. The more you supplement, the more you HAVE to supplement because milk supply decreases. The swag bags actively scupper breastfeeding.

    Our culture actively and routinely discourages breastfeeding, but let the breastfeeding activists try to help encourage it — then suddenly we are mean ol’ meanies. Oh noes! We are interfering with Nestle’s profits!

    Moms who want formula will be given formula. No babies will be asked to starve. The only people who stand to lose from this are the formula manufactures who do NOT want breastfeeding to work. And moms who are trying to breastfeed will be more likely to be able to do it successfully.

  24. Betty: You are correct that we have a culture that discourages nursing. Know the single biggest offender in that culture? The US (and all its related state) governments. And most of our corporations. Because they do not provide what women actually need to nurse long-term. Which is longer maternity leaves, paid leaves and most help with the expenses of nursing. Its all nice to have lactation consultations unless you can’t afford them. Even if this makes nursing more likely, it only extends the likelihood for the duration of maternity leave – and the data bears that out. Once work commences, nursing rates drop like a rock. And that’s related.

    Stuff like this lets the NYC government give itself a pat on the back to say “Look at how much we love moms and babies!” without getting some actual laws in place that would really help moms and babies. Until Bloomberg is willing to do that, he can shove off, to me.

  25. Moms who want formula will be given formula…

    …after answering a series of questions every time it is needed and having them endure a wait while the formula is secured from a medical dispenser. EVERY FEEDING. You don’t think this is unnecessarily punitive towards moms and babies?

  26. @Nico – it certainly seems like a good chunk of the US is treating the book as a ‘How to…’, rather than a piece of dystopian fiction.

    Sadly, until – paid maternity/paternity/adoption leave, a sense of a social contract between each person so that welfare and healthcare are seen as inalienable rights, and the recognition that being a primary caregiver is work become a reality, then this sort of thing will carry on.

    It’s far easier for those in power to blame individual parenting decisions for the ills of the nation, rather than holding up their hands and saying “OK, we’ve fucked things up and we need to make changes”.

    Blaming women whatever they do is just easier to do, because patriarchy.

  27. Betty, I have to wonder why you linked an article about something happening in Portland when we are talking about something else happening on the other side of the country, in NYC.

  28. I just loooove it when the left gets as far up in my ladybusiness as the far right. – chava

    Except Mayor Bloomberg is NOT the left. On the other hand, Bloomberg’s policies as mayor of big blue-liberal-bluish (if you know what I mean, and I think you do, wink, wink, nudge, nudge) NY are seen as the epitome of liberal policy making. So while Bloomberg is hardly making policies from a left-wing perspective, whatever he does is a big part of how people perceive the left.

    In general, I wonder how much opposition to liberalism and progressivism isn’t based on opposition to what those of us, for example, on leftish blogs are saying (even on blogs that are the home to “the sanctimonious women’s studies set”) but based on people’s perceptions of what goes on in big cities that have paternalistic mayors, entrenched political machines and what not.

    At the very least, if I were in charge of the Democratic party, I’d put a big emphasis on cleaning house and establishing the Democratic party as not only the party of “big government” but the party of “good government” rather than as the party of big city political machines and soft-drink bans.

  29. Stuff like this lets the NYC government give itself a pat on the back to say “Look at how much we love moms and babies!” without getting some actual laws in place that would really help moms and babies. Until Bloomberg is willing to do that, he can shove off, to me. – Drahill

    Exactly. And, essentially that was my wife’s and my response when we first heard of this bill (c.f. my earlier comment).

  30. AMEN to the paid nursing expenses. I hate how LLL and lactivists tout the line that breastfeeding is free. Not just less expensive than formula (largely true) but FREE.

    –Let’s see….
    1) at-home LC visit…$200. 60% covered by my insurance, because I was discharged from hospital early.
    2) Bras…$150. Not all women can make do with the cheap bras. I’m a large size and need a supportive bra for my back and neck to be ok.
    3) Hand pump….$40. Most women will need an electric double pump, more like $200. Accessories for it (storage, cleaning, etc)…$50.
    4) Nursing shirts, pads, etc (no, you don’t HAVE to have them, but very nice)…..$150.
    5) Nursing stool, pillow, breast care, etc–$60.
    6) Work-hours and sleep-hours lost to feeding the baby…I’m not sure, but a lot.

    And my breastfeeding experience has been virtually problem-free and very enjoyable. But free? Maybe to the state.

  31. Seems to me this doesn’t go nearly far enough. How can you even tell if the kid is really hungry? I mean, just because they’re screaming or something … we shouldn’t leave it up to a bunch of silly women to decide when their babies need feeding. I mean, you have heard of the obesity epidemic? It’s the babies who need a talking-to for whining about being hungry and being such big … well, babies. Hizzoner should come in himself with a news crew to tape him scolding a couple of the little brats, that will show ’em.

  32. Mac, it’s WIC that shames women into nursing, but will provide formula if you choose not to. (They’ll just belittle you every time, is all, which is stupid, because once you’re already not nursing for awhile you can’t actually just up and start doing it).

    Right, got it. That’s somewhat less gross than I thought (though I’m not clear on the difference? Isn’t WIC part of the welfare network?)

  33. Did anyone see the Law and Order years ago where the mother couldn’t get the baby to latch on and was terrified of formula so the baby starved to death? In the end I think she went to jail for murder or something like that. Don’t know if it was ripped from the headlines or just made up, but this thread sure reminded me of it. (Though there was plenty of culpability to go around in that episode.)

    Yeah, I remember that one. She got sent to prison. It was one of the few episodes where the “2nd chair” actually got to do much, and it was the horrible Abbie Carmichael, played by the equally horrible Angie Harmon, who tore the poor woman apart. Even Jack McCoy felt some sympathy for the defendant, but not hang-em-high Abbie. Which I gather is pretty much how Angie Harmon is in real life.

  34. –Let’s see….
    1) at-home LC visit…$200. 60% covered by my insurance, because I was discharged from hospital early.
    2) Bras…$150. Not all women can make do with the cheap bras. I’m a large size and need a supportive bra for my back and neck to be ok.
    3) Hand pump….$40. Most women will need an electric double pump, more like $200. Accessories for it (storage, cleaning, etc)…$50.
    4) Nursing shirts, pads, etc (no, you don’t HAVE to have them, but very nice)…..$150.
    5) Nursing stool, pillow, breast care, etc–$60.
    6) Work-hours and sleep-hours lost to feeding the baby…I’m not sure, but a lot.

    And my breastfeeding experience has been virtually problem-free and very enjoyable. But free? Maybe to the state.

    yep. as long as they don’t have to pay up, they’re happy for new mothers to shoulder the burden. and then something murky hidden under the surface about a woman’s choice to become a mother and should’ve known what came with it and why do we need feminism again?

  35. What does this mean for women who are HIV-positive? The virus can be transmitted by breastfeeding, even if the child was not infected during the birth. Isn’t a woman’s HIV status usually confidential? Are confidentiality rules broken if lactation specialists, etc, are told a mother has HIV?

  36. It’s the babies who need a talking-to for whining about being hungry

    “Formula will be provided only after the infant has listened to a taped recording of Ron Paul lecturing about personal responsibility…”

  37. JetGirl, that is a valid point. I would presume that a mother’s chart would contain that info – after all, it would be something the woman’s physician would need to know. A knowledgable nurse would consult the chart, note it, and show sensitivity towards the mother and not even ask, just provide the formula or ask in a very quiet and respectful manner. However, of course, that assumes that the chart is actually being looked at – or that the practitioner knows the mother. If my nurse had looked at mine, the mental illness would have been apparant. But she wasn’t the nurse that had been there before, who I did disclose it to. She didn’t bother. And that puts the mother in the position of having to state her own medical issues. Which she should not have to do.

  38. Wow, this is just fucked up.

    I’ve been breastfeeding for over a year now, it’s been convenient as hell! – But when Lev was born, during those initial couple of days we were in the hospital, the boobies didn’t fill up quickly enough. So they brought us formula, Lev ate, and we both got some sleep.

    The idea that I would have to *explain* this situation to someone, as if I’m some idiot who obviously doesn’t want to do right by her child/is possibly unfit to make parenting decisions in the first place, that is not something I would tolerate.

  39. Did anyone see the Law and Order years ago where the mother couldn’t get the baby to latch on and was terrified of formula so the baby starved to death?

    Can I just point out how that episode is just another example of how women, and their breastfeeding contingent especially, are treated like hysterical idiots by U.S. society? After it aired I got an earful from at least 3 or 4 different people (“friends” and family) about how those lactivists are scary firebrands that will let a baby die in the name of ideology. Leaving out the part where the whole thing was fictional and sensationalized in order to garner higher viewer ratings?

  40. Mac,
    WIC (Women, Infants children) is seperate from the department of social services and provides vouchers for food and formula to pregnant women and women with kids up to age 5. You can qualify for WIC with a higher income, and it’s intended to supplement what foods you buy with your own income (or foodstamps, if you get them).
    I didn’t do it long, last half of my pregnancy and first few months of my sons life, because all I got out of it, as a vegan, was a few boxes of cheerios and a couple bags of carrots, and peanut butter. I used the vouchers for the tuna, eggs, dairy cheese, and cow milk, and gave the food to my son’s auntie, because she had non-veg kids. But for the little I got out of it, It wasn’t worth the hassle of driving across town to get the vouchers and bringing doctors notes, etc, that they require. And the staff were assholes, so even less worth it.
    I hear you can get more veggies on it, now, and even soymilk in some counties, but my son is 7 now, so we don’t qualify.

  41. Oh! And dried beans/split peas were allowed on WIC, too. I do love me some split pea soup.

  42. Is this blog opposed to the biological functions of female bodied people? This with the last birth post makes me wonder.

    1. Is this blog opposed to the biological functions of female bodied people? This with the last birth post makes me wonder.

      Yes, you caught us. We hate the biological functions of female-bodied people.

  43. CherryBomb (like the name!) –The linked article in Portland talks about hospitals/areas that gave already implemented the no swag rule like the one that is going up in NYC. It also confirms that breastfeeding rates increase when swag bags are prohibited.

    Drahill — I agree that government and it’s lack of maternal leave policy is a significant reason the US has such low breastfeeding rates compared to other industrialized nations. But swag bags are ALSO helping to discourage breast feeding and thus should be banned from hospitals. I know I got at least 6 cans delivered to my door, anyway.

    Lauren — I honestly don’t think so. Once you have made your intention to bottle feed known, they will bring you the formula. If you are on the fence about it, they are doing the right thing in encouraging breastfeeding … I know some people feel this is “shaming”, but should the medical staff hide facts to make sure everyone is comfortable with their choices? My kids don’t eat enough veggies, which worries me and makes me feel bad, but I don’t rant against the medical evidence that they SHOULD be eating more produce.

  44. Mac,
    WIC (Women, Infants children) is seperate from the department of social services and provides vouchers for food and formula to pregnant women and women with kids up to age 5. You can qualify for WIC with a higher income, and it’s intended to supplement what foods you buy with your own income (or foodstamps, if you get them).

    Ours was all in the same building and you had to apply at the same time as applying for medicaid and food stamps.

    Then you had to go to a freaking nutrition class (mandatory) on if you don’t breastfeed you’re a wasteful idiot who doesn’t know how to raise kids.

    The woman in charge of our stupid meeting was a CPS worker. No pressure there.

  45. But swag bags are ALSO helping to discourage breast feeding and thus should be banned from hospitals. I know I got at least 6 cans delivered to my door, anyway.

    I think it’s important to remember that the formula bags are intended to be given out to all birthing patients at the time of their postpartum hospital discharge, regardless of whether or not they intended to breastfeed their babies. Banning them is a pushback against the notion that hospitals should ever be giving formula manufacturers a platform with which to shill for their products in the first place.

    And why even give those bags to women who aren’t formula feeding to begin with? Because when it was pushed on me when I left the hospital with my twins I was explicity told that I would realize how hopeless and pointless it was to even breastfeed them at all, and that I would cave in the middle of the night or whatever and give it to them. I’ve heard similar stories from lots of other women as well, and the inference is clear that the free formula bags are not given to either encourage breastfeeding or to bolster a patient’s confidence in their ability to do so.

  46. Can I just point out how that episode is just another example of how women, and their breastfeeding contingent especially, are treated like hysterical idiots by U.S. society? After it aired I got an earful from at least 3 or 4 different people (“friends” and family) about how those lactivists are scary firebrands that will let a baby die in the name of ideology. Leaving out the part where the whole thing was fictional and sensationalized in order to garner higher viewer ratings?

    I actually thought that episode was pretty ridiculous, and did make women out to be idiots who would just not feed their baby for no apparent reason. I don’t remember all the details now, but I think it also included a judge specifically saying that the mother bore more culpability than the father because it was her sole responsibility to feed the baby for the first several months. Or something along those lines. I’d have to watch it again. Maybe the father had gotten out by cutting a plea beforehand.

  47. @caperton – 2012 and we still have to void our waste like the beasts of the field.

    Fuck personal jetpacks, I want some sort of toileting revolution.

  48. Pheeno,
    My son’s aunt went to the WIC in the tribal TANF office, so yeah, I don’t know how I totally forgot they sometimes have it in the same building. Her experiences were even shittier than mine, she got hassled because 2 of her kids were underweight due to genetic problems, and because she formula fed.

    The woman in charge of our stupid meeting was a CPS worker. No pressure there.

    That sounds like loads of fun. I’m sure that was just a coincidence, though, with no intention of trying to intimidate their clients.

  49. Biological functions? I friggin’ hate homeostasis! Don’t even get me started on thermoregulation.

  50. @caperton – 2012 and we still have to void our waste like the beasts of the field.

    Fuck personal jetpacks, I want some sort of toileting revolution.

    I have always had this idea that I would go to one of those Intelligent Design presentations, and if there were a Q&A segment after sitting quietly and listening to an hour of their dreck, I would get up all thoughtful and earnest like and ask, “If we are intelligently designed, why do we have to go to the bathroom?” I mean really, doesn’t matter if you’re talking about no. 1 or no. 2; who would design something like that?

  51. After my C-Section, it sometimes took literally hours for nurses to respond to my requests for pain medication (which was supposed to be delivered on a set schedule, anyway, but I had to request it sometimes because they were busy/forgot/didn’t think I really needed it). I never produced breast milk with that pregnancy (I did for earlier, failed pregnancies, which was… baffling! Thanks, body!) and I cringe at the idea of having to jump through hoops just to feed my baby. Yes, I know a baby won’t wither and die from one delayed or even missed feeding. But still.

  52. The NY Post article is sensationalizing this ridiculously. If you go to the official FAQ http://www.nyc.gov/html/doh/downloads/pdf/ms/ms-latchonnyc-faq.pdf it says on page 2, before any discussion on formula use protocols, storage location, etc.:

    Supplemental feeding is defined as the administration of any liquid other than breast milk to
    breastfed babies.
    This includes water, glucose water and formula.

    This initiative has nothing to do with the 10% of NYC mothers who choose not to breastfeed.

  53. I live in Canada where this is the general policy. You have to ask for formula and lemme tell you, it comes with a healthy dose of shame and a nurse snitting about how you’re not trying hard enough and insisting that you keep trying for another hour. She will then hand you the formula with a disappointed look on her face while your nipples are bleeding and there’s a chunk missing out of the left one. That was just #1.

    Even #2 at a different hospital, where I elected to formula feed from the beginning, there was a riot act and shame.

    Trust me, it’ll make women feel like shit. We can’t win.

  54. Hi. I’m adopted. I was never breastfed. Not ONCE. I am an individual of above average intelligence, my immune system is healthy, I am a healthy weight, slightly taller than average and OMG I even have a healthy, loving, strongly-bonded relationship with my mother who never once breastfed me. (photographic evidence suggests that lack of breastfeeding did not equate to lack of cuddling, in fact, cuddling and snuggling seem to have been abundant.)

    As there is no physical reason why anyone would have ever assumed I was not my mother’s bio-child unless they asked about it, I hope that no one ever thought they had the right to shame her for not breastfeeding me without knowing I wasn’t her bio-kid. Even though my adoption was never a secret and was a comfortable topic of conversation with my family and their friends, i hope no one ever put her in a position where she felt uncomfortable and had to explain personal details about her life to justify her feeding choices. I got fed. I got love. I grew up healthy with a good immune system and normal eating habits.

    It is stupid, awful, using motherhood as an excuse to control women, shame them, control their physical autonomy that is a major reason why I never want kids of my own. Kids might be awesome. But if being a mother means it’s open season on public scrutiny by people who don’t know me and feel they can shame me for my choices relating to my body, it is NEVER going to happen.

  55. Wow. NYC tries to do something to encourage what pretty much everyone complaining here agrees is the healthier thing to do, and they’re getting hammered for it. I’m really beginning to believe most Americans want a, b, and c done–but only for other people, not themselves. Restricting choice and all that. Being personally acquainted with nurses and studying to become one myself, I think we’re quite capable of adjusting to the situation and not becoming the formula nazis. Have some faith.

  56. did you read the same regulations I did? Look, I fully support bars on formula companies advertising in hospitals. Fine. But “Limit access to infant formula by hospital staff”? And if you read the FAQs at the Latch On website, it is very clear that hospital staff have an obligation to strongly discourage bottle feeding, and “educate” women who say they want to bottle feed.

    No. Jill, your reading of the faqs completely missed where these regulations spell out that they are solely addressing supplemental feeding of formula to breastfed babies.

    Supplemental feeding is defined as the administration of any liquid other than breast milk to breastfed babies. This includes water, glucose water and formula.

    Ashley is correct, this isn’t about stopping parents from formula feeding their babies if they want while in the hospital. It’s a lot easier to manufacture righteous indignation when you ignore the facts as they sit in front of you. By the way, the faqs also spell out that each baby must be fed on demand regardless of whether that be with formula or breastmilk, so no formula fed baby is going to be denied formula at any time.

    Hospitals and their staff have been notoriously guilty for decades now for discouraging and undermining parents who want to breastfeed their children while still in the hospital postpartum. From giving misinformation, to flat out discouraging breastfeeding, to giving formula absent parental consent, and pushing formula onto breastfeeding parents, and even promoting specific formula brands at the behest of their manufacturers.

    Breastfeed your baby or don’t and give them formula, that isn’t the point here. The point is leaving that decision solely in the hands of parents and then giving them correct information and support in hospital if they do choose to breastfeed.

  57. Is this blog opposed to the biological functions of female bodied people? This with the last birth post makes me wonder.

    I know, right? I can’t believe they’d post something like this on a hat blog.

  58. No, Jill, your reading of the faqs completely missed where these regulations spell out that they are solely addressing supplemental feeding of formula to breastfed babies.

    No, it didn’t. The FAQs (pdf) have sections that address supplemental feeding and that address a mother’s choice to bottle-feed exclusively.

    What do we tell our staff to do when mothers (families) request infant formula?

    While breastfeeding is healthier for both mothers and babies, staff must respect a mother’s infant feeding choices. Educating mothers and families about breastfeeding and providing encouragement and support, both prenatally and after birth, is the best way to ensure breastfeeding success in your hospital.

    While in the hospital your staff can:

    * Assess if breastfeeding is going well and encourage the mother to keep trying.
    * Provide education and support to mothers who are experiencing difficulty.
    * If the mother still insists on receiving formula, document it in the chart along with the reason and distribute only the amount of formula needed for the feeding.
    * Train staff in breastfeeding support (CLC, IBCLC) who can be available to assist new mothers at all times regardless of day, night or weekends.

    This section is about mothers who choose to bottle-feed. The section after this is about mothers who choose to both breastfeed and bottle-feed. They’re about women who are choosing to bottle-feed, either exclusively or in conjunction with breastfeeding, and the staff’s job, as noted here, is to interrogate her and then find an authorized staff member to send down the hall to the locked formula dispensary every time the baby wants a meal.

    By all means, give mothers every bit of support they need in breastfeeding if that’s what they want to do. Lose the promotional swag, because you’re not in the maternity ward to get advertised to anyway. Educate families on the benefits of breastfeeding. Have someone always on hand to help with breastfeeding. Maintain an atmosphere where mothers who are struggling with nursing aren’t embarrassed or afraid to ask for help. But once you’ve done that, if a mother still tells you she doesn’t want to breastfeed, give her a damn bottle. Don’t push her, don’t make her explain herself to you, and don’t make the kid wait while you find someone with the passcode to get a single serving of formula out of storage–just give her a damn bottle.

  59. Jill, I disagree. The first step in that bulleted list is “assess if breastfeeding is going well”which tells me that this protocol applies to moms who choose to breastfeed.

    I’m a breastfeeding support person and I frequently get calls from distraught newborn moms concerned about feeding their baby. The majority of the time the behavior that’s concerning them, say fussing at the breast or being angry after a feeding, is normal newborn behavior. In that situation it’s my job to reassure them that everything is going well, and the vast majority of the time they feel better and go on to breastfeed without supplementing. I follow that protocol regularly in a supportive and non-shaming way. For the record, I do occasionally recommend formula, in one case because of signs of dehydration (mom had hemorrhaged at birth and her milk increase was delayed) and in another case to ease the mom’s mind. Mom being stressed is actually bad for breastfeeding.

    Or another example, this time my own. At 3 days old my second baby was fussing at the breast and for a few feedings coming off really angry. His diaper output was excellent, my milk had been in for a day and a half (VERY unusual), he was nursing well, and he never lost any weight (most babies lose around 7% of their birth weight in the first week). By all objective measures we didn’t need any supplementation whatsoever, but at that moment I totally understood why someone would think something’s wrong and want to give formula. I didn’t give him any and it turns out he just took 20 minutes to make a burp.

    A third example. Mom wanted to breastfeed but the first couple of latches were bad and her nipples were really sore. She asks a nurse for help and is told to bottle feed until they feel better. Calls me up crying at 6am, I give her advice on making her nipples feel better, show up at the hospital 2 hours later and help her figure out her latch. This is the type of stuff that happens in the hospital all the time.

  60. From the FAQ

    What about the diaper bags that we receive from formula companies? Can we distribute those without infant formula?
    No. Company logos are a potent marketing tool. Distributing any materials that have formula company logos, including diaper bags, confuses the mother, and implies that formula has equal nutritional value to breast milk and encourages formula use.

    Golly Goodness Gosh, I must be one extra smart little cookie for not getting “confused” by the free formula and diaper bag from the hospital! I think I still have that enfamil bag somewhere. (I was using it to hold some of the parts to my breast pump.)

  61. @LolaGirl & Ashley

    So how exactly does this work then. If a woman says she wants to formula feed they, what, cart her off to some other hospital where they don’t keep the formula locked in a closet?

    If a woman says she wants to breast feed then it’s suddenly fine to shame her if she wants/needs to supplement?

    They’re taking a problem with staff and instead of trying to fix that they just turn it into a problem for the patient.

  62. Chiara, you’ve heard about the new parent obsession with poop, right? Yeah, it’s real. But the number of diapers used in a day is the most reliable low tech way of seeing if baby is getting enough. Your average baby pees twice on day 2, my kid wet like 6 diapers that day cuz I had a stupid amount of milk.

  63. @Onymous, presumably they let her formula feed. I read elsewhere that NY hospitals aren’t allowed to give out formula without medical need, which suggests that moms would have to provide their own formula (and this initiative does mention this, pointing those who can’t afford formula to WIC), and while I don’t support banning formula from hospitals (patients shouldn’t have to provide their own food), that’s not stopping a mom from formula feeding.

    Yeah, they use paternalistic language, but a situation I deal with quite a lot:

    Mom: I’m nursing my 3 day old 20 times a day and I don’t think he’s getting enough. I think I need formula but I don’t know (no one who really wants to use formula calls me)
    Me: Ask what’s going on, diaper count, nipple pain, is milk in, etc. “Yup, some babies nurse a lot, sounds like things are going well, I don’t think you need formula, here’s what to expect over the next few days” bla bla bla

    That would be the ” Provide education and support to mothers who are experiencing difficulty.” step.

    Mom: Great, I feel so much better!
    Me: Call me if you have any more questions, let me know how it’s going.

    I also agree. There’s very little in this initiative I have a serious problem with, but really they should mandate lactation education for all medical staff that deal with postpartum women and newborns (nurses, pediatricians, neonatologists, etc.) as part of a continuing education requirement. Unfortunately too much of breastfeeding advocacy focuses on the mother, at this point the lactation community needs to focus on fixing the problems on the medical end. We have an 80% initiation rate, the vast majority want to breastfeed. We need to address why we have such a crappy follow through and I think this initiative is garnering way too much negative attention for what’s really a bandaid on the problem.

  64. NYC tries to do something to encourage what pretty much everyone complaining here agrees is the healthier thing to do, and they’re getting hammered for it.

    Is that so, pumpkin? Please find one quote from one of us that says shaming mothers is a healthy thing to do. Because if you don’t get that’s what my city is doing, then you’re missing the point.

    1. Telling someone you’re concerned about people being shamed and starting off by calling me ‘pumpkin’ seems odd. The behavior I was referring to was breast feeding not mother shaming. It’s not me that missed the point, it’s you that missed the point of my comment. I’ll repeat: NYC tries to do something beneficial, someone complains; NYC does nothing, someone complains. Give nurses some credit for being able to apply the new rules to encourage breast feeding without shaming mothers.

  65. What about the diaper bags that we receive from formula companies? Can we distribute those without infant formula?
    No. Company logos are a potent marketing tool. Distributing any materials that have formula company logos, including diaper bags, confuses the mother, and implies that formula has equal nutritional value to breast milk and encourages formula use.

    Oh. So women are stupid. Gotcha.

    And neglectful too. Yanno, for feeding their babies less nutritionally valuable formula.

  66. The fact of the matter is we can’t win. When I had my daughter, it was specifically written in my birth plan that I was going to exclusively breastfeed her, but her trip to the NICU put a little hiccup in it for a couple of days. Not just because they had to quick feed her, but also because no one got me a pump. I had to ask time and time again. Nor did anyone tell me of the feeding schedule for the babies in the NICU, so the second time I went down to attempt to nurse her, they told me they already gave her the formula. Oh, and because I gave birth to her on a Friday, and somehow my request for a lactation consultant got lost, I was shit out of luck until Monday, because she didn’t work weekends.

    It was a nurse in the intermediate care ward that ultimately showed me the best hold for nursing my daughter, and she was nursing like a champ by the time I was actually able to meet with the lactation consultant on Monday, when I was also banking up a ton of milk from pumping too. (The silver lining to having a difficult labor and running a fever means that your doctor is giving you antibiotics “just because”, and even though you are on Medicaid, they aren’t booting you out after 24 hours as is the normal policy. So I was able to stay in the hospital the whole weekend.) Despite it all, they sent me home with a case of formula, the liquid, spendy kind.

    They did it again, when we came back because my daughter was running a high fever, and Chicago doesn’t dick around with high fevers and young babies, so they put her in the hospital from the ER. And they tried to send us off with a case of formula, even as I stayed with her the whole time she was there, and nursed her CONSTANTLY.

    And every time the nurse from the city came around to make sure she was thriving and I wasn’t neglecting her, (I’m imagining because I had her on Medicaid and all, so therefore I didn’t really know how to feed a baby, because poor) I was handed a can of powdered formula. The fact of the matter is, the government will find a way to shame poor women no matter what they do. I had a very good advocate when I got on Medicaid, so the whole process was pretty painless for me, but I am well aware of how shaming and demoralizing it is for the vast majority of people who apply for and continue to use public aid. And really, women deserve to be able to relax and not have to be nitpicked about how they choose to feed their babies EVER, let alone after they have gone through all the effort and possible stress of birthing them. So, really, what it comes down to is that a woman’s wishes needs to be respected, and that isn’t what these guidelines are about.

  67. Jill, I disagree. The first step in that bulleted list is “assess if breastfeeding is going well”which tells me that this protocol applies to moms who choose to breastfeed.

    Read. The. Document.

    The very next heading is “What do we tell our staff to do when mothers/families state that they want to both breastfeed and bottle feed their infants?”

    A colleague of mine gave birth in a NYC hospital about 6 months ago. She had no intention of breastfeeding. Period. She made that clear in her birth plan. Nevertheless, she was constantly harrassed by doctors, nurses, “counselors.” The four days she was in the hospital she estimated that at least 15 people came to her room to lecture her about how selfish she was being. I have zero faith in the willingness of health care providers to respect the decisions of the people who give birth when those decisions conflict with their own views of what is appropriate.

  68. @Pheenobarbidoll, formula companies aren’t stupid either. If they weren’t pretty sure that all of that marketing stuff worked on enough women to more than get back the money they spend on it, they wouldn’t spend the money on it.

    Saying that advertising affects people’s behavior is not saying that people are stupid. It’s saying that advertising affects people’s behavior. Because it does.

  69. @Pheenobarbidoll, formula companies aren’t stupid either. If they weren’t pretty sure that all of that marketing stuff worked on enough women to more than get back the money they spend on it, they wouldn’t spend the money on it.

    But the “ban the swag bags” campaigns are aiming for low-hanging fruit. It’s relatively easy to get unpopular companies additional bad press, never mind the net effect of this rhetoric making mothers who don’t breastfeed feel like bad mothers, instead of handling the infrastructural issues that keep new mothers from breastfeeding. It’s easy, but shallow, to blame branding campaigns.

    The reason swag bags are “effective” (what this means, I don’t know — what are our metrics?) is that having a baby is one of the ONLY times folks will ever have a hospital visit for a good reason. It’s the same reason that new hospitals have mega-loaded birthing suites compared to, say, the surgery recovery rooms, and why they give the new moms a free steak dinner if she wants it. Because you leave feeling good. Free swag is part of feel-good customer service.

  70. So many of these comments are ridiculously overdramatizing an already overdramatized issue. “Babies will be forced to wait an hour for a bottle!” No. I work as an LC at a hospital with these policies so let’s clear some things up:
    1) You don’t want to breastfeed, you don’t. You get your bottles on admission and that’s the end. The LC doesn’t see you unless you ask to be seen for some reason, like engorgement.
    2) You want to breastfeed, you breastfeed. Nurses can’t sneak formula behind your back. Before we started documenting the mother’s consent, there was a lot of “she said/she said” after the night shift left. The nurse claimed the mom asked for a bottle, the mom claimed the nurse gave it without permission. Now if there’s a bottle, everything is documented and no one can say they didn’t know.
    3) You need a bottle, the nurse or NA brings it to you. There’s no “queue” and no one is waiting for an hour. The formula is in the cabinet with all the other supplies. (That is totally staff-facing by the way – it’s not like the parents ever know it’s locked up. So is the Tylenol and that’s not shaming people with headaches.) We limit the amount of formula we give per feeding in part because people will give insanely inappropriate amounts. A newborn has a stomach made to hold about a third of an ounce at birth. I have seen people give over two ounces at one feeding!! It’s considered an accomplishment by grandma that she got the baby to eat so much, but it is not good for the baby.
    4) If you are asking for formula for personal reasons, we document the reason. If the baby needs it for medical reasons, we document that too. Again, this is not to shame anybody or demand they give us a good excuse, it is to push the medical/nursing staff to acknowledge that “the baby cried some” is not a reason to tell the mother “you need to formula feed or your baby will starve”. (You think people don’t do that? You are wrong.) Medical reasons to supplement include excessive weight loss, jaundice associated with poor feeding, etc.
    5) No one gets lectured. The consent they sign does say that giving bottles may interfere with their STATED plan to breastfeed. That is the truth, so I don’t think there’s a big problem with it. I work with a lot of moms who choose to formula feed for various reasons, usually because they believe they don’t have enough milk. I disagree, and I explain why I don’t think that there is a medical need for supplementation. I say that while there is no medical need, it is their baby and they can decide whatever they want. Some parents hear my explanation, feel reassured, and keep breastfeeding exclusively. Some decide they want to go ahead and supplement. Their baby, their choice. 

    So much for the heavy-handed police state – sorry if real life disappoints. I feel like so many of these comments are like a Tea Party vision of Obamacare.

  71. Betty: You have entirely missed my point. You’re basically saying “But…but…the swag bags!” And what I am pointing out is that swag bags are not the largest contributor to low nursing rates. Lack of financial support for nursing and bad maternity leave polcies are. Look at the data to confirm that. And that lack of support comes from the government. Swag bags are a boogeyman that is convienent for the current power structure, because they absolve them of responsibility to do anything. So..yeah, you still haven’t answered my question about why this initiative is any good when it will not resolve (and potentially indemnify) the largest offenders of the bunch.

  72. A lot of folks seem to be missing the point here. 90% of women who give birth in NYC hospitals breastfeed. That’s a HUGE number, and doesn’t exactly point to a problem that necessitates locking up formula during hospital stays.

    What IS a problem is the fact that most of these women — many of whom apparently intend to breastfeed for at least 6 months — end up stopping after 2-3 months. What’s happening at 2-3 months that’s getting in the way of breastfeeding for women who want to breastfeed? Because that’s what needs to be addressed. Not formula in hospitals where the overwhelming majority of women are already breastfeeding.

  73. A lot of folks seem to be missing the point here. 90% of women who give birth in NYC hospitals breastfeed. That’s a HUGE number, and doesn’t exactly point to a problem that necessitates locking up formula during hospital stays.

    I feel like you’re missing the point a bit. I mean, the formula thing ONLY applies to breastfeeding mothers. It says that in any number of places. If a higher percentage of mothers brestfeed these rules would be more applicable not less.

    According to Rebecca @80 there is a good reason for locking up formula:

    Nurses can’t sneak formula behind your back. Before we started documenting the mother’s consent, there was a lot of “she said/she said” after the night shift left. The nurse claimed the mom asked for a bottle, the mom claimed the nurse gave it without permission. Now if there’s a bottle, everything is documented and no one can say they didn’t know.

    That sounds like a perfectly reasonable explanation to me.

  74. Research has shown that mothers who intend to breastfeed exclusively still tend to have hospital staff supplement with formula. It seems like this campaign is trying to address this. It’s true that going back to work after 2-3 months is highly associated with stopping exclusive breastfeeding, but there are other factors, and it seems like supplementation is part of that reason.
    But it’s also true that mothers can’t win, no matter what they choose, and that people feel entirely too comfortable shaming mothers (and parents in general). What the best solution is still remains unknown.

  75. I feel like you’re missing the point a bit. I mean, the formula thing ONLY applies to breastfeeding mothers. It says that in any number of places. If a higher percentage of mothers brestfeed these rules would be more applicable not less.

    Pretending that initiatives that put formula under lock and key won’t affect formula-feeding mothers is Pollyannaish, Steve. It’s not about being easily duped by branding campaigns, or under-educated, or being immoral of bad moms. It’s about what Jill said. The issue isn’t getting mothers to start breastfeeding — by and large they try it out. Why it doesn’t work is institutional. SOCIETAL. It’s about class and race and worker’s rights, money, personal and institutional support. Those issues aren’t resolved by bullshit “out of sight, out of mind” campaigns.

  76. Steve,

    I have to wonder about the source of formula sneaking. That to me is not a vast conspiracy or nurses trying to fuck with a birth plan. In most cases where a medical staffer supplements against a mother’s wishes, it is due to a mistaken belief that the child needs it or that supplementing is appropriate. This is a problem with medical education, full stop. If a staffer believes formula is medically necessary, they can still sign out formula against the mother’s wishes. Since the child is already born, the mother, while having direction over her child’s care, does not have absolute authority.

    Locking up formula does nothing to lessen the edcuational and professional holes that lead to unauthorized supplementing. Providing correct education to medical staff is the best feasible way to reduce unnecessary supplementing – not locking up the formula.

    And the major problem with this campaign is that it is not coming from a private entity. There have been many campaigns to bar free formula from hospitals that private groups have done. The largest hypocrisy to me here is that the government is doing it – when it is that same government’s own policies that are the biggest hurdles to nursing. You can surely see why many of us believe that until that same government is willing to correct its barriers, it has no business adressing such smaller ones.

  77. Jill, 90% of mothers in NYC initiate breastfeeding, only 1/3 are exclusively breastfeeding (or giving breastmilk in a bottle) at 2-3 months. There’s usually a gradual decrease in breastfeeding and increase in formula feeding that the vast majority of the time starts in the hospital with unnecessary supplementation pushed by ill-informed medical staff.

    Early breastfeeding is more a mind game than anything else. If you believe your body works and you aren’t repeatedly told that it doesn’t, breastfeeding is (usually) pretty darn easy and something like an angry baby won’t make you believe something is wrong. If you believe breastfeeding is hard, if you’re told that it’s going poorly, if a medical person suggests you’re starving your baby (and plenty do without any evidence), breastfeeding is very hard and usually fails.

    Also, in case you were unaware, breastfeeding works on a supply and demand basis. The more you nurse, the more milk you have. Not emptying the breasts sufficiently, whether through poor latch or formula use in the first two weeks very often permanently reduces the milk supply. Those first two weeks are vital to breastfeeding success.

    That’s why it’s so important to provide in-hospital support and discourage formula use without medical reason. Which is why there really needs to be mandated lactation training as part of continuing education for all medical professionals working with postpartum mothers and newborns.

  78. Ugh, wrong sentence in the beginning. Only 1/3 are giving any breastmilk at 2-3 months, the percentage of exclusive breastfeeding is much lower. I’m trying to find that statistic now. That means the vast majority are using formula in the beginning, before the return to work.

  79. You can surely see why many of us believe that until that same government is willing to correct its barriers, it has no business adressing such smaller ones.

    Honestly I can’t see why the one should affect the other.

  80. Ashley, the data is actually correct. Nationally, about 75% of mothers initiate nursing in the hospital. Now, maybe that to you is low, but 3 out of 4 is a pretty decent rate (especially when you consider that the 25% who don’t include mothers who use formula due to medical need). In NYC, that number is around 90%. However, at 3 months, only about 1/3 of those mothers are giving any breastmilk.

    Now, that begs the question of why. You say it is due to a lack of support, but that doesn’t seem to bear out statistically. Among all women in a major study:

    32% never started nursing
    4% nursed for a week or less
    13% nursed for at least 1 month
    and 51% nursed for 2 or more months

    http://www.ncbi.nlm.nih.gov/pubmed/16322165

    However, as you note, after the 2-month mark, the rates drop like a rock. Well, does that shock you at all? 2-3 months is when most women’s maternity leave dries up. If a woman can get over the initial weeks and months of nursing, she is more likely to be able to continue with less difficultly. However, the data is saying at the time frame when most women should be getting the hang of nursing, they stop. Well, it doesn’t take a rocket scientist to figure this out. They stop because they don’t have the option to take 6 months off for exclusive nursing, because their jobs don’t provide pumping spaces or because they can’t pay for nursing expenses anymore. The data is all there, its just that people don’t want to see it that all the education and encouragement in the world cannot overcome structural and legal inequality. So that’s where the focus should lie.

  81. I don’t want to slag off nurses. I know a lot of nurses (some of my best friends are nurses!™) who are compassionate and conscientious and respectful. But there are a lot of personal accounts from commenters, both on this post and on others, about nurses and lactation counselors who haven’t been that way–who have been pushy, judgmental, negligent, and thoughtless. What’s the ratio of compassionate nurses to judgmental nurses? No telling, but we can’t ignore the lived experiences of a lot of new mothers.

    On top of that, we have arguments of Nurses are good and supportive and helpful and so this policy won’t have negative side effects vs. Nurses sneak formula and bottle-feed your baby behind your back and don’t honor your wishes, so they need extra rules. Whether it’s either or both, we still have a policy that’s based on locking up baby formula and dispensing it bit by bit like feeding a baby bird, rather than on treating new mothers like adults: educating them about breastfeeding, letting them know that support is available, and then trusting them to make their own choice. And then honoring that choice.

  82. However, as you note, after the 2-month mark, the rates drop like a rock. Well, does that shock you at all? 2-3 months is when most women’s maternity leave dries up. If a woman can get over the initial weeks and months of nursing, she is more likely to be able to continue with less difficultly. However, the data is saying at the time frame when most women should be getting the hang of nursing, they stop. Well, it doesn’t take a rocket scientist to figure this out. They stop because they don’t have the option to take 6 months off for exclusive nursing, because their jobs don’t provide pumping spaces or because they can’t pay for nursing expenses anymore. The data is all there, its just that people don’t want to see it that all the education and encouragement in the world cannot overcome structural and legal inequality. So that’s where the focus should lie.

    But why is that any more relevant to this conversation than one about defense spending? or any other government spending that isn’t on maternity leave? Why is this bit of funding specifically taking resources away from maternity leave more than any other?

  83. Honestly I can’t see why the one should affect the other.

    It’s like slapping a band-aid on a brain injury.

  84. Steve: the point is that what are effectively meaningless gestures basically create a cover to neglect more meaningful change. Bloomberg can now say “Look, I support mothers! I put policies in place that help nursing!” By doing this, he now has no incentive to address the bigger hurdles that he is in a position to remedy – like by starting with, oh, let’s say the multitudes of NYC public female workers.

    One has to do with the other because small, ineffective gestures most often provide cover for NOT doing the better gestures. That’s political science 101 – small, largely meaingless gestures can get a politican out of having to do something bigger (and more controversial). That is how one effects the other. It’s not that difficult to see.

  85. Early breastfeeding is more a mind game than anything else. If you believe your body works and you aren’t repeatedly told that it doesn’t, breastfeeding is (usually) pretty darn easy and something like an angry baby won’t make you believe something is wrong. If you believe breastfeeding is hard, if you’re told that it’s going poorly, if a medical person suggests you’re starving your baby (and plenty do without any evidence), breastfeeding is very hard and usually fails.

    You know, I’ve heard this so damn much. And I’m willing to give you that IF you have the following:
    –a full term, healthy baby (NOT a 37-38 weeker)
    –no hormonal conditions (hypoplasia, PCOS),
    –no medical conditions during pregnancy (eclampsia, g. diabetes)
    –a non-traumatic vaginal birth
    –a baby without tongue tie, a weak suck or palatal issue
    –normal nipples

    Then, yes, breastfeeding is more likely to work out that not. Some hard work and education are still necessary, as its still a steep learning curve. But there’s beginning to be correlative evidence between the above conditions and poor breastfeeding success, so the EVERYONE CAN TOTES do it…is misleading.

    Anecdotally, of the group of women in my peer group with young babies, I am the ONLY ONE who has been able to make EBF work and who found it “easy.” (I am also the only one without more than one of the above conditions). All of my friends had huge amounts of support, education, and were/are extremely dedicated–to an extreme, I think, that damaged their own mental health and their early bonding with their new family.

    I have to say, after having gone to various new mothers’ BF groups and watching multiple women weep as they talked about how much pain they were in and how hard it was soured me on the claim that it is generally ‘easy.’ So did the fact that, frequently, when a woman with older children talks about it, she calls it “the hardest thing she’s ever done.” Seriously. The L&D nurse in the hospital pulled me aside to tell me that. The doctor at my postpartum checkup told me. My mother, etc etc. Nursing is NOT always, or even mostly, easy.

  86. FWIW, when I say “easy,” I mean “my nipples did not crack and bleed and I was never worried about how much the baby was eating or have to do an insane song-and-dance with supplementing, extra pumping and fenugreek oatmeal cookies that meant I never slept more than 30 mins in a row.”

    I did experience some pretty severe wrist pain, a minor breast infection, and the standard lack of long stretches of sleep after a 30 hour labor. So “easy”? I don’t know. It’s easy NOW, but the first six weeks were certainly challenging, though very manageable with a supportive partner, plenty of food/water, and educated help.

  87. Steve,

    I was not addressing the funding at all. That is your argument. My argument is one of policy. You seem to basically be arguing “well, how does this hurt?” It hurts for the reasons I stated above – because basically, this policy is a reaffirmation that it is the duty of hospitals and individual women to promote nursing AGAINST the tide of hurdles that very same government puts up against nursing mothers. So yes, stuff like this is hurtful because it is just another brick in the pile telling the individual that it is their responsibility to parent in a certain way when the government is doing nothing to help make that way possible. And let us also note that iniatives like these actually lessen the chance that real change will actually happen.

  88. And let us also note that iniatives like these actually lessen the chance that real change will actually happen.

    I will not note that. You offer no facts to base that opinion on, and you don’t even present it as opinion. It is your speculation based on what you call Political Science 101, but seems to me more like cod Psychology 101.

  89. Fat Steve @ 101, LOLWAT? She actually has scads of research and feminist theory behind her. You’re, what, refereeing blog comments?

    Maybe this is another thread you should sit out.

  90. @Pheenobarbidoll, formula companies aren’t stupid either. If they weren’t pretty sure that all of that marketing stuff worked on enough women to more than get back the money they spend on it, they wouldn’t spend the money on it.

    Know how you combat that?

    You tell the mother ” We got this stuff for free, so the company could have free marketing, here are pamphlets that have information on both formula and breastfeeding”.

    And then you DROP IT and let her decision stand.

  91. Uh, no Steve. It’s not that hard. Doing what actually needs to be done to make nursing easier would be risky for a politician. Businesses would protest about having to pay their workers more, losing female workers more, etc. Insurance companies would hate it, corporations would hate it, Republicans would hate it.

    So…yeah. Doing what needs to be done is a huge political risk. But that does not change that the steps would be totally necessary. And plenty of women know that (Talk to a nursing mother and ask her if longer and paid maternity leaves wouldn’t make her life much better). Major NGOs that actual promote nursing (like World Breastfeeding Action) routinely state that such reforms will be necessary to increase long-term nursing across the board. But somebody is gonna have to put their neck out there to actually do it.

    So…yeah. Its not just me. Google what’s out there and see that every major breastfeeding NGO says the exact same thing. So until we get those reforms, we basically have very little. And that’s not Psych., sweetie, that’s politics.

  92. I have a friend in upstate NY who was bullied relentlessly by a lactation consulant to breastfeed. She wanted to formula feed. I gave birth in Georgia, and the hospital bullied us to formula feed, and, I suspect, gave formula to our child without our consent, just as other commenters have experienced. When he slept in the nursery, he never wanted to eat for some reason. When he slept in the room with us, he nursed. Hmmmm. I agree that the big problem is nursing/hospital staff who believe that whatever you’ve decided for yourself and your child, you’re wrong. But maybe if they had to sign their name to a sheet that they had given the baby a bottle, they’d be less able to completely ignore breastfeeding moms’ wishes and sneak bottles to breastfeeding babies. So if this legislation addresses that sabotage, great. Now how to get nurses to stopy bullying women no matter what their choices are…

  93. Having had the experience of nursing because I felt obligated to versus because I truly wanted to, I have to say that this idea is absoloutely horrible at best. I did try with each of my 3 children, but I was never able to nurse for longer than about 3-5 weeks each time. Though each time was for different reasons (mostly related to my personal health), we were all happier after switching to formula. I was able to handle my health issues and I wasn’t so stressed.

    Who in their right mind would ever think that the best thing for mothers and babies is to guilt, pressure, and stress out new moms? Having a new baby is stressful enough even in the best of situations and even when most of it is positive stress (Yes, even being excited and happy about the new baby is still a form of stress.). I’d probably have snapped and chewed out a nurse or dr. trying to guilt trip me out of letting my baby have a bottle so that I can have a nap after giving birth. Then again, in any given situation, I have a low tolerance for anyone trying to control me. That goes double for people who try to do it with fear, guilt, intimidation, and/or manipulation.

  94. Uh, no Steve. It’s not that hard. Doing what actually needs to be done to make nursing easier would be risky for a politician. Businesses would protest about having to pay their workers more, losing female workers more, etc. Insurance companies would hate it, corporations would hate it, Republicans would hate it.

    So…yeah. Doing what needs to be done is a huge political risk. But that does not change that the steps would be totally necessary. And plenty of women know that (Talk to a nursing mother and ask her if longer and paid maternity leaves wouldn’t make her life much better). Major NGOs that actual promote nursing (like World Breastfeeding Action) routinely state that such reforms will be necessary to increase long-term nursing across the board. But somebody is gonna have to put their neck out there to actually do it.

    So…yeah. Its not just me. Google what’s out there and see that every major breastfeeding NGO says the exact same thing. So until we get those reforms, we basically have very little. And that’s not Psych., sweetie, that’s politics.

    I don’t deny any of that. I was asking for evidence that initiatives like this LESSEN the chance of initiatives like the ones you mention from happening.

  95. Steve,

    The problem with what you ask is that, at least to my knowledge, this is the first iniative of its kind. Most iniatives of this nature are instituted voluntarily by hospitals after campaigns from private interest groups. This is the first one (at least on a large scale) from a government mandate. Now, to the point:

    If Bloomberg truly was concerned about nursing rates, he would have had somebody do the research on this. And if they looked at the most reputable sources (UN, UNIFEM, UNICEF, WABA). they see that maternal leave policies are the single most effective way to increase long-term nursing rates in any given location. This is not in dispute. So then, it begs the question – why do something that has been shown to be far less effective and effective only in the short term? Its largely not a funding issue – as I pointed out above, the costs of changing maternal leave would largely be borne by private entities, except for public employees. Moreover, this does not even move NYC towards the optimum conditions in any way (it can be done in increments).

    So I suppose what you are asking for are analogies on the local or state level. Well, I only know my own state, so I suppose I must think federally. Examples of politicians offering lesser gestures instead of addressing real needs? Well, look all over. Crack a newspaper. The news is full of politicans making symbolic gestures on both sides of the aisle.

    So really, I think the evidence is there in the actual facts: 1.) We know what really needs to be done to increase long-term nursing rates. 2.) Government refuses to actually imput these conditions or any changes leading to these conditions over time. 3.) Government favors policies that put the onus for optium conditions on private entities.

    Honestly? I doubt this will convince you. You’re basically saying “well, show me the proof! Bring me the evidence!” But the proof is in the rates of nursing, the copious evidence of what needs to be done and our government’s continued insistence at every level that we don’t need to do those things. It speaks for itself. If Bloomberg truly wanted to increase nursing rates, the answer is already there. His refusal to act on frankly speaks volumes itself.

  96. Just to share: The mayor’s office has been gracious enough to reach out for conversation, and I’ll post an update here as soon as I have postworthy update material.

  97. @Lauren: “Rebecca, read the original document.” …I did?

    @Caperton: “On top of that, we have arguments of Nurses are good and supportive and helpful and so this policy won’t have negative side effects vs. Nurses sneak formula and bottle-feed your baby behind your back and don’t honor your wishes, so they need extra rules. Whether it’s either or both…”
    It is both, and also Nurses can be pushy jerks about both breast and formula feeding (and a million other topics as well “stop picking up the baby when it cries!”) They do need extra rules. These are some of the rules.

    “…Whether it’s either or both, we still have a policy that’s based on locking up baby formula and dispensing it bit by bit like feeding a baby bird, rather than on treating new mothers like adults: educating them about breastfeeding, letting them know that support is available, and then trusting them to make their own choice. And then honoring that choice.”
    But see this is where I don’t get it. How does the status quo honor people’s choices? We DO have breastfeeding moms getting the runaround and staff disrespecting them. This policy is meant to address that. In the meantime, everyone still gets what they want. This obsession about the locking up is still so puzzling to me. No mother could ever go and help herself to the formula cabinet. She always had to call the nurse to get formula brought to her. The lock is for the STAFF. And actually, feeding a baby human IS like feeding a baby bird (except for the worms part). They only need very small amounts. And they are OK if you bring them one meal at a time; they don’t know or care where the next meal is stored.

    Finally, I am ALL FOR maternity leave. This is a HUGE and important component of breastfeeding support. And you better believe breastfeeding advocates know it and talk about it A LOT. It doesn’t mean that the hospital isn’t important too, and is a place where public health officials can actually make a concrete, immediate difference. People who are sabotaged in the hospital don’t ever make it to 2-3 months out as it is. I did some number-crunching for a WIC office and 50% of their moms who initiated breastfeeding stopped in the first two weeks. There is a huge drop-off after the much-vaunted 90% initiation, and that actually starts in the hospital for many people.

  98. As someone who struggled with incredibly low supply, I find the “breastfeeding is more a mind game than anything else” incredibly ignorant and frankly insulting. I understand the reference was to most cases, and that mine was perhaps atypical., but i still feel compelled to point out that i pumped 6-8 times a day for weeks (after trying to nurse, to try to ramp up supply), took every galactagogue under the sun, and was supported by the most supportive husband, family and lactation consultant imaginable. And still, I was unable to produce anything near enough to sufficiently feed my baby. Sometimes our bodies don’t work the way they are supposed to. It’s not always a lack of will power or positive thinking. Many thanks to Capterton, Chava and others for the post and thoughtful comments.

  99. We DO have breastfeeding moms getting the runaround and staff disrespecting them.

    That’s a staff education issue, not a mother education issue. It’s not resolvable by locking up baby food.

    I know it’s not going to change anyone’s mind, but I bottle-fed both of my children from birth, acting upon advice from my doctor, despite a lot of pressure from lactation specialists, my doula, who emailed me to let me know that my body would mourn like I’d had a dead baby if I didn’t breastfeed, and the midwife, who finally admitted that part of her insistence was her goal to get as close to 100% initiation rates as possible. The lactation specialists, doula, and midwife were wholly uninterested in mental health contraindications and I got tired of explaining and justifying my decision. It sucks having among the first memories of your time with your new baby a fight against the insinuation that you’re a bad, irresponsible, and uneducated parent thanks to your providers’ agenda, regardless of your feeding choices. But I really resist the insistence that this particular pro-breastfeeding agenda is neutral on the issue of “honoring women’s choices” particularly because of the emphasis on denial and punitive lectures.

  100. Honestly? I doubt this will convince you. You’re basically saying “well, show me the proof! Bring me the evidence!” But the proof is in the rates of nursing, the copious evidence of what needs to be done and our government’s continued insistence at every level that we don’t need to do those things. It speaks for itself. If Bloomberg truly wanted to increase nursing rates, the answer is already there. His refusal to act on frankly speaks volumes itself.

    I’m not doubting that Bloomberg chose to give less money to this problem than was necessary. But it is

    your opinion

    that this will be used as an excuse not to do more. My opinion is that anything you can do to support any government policy direction you favor will keep the conversation going and therefore is a positive step. I’ve got no issues with you disagreeing or thinking my opinion is asinine, I merely objected to you putting forth your opinion as fact.

  101. @Lauren: “That’s a staff education issue, not a mother education issue. It’s not resolvable by locking up baby food.”
    Again, locking up the formula is PART of what they are doing for staff. When you call for a bottle, do you know if the nurse has to deal with a lock or not? Nope. But she can’t be snagging bottles left and right for moms who don’t want them. Staff education is also part of that; it’s still just so puzzling to me that people are acting like the baby itself will have to open a bank vault to get fed.

    I’m very sorry that you had to deal with people not respecting your decision. I think a vital part of staff education is respectfully dealing with the mothers who are planning not to breastfeed. In an ideal world, a mom discusses her infant feeding choice with someone who can present risks & benefits, is given time to think about it, lets them know her decision, the decision is documented, and then she gets no more aggro. That is how it works at our hospital. Mom had the discussion, made her decision, bottle babies are bottle babies, and that’s the end of it.

  102. Steve:

    I think you’re confusing “keeping the conversation going” with “keeping the conversation going in the right direction.” The mere presence of a conversation does not mean that something positive is happening. The conversation helps no one if it is regressive. It is not positive, for example, if the conversation is being dominated by arguments about, say, how much breastfeeding education is necesary from hospitals. The data shows that breastfeeding education is working in hospitals – 90% of NYC moms start doing it. The problem is that this initiative speaks greatly to the responsibility of hospitals and individual mothers while not addresing a governmental role at all (seriously, at all). And a conversation devoid of any governmental responsibility is not a progressive or positive step, as you say. It seems like you’re of the camp that “well, at least people are talking about it!” Yeah, no. Talk means nothing if it is ultimately or largely regressive. We should not have to take steps backward to go forward – because while this stuff may only effect you in theory, for women it’s not. So…yeah. Your argument isn’t valid.

    Basically, you are arguing that there are no facts to show that lesser iniatives block the larger more effective ones. But if you look up the UN and WABA reports on breastfeeding, they do actually note that more progressive nations that actually has instituted the optimum conditions have very few public health nursing initiatives – since removing the actual barriers to long-term nursing, most women choose it on their own.

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