Are "Baby Friendly" hospitals dishonoring cultural diversity

CrunchyMama, ASN, RN · Nov 11, 2009

Bring your own, huh? I find this to be a really narrow-minded and rude thing to say. I have worked in OB and I know what the benefits of breastfeeding are, however I chose not to breastfeed. To breast or formula feed is a personal decision and shouldn't be mandated by anyone(ie; withholding formula when a mother chooses to formula feed). We provide food for adults, we have to provide food for infants.
Perhaps the reasons I chose to formula feed may seem selfish to you, but it worked for my lifestyle. I think a happy mom is a better mom, and if a woman is going to be miserable breastfeeding why should she do it?
Everyone's situation is different. If someone wants to breastfeed, great, let's help them. If not, that's ok too.

Yes bring your own. Why should a hospital supply it for those that choose to formula feed for selfish reasons? Healthcare providers are suppose to be promoting health....because of this, I personally wouldn't feel comfortable handing over a bottle of "food" to a mom to give to her baby. Babies are designed to breastfeed....it's what they're suppose to get. Formula messes with their system....it's an artificial food and a poorly made one, hence the reason so many babies have problems digesting it. Yes, it is a personal decision...one that should be researched thoroughly (sad a human should have to even research such a basic need) and the best decision should be made. I'm not saying breastfeeding should be mandated....I just wish hospitals would offer more support and education and not make it so easy for a mom to make a bad decision. There's no reason for a mom to feel miserable for giving her baby the best. Yes, breastfeeding is tough in the beginning. Anything that hasn't been done before is tough....but do we always take the easy way out when things get rough? No...we get through it and move on. Breastfeeding not only is good for mom but also best for baby....that should be the number 1 concern....not "oh, my boobs are for my husband" or "breastfeeding is gross" or whatever else moms come up with (I've just about heard it all). Sorry....but our society sucks when it comes to this topic. If you feel confident in your decision then nothing I say should bother you, since you think you made the right choice. Oh and trust me....I know I wouldn't fit in well in OB, lol....I would go insane, lol.

CrunchyMama, ASN, RN · Nov 11, 2009

barkow said:
on the topic of wic, the rules have recently changed and there are more substantial benefits for breastfeeding and less formula benefits (so parents will be paying more out of pocket). if our government stopped funding formula today, it wouldn't stop most mothers who use wic for formula benefits from formula feeding. it would likely harm babies, though, because parents would be more likely to dilute formula to make it "stretch" (a dangerous practice), feed cow's milk in place of some formula, or start solids early. in order for formula use to decrease, we have to address the barriers to breastfeeding and we have to be honest with each other about the risks of formula feeding (vs the benefits of bfing). until that happens, no change is going to make a strong impact.

only commenting on this.... i don't believe that if wic cut funding formula, parents would dilute it etc etc. i believe it would give more moms the initiative to breastfeed. i know of a few moms that simply formula fed because they knew they'd get some from wic. so that frame of mind is shared by many others i'm sure. my own formula feeding sil asked my breastfeeding sister who's on wic to ask for formula. she didn't however because it would mess with her own checks...but it happens. seriously, why go through the "trouble" of breastfeeding when you can get formula for free from wic? moms just aren't educated enough about the benefits of breastfeeding...for her and the baby and the dangers of using formula. it's pitiful and won't change for a long long time i'm sure. especially with the way we've sexualized breasts. :/

CrunchyMama, ASN, RN · Nov 11, 2009

As far as bring your own formula arguments- when people are patients in a hospital in the United States, they are entitled to not only receive food, but to receive food specific to their individual diets. Newborns are also patients in the hospital and are entitled to be fed in their specific diet, which may be formula or breast milk. It would not be vegetarian-friendly to tell someone that the hospital does not prepare food without meat, so tough luck, bring your own. Moms can bring their own formula and be ticked off, but in the end those babies are still being fed formula so nothing has been solved. So much needs to be changed in our culture to make breastfeeding the norm and have moms feel supported, and it's just frustrating how the baby friendly hospitals are not attacking the root of the problem.

I understand your point and others that share your same thoughts...I really do. I just don't think like that. I think new babies are entitled to breastmilk...not crap in a can. And they are considering we have boobs and make the milk. Makes sense to me. My friend had a baby in Germany when her husband was stationed there....they had to bring their own pain meds. It's not that far off to have moms bring their own formula. Breastfeeding moms bring their own...

rn/writer, RN · Nov 11, 2009

why should the hospital provide formula that can jeopardize a babys health. If a mom chooses to for selfish reasons, then bring your own.

Who gets to decide what is a "selfish" reason?

I looked into breastfeeding and then realized the problems my son was having was because of the formula (acid reflux and horrible constipation).

Several babies in our family had reflux and other digestive problems even though they were exclusively breastfed. The difficulties subsided only with medication. As for formula causing digestive upsets, one brand may work better than another and some babies need soy products.

I personally wouldn't feel comfortable handing over a bottle of "food" to a mom to give to her baby.

Referring to formula as "food" like it's some kind of poison is just not helpful. Millions of babies have "survived" the horrors of being given formula and lived to tell about it.

I understand that you had a bad experience, but many mothers and babies do just fine with formula, so long as it isn't accompanied by condemnation.

Home Health Columnist / Guide · Nov 11, 2009

our home care agency sees about 350 moms/month with majoriy of referrals indicating breast + bottle feeding. our mom baby nurses focus on "best is best". pa medical assistance plans provide 2 preapproved visits for followup care. if mom needs additional visits for breastfeeding advice, support they will pay for it as viewed as best for baby while also decreasing wic program costs so win win for breastfeeding here.

independece blue cross (ibc) states 54% moms in philadelphia area are breast feeding.

national breastfeeding awareness month promotes breastfeeding

through ibc's baby blueprints program, members can receive up to $50 back for taking a childbirth or breastfeeding class, $50 back on the purchase of a breast pump and $100 toward support from a lactation consultant, a health care provider who helps new mothers learn to properly breastfeeding their newborns. in certain acute medical situations, ibc covers rental costs for hospital grade breast pumps for nursing mothers.

they also will authorize additional mombaby homecare visit if lacation issue arrise/persist.

needs to be a total team approach to improve breastfeeding rates while allowing for cultural/personal differences. education and support are key.

CrunchyMama, ASN, RN · Nov 11, 2009

who gets to decide what is a "selfish" reason?
common sense can tell you if someone is being selfish.
several babies in our family had reflux and other digestive problems even though they were exclusively breastfed. the difficulties subsided only with medication. as for formula causing digestive upsets, one brand may work better than another and some babies need soy products.
yes, breastfed babies can have acid reflux, but it's not as common as formula fed babies. often times it's something the mother is eating. dairy is the main culprit. limit dairy and the problem may disappear. babies need breastmilk is my point and a mother shouldn't have to switch formulas constantly (i had to as well), if the baby was getting what he/she is suppose to, that wouldn't have to happen. soy? not healthy at all, i wouldn't give it to my dog (if i had one).
referring to formula as "food" like it's some kind of poison is just not helpful. millions of babies have "survived" the horrors of being given formula and lived to tell about it.
considering there's an ingredient in formula that is poisonous to rats, then yeah i can understand why some would refer to it as a poison. survived? yes and look at all the health problems we have....hmm! you can also survive on burger king.
i understand that you had a bad experience, but many mothers and babies do just fine with formula, so long as it isn't accompanied by condemnation.

i'm not the only one with a bad experience. talk to any formula feeder....i bet any one of them had problems with acid reflux, constipation, excessive spit up, colic, having to switch formula 283 times or whatever. look at all the babies that have died in other countries due to formula, i even know of a mom in this country, her son almost died. this problem isn't just with my own child, it happens quite frequently. not to mention formula fed babies smell bad, lol.

jesskalpn · Nov 11, 2009

i'm not the only one with a bad experience. talk to any formula feeder....i bet any one of them had problems with acid reflux, constipation, excessive spit up, colic, having to switch formula 283 times or whatever. look at all the babies that have died in other countries due to formula, i even know of a mom in this country, her son almost died. this problem isn't just with my own child, it happens quite frequently. not to mention formula fed babies smell bad, lol.

as a formula feeder, i will tell you that i had none of the above problems. my daugther did well and is healthy and happy, and incidentally did not "smell bad". i'm sure i haven't scarred her for life because i gave her formula. if you're going to use examples to try to back up your opinion you should at least have some research to cite with it (although, i'm sure you can find something to back up anything on the internet these days).

and you're right, your judgemental viewpoint about formula-feeding probably wouldn't mesh well in ob.

i don't think that anyone here is arguing that breastmilk is not better, but to belittle the choice of women you don't know and whose situations you have not experienced is just rude.

CrunchyMama, ASN, RN · Nov 11, 2009

as a formula feeder, i will tell you that i had none of the above problems. my daugther did well and is healthy and happy, and incidentally did not "smell bad". i'm sure i haven't scarred her for life because i gave her formula. if you're going to use examples to try to back up your opinion you should at least have some research to cite with it (although, i'm sure you can find something to back up anything on the internet these days).
great! i'm not saying every baby has such problems...but a lot do. i don't remember my son smelling bad either but every formula fed baby i've come in contact with since then i can smell something different. my friends son makes me gag! you just don't realize it when you're used to it. their pukes and poops smell bad compared to breastfed poops and pukes. go check out the medical problems comparing formula fed and breastfed children....not saying you scarred your daughter, just set her up for future health problems down the road. also, breastfeeding decreases your chance of certain cancers and disorders...so you can say you scarred yourself too.
and you're right, your judgemental viewpoint about formula-feeding probably wouldn't mesh well in ob.
giving facts is not being judgmental. i have an educated veiwpoint.
i don't think that anyone here is arguing that breastmilk is not better, but to belittle the choice of women you don't know and whose situations you have not experienced is just rude.
according to you i'm rude because you're a formula feeder and this conversation is requiring you to defend your choice. i'm not being rude....i'm just stating facts and because you don't like hearing those facts you think i'm rude. that's fine but you must remember that there's more information out there then what you think you know...so just because someone is giving out that information that is different then yours that doesn't mean they're being rude......

.......

Marymoomoo · Nov 11, 2009

i don't believe that if wic cut funding formula, parents would dilute it etc etc. i believe it would give more moms the initiative to breastfeed...moms just aren't educated enough about the benefits of breastfeeding...for her and the baby and the dangers of using formula. it's pitiful and won't change for a long long time i'm sure. especially with the way we've sexualized breasts. :/

studies have shown that most mothers do know that "breast is best", but that knowledge isn't enough to encourage mothers to breastfeed. the many barriers to breastfeeding have to be addressed, including short (or no) maternity leave. additionally, mothers need support beyond the mother/baby unit.

i used to think that cutting funding for wic formula would help more mothers consider breastfeeding as an option. i soon discovered that may be true for some mothers, but the majority who use wic have chosen formula just like the majority that don't use wic have chosen formula, and their choice isn't likely to change because the funding is no longer there.

i personally think that the recent changes in wic, including the modified food packages and increased support for breastfeeding, are steps in the right direction. :)

i understand your point and others that share your same thoughts...i really do. i just don't think like that. i think new babies are entitled to breastmilk...not crap in a can. and they are considering we have boobs and make the milk. makes sense to me. my friend had a baby in germany when her husband was stationed there....they had to bring their own pain meds. it's not that far off to have moms bring their own formula. breastfeeding moms bring their own...

and in the uk, mothers bring their own formula if that is how they choose to feed. this is the usa, and that doesn't fly. we must provide food to our patients. if a mother isn't breastfeeding, then her baby will be given formula. i don't think not providing formula in the hospital will change anyone's mind about it, anyway.

imho, we should be looking at ways to stop the influence of formula manufacturers (such as removing formula advertising from hospitals and clinics), educating parents about the differences in breastmilk/formula and how those differences can affect health, and providing long term support for breastfeeding mothers. those things will make a difference in breastfeeding rates, not limiting access to fomula.

yes, breastfed babies can have acid reflux, but it's not as common as formula fed babies. often times it's something the mother is eating. dairy is the main culprit. limit dairy and the problem may disappear. babies need breastmilk is my point and a mother shouldn't have to switch formulas constantly (i had to as well), if the baby was getting what he/she is suppose to, that wouldn't have to happen. soy? not healthy at all, i wouldn't give it to my dog (if i had one).

that's a really simplified way of looking at the issue. many babies suffer from reflux because of their immature digestive systems. the cause of the reflux is usually not what the baby is fed. research has shown that breastfed babies fare better if they do have reflux, which is important to know.

referring to formula as "food" like it's some kind of poison is just not helpful. millions of babies have "survived" the horrors of being given formula and lived to tell about it.

considering there's an ingredient in formula that is poisonous to rats, then yeah i can understand why some would refer to it as a poison. survived? yes and look at all the health problems we have....hmm! you can also survive on burger king.

i would like to say that this is not the kind of attitude that will encourage nurses to promote breastfeeding.

first of all, formula does not have an ingredient that is poisonous to rats. i was around on the bfing forums years ago when the story that started the "rat poison" argument first started circulating. a mother had all this formula sitting around from the samples she received in the mail. she wasn't going to use it, so she thought she would mix some up and leave it out for the stray cats in her neighborhood. the next day, she went to refill the bowl and found a dead rat in there. the conclusion was that the formula killed the rat. formula is nothing more than dried milk powder (or soy protein), oils, vitamins, and minerals. there is nothing poisonous in it.

it is true that there can be manufacturing errors with formula. babies have died or have been seriously injuried because of metal shards in the can, too many or too few vitamins, or even dangerous bacterial contamination. yes, parents and health care providers should be aware of that risk. they should also be aware of the risks due to not breastfeeding (differences in gut flora, no immune factors in formula, etc). they should also know how to mix, store, and feed formula and to lessen the risk. telling a mother that formula is poison or "crap in a can" is not going to benefit anyone.

not to mention formula fed babies smell bad, lol.

yes, formula fed babies have a different smell to their vomit and stool. however, i don't see how it serves our cause to go about telling others that their children smell bad.

giving facts is not being judgmental. i have an educated veiwpoint.

let's share facts and research and leave the judgement out of it. :)

breastfeeding is the biological norm. our bodies begin the work of producing milk during pregnancy, and our bodies produce milk after birth (even if we choose not to breastfeed, lii begins because it's hormonally driven). newborn babies instinctively know how to search for the breast. the mother's body is the ideal extrauterine environment for the baby. there's so many wonderful things to talk about--the research in the last few years has been amazing! there's so much we're just learning about breastmilk, the mechanics of breastfeeding, and the mother-baby relationship. imho, we should be sharing that wonderful information instead of bashing women who choose to (or need to) feed formula. that serves no purpose other than to make a few people feel superior for their choice.

rn/writer, RN · Nov 12, 2009

Thank you, Marymoomoo (I love your name!) for a really great post. And thank you for presenting the kind of approach that acknowledges the benefits and wonders of breastfeeding without any condemnation. Much more effective to inspire rather than insult, scare or shame mothers into breastfeeding.

I'm reading a book called "Bad Mother" by Ayelet Waldman about the ways we mothers judge each other and beat each other up. She has an entire chapter on breastfeeding and the agonies and bad reactions she suffered when her youngest child couldn't latch due to a misshapen palate. She tried all kinds of measures--pumping (which really hurt), different kinds of nipples, finger feeding with a syringe-thingy attached, gentian violet for breast infections, before she finally, after six months of suffering, said, "Enough!" Even when feeding her son EBM, she felt compelled to explain herself to onlookers. This softened her own thinking and made her sad that we women, who can be so supportive and strong and encouraging, withhold that so easily from one another.

If a woman chooses to bottle feed and isn't made to feel like a selfish witch, who knows? Precious seeds might be planted for breastfeeding a subsequent child.

Breastmilk is the preferred food for babies, but everyone needs (and deserves!) the milk of human kindness.

LovebugLPN · Nov 12, 2009

I would like to tell you that when young mothers do not get enough formula from WIC they do not breastfeed they make formula. They take condensed milk and mix it with karo syrup. I was one of those young moms and that is what we felt we had to do to feed our children. A lot of girls in my area did that. We did not give our kids formula because we were "selfish" as Crunchy says. We did it for many reasons. I did it because I was young and told that bonding with my child was "wrong" (by nurses at the hospital). You really can't judge people for how they choose to feed their children because you have no clue why they are making these choices.

bugvw70 · Nov 12, 2009

I am very pro- BF and educated myself very thoroughly during my pregnancy. After an incredibly scary labor where my son went into distress twice and had a code called on him before having an emergency C section, I delivered a 9 lb 14 oz baby boy with an insatiable appetite. I exclusively BF for the first 10 weeks while I was on maternity leave. On returning to work I pumped religiously several times a shift, reducing my productivity at work and putting myself at a disadvantage to my coworkers (commission based pay) Despite pumping frequently at work, feeding my baby in his sleep after coming home at 10 oclock at night and again in the middle of the night and in person during the day I still could not keep up with him. I took fenugreek and brewers yeast. I made sure that I was drinking 10-12 glasses of water a day. I gave up any and all caffeine.

I was a wreck! I was constantly worrying about breastmilk. I was hungry all the time and I wasn't sleeping (despite the fact that my baby had started sleeping through the night I had to get up and feed or pump just to keep up anough milk production). I had to supplement with formula as my son would still be hungry after eating. Just before six months I had a string of incidents that caused me to lose a large supply of expressed breast milk. After the third instance in a weeks time I sat in the floor and broke down in tears. After alot of discussion with my husband we decided that it was time to switch to formula.

I cried. I grieved for what I thought would be the loss of my bonding with my son. I felt like a BAD MOM. Within days I realized that instead of giving up, this was the best thing I could have done for myself and for my baby. I bonded MORE with my son. I finally had the time and energy to actually ENJOY my baby rather than just focusing on FEEDING my baby. I began to not feel tired, run down, and sick constantly.

I was finally starting to go back to being myself, yet, somehow I still felt like a failure. Why, after giving my child a loving home and all of the support and comfort and care that a parent possibly could, did I feel like a failure? Because of self-righteous, self-important, know-it-alls. Because of that militant group of women out there who had long before conception decided what was going to be right for me and my child. Is breast milk best for baby? Absolutely, but what is even better is a loving mom who is able to make parenting work in her life as she sees her and her childs' needs. Better yet is when we have a society where moms don't have to worry about feeling "weird" BFing in publice because someone might look at them funny or about bottle feeging in public because someone might be around the corner ready to lecture us on how we are abusing our children by doing what we feel is best for our own families. Everyone's story is different and you don't need to know what their story is. Have enough respect to assume that they have one and that, if provided the proper education, that they have made the best decision for themselves and STAY OUT OF IT!