Yesterday on The PediaBlog, we saw the statistics supporting the conclusion that society as a whole — but especially pediatricians and other pediatric providers — needs to consider breast milk as “life-saving medicine” instead of just another infant feeding option. If breastfeeding could save 823,000 young souls under the age of five around the world each year, why, asked Pediatric Alliance’s Sara DePierre, don’t more moms breastfeed:
So if these statistics are so enticing and the AAP backs breastfeeding, why is it that only 1-in-5 women in the United States exclusively breastfeeds to the recommended 6-month mark? Could it be that the marketing of breast milk substitutes has been so good it actually has our society convinced that infant formulas are equivalent? In my oh-so-humble opinion, yes, it is.
A new study published this week in Pediatrics has found significant differences among white, black, and Hispanic moms when it comes to breastfeeding—and in-hospital introduction to formula and family history may be two of the culprits.
Researchers evaluated 1,636 black, white, and Hispanic women who delivered in hospitals in Los Angeles; Baltimore, Maryland; Washington, D.C.; and Lake County, Illinois, with a focus on attitudes toward breastfeeding, family history, and introduction to formula while still in the hospital. They then followed up with the moms one month postpartum, and again at the six-month mark.
What they found was a huge discrepancy in the mothers’ initial decision to breastfeed. In fact, one of the biggest takeaways was that black mothers were nine times more likely to be given formula in the hospital than white mothers. Whoa!
Higher rates of poverty and lower levels of education are other factors driving the racial disparity seen with breastfeeding initiation and duration. Having a family member who breastfed previously was found to be a very strong driving force for successful breastfeeding, especially among Hispanic mothers. Becker says the pediatric researchers are recommending that hospital nurseries limit the availability of commercial infant formulas:
The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life, which is why the researchers are now hoping hospitals and policy makers will step up and consider nondemographic factors to help bridge the gap.
“Our results suggest that hospitals and policy makers should limit in-hospital formula introduction and consider family history and demographics to reduce racial and ethnic breastfeeding disparities,” explained study co-investigator Madeleine Shalowitz.
“Change is possible,” added McKinney. “And we hope to see racial and ethnic disparities in breastfeeding diminish as more hospitals serving low-income populations become ‘baby-friendly’ and encourage breastfeeding through close maternal-infant contact after birth and discouraging formula use.”
Bottle-feeding infant formula is both expensive (in terms of money and pediatric health outcomes) and inconvenient for many mothers. Maybe hospital nurseries should have a “BYOB” policy, where breastmilk is the preferred beverage and commercial infant formula can be brought into the hospital by parents as an alternative beverage choice. Moms who want to bottle-feed their newborns should be able to bring their own formula supply with them, as long as it can be verified that the milk being used meets specific quality assurance criteria (such as nutritional components and expiration dates, for example). If the cost of formula is a burden, mothers should be able to apply early and receive enough formula from WIC before the baby is born. Better yet, we should provide stronger encouragement and support to help mothers succeed with breastfeeding, which, we discovered yesterday, has enormous benefits for baby and mom.
Is this even possible? Infant formula companies have a very strong, singular incentive for keeping hospital nurseries stocked with their products, so I’m not holding my breath.