Yesterday I went to hear Dr. Jack Newman at the La Leche League Conference for Breastfeeding Professionals at Tel Hashomer hospital. I have summarized some of the more interesting points below.
In the context of discussing the International WHO Code of Marketing Breastmilk Substitutes (Israel is a signatory), he described the attitudes that formula companies try to foster through their marketing.
THE FOLLOWING ARE FALSEHOODS PERPETUATED IN FORMULA ADVERTISING. DR. NEWMAN’S VIEWS ARE IN PARENTHESES.
- Breastmilk is best, but formula is almost as good.
- Actually, formula is better.
- Breastfeeding is for “infants,” yet formula is necessary through toddlerhood. (Dr. Newman showed a photo of one type marketed for children up to seven years old.)
- Fathers won’t bond with their babies unless they can feed them..
- Breastfeeding is difficult, exhausting, and limiting.
- You can eat only white rice and drink only water until you wean. Forget coffee, alcoholic beverages and cigarettes. (Dr. Newman believes that even the few heroin addicts who choose to breastfeed should be encouraged and not only because breastfeeding will not harm their babies. On the contrary, these babies need breastmilk because they are at high risk for serious medical problems.)
- Doctors need to be involved in decisions concerning infant feeding. Formula labels read: “Don’t change formulas before consulting with your doctor.” (Unfortunately the extent of most pediatricians’ knowledge of breastfeeding problems is limited to advising mothers to wean. And there are no significant differences between formulas because no one really knows how much of each ingredient should be included.)
- Bottle-feeding mothers should never be made to feel guilty by being told about risks. But it’s fine to make breastfeeding mothers feel guilty with such statements as, “If you keep breastfeeding your baby won’t gain enough weight and will become brain-damaged.” “If you don’t treat the jaundice with formula (not necessary) your baby will be brain-damaged.”
While discussing marketing, Dr. Newman made the point that mothers who start off breastfeeding are actually likely to spend more on formula than mothers who don’t. How does this work? Mothers who intend to bottlefeed from the start are usually poorer and wean their babies from expensive formula to homogenized milk at an early age, often at three or four months. A better-educated, “well-informed” mother, intending to breastfeed but ending up weaning or supplementing, is more likely to follow the AAP’s recommendation to continue with formula for a full year. Older babies eat larger quantities. This explains why formula companies send more coupons and samples to pregnant women who indicate that they are planning to breastfeed. Over 90% of mothers who start bottlefeeding in the hospital continue with the brand they received there, which is why formula companies do everything they can to get their brand into as many hospitals as they can. They not only donate the formula, they deliver it, “educate” the staff, and take care of disposal and recycling.
Dr. Newman believes that a six-month-old baby on a well-balanced diet of solid food and homogenized milk does not need formula, and that the AAP recommendation to continue with formula for a year was influenced by the formula companies who donate $2 million annually to the medical organization. Similarly, the AAP SIDS Task Force recommended pacifier use for all babies despite relying on one questionable study. The study did not show that sucking on a pacifier was more beneficial than breastfeeding in preventing SIDS. I criticized a different recommendation of the SIDS task force here.
Another lecture focused on encouraging babies who refuse the breast. The most important way of preventing this problem is to encourage mother/baby skin contact from birth. A baby kept on his mother for the first 24 hours will usually crawl to the breast and self-latch, while one forced to eat according to a schedule is more likely to resist. Even in Toronto, where birth is highly medicalized, implementing such a policy was easy. The Israeli health ministry has made moves in this direction but we are nowhere near there yet.. Dr. Newman insisted that educating doctors and health care professionals was not enough; the mothers themselves must demand the changes. I have written here about the Baby Friendly Hospital Initiative. Dr. Newman has travelled all around the world as an advisor for UNICEF, evaluating hospitals according to this standard.
It turns out that Dr. Newman was born in Rehovot, the child of Jewish refugees from Poland. Because none of his father’s family survived, and his mother’s only family was in Toronto, they ended up moving there in 1948. I wonder what Dr. Newman’s career would have been had they stayed here. At any rate, I hope his visit will have an impact on the Israeli attitude toward babies and breastfeeding. Those of you in Israel who are intrigued can hear him tomorrow (Friday), where he will be lecturing to the general public at Sorasky Hall (Nursing School) at Tel Hashomer, from 9:15-13:30. Topics include Bottlefeeding mentality and breastfeeding myths, Breastfeeding and adult health (benefits for mothers and formerly breastfed babies), and Breastfeeding toddlers. Cost is NIS 135 and partners come free. The program can be downloaded here.
Heroin addicts who become pregnant should immediately seek heroin addiction treatment before anything untoward happens to her or the baby.