Proposed Law Promotes Breastfeeding in Israeli Hospitals

new baby in hospitalLikud MK Danny Danon has introduced a law preventing formula companies from advertising in maternity wards. If passed by the full Knesset, hospitals will no longer accept free formula and other gifts from manufacturers. Currently companies compete for the chance to “donate” formula and valuable equipment to the hospital nursery, in exchange for exclusive distribution in that hospital.

The proposed law also requires mothers (not fathers) to sign a consent form before their babies get formula. The formula will have only an identification tag and no brand name or logo. Finally, manufacturers must sell formula to hospitals only at a predetermined wholesale price with no discounts.

This article points out that formula companies pay hospitals about 8% of their annual profits (NIS 35-40 million) to guarantee that new babies will get their brand of formula in the hospital. Parents imagine that they are getting free formula, but make no mistake, consumers pay the cost of this “gift.” And the health system, i.e. the taxpayer, ultimately pays via increased health costs from formula use.

Ynet called the article, Formula to Be Banned in Hospitals? I guess the editors decided that the question mark made it okay to lie about what the law actually says. Formula won’t be banned, only regulated.

The proposed law takes its main points from the World Health Organization’s International Code of Marketing Breastmilk Substitutes, the WHO Code. Israel is a signatory, but the WHO recommends enforcing it by legislation.

The proposed law has provoked a backlash. According to Ynet:

. . . A group has already formed an online petition protesting the bill. Led by psychologist Anne Hadar, the petition claims that not only does the bill not fulfill its purpose, it is also infringes on the new mother’s rights.

“We, the women who give birth are not little girls who can be summoned like misbehaved schoolgirls and pressured” the petition stated.

On a section of the bill claiming that “breastfeeding has nutritional, health developmental and psychological advantages for the baby. Side by side with the advantages to the mother, among which is the strengthening of the bond between mother and child”, the petitioners ask: “What does that mean? Is a woman who chooses not to breastfeed unable to bond with her baby? Will her connection to her child be any less strong?”

Misbehaved schoolgirls? I don’t think so. It’s much more condescending to undermine a mother’s decision to breastfeed by giving bottles without her consent. This occurs daily in Israeli hospitals.

Breastfeeding is the biological norm, and giving formula is a medical intervention with repercussions for infant and adult health. Medical interventions by hospital staff require justification, a discussion of the risks, and parental consent.  Feeding a baby against the mother’s wishes is a much bigger infringement of rights than prohibiting formula marketing. Exactly what right does the proposed law take away from parents?

Only privileged mothers have a true “choice” between breastfeeding or bottle-feeding, since despite the current price wars formula is still expensive. Mothers who request formula won’t get turned down by hospital staff, but may have to pay the price later. Dr. Jack Newman points out that formula companies market to higher-income families, because they are more likely to stick to one brand and use it for longer than poorer families. Also, they buy the higher-end products.

Unfortunately, every effort to restrict formula marketing provokes a defensive response by bottle-feeders. You would think that asking for consent to feed formula in a health-care institution, or requiring hospitals to purchase it, is equivalent to putting a scarlet letter on the foreheads of bottle-feeders. Saying anything positive about breastfeeding, or highlighting the documented risks of formula, provokes a similar reaction.

Others have pointed out that the new law will create problems because of the routine separation between mothers and babies in Israeli hospitals. If the hospitals would introduce Baby-Friendly Hospital Initiative policies, with mothers and babies together 24 hours a day, the health system would save money. Being left alone with their babies is the best way to get started breastfeeding. One study showed that mothers got interrupted 54 times over a 12-hour period in the hospital.  It’s not about interfering with parents’ choices and it’s not about guilt. It’s not about what makes a good mother. It’s about getting accurate information to parents and protecting babies from marketing tactics.

This document from the WHO on the Ten Steps to Successful Breastfeeding provides the evidence for rooming in (Step 7).

What I expect is that at admission, the hospital will present the form. Whoever wants to, will sign and whoever wants to give formula, will do so.

On a related note, here’s a beautiful article and video about a mother who asked for her baby to be placed on her chest before the c-section was even finished.

Related:

Haredim Shortchanged by Formula Freebies: How free formula harms young families

Breastfeeding and Cosmetic Surgery in Israel

In Which I Meet and Talk with the Mom of a Remedia Baby

Babies Left to Scream in Israeli Maternity Ward 

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Comments

  1. Couldnt agree with you more. Congrats on taking your exam!

  2. I saw something on the news about this a few weeks ago. A lactation advocate specifically said on camera “Yes, women will have to sign a form saying that they are bad mothers”

    That one line on a news program pretty much negates everything this law is trying to accomplish.

    • What kind of lactation advocate, Abbi? Did you catch her name?

    • Observer says:

      Lovely! That one line is hugely damaging, because it expresses the attitude of many lactation activists. Of course, that’s not what the form is going to say, and that’s probably not what the bill’s proponents had in mind. But given this kind of statement, this legislation is going to wind up being perceived as extremely coercive. After all, what mother is going to take a chance of having it on record that she made a decision to be a bad mother.

      What is worse, in some ways, is that many lactivists would be perfectly pleased; they have a very strong attitude that it’s quite all right to force women to nurse.

      • I still want to know who said it. It doesn’t sound like any “lactation advocate” that I know.

      • Whoa. One person claiming to be a “lactation activist” made a stupid, insensitive comment. Let’s not extrapolate to “many” lactation activists. Everyone I know who works with mothers realizes how important formula is in many, many situations. Abbi, it sounds like this woman was representing the “against” position regarding the bill.

        • Observer says:

          Unfortunately, at least in the states, many lactation activists do have this kind of attitude. And, as with most other things, the negative stories spread.

          The problem is that whether this woman really is a lactation activist or not, she sounds like a lot of the stories many people have heard. Not a good thing for people trying to get this bill passed.

          I would think that the best thing proponents could do in response to such a statement is to make sure to make the station give them a chance to say something like “Give us all a break. I have no idea what this woman was thinking, but it doesn’t bear the faintest relation to reality. All we want is to keep parents from being forced into things and to keep hospitals from sneaking things behind the parents back.”

          • If signing the formula consent form makes someone feel like a bad mother, she shouldn’t sign it! If a mother doesn’t care if her baby gets formula, she should sign it. Who cares what someone else thinks, if you believe they’re wrong? Some people will think I’m a bad mother for NOT signing it because it (supposedly) means I’m willing to let my babies starve to death rather than give formula. That wouldn’t affect my decision.

  3. I really think lactation advocates are shooting themselves in the foot with this legislation. I can see the benefit of forcing hospitals to buy generic formula and cover the name if it’s a brand name. But forcing mothers to sign a consent form either won’t make a difference or will make mothers just resent lactation advocates even more for making them sign a form that puts formula in the same category as a dangerous medical procedure.

    And forcing mothers to be alone with their babies for the first 48 hours (without the help of husbands or grandmothers at night or the ability to legally sleep in bed with your baby) is a great way to exhaust mothers and impede recovery and breastfeeding itself in some cases, especially for those who have C sections. Mothers need sleep and rest just as much as babies need breastmilk (if not more). Being forced to change meconium diapers at 2 am 12 hours after delivering is the height of absurdity (and the reason I wouldn’t ever dream of doing rooming in again.)

    Also, I don’t understand this line: “You would think that asking for consent to feed formula in a health-care institution, or requiring hospitals to purchase it, is equivalent to putting a scarlet letter on the foreheads of bottle-feeders. ” But it is putting a scarlet letter on bottle feeders. The only other things for which you need to sign a consent form are dangerous medical procedures. So if formula isn’t as dangerous as a tonsillectomy, (which could be necessary, but still dangerous), why would you need to sign a consent form to get it?

    • Abbi, I don’t know which procedures need to be signed for and which don’t. I do know plenty of babies who received formula against their mothers’ explicit wishes and against the recommendations of every major medical organization in the world. What do you suggest as a solution?

      As far as caring for babies at night, the research does not support your argument. The latest study showed that mothers with their babies got just as much sleep, were as alert the next day and were more responsive to their babies. If changing the diaper is such a hardship a nurse can be called to do it–she won’t be needed in the nursery.

      • I gave birth both times in the states and the first time i attempted rooming in the first night, by the second i realized my mother (who nursed all three of her children despite crazy c section situations in Israel) was 100% correct and rooming in was indeed not such a great idea. both of my girls got formula in the hospital at night and nursed with me during the day. with my first i had complications and my milk did not come in for nearly TWO WEEKS and i was able to nurse her for 18 months (she would have gone longer but i got pregnant again). My second was 3 weeks early and on the small side, my pediatrician recommended supplementing in the beginning and she nursed for 13 months (her choice). Giving formula in the hospital is not necessarily a bad thing, but regulating it may be a good thing. Also pointing out to bottle feeding moms that you don’t HAVE to use the same formula all the time may help with expenses.

        • Yes, I have a friend who is giving birth to her 4th in December here in Israel, but it’s her first Israeli birth. She said she did rooming in with the others and would like to for this one. I warned her that it’s different here- she was shocked to here that her husband can’t stay all night in the room and that the nurses don’t help with diaper changing, etc. at night.

      • Observer says:

        I’d love to see the studies. Frankly, I don’t believe that women who have full rooming in get as much rest as women who don’t. Of course, I could be wrong, but I have also seen plenty of studies that don’t prove what they claim to prove.

  4. Elisheva says:

    I read Anne Hadar’s petition, and was embarassed for her. I’m sorry to say my impression was that she’s either very innocent, or downright stupid. That’s not to say that the bill cannot be criticized. Comparing it to the WHO’s Code leaves many open question marks. But gosh, let somebody come along and formulate an intelligent petition. In this one, every sentence is sillier than the one before.

  5. Maybe legislation does put the issue of BF on the front pages and encourage discussion. But this does not replace the need for education and addressing the concerns of moms about BF

  6. There’s a better way to achieve this than consent forms – simply have the hospitals not provide any formula at all. If a mother knows she wants to feed her baby formula, she brings some from home when she comes to give birth. If she ends up needing to supplement, she sends someone out to the drugstore to pick some up just as she would at home. I’ve heard that this is how it works in Canadian hospitals. This way there’s no guilt trip towards mothers who want to formula feed (shampoo also isn’t provided by the hospitals… they’re not saying that it’s wrong to wash your hair!) but there is no hidden marketing either.
    A relative of mine who is a lactation consultant in Israel told me that formula companies’ marketing in hospitals is even worse that you describe it: she says that formula companies pay for hospital nurseries in exchange for the hospitals exclusively using their formula brand. She says that explains why there are almost no hospitals in Israel that allow for full rooming in – because the big bucks are being paid by formula companies to build nurseries, so there’s no money for facilities that allow rooming in. So this bill could also end up leading to more baby-friendly hospitals.

  7. I’m in the US, and my hospital was very good, but I am still lucky that I knew a good lactation consultant. I put the baby on the breast while still in the delivery room, but he was groggy and didn’t latch (I’d had an epidural). When I was moved to the room, the nurse wanted to take him to the nursery, but I said no. I insisted my son stay with me until he got his first meal. Finally, at 2 am (about 6 hours after he was born) he latched on and got a decent suck. I kept him with me through the night, and he only went to the nursery for an hour the next morning for some tests, and came back to me (I had not given consent for any bottles or pacifiers, and he was not given any).
    Anyway, I still wasn’t confident I had the breastfeeding down- he was taking a long time to latch, sometimes growing frustrated in the process which made it harder. I was in pain. It was Shabbos morning, but this lady in my mom’s shul who is a lactation consultant walked over to see me and helped out. She assured me that what I was experiencing was normal in the beginning, it would get better, and the baby was getting all he needed and not to let anyone tell me otherwise. Thanks to her, I powered through, and now b’h have a successful nursing relationship with my 4 month, who has never tasted anything other than boob juice and his own fingers.
    I had a bad experience with the pediatrician though. First visit (day after discharge) he had not put on any weight. Doctor suggested I supplement with formula- which I knew from the lactation consultant is the LAST thing you do if you suspect low supply, plus, my mature milk had only come in that morning, so OF COURSE he hadn’t gained anything yet! When I brought him back at the end of the week, he was close to, but not at his birth weight. She sent me home with formula samples, which I immediately donated to a gemach and just kept on nursing as per lc’s instructions. Third visit, at 1 month, baby was happy, healthy, gaining like he was supposed to, and doctor expressed concern that he was ‘only’ 25th percentile (not according to the WHO charts, of course). I’d had enough. Switched doctors, to one who is supportive of breastfeeding, uses the WHO charts for exclusively breastfed babies, and he agreed that the other doctor was being overly alarmist in trying to push formula on my baby.

  8. I watched the video. What a cutie. But it still said “after frequent drying.” From what I remember of my three births in the US, they de-slimed the baby and weighed them within about a minute, then I was handed a little wrapped bundle.

    The petition where it says, “Is a woman who chooses not to breastfeed unable to bond with her baby? Will her connection to her child be any less strong?” It reminds me of saying, “Is a person who uses a wheel chair any less mobile?” Sure, they can be just as active and more. But it’s not natural. Women who bottle feed have to go out of their way to build the closeness, and the ingredients will never be replicated. New mothers are not misbehaved school girls. They are exhausted, tired, emotionally strained, and their hormones are out of whack. They are MORE easily pressured than stubborn teenagers, and they need extra protection to respect the choices they made before several hours of labor or a C-Section. ESPECIALLY after a C-section, women need extra support because nursing can be uncomfortable. I’ve seen women pressured into letting nurses give bottles after a C-section, but they never manage to nurse well and regret it within a couple weeks when their wounds have healed and they’re stuck home washing bottles.

    • Huh? My SIL had to bottle feed all of her kids because bfing didn’t work out for any of them, despite the insane lengths she went to make enough milk. She bonded with all of them and didn’t have to go “out of her way” to build closeness with her kids.

      This is another attachment parenting myth that has been blown completely out of proportion. Bonding is a complex process and can’t be reduced to a binary of breastfeeding or bottlefeeding. Plenty of adopted children bond perfectly fine through bottlefeeding or simply being loved by their new parents.

      • I agree that breastfeeding is no guarantee of bonding. But it does provide a hormonal and physiological mechanism that ensures frequent physical contact and release of oxytocin. This naturally increases attachment. All touching leads to oxytocin release and of course bottlefeeding moms can bond beautifully. Breastfeeding moms can be cold and detached, especially if they are in pain or separated from their babies. All things being equal, though, bottle-feeding moms do have to make a little more effort at the beginning to establish bonding. You can’t bond, though, if your babies aren’t with you. The WHO recommends rooming in for bottle-fed babies too.

  9. I think that this is only half a job.
    As new Ima describes, sometimes you are not sure that you are doing the right thing.
    It would be far far better to add someting positive and make a law that all hospitals should employ lactation consultants, and that there should be enough available so that every new mother would see a lactation consultant within 24 hours of the birth even on Shabbat!!!! than limiting the use of formula.

    In some cases formula saves lives – or is essential for well being of the baby. In these cases, not telling the mother what formula the baby got is not a good idea.

    In addition, the problem is that all these regulations are the state forcing things on people. Having met the nurses in the baby wards, the most important thing in the end is EDUCATION. Even if a mother does not sign, those elderly nurses will pressure mothers all the time to give formula. (they used to wake up the (nursing only) mother at n ight every time the baby cried and say – look, this is all because you wont let us give formula.

    In short, while the cause here is very good. I think that there are better ways to achieve the end, i..e much much wider avaialabilty of certified lactation advisers on the staff of maternity wards (have the formula company pay their wages!!!!),with a plan that every new mother see one, and reeducate the nurses on the baby ward to be aceptant of the mother decisions

    • I agree that more education is necessary.
      The type of formula the baby receives won’t be a state secret–it just won’t be advertised so the companies won’t get free marketing. The packages and the bottles will be marked with a code. It’s necessary in case the baby has a reaction, or there is a defective can of formula.

      Actually, Keren, in the article I linked to it mentions that one of the bribes that the formula companie s use is the salary for hiring an extra nurse–who is called a lacatation consultant!! It’s clearly against the WHO Code for formula companies to pay for “education.”

      • I meant a real proper IBLC lactation consultant!

        I am sure that many mother go home without exactly knowing if they are doing things correctly, and becuase of this easily give that first bottle because the baby cried at night

        • My point is that the IBCLC’s salary may not come from a formula company, both according to the Code and the profession’s standards. It’s true that lack of knowledge contributes to unnecessary formula, but so does formula marketing and free samples!! If they had to run out to get the formula they are more likely to get through the first difficult nights.

  10. I couldn’t disagree with this law more.
    I am a mother of two and I am highly dedicated to breastfeeding.
    But with my first daughter, I just didn’t make any milk. Like…almost NONE. I worked and worked and prayed and prayed so that my milk should come in, but it just never happened. I cannot express how psychologically stressful this was for me. What I needed, and what would have been best for my mental health, for my bond with my baby, and for both of our overall well-beings, would have been if a nurse had told me that formula wouldn’t kill my baby and that I should consider giving her bottles while I sorted our my breastfeeding nightmare.

    Instead, I had a whole industry of lactation ‘professionals’ repeating a tired chorus of “If you just try a little harder for two more weeks, your milk will come in”. It never did. And after 6 weeks of hell, I finally gave it up.

    Then I had my second child and I knew that I would take a whole new approach to breastfeeding and would ignore that lactation nazis altogether. I decided that I would give my baby formula from the beginning and that I would NOT STRESS about breastfeeding. I would offer my baby the breast as much as he/she wanted and if my milk ever came in, then great! And if not, then fine too. Of course, without the stress I ended up getting some milk (about a half supply), and I’m happily nursing my baby this time around.

    It wasn’t until I had a positive breastfeeding experience with my second baby that I realized what a terrible thing it is for nurses and doctors to force breastfeeding and stress out mothers. It seriously affected the bond I experienced with my first child and it took months to overcome that.

    If a mother wants to breastfeed, then it goes without saying that her baby should not be given formula against her will. But many MANY mothers are so brainwashed into thinking that formula is poison, that they are starving their newborns, rather than give them a bottle, when they SHOULD be giving them a bottle. Not every woman has a normal milk pattern. Not every woman can afford to exclusively breastfeed until her milk comes in. And not ever woman realizes that her baby isn’t thriving because of her reluctance to offer some formula. That is where education is needed, in my opinion.

    • Hi Adii,
      What a painful experience. Not only did you not have enough milk, you didn’t get support you needed at a vulnerable time. I’m glad your breastfeeding experience with this baby is satisfying.
      In their defense (and for other mothers reading), it can be hard to know at what point to “give up.” Sometimes things turn around suddenly after a slow start. But it sounds like you were pressured (never a good thing) and long past the point where you felt comfortable.

      Formula should be seen as one of many tools. There are many times when formula is necessary–when the mother has a medical condition, or signs indicate that the baby is not getting enough milk (based on objective criteria) or her milk is not available. The number one rule is “feed the baby.”

      I completely agree with you about education for when it is necessary to feed the baby. Keep in mind that the hospital policies lead to poor breastfeeding outcomes. Keeping mother and baby together will mean a positive breastfeeding experience for many more mothers although it obviously can’t prevent every problem. Situations like yours are relatively rare, especially without predisposing factors that the staff needs to keep in mind.

      In Israel, situations where formula is withheld when needed are much less common than the baby getting formula when not needed. Some 70% of babies have had a bottle by the time they go home, and this has implications for public health. For every mother whose baby gets formula against her wishes, there are another 5 who weren’t adamantly opposed but are offered formula when their baby doesn’t need it. The law will address this and there doesn’t have to be
      Again, I am really, really sorry that happened to you. It shouldn’t have.

  11. I think that people will end up seeing the advantages of theis legislation. There is nothing in there about emposing rooming in. The point is to protect the mothers and babies rights. The present situation does not work. The mothers think that giving a bottle is normal. Nurses tell mothers that their baby is crying because they don’t have enough milk and that they are starving the baby, basically forcing the mother through incorrect guilt to give a bottle. Nurses give babies a bottle even when the mother specifically asked not to. Where is the outcry to help these mothers? If the choice is to perhaps hurt the formula-feeding mother’s feelings (though not on purpose) or protect the breastfeeding couples basic rights not to give formula, I vote to protect the mother and baby’s rights. The research shows that even one bottle of formula hurts the baby. Of course sometimes it is needed, I am only talking about when it is not needed.

    • Until we change the nurses in the hospital, nothing will help!

      On the other hand, we never ever knew the reason my baby did not know how to nurse properly (and had to have formula). One suggestion raised was that “just one bottle” (or maybe 2) she had been given after my ceaserean, got her used to the wrong sucking pattern who knows!

      • I completely agree with Keren- and it’s not so much the nurses, as the head nurse on the maternity ward. She pretty much decides how the floor is run. The head nurse in the Meir Hospital maternity ward doesn’t allow pacifiers, wakes up every mother for nursing through the night unless you request not to be woken and every nurse on the ward apparently can help with breastfeeding (don’t know if they are IBCLC, but when I asked a random nurse if she would check the latch, she adjusted my position and suggested i aim my nipple for the baby’s palate, which helped enormously, so she seemed to know what she’s talking about). In Ein Karem, i think they have an LC on the ward, but not on shabbat and there was less of a “lactation atmosphere” on the ward).

        Israeli lactation advocates should focus on how maternity nurses are trained and pressure the nursing schools to make sure all mat nurses are trained as lactation consultants as well. That’s what is really going to affect breastfeeding stats, not signing consent forms.

  12. It’s really about facilities and services available in the hospital. If you have a pleasant room situation where you and your baby can bond and a staff that can take the time to help you when you need it, then this can be a positive change. [BUT if the maternity ward is overcrowded and the staff is overworked then ‘rooming in’ and no formula can make your experience extremely unpleasant. (I was in a room designed for 3 women but held 4 beds for 4 mothers and I had twins so there were 4 moms and 5 babies and only one sink to wash the babies in and this was before there were disposable diapers and wipes. Oh and I missed lunch because I had to nurse TWO babies and lunch was served at the other end of the floor for 20 minutes. ]

  13. I think it’s a GREAT idea that nurses won’t be able to give formula without asking for parental consent. This way, hopefully, next time I have a baby I won’t have to fret and worry and run after the nurses, and specifically require that my baby won’t be given any formula during the several hours they require the baby to spend in the nursery for check-ups before they let her out for rooming in with me.

    As for rooming in… I just think there is something very unnatural in carrying a baby for 9 months, and shortly after birth handing her to the care of strangers. I mean, I won’t give my toddler over to a stranger overnight! What about a newborn, then?

    I did rooming in with my two so far, and they were very very peaceful because they had all they needed right next to them: mama and her milk. And I slept peacefully for *many* hours with them by my side. But the babies in the nursery on the opposite side of the corridor, oh, the poor things wailed non-stop. It broke my heart to hear them.

  14. I am 100% behind this law, at least, what I understand of it. (Have not read it myself, is what I’m saying…) My babies were given formula, without my consent, in the hospital. They were separated from me (post c-section) for a terribly long time, without reason. Why couldn’t they bring the babies to me?? Or wheel me down the hallway to them? The fact that they could give the babies formula, w/o my saying yes or no, allowed such a thing. Formula also, I believe, led to one of my twins having a traumatic throwing up of her formula, which landed her in the pikida with a tube. She was never allowed to try to breastfeed first, and she had an allergy to milk. IF THEY HADN’T given her formula, that may have never happened, and I might have been able to be with her more. It took me almost TWO MONTHS post birth to undue the breastfeeding damage the hospital caused… Thank G-d, I was able to eventually nurse my babies exclusively after those two months of crazy, crazy pumping and medication, and they are still nursing now at 18 months. But why should I have had to suffer for those two months?? I nursed my first two, born in the US, without any problems. I knew how to nurse a baby. Our problems were created by the hospitals policies and their formula pushing.

    I don’t see how this bill is “anti-formula feeding MOMS”. I think a mother should have a right to how her baby is fed in the hospital, and I had no rights. The formula feeding moms are not losing their rights. They just have one extra signature to give. It’s the breastfeeding moms who will be REGAINING their rights. I think it’s a step in the right direction… Next step, allowing rooming-in and not separating for ridiculous amounts of time post c-section.

  15. Krystle says:

    No, what is condescending in the extreme is for a MALE politician to decide what is best for a mother or a child based on studies done in a THIRD WORLD COUNTRY. This is insanity? What is next. Hide the formula and make a mother do a walk of shame before she can buy it? All because a bunch of new-age mid-wify lactation experts think having your baby in a pile of dry leaves and nursing from your breast means they will be impenetrable to any disease or hardship. There’s nothing wrong with making sure the mother is okay with using formula. There IS something wrong with making mother feel shameful when they can’t or don’t wish to nurse.

Trackbacks

  1. […] Hannah took the same exam, and she posted Proposed Law Promotes Breastfeeding in Israeli Hospitals. […]

  2. […] 31, 2011 By mother in israel Leave a Comment Rachel Gurevich left a comment in response to the proposed law requiring parental consent for feeding formula to newborns. When I wrote to her about publishing it as a new post, she asked to expand it. What follows is […]

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