Fear-mongering does not promote breast feeding

8 Nov
How the City of Ottawa views bottle feeding

How the City of Ottawa views bottle feeding

I was about to go to bed when I saw this post pop up on my feed from Fearless Formula Feeder about the City of Ottawa’s information page on “informed consent” when it comes to breast feeding. While I support efforts to encourage women to nurse their babies, I don’t think it should be done by scaring women who may be considering (or have already made) a different choice. The site lists Sudden Infant Death Syndrome and obesity in a matter-of-fact list as possible risks associated with bottle feeding, presented in such a way as to terrify new mothers. It also implies that women who formula feed will get cancer and “brittle bones.” It makes these appear to be foregone conclusions.

I work in communications for a living. I know the power of a bulleted list, of random factoids pulled from a series of unrelated studies. The way that the text is presented on the city’s website is purposely alarmist. It’s offensive and will do nothing to help women who are struggling to breast feed or who may be looking for guidelines on how to mix formula safely. It links to a page on formula feeding guidelines only after forcing the reader to scan through “facts” designed to convince women that they are terrible people if they cannot or will not breast feed.

Also? The list of “risks” is based on shaky science. As Hanna Rosin and others have pointed out, the majority of breast feeding studies do not take a wide array of socioeconomic factors into account. The reality is that wealthier or upper middle class women are more likely to nurse. They are also more likely to take their children to the doctor and have access to nutritious food and prenatal care. Their children are more likely to thrive and less likely to be “obese,”, no matter how they are fed. Breast feeding is wonderful when it works — it’s nurturing, promotes a healthy digestive system and is free to boot. But it’s not the only way to feed a baby and help them thrive.

When I switched to bottle feeding when Daphne was four months old, there were so few resources on how to do it safely and properly. I already felt like a terrible mother for feeding my baby the “poison” that the formula companies were clearly pushing on me (I got over that one fast). There was also so little discourse on the advantages associated with being able to share the task of infant feeding. Bottle feeding brought equality to my parenting relationship with my wife, in a way that I did not viscerally understand until I was finally able to get a little more sleep.

As a feminist and a mother, I am solidly pro-choice. And this includes the right to make a truly informed decision about how to feed your baby — one that isn’t coloured by fear-mongering, fatphobic, woman-shaming tactics. Women in Ottawa deserve better.

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18 Responses to “Fear-mongering does not promote breast feeding”

  1. syrens November 8, 2013 at 8:49 pm #

    Thanks for writing this.

    I was bottle-fed as a baby. My cleft-palate (relatively minor) and split uvula meant that swallowing was basically the luck fo the draw pre-corrective-surgery. Bottle feeding meant that I was able to eat, well, at all. And, hey, now I’m a powerhouse Amazon, so clearly it didn’t do me any harm. 😉

  2. Kacey November 8, 2013 at 9:42 pm #

    Oh for goodness sake, the science is not ‘shaky’. The evidence of the importance of breastfeeding is irrefutable and supported by every reputable health authority in the world. You are naive if you believe researchers have not taken into account socioeconomic status and education. Please do not rely on the uninformed opinions of Hanna Rosin, Joan Wolfe et al. They are not epidemiologists and are simply not qualified enough to be across all the research necessary to make informed judgments. They are grossly irresponsible to misinform people as they do.
    I also dispute that there is a lack of information about how to bottlefeed safely. There is an abundance of information from respected health departments and clinics.

    • Queer Femme Mama November 9, 2013 at 10:39 am #

      Correlation is not causation. There may be infinitesimal risks associated with formula feeding, but those are mitigated by better education (not shame-based). I am pro-breastfeeding. I struggled very hard to do so for four months. But I also think that the whole picture needs to be taken into account. A child needs a healthy, functional parent. While I would agree that breast milk is a superior substance, breast*feeding* is not ideal for all families. That’s why I am pro-choice on this matter. and that is a lot different than being brainwashed by formula companies (for the record, I never received or accepted a single free sample, ever).

      • Kacey November 9, 2013 at 4:13 pm #

        “Correlation is not causation” is mindlessly stated in this discussion. In all health research it is often difficult to prove causation. It is often difficult to conduct RCT’s as it is not ethical to do so. There is often many confounding factors. However when there is a large body of credible research that shows correlation than conclusions can be drawn. I would have thought it was unethical to not report this research to parents. I personally think it is patronising to withhold information.

  3. Alison November 9, 2013 at 12:42 am #

    But you know if our children are obese they’ll be fat and uhm fat, because fat and uhm obesity and bad bad bad fat. No one who is fat has a good quality of life or good health apparently even if their blood pressure and blood work is normal (like their thighs could rub together and wear out clothes quicker because fat?) They’re still a ticking time bomb apparently.

    Okay, sorry for my incoherent snark on obesity fear-mongering. I’m hoping to have one more go at having another baby (I was the letter writer in the FFF article and even with my blow-off copy and paste from the public health department I’m not letting this issue go until the informed decision page is changed from its current form). I have a 7 year old that was primarily formula fed and seems to have dodged the bad health bullet that I was scaredbout (she also appears to be intelligent). She had her first ear infection at 5 years old (and her first round on abx at the same time), despite having genes that are prone to being obese, she’s skinny (even if she wasn’t, both her parents struggle with weight, even her formerly breastfed mother so the likelihood that it was just from the formula would be unlikely).

    The fear mongering that is expressed on that site is inexcusable and irresponsible. In the pregnancy and babies section there are more risks about formula feeding listed than there are about smoking from what I have seen.

    Digging further, the city of Ottawa has been officially designated a baby-friendly initiative public health unit, which has been bestowed to them by the Breastfeeding Committee of Canada who in all of their wisdom looking into their literature, believe that health care workers giving information to parents on infant feeding must include the include the benefits of breastfeeding and the risks of formula feeding both to mother and baby so that parents can then make “an informed decision”. So not only on that list they refrain from giving stats on absolute risk and other measures that can be done to mitigate risk, they also fail dramatically on the concept of what ‘informed decision’ making actually is (they’re coercive instead of neutral).

    Anyway, I appreciate you writing this and think it’s awesome you work for a union (I’m a fed and am a member in good standing for one of the unions).

    Digging further and as to the reply I received from the OPH

    • Queer Femme Mama November 9, 2013 at 10:42 am #

      Please stay in touch! I would love to support you in this. I can’t stand the dogmatic, fear and eugenics-based arguments in favour of breastfeeding. I think the city can do a much better job of increasing breastfeeding rates without shaming or terrifying new mothers.

      • Kacey November 9, 2013 at 4:48 pm #

        This I don’t understand. Please try to explain to me how informing parents of where the research is at is “shaming”parents. It is about reporting risk. It does not mean that your baby is going to succumb to SIDS or become fat. It is just about letting parents know about what credible research is showing so that they can moderate their behaviour as much as possible to reduce that risk.

        Women talk about pro-choice. But what choice do you have when your hospital staff are poorly trained in breastfeeding support or birth interventions impact on your ability to begin breastfeeding. Even if you want to continue breastfeeding what “choice” do you have if you have no maternity leave or inadequate post natal support. This is the reality for many many mothers. They do not ‘choose’ to formula feed. They have no choice but to try to pump and feed EBM (difficult for some mothers) or to feed their babies formula.

        By acknowledging the importance of breastfeeding we can try to push recalcitrant health care systems and governments to change practices to truly support mothers to breastfeed their babies. Then we will have true choice for mothers to be able to breastfeed or bottle feed EBM, donor milk or formula. We are long way from that yet.

        By trying to dilute the message like this from Ottawa of the risks associated with not breastfeeding, I would argue you are denying all mothers true choice.

  4. Marianna Annadanna November 9, 2013 at 3:40 am #

    Well said. Pro choice!

    Just thinking out loud:

    I personally love breastfeeding (she’s four months). It was hell for 8 weeks but we got our groove and I get enough positivity from it that any negative aspects are balanced. That said, I HATE the pressure and overflow of advice on breastfeeding. If I’d had more info on formula it may not have scared me so much. I guess that’s the point eh? Scare me away from formula. But I’m an educated, “wealthy” person who would have made an informed decision best for my family. Is the risk that less informed mothers won’t make the decision in the same way??

    • Queer Femme Mama November 9, 2013 at 10:43 am #

      There is certainly still a problem with hospitals pushing formula on newborns and a lack of lactation support for new mothers. I think we can improve in those areas, while still offering a modicum of balance that does not characterize formula feeding mothers as “bad” or “dangerous.”

      • Kacey November 9, 2013 at 6:18 pm #

        Alerting mothers to the deficiencies of formula or to the unethical marketing of formula companies in no way characterizes mothers who have to use formula for their babies as ‘bad’ or ‘dangerous’. No reputable breastfeeding support person or organization would ever do so.
        We can still support mothers who formula feed their babies without hiding or diluting important health messages. If Ottawa isn’t supporting formula feeding mothers well enough, lobby for this rather than calling for the censoring of health messages.

  5. Heather November 9, 2013 at 10:09 am #

    I agree, this piece of communication was far too judgmental on parents who are unable to breastfeed. It assumes that formula feeding is always a choice and that it will inevitably be harmful. I wonder about the causes behind this tone, in terms of a communications strategy. Your specialized experience, Ariel, makes you very strong at framing and presenting issues to the public. In some departments that role is shared by a team of practitioners who may not have as much training in Knowledge Translation and communications. That doesn’t lessen the negative impact of this information page implying that parents are failures if they need to use formula, but it may be a way for the Ottawa Public Health department to think about strengthening their communication design practices if they read this article.

    • Queer Femme Mama November 9, 2013 at 10:44 am #

      I would be happy to help the city re-write the page in a manner that is not so dogmatic and fear-based.

      • Kacey November 9, 2013 at 6:39 pm #

        Ok I’m curious….how would you frame the message? Please take into account that breastfeeding advocates have worked very hard to get breastfeeding recognized as the norm. For many years health messages stated the “benefits” of breastfeeding which of course placed formula feeding as the normal way of feeding babies.

  6. Jendra November 9, 2013 at 2:18 pm #

    I hear you 100%. You can easily drink the Kool Aid surrounding breastfeeding and feel so awful when it doesn’t work out. I think we need a calmer and more fact-based discussion surrounding breastfeeding, such as supporting women who do it, in ever way they need– but then providing bottle-feeding mothers with all the support and info they need too.

    • Kacey November 9, 2013 at 6:48 pm #

      I would argument that mothers are only in the last few years getting the facts about infant feeding. For many years the risks of not breastfeeding have been downplayed by health professionals. They censor their message ( I have seen it happen many times at seminars) in the belief that they are doing the right thing so that mothers who are unable to breastfeed don’t feel guilty.

      I believe it is often a cop out so that they don’t have to update their knowledge or change their practice in order to truly help mothers reach their breastfeeding goals.

  7. queerfamilymatters November 10, 2013 at 12:19 am #

    Here here! While breastfeeding is certainly a really good option, shaming parents who bottle feed and/or use formula is harmful and inherently anti-feminist. In addition to all the shaming and fear-mongering, it ignores the reality that some moms really can’t breastfeed all the time, even if they are not having complications expressing milk. Not all workplaces allow safe places to pump, especially low-wage jobs. Some moms work more than 1 job to support their family and simply don’t have the time and support to breastfeed. I am not saying that breastfeeding isn’t a great option, but it isn’t the only one and no one should feel like a bad parent for either choosing not to or not being able to breastfeed. Amen, sister!

    • Kacey November 10, 2013 at 2:50 pm #

      Breastfeeding is not just ” a really good option”. That is like saying carrying a fetus in a womb is a ‘good option’ but hey babies who need incubator care manage to survive and sometimes thrive so why can’t that be a good option for women who really can’t carry a baby in their womb all the time.

      Your argument ignores the fact that breastfeeding is the biological norm. It ignores the fact that we are not talking about equal options here. Breastfeeding is the natural extension from the womb environment. Formula is deficient in many components found in breastmilk, some of which we are just finding. Who would have thought stem cells would be found in breastmilk. Why is the thymus of breastfed infants much larger than that of formula fed infants? So much still to learn about breastmilk components and what they do.

      Sometimes, like everything in life, things do not run smoothly and alternatives have to be found. We are lucky in first world countries that we have safe water and electricity so that these alternatives are relatively safe. However for a couple of generations we lost sight of the fact that breastfeeding is the biological norm. The evidence is strongly mounting that there are health risks for both mother and baby when it doesn’t happen.

  8. beninthecity November 14, 2013 at 1:49 pm #

    Thanks for posting this! I’m a stay-at-home dad of two kids who both needed to supplement pumped breast milk with formula. Too often people seem ready to sacrifice what’s good and possible for what’s best, but impossible. Presenting the pros and cons of breastfeeding in simplistic, dichotomized terms can be counterproductive in a messy, imperfect world.

    My wife was able to maintain her career because of formula. In addition to the impact she’s had on countless lives professionally, her career has allowed our kids to have a home, a dedicated caregiver, Christmas presents, food, swimming lessons, healthcare, and pretty much everything else that has contributed to their well-being over the last decade. Would we have liked to be able to breastfeed exclusively? Of course! But in the real world that wasn’t an option and sensationalizing the issue doesn’t change that.

    Thanks for giving such a clear, rational voice to families that don’t easily fit into traditional boxes, but who are able to carry on by making workable compromises.

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