Note to hospitals: Formula is not the enemy

Maryland officials recently, and rather self righteously, announced that in an effort to encourage breastfeeding, the state's 32 birthing hospitals will no longer offer company-sponsored gift bags of formula to new moms, following in the footsteps of Rhode Island, Massachusetts and Delaware. I'm all for getting rid of the swag bag; hospitals shouldn't be marketing anything. But linking the decision to breastfeeding sends a message that formula itself is bad, piling on to the already enormous — and sometimes detrimental — pressure to nurse.

I don't remember whether I was given a sample of formula when I left GBMC with my daughter three years ago, but if I was, I'm sure I tossed it. The parenting books I read and classes I attended had convinced me that breastfeeding was superior to formula for a child's emotional, social, physical and cognitive development. And I was going to give it my all, despite having been fed formula myself. (The year I was born, 1972, was the country's worst for initiating breastfeeding; only 22 percent of new mothers tried it.)


I was so committed that I didn't turn to formula even as my newborn struggled to gain weight after leaving the hospital, hovering around 6 pounds at her two-week check up, when the doctor suggested we add a pumped bottle of milk to the feeding schedule. That did little, and a week later, exhausted from ineffective, all-hours feedings and terrified I was failing my child, I went to see a lactation consultant, who had the common sense to give me a bottle of formula and the OK to use it. I felt like a failure, but I also felt immense relief watching my little girl drain that bottle.

It turned out that wasn't the end of nursing for us. The LC put me on a strict regimen of feedings and pumpings to get the hang of things, and, perhaps more importantly, gave me permission to supplement with formula. I'm not sure anyone but an LC could have convinced me that was acceptable at the time. My various online parenting groups were posting positive breastfeeding stories daily, and members offered frequent "you can do it!" pep talks. And there were those studies claiming it made your kids smarter, boosted their immune systems and facilitated the all important parent/child bond; the inference, of course, being that formula made your kids dumber, sicker and detached.

In short, breastfeeding meant you were a better mother, and its more militant supporters were happy to shame you into it. I know one woman who faked breastfeeding around another mom to avoid judgment, pretending to nurse in one room while she really fed her child bottles. And other women have solicited breast milk donations from strangers over the Internet to avoid turning to formula (there are entire online forums devoted to the breast milk trade).

Breast milk does have confirmed advantages for the mother (certain cancer risk reductions among them) and child, including substances to enhance a baby's immune system along with fatty acids that support brain development. But their significance may be minimal, and the science is murkier on breast milk's long-term benefits over formula; some recent analyses suggest that breastfed babies may end up ahead because of the privileges associated with the types of households they're in, which are frequently well educated and well off.

Ironically, supporters of breastfeeding in this country are often only supporters to a point — typically a child's first birthday. After that arbitrary cutoff, it suddenly becomes weird. I've been in the weird category for two years now, and no one is more surprised than I. As a young woman, the idea of breastfeeding seemed too crunchy for me, and while I supported a woman's right to do it, I would quickly avert my eyes if I saw it.

That was in the 1990s, when about 60 percent of women gave breastfeeding a try, though far fewer stuck with it; 30 percent were still nursing six months after their baby's birth. Today, thanks to breastfeeding promotion campaigns, nearly 77 percent of American women try it (69 percent in Maryland), while 49 percent continue nursing to at least the six month mark (52 percent in Maryland).

And then there are those of us at 38 months and counting. For my family, breastfeeding was initially about nutrition, antibodies and hoping to give my child a leg up on life. But it grew to be more about comfort for my daughter and closeness, and there has yet to come a point where it feels right to take that away from her, so here we are, still at it.

It works for us. But it doesn't for many other families for many reasons, ranging from supply issues and work schedules to personal choice. And while I recognize that there is still a need to promote breastfeeding today, especially its acceptance in public or its continuance for extended periods of time, it should not be done at the expense of formula. Formula is not the enemy; the debilitating stress over the decision to use it is.

Tricia Bishop is The Sun's deputy editorial page editor. Her column runs every other Friday. Her email is; Twitter: @triciabishop.