On My Soap Box

Tessa, age 2, breastfeeding her baby.

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In some of my other lives (yes, I am sort of cat-like) I advocate for childbirth and breastfeeding issues. When I heard a caller being given some sketchy advice today on the radio, I had to jump on my booby-bandwagon and send in a letter. The last time I did something like this, I ended up doing a monthly appearance on our local morning TV show about childbirth and prenatal health. I don't expect this letter will even get read by the host of the show, but maybe someone here will read it!

(Ignore the funky formating at the end).

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Dear Mr. Howard,

Let me first say how much I love and respect your life’s work and your show. I appreciate all that I learn from you and I listen regularly. I must say, though, that today you stepped out of your area of expertise to give some rather unpleasant and inaccurate advice, and I was hoping to help provide you with the facts.

Today you recommended a new father-to-be to “invest” in a cheap can of generic baby formula to take to the hospital when they go to have their baby. Your goal was to help him to avoid the expensive hospital promoted brands that are frequently pushed on mothers, because, as you put it, not everyone can breastfeed.

I want to address a few things here. First, as a doula (trained birth assistant), childbirth educator and mother who has breastfed for over 10 years of my life, I believe that more sound financial advice could have been given to this father-to-be. But to begin with, most women can successfully breastfeed. It is a dissemination of misinformation to imply that failure is so likely that families should come to the hospital prepared for it. In fact, in certified “Baby Friendly” hospitals, formula giveaways are now being banned because of the message that they send to healthy, capable women, which make up the outstanding majority of birthing mothers, that they cannot successfully breastfeed.

Breastfeeding, when well supported, should be pointed out as the only free or nearly free option for infant feeding available. Appliances such as breast pumps are not necessary unless a family chooses to pump milk to fit into a particular lifestyle (for example, working mothers or mothers who choose not to feed in public). Excellent pumps may be rented, and are often covered by a woman’s health insurance. Inexpensive but very effective hand pumps may be purchased for about the cost of 1-2 cans of formula.

One year of formula for one infant can cost between $700 and $3000, the current average being $1,200. However, the greater costs to a mother’s and baby’s health must be added to the calculations. According to a study cited at http://pediatrics.aappublications.org/cgi/content/full/103/4/S1/870 , the health care costs for never-breast fed infants for doctor visits, medications and hospitalizations cost the managed health care system between $331-$475 over breastfed infants in the first year of life. One must add to this cost the lost wages of maternal absenteeism when working mothers must stay home from work to care for a sick infant. Studies show infant health issues that breastfeeding can protect against include eczema, middle-ear infections, lower respiratory tract infections like pneumonia, asthma, type 1 diabetes and sudden infant death syndrome (SIDS). (http://www.reuters.com/article/idUSTRE6342ZG20100405). In a 1995 study by Kaiser-Permanente Health Maintenance Organization in North Carolina it was found that formula fed babies' annual health costs averaged over $1400 more per infant than their breastfed counterparts. (http://www.breastfeeding.com/reading_room/what_should_know_formula2.html)

This is not the only cost, however, as studies show that maternal health is improved by breastfeeding, including reduced rates of osteoporosis, uterine, breast and ovarian cancer, lower rates of diabetes, high blood pressure and high cholesterol - all known to cause heart disease. In other studies, women who had breastfed their babies for more than a year were 10 % less likely to have had a heart attack, stroke, or developed heart disease than women who had never breastfed.

(http://www.upi.com/Health_News/2009/04/21/Breastfeeding-helps-mothers-health-too/UPI-41491240348466/). The cost savings over a lifetime has not yet been effectively calculated, but is undeniable.

While it is true that all infant formulas in the US are regulated by the FDA and required to contain certain basic components, perhaps more sound financial advice than encouraging someone to buy cheap formula to feed their babies in order to save money would be to first enthusiastically encourage breastfeeding. Financially speaking, the best preparation for a new family would be to locate excellent professional breastfeeding support from a trained Lactation Consultant (LC) prior to their birth, the cost of which varies between free (through La Leche League, WIC, Birth and Beyond and other local community breastfeeding support agencies) to $75-$150 per hour. Most breastfeeding problems can be resolved in 3-4 visits from a lactation consultant. While most women can find this support for free, the cost of breastfeeding support would equal the amount spent on formula in just a month or two.

In an attempt to appeal to your money sense, I have not focused on the many other priceless psychosocial, emotional, societal, and environmental benefits of breastfeeding. I hope in the future you will encourage breastfeeding as the first and best financial option for callers making plans for their future families. People trust you and will certainly take your advice for better or for worse. Let’s make it for better!

Best wishes,

Laine Holman

ICAN of Sacramento

DONA certified doula

Mother of 4 and one on the way.