A Peek Into the Past: Breastfeeding, Formula, and Hospital Politics

Once upon a time, Miriam and I wrote a book. And in that book, we had over 400 pages of material. Our vision, however, was to give new and expecting moms a nursing companion–a book they could hold in one hand. So we snipped. And trimmed. And cut. It’s hard to say no to hundreds of hours of work, but thankfully, all’s not entirely lost. We’re bringing you some of our largest unseen sections from TOBB, in a series of blog posts.

“A Peek into the Past” is a pithy round-up of our societal evolution of parenting practices, mostly in the U.S. You’ll learn about the history of birth, baby-wearing, breastfeeding, potty training, co-sleeping and more–eight posts for our eight chapters. Enjoy, ask questions, and share with friends! ~Megan

Let’s head back to sixth grade science for a second. Remember those classification lessons: Kingdom, phylum, class? As humans, we’re part of the Mammalia class. That means we have backbones (literally, though not always figuratively), birth live young, breathe air, grow hair, and have mammary glands, hence the name. These mammary glands are responsible for producing milk to feed our young. Breast comes from the Latin word “mammary.”

It helps to know our biological purpose when we consider just how far we’ve strayed. Breastfeeding advocates aren’t just spouting off some “hippie ideology.” They remind us what our breasts were created for. We were made to nurse our babies. Whether women choose to nurse their babies or not is a different story, but that’s why the girls are here.

In colonial times, if a woman was unable to produce milk for her baby, her only option was to find a nursing mother – often a cousin, sister, or aunt – to feed the baby. Upper class women usually chose to feed their children by  hiring a “wet nurse,” since breastfeeding was considered improper. Most non-breastfed babies were fed cows’ milk or prescribed homemade mixtures of evaporated milk, sugar, corn syrup and water.

Scientists in the 18^th century invented a new option for infant feeding. Formula was great news for institutionalized babies, many of whom ended up with gastroenteritis from contaminated cows’ milk. But formula was bad news for previously healthy, breast-fed babies. Manufacturers produced and marketed this artificial food en masse, and doctors and parents viewed the chemical substitute as an acceptable alternative to human milk.

Formula Rising
Beginning with a debut in the 1800s, formula companies have run one of the most successful anti-public health campaigns in the history of the world. The formula industry is currently worth billions of dollars. And the ill-effects of this chemical food product cost us billions as well. One study estimates that the U.S. could save $13 billion a year in health care dollars if moms chose breast over bottle in the early months.[i] The formula empire’s marketing strategies undermine women’s ability to provide for their babies by implying that infants need more than just breast milk for optimal health and nourishment. Another dangerous — and false — message is that the chemical makeup of artificial formula is very close to breast milk.

As the formula empire grew, it lured pediatricians on board. A steady flow of free samples brought income to pediatricians via mothers seeking “doctor recommended” formula and feeding advice. Samples in doctor’s offices also provided free marketing and endorsement from credible professionals. Formula companies didn’t stop there. Giants like Nestle and Enfamil also sponsor infant nutrition research and conferences that keep doctors informed of their “research.” How’s that for scientific bias? On top of funding research, some formula companies have built entire maternity wings for “free,” ensuring mother-baby separation and greater likelihood of formula introduction for new babies.

As male obstetricians began delivering babies in the 20^th century, the locus of control was transferred from mama to man. Technology determined birth outcomes, and nursing was replaced by powdered milk as infants slept in plastic boxes instead of mothers’ arms. Babies spent more hours in nurseries than with mom, due to “expert” recommendations of rigid schedules and regimented care. Women who tried to nurse were set up to fail, as they only saw their babies after long intervals, and our bodies weren’t designed to make milk in that manner.

Thanks to marketing dollars well-spent, upper class women opted for a new “status show:” formula. Nursing was associated with lower class. Little support was given to women who wanted to nurse their babies.

Another nail was hammered into the nursing coffin: the sexualization of breasts. Thanks in part to a 1950s boom in pornographic magazines, the primary function of breasts was lost in the public consciousness. Anyone who has witnessed a deleted Facebook picture of a woman nursing, only to be bombarded with scantily clad women in their newsfeed. Parity, thy name is not Facebook.

To add insult to injury, motherms who birthed in hospitals were sold out by their caregivers. Though OBs and delivery nurses should have known better, they offered new moms “choices” – sharing the pros and cons of nursing versus formula-feeding. Formula companies made this their decision easy, handing out free samples and brochures boasting a “proper” alternative to breast milk. The healthcare community went on the defensive – touting benefits of mama’s milk rather than sharing dangers of formula.

Formula has been recalled many times, with some incidents of contamination accidental, and some profit- motivated. In 2008 a major U.S. formula recall was due to widespread contamination by melamine, a substance that, according to the Material Safety Data Sheet, is “harmful if swallowed, inhaled or absorbed through the skin. Chronic exposure may cause cancer or reproductive damage.”

The Tide Turns

Some positive trends gained traction in the 1950s. At a time when most women were hoodwinked by the powerful formula industry, a small but vocal group of mothers and doctors began to chip away at poor medical advice and social stigmas around breastfeeding. Peer reviewed articles on the importance of breast milk and benefits of nursing were published. Mother-to-mother support groups like La Leche League popped up around the country. Surprisingly, the feminist movement of the 1960s, which sent hordes of women into the workforce, had little impact on breastfeeding. Numbers continued to rise. Grassroots efforts brought the breastfeeding rate to a 20^th century all-time high in the 1980s: 61.9%. But rates dropped again shortly after, likely due to an economic downturn which sent more mothers to work, and ramped up formula advertising.

Despite increased mother-baby nursing pairs, mid-century breastfeeding was widely considered inferior to formula and improper, so medicine found a way to end milk production. Bromocriptine shots were often given automatically in hospitals during the 1960s and 70s to dry up mothers’ milk. In 1994 the FDA banned bromocriptine due to risk of cancer and stroke.

By 2009, 74% of U.S. women initiated breastfeeding after birth. While this number seems high, three months later, only 35% of babies were still exclusively breastfed. At six months, the ­optimal time for exclusive breastfeeding according to both the World Health Organization (WHO) and the AAP, just 15% of babies are exclusively breastfed.[i] Mothers nursing toddlers? A slim minority: only 8% of mothers are breastfeeding at 18 months, despite the WHO’s recommendation of 2+ years.

Still, nursing is on the rise, with most moms trying to nurse their babies immediately after birth. Advocacy groups, breastfeeding organizations, and some passionate caregivers and individuals often agree: clear goals to enhance moms’ and babies’ wellbeing includes increasing both support for moms who wish to nurse their babies, as well as public awareness about the ways that formula can harm newborns’ developing systems.

What do you think it will take to put mothers and babies ahead of formula companies?

Want to read more? Check out The Other Baby Book on Kindle or in paperback.