He's done it again. New York mayor, Michael Bloomberg, has made the headlines for his extreme measures to control the behavior and limit the choices of his constituents through nanny-state policies and programs. While some could argue that the salt and trans fats bans have a direct impact on consumer health and there are many potential benefits, the latest measures reek of pure idiocy. I wrote previously on how ridiculous I felt the soda ban was. Another absurd ban is the donation of foods to homeless shelters because the Department of Homeless Services cannot measure the nutritional content of donated food- or in other words, it may contain too much salt. Now it seems that the brazen Bloomberg is reaching even further into the private lives of individuals. It is a true war on women (unlike the war fabricated by proponents of the PPACA that included free birth control). 

The program to "encourage" new mothers to breastfeed is set to begin in September and affects New York hospitals.   It begins with “ 'the city keep[ing] tabs on the number of bottles that participating hospitals stock and use' " (3). Then it outlines that new mothers who want formula for their babies must wait for a nurse sign out the formula like a medication. Not only must mom ask and wait, but she must then sit through a lecture about how breastfeeding is the better option each time she receives a bottle. I am sure this "mandated talk" will be generic and scripted by someone beforehand.  Most likely, it will be the same information that she has encountered throughout her maternity care and in advertising. But it does not stop there. To make this measure even more sinister, the hospital staff must document a medical reason for providing the formula. Granted,  "The New York City Department of Health and Mental Hygiene...is strongly encouraging — though not yet requiring —" this new program (3). My question is how long it will be before it becomes mandatory, and what if any provisions are set for those who have exetenuating circumstances.

There are several reasons I question Bloomberg's motivation and reasoning. First of all, breastfeeding statistics for New York City mothers would indicate that the majority do breastfeed initially. According to an article by Lauren Swanson from a Kansas news station,"Ninety percent of new moms in New York breast feed exclusively at first, but only 31 percent keep it up past the first 2 months" (7). Therefore, one has to wonder if 90% of new moms breastfeed, then why is there such a push to restrict formula in the hospitals. Another question to consider is why the percentage drops so significantly after 2 months. Is there any evidence that clearly demonstrates how this initiative addresses the second statistic? It would seem an illogical conclusion to assert that restricting access to formula in hospitals during the first days of life will greatly affect the outcome of the number of mothers who breastfeed 2 months later. (It is recommended that mothers breastfeed for at least the first 6 months of life.)

Besides the outward appearance of an effort to promote and encourage breastfeeding, I also believe there is a hidden motivation. According to Micheal Tennant from The New American, "A near ban on infant formula is, it seems, the ultimate objective of the United Nations. Its World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) launched a program called the Baby-friendly Hospital Initiative (BFHI) in 1991 with the express purpose of getting governments the world over to promote heavily, if not mandate, 'exclusive breastfeeding from birth for 6 months, and continued breastfeeding with timely and appropriate complementary feeding for two years or longer' ” (3). I skimmed through the BFHI (4) and found that the initiative by Bloomberg does indeed fall into some of the guidelines set forth in this document. I can only concur with Tennant's statement that "Bloomberg’s program — which, according to the Huffington Post, is “sponsored by” the WHO — represents just the tip of the iceberg" (3).

Proponents of the program argue that it will foster breastfeeding. According to Lisa Paladino of Staten Island University Hospital: “The key to getting more moms to breastfeed is making the formula less accessible. This way, the RN has to sign out the formula like any other medication. The nurse’s aide can’t just go grab another bottle” (1). The National Alliance for Breast-feeding Advocacy also claims that it is a good program because,"... keeping baby formula under lock and key, like medicines are kept, helps prevent hospital staffers from reaching for a bottle first, instead of encouraging new mothers to nurse their babies"(5). Both statements imply that there is laziness on the part of medical staff, perhaps even some measure to discourage breastfeeding. In May, when he introduced Latch On NYC, Health Commissioner Thomas Farley said, "Human breast milk is best for babies and mothers...With this initiative the New York City health community is joining together to support mothers who choose to breastfeed” (2). His statement would indicate that there is not currently a support system for mothers. On the other hand, a commentator in a CNN video states that, "Just want to make it a little more difficult and put an extra step…you want to have the mom think about the choice" (8). This statement would imply that new mothers are not aware of their options and have not thoroughly considered their choice. All of these statements imply that hospital staffers and mothers lack the proper knowledge to make a decision about whether or not to breastfeed; they lack the support of the community; and they are simply too lazy to commit to breastfeeding. That is an oversimplification at its worst and highly insulting to all of the mothers who make conscious, educated decisions and the professionals who provide supportive, compassionate care. As Tennant states,  "A mother’s choice not to breastfeed, on the other hand, will not be supported" (3). 
Being a mother of two, I can draw from personal experience to see how invasive this initiative is. I know what it is like to feel pressured and judged. I know the overwhelming guilt and worry a mother faces when she has to make decisions that may not be the popular choice. Not only have I experienced these things, but I have experienced them at two very different periods in my life in two very different sets of circumstances.

I was only 20 when I had my son. Although I was young, I was excited and fully embraced the responsibilities of motherhood. Throughout my pregnancy I read voraciously on the topics of pregnancy, childbirth, and infant care. I asked my doctors plenty of questions, referred to advice from loved ones, and gathered books and pamphlets educating myself as much as possible. This was in 1993, so I did not have the Internet for reference, but there was a wealth of information available to me regardless. At the time, breastfeeding was strongly encouraged, and I fully intended to start that way. Unfortunately, other factors came into play, and I was only able to nurse my son for 3 weeks before I switched solely to formula. Now many would argue that I faced tremendous circumstances, and that this initiative is not geared for women in that position.  I hesitate to relate my experience knowing that. Nevertheless, they are so many factors that I think too many people do not understand, any one of which is important and not taken into consideration by a majority of those who advocate blindly for such policies. 

First of all, my son was breech; therefore, I had to undergo a c-section. That in and of itself is no easy task as any mother who has had one will testify. It is painful and can have many lasting effects, some of which may make breastfeeding uncomfortable and difficult. To add to it, my son was born with myelomeningocele, a form of spina bifida. The nerves on his lower spine were completely exposed, which required surgery within a few hours of birth. Therefore, not only was I not able to hold him, I did not even get to see him except for a brief moment to touch his foot. With, and because of, the support of hospital staff, I did use a pump while I waited for word on the outcome of the surgery. When I was finally able to breastfeed him, it was in the NICU. Once again, I had the full encouragement and support of the nurses and staff. Unfortunately, my son had difficulty latching on and was not gaining enough weight. I had to supplement with formula for my son's survival and well-being. It was especially crucial because he then developed hydrocephalus and had to undergo another surgery when he was 1 week old. It was crucial that he weigh enough to survive the surgery. The entire two weeks that my son was in the NICU the staff provided me with plenty of support, privacy, and encouragement in breastfeeding and caring for my son. What made it even easier for me to be independent and bond with him was that I had the ability to feed him on my own. Yes, I was able to nurse him, but I was also able to access formula myself so that I could make his supplemental bottles. It was one of the few things that gave me comfort during that difficult period. I did not have to listen to speeches about how I should try harder or focus on breastfeeding. I did not have to rely on a nurse to bring me formula. I did not have to feel embarrassed or pressured. Despite a rough start and often having to rely on a pump, I did continue to breastfeed my son when I brought him home. Nevertheless, it was extremely difficult and stressful as we could not ease into a feeding schedule, and he teetered between maintaining and losing weight. The third week of his young was filled with hours spent traveling and waiting because every day we had to visit different doctors: a pediatrician, the neurologist, the orthopedic specialist, etc. At the end of that week, knowing that many more months would continue in the same way, I decided to stop breastfeeding. I knew all of the benefits of continuing, but I had to weigh my own personal feelings and the stresses we were to endure. I felt an immense amount of guilt and pressure to continue, but I was mentally and physically exhausted. I just could not do it.

I will grant the fact that the majority of women do not experience what I did with my son. One might argue that there were extenuating circumstances well beyond my control, which is true. But that does not diminish the immense pressure I felt to breastfeed him, or the immense guilt I grappled with when I quit. That is part of the reason why when I became pregnant with my daughter 15 years later I was determined to breastfeed her for as long as I could. Fortunately, everything progressed "normally," and I was able to deliver her naturally. She was a healthy baby, and I was able to see and hold her immediately.  Once again, the hospital staff were very supportive of my choice to breastfeed. My husband and I attended a class for new parents, and we read literature and followed advice. It took her a couple days to latch on fully, but we did not despair and continued trying. The first month she was not gaining weight as she should, and the pediatrician recommended that we consider supplementing. I thought about this for quite a while, but when I admitted that she was still hungry after nursing I conceded that we needed to do the right and best thing for her. So we began to supplement her feedings with formula. I always breastfed her first and then allowed her to feed from the bottle afterwards. She took to both and began thriving. It was when she was around three months old that I noticed she needed more and more formula. Once again, I felt an overwhelming amount of worry and guilt. Had I made the wrong decision to supplement? In doing so, had I made her more reliant on formula? Was she beginning to reject breastfeeding for the bottle? In a relatively short time I had my answer. The reason had nothing to do with any of those factors. It had to do with me. I had become hypothyroid, and quite simply, my body stopped producing breast milk. By the time I was diagnosed and began taking medication, it was too late. 
The sad part about all of this is that it puts an extreme amount of unnecessary and unfair pressure on women who have educated themselves about the options and made a clear choice.  Many people arguing in favor of the initiative cite reasons why breastfeeding is the best choice (clearly not what should be the focus here) and throw out false and ridiculous generalizations about mothers who choose not to breastfeed such as they are not educated enough, formula manufacturers sway them with swag and advertising, or that they are being coerced into using formula. Also the assertions that nurses are too lazy to support breastfeeding mothers and circumvent the process by offering babies bottles instead is pure fabrication. 

It astonishes and baffles me how many stood up and claimed it was a war on a woman's right to choose when anyone objected to provisions for free birth control and the mandate on Catholic institutions to provide it set forth in the PPACA , yet they do not argue that this is an infringement on a woman's choice. It seems that it is acceptable when Bloomberg and other organizations attempt to coerce individuals by limiting access and adding undue pressure. It also leads to judgment against mothers who choose to bottle-feed their babies at a time when all mothers should be encouraged and empowered to decide for themselves what works best for them. (If you don't believe that there is judgment and pressure out there against mothers who choose not to breastfeed, read Stephanie Wilder-Taylor's blog entry In Defense of Formula. Be sure to read all of the comments at the end as well.)

On a final note, I think every American should be concerned with this new trend by Bloomberg and the nanny-state. How many other officials will follow (or at least attempt to) in Bloomberg's footsteps? Will it stop with this initiative or is this just the beginning? Will mothers in the future who are unable or choose not to breastfeed be required to use surrogate breast milk? Will they be required to hire a wet nurse? After all, why should one stop short of restricting access to formula? Why not just outlaw it altogether? Maybe I exaggerate, but who can predict the limits of tyranny? 

eddie coleman
1/27/2014 10:35:13 pm

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    Who am I? Just an average woman living an average life. There are many labels I would use to define myself: mom, wife, daughter, student, educator, American, etc. I have no professional experience nor am I claiming to be a writer. Sometimes I am brushing up on some skills I will need when I return to academia, and sometimes I am just sharing or venting.  


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