Policy Brief
sun897585115
PBSample3.pdf
McKenzie Ramirez
Drop the Bottle Raising the Standards for Infant Nutrition in Colorado A Policy Brief
Drop the Bottle: Raising the
Standards for Infant Nutrition
What’s Average? Discrepancies in Definition and Practice
Common. General. Typical. Normal.
Obese. Sickly. Decreased Mental Abilities.
When did these two strings of words become synonymous? The “norm” for infant nutrition should be based on what is averagely beneficial for an infant’s health. Instead, society has declared that the average type of infant nutrition is the one that allows for the most health break downs. The form of infant nutrition that provides the most protection and benefits for infants is praised as “best” and its administers, “overachievers.” What happened? Prior to the late 1800’s, breast milk was the first choice in baby nutrition. However, with the invention of food sterilization techniques and advances in medicine, formula was successfully advertised to be the best form of nutrition for children. This has had an extremely negative effect on the societal views of, as well as the practice of, breastfeeding (Stevens, Patrick, and Pickler, 35). As modern medicine continues to advance, doctors are beginning to realize that
breast milk has many benefits over formulas such as “less severe cases of diarrhea, respiratory infections, and ear infections” (Department of Health and Human Services, 125).
Righting a Wrong The Harm of Faulty Definitions in Colorado Despite these astounding health perks, according to the 2012 Breastfeeding Report Card released by the CDC, only 87.5% of mothers in Colorado ever attempt breastfeeding even once—earning us the spot of fifth in the nation (McCrimmon). The percent of women who make it the recommended six months exclusively breastfeeding is extremely low at 26.6% (McCrimmon). However, it is this low percentage that has earned Colorado the number one breastfeeding state in the nation in 2012 (McCrimmon).
La Leche League Advocates Education While the medical solution is clear, the social solutions are not so clear. Support is obviously part of the solution—a solution that La Leche League aims to help fix. La Leche League International is a group that provides worldwide support for breastfeeding mothers through support groups, information, education, and encouragement (LLLI). A leader of the La Leche League (aka LLL) of Lakewood support group had many things to say on the topic.
“Frozen breast milk is still
healthier than
formula”
Paulina is also a certified lactation specialist, duela, coordinator for the LLL Mountain Plains region, and works at the Colorado Breastfeeding Coalition. When it comes to the choice of bottle-feeding over breastfeeding, Paulina says, “It’s usually misinformation that’s the problem. Social pressure from the family is hard too. It makes women insecure when they are being questioned—especially if everything isn’t going perfectly.” To avoid guilty and pressured mothers, LLL advocates the spread of information. However, to specifically evade the dangers of viewing bottle-feeding as “acceptable,” a large spread of information and change in mindset is necessitated.
Are There Any Benefits to Being “Average”? Convenience The biggest benefit formula- feeding can offer is time. As time has progressed in our society, mothers have begun to claim the title “bacon-winner” in addition to the traditional “mother” role. According to the U.S. Department of Labor, “In 2010, women represented 46.7 percent of the United States labor force, a slightly larger share than at the start of the recession in 2007” (Office of the Secretary). Breastfeeding can become time consuming, because for the first six months the woman must the sole provider for feeding her infant. This makes it difficult for a mother to be away from her child for any duration of time, especially if she is among the majority of women who work. Of course it makes more sense for the baby of a working mother to be formula fed; with powdered formula fathers, aunts, uncles, grandparents, and siblings can all pitch in and help feed the new family member. What most women do not realize is that breast
milk can be available on-the-go as well. According to The BabyCenter Editorial Team, “It is generally accepted that you can refrigerate breast milk for three to five days and freeze it for three to six months” (The BabyCenter Editorial Team).So, it is possible to be a working mom and breastfeed! The Editorial team goes on to caution mothers not to freeze the milk if it can be used within three to five days because freezing milk will destroy some of the antibodies contained in the milk; however, the team is quick to add that, “frozen breast milk is still healthier than
formula” (The BabyCenter Editorial Team). Sense of Ease When a woman has her first child, it is easy to become frantic every time the baby cries. Paulina from La Leche League believes that societal pressures add even more fuel to this frantic fire, “In the
1950’s we had a generation of women who were told that formula was better. Those are mothers and grandmothers of the new mothers today, and it’s hard not to be influenced by that kind of advice. It’s hard to keep breastfeeding when the women you trust are asking you, ‘Is the baby getting enough milk? He’s crying, and are you sure he’s getting the right nutrients?’” While it’s not true that a woman can’t support her child with her breast milk, a crying baby and a judgmental audience often cause women to jump to conclusion that prevails as the most widespread myth of today: I don’t have enough milk. Once this conclusion is reached, it’s a matter of moments before the switch is made to the never-ending-supply of formula. According to Paulina, a mother’s milk supply can take time to build up, but after a couple of days trying to nurse, the mother should be producing enough milk for her infant.
Social Acceptance Other than time and a sense of ease, bottle- feeding is a more socially acceptable past time than breastfeeding. According to Tonse Raju, MD, “In some parts of the United States, a woman waiting for a bus and breast-feeding her 6-week-old son could be arrested for violating “public indecency” laws;; however, if she unzipped her bag, pulled out a bottle, and fed her son, she would be performing a perfectly decent act” (Raju). A recent survey of University of Denver students show that students, too, associate breastfeeding with a sense of “indecency.” In two different questions, when students were asked how appropriate they found breastfeeding and bottle feeding, 53% of the 59 students surveyed rated breastfeeding in public positively, while 22% of students rated breastfeeding indifferently, and 25% of students rated public breastfeeding negatively. This seems positive until it is compared with its partner question; 93% of 59 students surveyed decided that it was appropriate to bottle-feed in public, 7% of students were indifferent to public bottle- feeding, and 0% were against public bottle- feeding. A comparison of the two figures is provided in Figures 1 and 2. Although it is disheartening that society puts so much negative pressure on breastfeeding, there are other publically accepted methods for breastfeeding in public. The first method was a suggested option for the “time” issue: pump and store milk. Carrying a bottle full of breast milk looks no different than a bottle full of formula. Mothers can also carry a feeding shawl—which is basically a glorified blanket—or wear a camisole under a shirt to provide discreet feeding. If these are still too public, most public
buildings will have lactation rooms, but hopefully, mothers will be confident enough in the positive decision they are making for their baby that they will be able to breastfeed publically without shame.
The Very Short of It In short, the only benefits that result from bottle-feeding are the benefits of convenience, a sense of ease, and a higher level of social acceptance. None of the benefits are positive for the health of the baby--only the mental state of the mother. In addition, the problems that drive mothers to bottle-feed are the result of a lack of information or misinformation about breastfeeding. By putting in a little more time and effort, the standards of children’s lives everywhere can be raised.
The Overachievers What “Average” Can’t offer
For those “overachieving”
moms who choose to breastfeed, medicinal research and studies have discovered that there are quite a few perks. Breastfed babies have a head start on fighting off viral and bacterial
diseases. An infant’s immune system is not fully developed until he or she reaches the age of two (Department of Health and Human Service). Within milk there are several “immunologic agents, such as secretory antibodies, leukocytes, and carbohydrates,” that provide breastfed children protection that formula fed infants do not receive (Department of Health and Human Service). In addition to sustaining a child until his or her immune system develops, breast milk also helps “kickstart”
Figure 2: Results of survey measuring appropriateness of bottle-feeding.
Figure 1: Results of survey measuring appropriateness of breastfeeding.
Mothers Who Should NOT Breastfeed
1. HIV-infected Mothers
2. Mothers with T-cell leukemiavirus type 1: (HTLV-1)
3. Hepatitis C-infected Mothers
4. Mothers on Illicit Drugs
5. Mothers who have Infants with Metabolic Disorders
6. Tobacco Consuming Mothers
7. Excessive Alcohol Consuming Mothers
8. Mothers with Primary Lactation Failure
the development of immune system. Human milk contains factors—like anti- inflammatory factors—that “regulate the response of the immune system against infection” (Department of Health and Human Service 125). Animal substituted milk does not contain resistance to human specific diseases, although sometimes the presence of foreign immunologic agents are enough to protect children against infection. Formula fed children do not have even this basic level of security. In a study meant to equate formula-fed infants with breastfed infants, Aline Andres, PhD, stated that, “Breast-fed children have a slight cognitive development advantage over both soy-based and milk-based formula-fed infants, but formula-fed children are within normal limits on standardized tests” (Zacharyczuk). If formula is made to equal breast milk—the brand Similac states in their advertising, “Closer than ever to breast milk”—why does society hold infant nutrition to the substitute’s level?
A Word of Caution When “Average” Is Best Of course, there is no perfect solution to a problem and there is always an exception to the rule. According the Department of Health and Human Services, there are several instances when breastfeeding becomes hazardous to
infants (Department of Health and Human Service 127-129).
Environmental Toxins While environmental toxins have been noted as a cause to bottle-feed over breastfeed, mothers living in environmentally toxic environments are exposing their child to toxins by their choice of habitation. Breastfeeding a baby exposed to toxic environments, such as polychlorinated biphenyls, DDT, or dioxin, will still give the baby a better immune system. The best choice for the baby’s health is to move. However, if a mother was previously exposed to an environmentally toxic environment and the baby’s current living situation is not, it would be best not to breastfeed the baby.
Not-So-Fun Fact
There has been a recent concern about the “presence of bacteria, in particular Enterbacter Sakazakii, in powdered infant formula milk”
(Forsythe).
Allergies It is nearly impossible for a newborn infant to be allergic to his or her mother’s milk unless the baby has a metabolic issue mentioned above. If a child expresses an allergic reaction to his mother’s milk, it is more likely that the child is allergic to something in the mother’s diet than the milk itself. This can be fixed by having the mother change her diet to locate the infant’s allergies and alleviating them. Primary Lactation Failure Primary lactation failure only accounts for 4% of women despite the familiar story of “my milk never came in” (Brodesser- Akner). Primary lactation failure, as opposed to secondary lactation failure, characterized women who never were able to produce milk. Secondary lactation failure describes women who were once able to breastfeed, but then ran into problems. Secondary lactation failure is more often than not solvable, but primary lactation is failure is one of the acceptable medical reasons to not breastfeed. Reasons for this rare malfunction include glandular tissue problems, malformed breast-shape, prior breast surgery, and Sheehan’s syndrome (Brodesser-Akner, 1). Sheehan’s syndrome is a condition where a woman suffers a post- partum pituitary shock. (Brodesser-Akner). As the pituitary gland controls hormones, it also controls breastfeeding, and severe stress to this gland can negatively affect breastfeeding. Despite the medical validity of this problem, primary lactation failure is still extremely rare. Generally, women are misinformed of their ability to feed.
The Poison in the Bottle Risks of Formula Feeding Because breast milk protects against many infections and illnesses, being a formula fed child increases the risks of catching an illness. In fact, if just 90 percent of the families in the U.S. complied with recommendations and exclusively breastfed for the first six months of life, the U.S. would save $13 billion a year” says Jennifer Dellaport, the Colorado Health Department’s breastfeeding specialist (McCrimmon). This massive sum stems from many extremely disastrous, but fairly rare, diseases—such as necrotizing enterocolitis—as well as the top three indicators of a breastfeed child: asthma, diabetes type 1, and obesity.Along with the money, 911 lives—mostly infants—could be saved. Therefore, by picking up the bottle, mothers are unconsciously rolling the die on their children’s lives.
Obesity Has the Odds Of course, one of the most talked of risks is the correlation between breastfeeding and obesity, but why is obesity a result of formula feeding? First, as mentioned before, breast milk is species specific. Cow’s milk encourages rapid body mass growth, and is
a major component of formula ("Formula Feeding and Obesity”). Thus, infants on formula are stimulated to produce too many fat cells. Next, breastfeeding is appetite driven. With breast milk an infant chooses when he is hungry, works for the food he gets, and stops when he is full. Formula feeding is schedule driven, and often a baby is not hungry when he or she is presented with the food. It simply becomes habit to eat when food is presented—a habit that carries throughout his or her life. Lastly, leptin and ghrelin are hormones in breast milk that control appetite. They stimulate pathways in an infants’ stomach to help teach him when he is full. These are not present in formula, and have long-term detrimental effects.
Put Down the Bottle “Benefits” versus “Risks” As shown by this paper, breastfeeding is more beneficial to an infant’s health than bottle-feeding. The conundrum is that society allows the standards for infant nutrition to be based off of the substitute perpetuated because of convenience. What is desperately needed in this moment is a change of viewpoint. Allowing bottle- feeding to be viewed as “average” provides a larger acceptance of the less-than -stellar substitute. Instead of viewing the situation as breastfeeding coming with “benefits,” one should consider the situation of having bottle-fed children at “risk.” Instead of breastfed children being at an advantage, bottle-fed children are at a disadvantage. To achieve this massive change in mindset, several changes must be made—including a change of vocabulary. Spread the Hate Like many problems, the solution to breastfeeding over bottle-feeding lies in the information the public has access to. In a
recent survey of University of Denver students, 97% of students acknowledged that breastfeeding was better for infants, but only 26% even considered that formula could be detrimental. This shows that “pro- breastfeeding” movements are doing a fantastic job of spreading the news of the benefits of breastfeeding, but they aren’t particularly motivating the population to abandon the “norm.” By spreading anti- bottle-feeding information instead of pro- breastfeeding information, a change in mindset about child nutrition could be accomplished.
Presenting the “anti-formula” information as early as high school in nutrition classes could be useful. Even a half hour presentation for all four years would plant the idea in students’ minds. Adding the information again in college nutrition
What can Colorado mothers do?
Do the Research. Breastfeeding mothers can face opposition from friends, family, and the public. Make sure you have the facts to feel secure.
Pick the Right Hospital. While there are only three “baby-friendly” hospitals in Colorado, 35 out of 52 hospitals do not give formula care packages (McCrimmon). Find the hospital to support you.
Find a Support Group. Breastfeeding is made easier with the support of those who understand your decision. Find a breastfeeding support group near you to help you stick to your decision.
Ask Questions. No breastfeeding experience is the same, so don’t be afraid to ask questions.
La Leche League of DU Students Will: Educate the Masses: To effectively
spread information about formula’s dangers, the LLL if DU will design pamphlets that target the negatives of formula instead of the positives of breastfeeding. We will then distribute these pamphlets to high schools, college nutrition and health classes, and doctor’s offices where the information will be the most effective.
Form Alliances: To reach more people, LLL of DU will need to form alliances. The La Leche League International is a given, but a partnership with DU’s “Health Pioneers” club could be equally beneficial. This connection would be used to hold information nights and sessions about the risks of formula.
Provide Support: To provide optimal support for breastfeeding mothers, LLL of DU members will research support groups for breastfeeding—including times and locations—and distribute them to non-Baby- Friendly hospitals. As a personal commitment, members promise to defend breastfeeding mothers in conversation and in public.
Endorse Encouragement: As students, there are some battles LLL members cannot fight. However, we can encourage others to fight for us. Therefore, we will write. First, we will write professors and nutritionists letters advocating “anti- formula” lessons in college and high school nutrition classes. In addition, we will write Baby-Friendly hospitals to sponsor breastfeeding classes before birth that mirror Lamaze classes.
classes could motivate mothers-to-be to make the best decisions. The La Leche League is a fantastic support group that is often heard of too late in the breastfeeding game, so spreading the knowledge of its existence beforehand could be key. Much like general parenting and birthing classes, a breastfeeding class before birth would provide mother’s with knowledge of the problems they might face, and how to combat them. This way, mothers are more likely to continue breastfeeding.
Pick Up a Pen and Arm Infants with an “Average” Future La Leche League of DU—Our Mission To show our support in the battle between breastfeeding and bottle-feeding, the University of Denver needs to create an “anti-bottle” group. This group would be considered an offshoot of La Leche League, and would be known as the La Leche League of University of Denver. It would be tasked with furthering knowledge skills, but what we need most is students willing to make a difference. In our efforts to change society’s ideas of “average” infant nutrition, students will perform many duties.
Pick Up a Book Additional Reading
“The Womanly Art of Breastfeeding” by Diana West Find “Baby-friendly” hospitals: http://www.babyfriendlyusa.org Find a support group near you: http://www.llli.org/
Works Cited
Brodesser-Akner, Taffy. "The Breastfeeding Conspiracy." Babble RSS. Disney, 18 Jan. 2010.
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Forsythe, Stephen J. "Enterobacter Sakazakii and Other Bacteria in Powdered Infant Milk
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McCrimmon, Katie. "Colorado No. 1 for Breastfeeding in First 6 Months." Health Policy
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Office of the Secretary. "Women's Employment During the Recovery." DOL Special Reports.
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Raju, T. "Continued Barriers for Breast-feeding in Public and the Workplace." The Journal of
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The BabyCenter Editorial Team. "How Long Will Breast Milk Stay Fresh for My Baby?"
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Zacharyczuk, Colleen. "Formula as Good for Breast-milk for Cognitive Development."Infectious
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