Thursday, January 13, 2011

Choice: the conundrum of infant feeding

Should a society let women have choice in how an infant is fed, when that society understands the enormous health consequences of deciding to use artificial milks? There are people who believe that women, particularly women in poverty or women in developing nations must be made to breastfeed. The infant should not be made to suffer because the mother hasn't enough sense to breastfeed. Governments should not have to pay for the infant formula and the subsequent health problems resulting from infant formula use. A few years ago I spoke at a gathering explaining the WIC Program (at that time I was employed by the local WIC Program) and its promotion of breastfeeding. When I had finished speaking, a well-dressed woman came up to talk to me. She wanted to let me know what a good thing I was doing. Which of course, made me feel good, but then she launched into a rant about how women on welfare must be made to breastfeed or be kicked off the Program. I found myself shocked. Shocked that my speech triggered those kind of thoughts. How does one make a woman breastfeed? Do you send an armed guard to watch her every move. Women on public assistance already believe (with some justification) that the government invades their privacy. So the well-off people of the world want people like myself to control women on public assistance. Well, I am not the breastfeeding police, nor are the many who serve these Programs. Should the issue be about women's choice between formula feeding or breastfeeding? Or rather is the real issue a society that creates/markets values that subvert breastfeeding? Our society values the employed mother, because those that don't work have less value in our money-driven society. How do you put a price on the work that women do within the home and in bringing up their children? Despite our supposed female liberation, most women are the caretakers of the children and the home. And now society has determined that we also must be employed to be of value to society. I did home visits to WIC breastfeeding mothers and became intrigued by what this liberation means to young resource-deprived woman. She wants to breastfeed, can't ask for breaks at her place of employment because low paying jobs often have young male supervisors. Most young women refuse to consider discussing their need to pump during employment with a young male supervisor. Often the kind of job these young women had didn't have scheduled breaks: work when its busy, take a break when its slow. At home visits I was taken aback by the fact that often the father of the baby (boyfriend, maybe not father) was unemployed and seemed uninterested in helping with the baby. One shouldn't generalize situations but I remember thinking if this is young people's version of the sexual revolution and women's liberation who in their right mind would want it? Or is it just a woman trapped by a society that has concocted rules that punish single women for having babies? Back at that time, the Florida legislature required that women who received public assistance needed to be employed at 2 months postpartum or lose all benefits. Most of the mothers I met were scrambling to go back to work at 2 weeks postpartum.
Anyway, I found that employment is a risk factor for weaning and weaning early. There is clearly a lack of support and funding to help women in poverty mother their babies. So in these situations are women making a choice or has government programs created the need for the decision to use artificial baby milks?
How do women make a choice to not breastfeed? The mother may decide not to breastfeed because she thinks breastfeeding is "icky." but her body does not know that she has made that choice. Thus, after birth the mother's mammary glands go into full production and she has to actively suppress lactation. What are the ramifications of actively suppressing lactation? She may face a higher risk of breast cancer than the woman who breastfeeds. But we know that people make choices about their biology. We can decide not to walk, to let our legs become useless appendages. But most people would think that pretty weird decision to make, and an enormous burden to their family and society. Who wants to be crippled in life? The same can be said about breastfeeding. We can make the choice to not breastfeed. We can deny our biology. But the ramifications to families and to society run deep, when we decide against using our bodies in the way they function. Handicapped? Yes. But would I want breastfeeding to be mandatory? No, because life ultimately must be lived by the mother not the government, not society. No one can make someone breastfeed her baby, just as no one can make a baby breastfeed. It takes willingness and education of the mother, and most of all a society supportive of breastfeeding. Choice is the illusion.

Another interesting patent regarding the use of lactalbumin (from human milk or a recombinant) to treat bacterial infections and cancer. Patent #7524932 called, "Lactalbumin production process," invented by Catharina Svanborg and owned by Nya HAMLET Pharma AB of Denmark filed in 2006 (same patent filed in 1998 by same inventors, same title, only owned by HAMLET Pharma AB-Sweden)

"A fraction from human milk containing an oligomeric complex, described as multimeric .alpha.-lactalbumin or MAL has previously been reported which has different biological properties to the monomeric form. In particular, the oligomeric complex is reported as having therapeutic applications both in the field of antibiotic (WO96/04929) and cancer therapy (A. H{dot over (a)}kansson et al., Proc. Natl. Acad. Sci USA, (1995) 92, 8064-8068). In particular, the oligomeric form of .alpha.-lactalbumin induces apoptotic cell death in cancer cells and immature cells, but not in healthy cells. These observations suggested that the protein acquires novel biological properties after conformational switching. "

Hm, a human milk component that works like an antibiotic and cancer therapy....pretty darn the choice is between the substance that works like an antibiotic and kills cancer cells versus the substance that continues to have adverse effects? Choice????
Copyright 2011 Valerie W. McClain


  1. The fact is Breastfeeding in America is NOT easy- hospitals get moms off to a bad start often supplementing or giving pacifiers, drugs during labor impede the nursing relationship, inductions done too soon make nursing more difficult, the list goes on. . . Many moms who are not on WIC try to breastfeed and for whatever reason (usually not a valid medical one) end up needing to stop. If so many people who want to succeed at it stop then I don't know how you go about enforcing it among those who don't want to succeed.
    I do think that breastfeeding education should be required in order to receive formula though. People should be required to know the risks that they are putting their baby under if they give them formula. Its okay for mom's to feel a little bad (not necessarily guilty if its not their fault but still sad about it) that their child isn't receiving the best nutrition, whether by their choice or circumstances out of their control.

  2. Lynn,
    Thank you for your comment and your perspective. Birthing in the USA is part of the problem and it impacts all women. My personal view is that birthing in hospitals for the most part has become a travesty, an assault on women and babies. It is no surprise to me as someone who had home births, that breastfeeding is severely impacted by highly technical, medical births.
    I believe that infant formula should only be given out by prescription since the industry is hell-bent in creating an infant formula that mimics drugs (for example adding an insulin acting component as mentioned in my previous post). And that infant formula should have a black box label with the risks labeled on it for the consumer. The ability to buy a product which creates adverse effects (admitted by industry in their patents) should mean more governmental regulation. Adverse biological effects extend to the mother who because she does not breastfeed, increases her risk of breast and ovarian cancers.
    Are moms responsible for failing to breastfeed or has our society failed them? I think the US culture/society has failed mothers and babies. Mothers should not feel guilt over not breastfeeding. Instead they should feel anger over how our society has set them up to fail.
    What are valid reasons to quit breastfeeding? I would suggest that in a mother's eyes her reasoning is valid. We cannot live her life and know what she is up against in her world. For example, I worked with a mom who was on the WIC Program. Her baby was premature and still in the hospital. The WIC Program loaned out an electric pump to her. Contact with her was difficult, she had no phone. Contact with relatives who had a phone, told us that she was at the hospital (one hour away) or they didn't know where she was. We eventually found out that she was not breastfeeding and we asked for the breast pump back. The mother eventually brought it back, in pieces. What happened? The boyfriend, the father of her baby, got angry with her and he broke it. This mother was in an abusive relationship. We know from medical literature that women who are in abusive relationships are more likely to have premature births. Is breastfeeding failure in this case, her fault? the boyfriend's fault? society's fault? WIC's fault? The treatment of women by male partners impacts breastfeeding,too. If a women is fearful of her partner (because of actual violence or perceived violence), birth and breastfeeding are effected. I choose to believe that our culture should bare the guilt of failed breastfeeding not mothers.