REASONS AMERICAN WOMEN WON’T BREASTFEED
100 YEARS OF PRECEDENT
Originally, synthetic formula was meant as a more-nutritious alternative to animal milk for infants whose mothers had died in child birth or otherwise were not available to breastfeed. By the late early 1900s, commercial formula brands were marketing their powders in women’s magazines. “Mothers were told they needed formula to create more milk, or to rest or exercise — a lot of incorrect recommendations,” according to Marsha Walker, executive director of the National Alliance for Breastfeeding Advocacy.
In World War II, more women entered the workforce. At the same time, the conception of a “scientific motherhood” took hold, Ms. Walker said. Motherhood, like production, became very regimented. “You can decide when your baby naps or when you pick it up,” Ms. Walker said, “but breastfeeding can’t be regimented.”
Today, formula is a convenience — often a necessary one — for mothers who work outside the home. According to the latest Bureau of Labor Statistics numbers, the labor force participation rate for mothers with infants is 57%, up from 53% in 2004. The U.S. is also one of few developed countries that has no guaranteed paid maternity leave, making the choice to return to work more necessary.
While federal law gives women a time and place to pump breastmilk, work often makes it difficult. Laurence Grummer-Strawn, chief of the Nutrition Branch at the CDC, said this affects low-income women the most. “An executive who has an office doesn’t need a special room for expressing milk; she can just close the door,” he said.
Race and income are major predictors of whether a woman will exclusively breastfeed for six months. The highest rate of breastfeeding is among wealthy whites. Meanwhile, women with low incomes are often financially compelled to quickly return to the workforce. The jobs of low income women are also less likely to offer paid maternity leave.
Whether a woman breastfeeds or not greatly depends on whether her friends, family and community do so.
More than half of infants born in the U.S participate in WIC, a program that helps low-income new mothers afford food, whether they choose to breastfeed or not. Despite pro-breastfeeding campaigns that have lessened the organization’s formula dependence, WIC still is responsible for more than half the U.S. formula consumption.
FORMULA IS PUSHED IN HOSPITALS
Research shows that the main factor in continued breastfeeding is whether a woman exclusively breastfeeds at the hospital or not. Mothers often perceive introductions of formula — either from a nurse trying to offer a new mother rest or from gift bags given out by hospitals — as a suggestion, not an exception.
“At the time of birth many women are ‘sitting on the fence’ on their decision to breastfeed or not,” said Rafael Perez-Escamilla, director of the Office of Public Health Practice at Yale’s School of Public Health. “Formula samples received from a medical facility signals to the mom that formula feeding is medically endorsed.”
More than half of U.S. hospitals offer new mothers free formula gift bags, according to the CDC. A CDC epidemiological review of studies on the gift bags found that 7 out of 11 showed lower exclusive breastfeeding rates among those who received them.
“The less a baby suckles, usually because formula is introduced, the less milk a woman produces, setting up a downward cycle so that eventually mother will actually have insufficient milk,” said Chessa Lutter, senior adviser of food and nutrition at the WHO’s Pan American Health Organization.
FORMULA IS ADVERTISED HEAVILY
Today, formula is a convenience — often a necessary one — for mothers who are working outside the home. It’s also a product marketed ubiquitiously, from advice on TV and their social media feeds, to coupons in the mail and on mommy blogs, to free samples at obstetricians and hospitals.
Unlike countries that follow the WHO’s International Code of Marketing of Breastmilk Substitutes, the U.S. doesn’t restrict formula marketing to the public. Research firm Euromonitor estimates the U.S. baby milk formula market to be a $5 billion industry. Amid leveling sales, formula companies have increased their overall marketing budget 70% from four years ago, according to Kantar Media.
Mead Johnson Nutrition and Abbott Laboratories — which combined have the majority U.S. share for baby formula — would not comment on specific advertising practices, but said they don’t view their advertising as affecting breastfeeding rates.
According to Abbott, “We market our Similac infant formulas to compete against other brands of infant formula, not to compete against breastfeeding.” One consistent element of formula marketing emphasizes formula’s similarity to breastmilk. According to Mead Johnson, “Our research and development efforts are focused on making our infant formulas as close to breast milk as possible.”