Babies Were Born to be Breastfed
August 31, 2007 by Amy Spangler | 7 questions or comments
According to the report, “In an effort to tone down blunt ads, the formula industry hired a former chairman of the Republican National Committee and a former regulatory official to lobby the Health and Human Services Department (HHS). Not long afterward, department political appointees toned down the campaign.”
The formula industry’s intervention is being scrutinized in light of testimony by former Surgeon General Richard H. Carmona that the Bush administration repeatedly allowed political considerations to interfere with his efforts to promote public health.
Kauffman and Lee report that, “The Congressional Committee on Oversight and Government Reform is investigating allegations from former officials that Carmona was blocked from participating in the breastfeeding advocacy effort and that those designing the ad campaign were overruled by superiors at the formula industry’s insistence.”
It is clear that the campaign ads were modified at the request of HHS, but only after scientists from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Centers for Disease Control and Prevention (CDC) had an opportunity to review the scientific data. The extent to which Dr. Carmona was blocked from participating in the campaign remains to be elucidated.
I had the opportunity to serve as Chair of the U.S. Breastfeeding Committee during the development and launch of the campaign, and to see first hand, genuine efforts by HHS Assistant Secretary Kevin Keane and representatives of the Ad Council to formulate ads that were both scientifically credible and emotionally compelling.
For me the greater disappointment was that the message of the campaign - Babies were born to be breastfed - was overshadowed by the controversy surrounding the campaign - controversy that neither HHS nor the Ad Council anticipated - controversy generated by deep-seated animosity between the formula industry and the breastfeeding community - controversy over wealth or health.
Health risk messages by their nature are controversial. When fear is used as a mechanism for behavior change, there better be strategies in place to support that behavior change. In other words, if we tell mothers and fathers that babies exclusively breastfed for 6 months have less risk for ear infections, pneumonia, asthma, obesity and a myriad of other acute and chronic diseases, and they subsequently decide to breastfeed exclusively for 6 months, we better have the resources in place to support that decision - including skilled lactation care and services, extended, paid maternity leave, worksite-based child care, flexible work schedules, and time and space at school or work to breastfeed or express milk.
Joan Wolf, author of Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign, is a wonderful example of what happens when misinformed individuals with misguided agendas attempt to influence public health policy.
Breastfeeding promotion presents a unique challenge because it defies comparisons. Wolf was critical of the comparison made by myself and others between breastfeeding and smoking - and perhaps rightfully so. There is no level of nicotine intake that is ever recommended or required, but there are situations when formula (artificial baby milk) may be needed.
Perhaps cesarean birth would be a more plausible comparison.
Vaginal birth is normal. When normal is not possible, a solution must be implemented. Cesarean birth is a solution. As a solution, cesarean birth should not be promoted as “better than,” “equal to,” or “nearly like,” normal i.e. vaginal birth. There are situations when cesarean birth is needed, and the associated risks are then viewed as acceptable. Conversely, unnecessary cesareans births carry unacceptable risks.
What about breastfeeding and formula-feeding?
Breastfeeding is normal. Formula-feeding is a solution that is implemented when a problem precludes normal. When the promotion of a solution alters society’s perception of normal and negatively impacts public health, the promotion needs to be curtailed.
There is a reason why we have an International Code of Marketing of Breastmilk Substitutes.
There is a reason why we have a Congressional Committee on Oversight and Government Reform.
The fact remains, Babies were born to be breastfed.
wonderfully stated!
best,
karenq
Very well said!
Ditto!! Great analogy.
Thank you, Amy, may your statement be heard by many! c
Amy, thanks so much for responding and so succinctly. Hopefully this will be published in the Washington Post.
Ann
Amy, thank you for all you do on behalf of breastfeeding mothers and babies. I think your comments need to be submitted and published as a letter to the editor of the Washington Post.
Rebecca Goldin, author of the STATS article–Scaring Women Into Breastfeeding: Mention Leukemia Risk to Baby–critiques a Los Angeles Times op-ed by Wendy Orent in which Orent accuses the formula industry and the Bush administration of quieting a well-established scientific message.
ORENT: “What science the Bush administration chooses to stifle or promote seems to be a matter of politics and economics. According to a recent story in the Washington Post, the multi-billion dollar baby formula industry pressured the Department of Health and Human Services (DHHS) to weaken a 2004 public-service campaign promoting breast-feeding–and it worked, even though the science supported the other side.”
GOLDIN: “One of the roles that the Department of Health and Human Services (DHHS) has in promoting public health is to portray risks and benefits accurately, yet Orent’s article did just the opposite, advocating that women be told in the starkest terms possible that they are risking their children’s lives by not breastfeeding despite the fact that the science and the statistics do not support this view. The art of presenting all the information to women who are making a decision to breastfeed or not while balancing the many deciding factors is to give them a perspective on what their decisions mean. Scare tactics are not the way to drive public policy.”
SPANGLER: Informed decision-making is the mantra of breastfeeding advocates–providing all of the information is a professional responsibility–one we ought not to forget.