A NEW TYRANNY FOR MOTHERS COMING

Formula feeding moving towards becoming "child abuse".



Warning: Public health officials have determined that not breast-feeding may be hazardous to your baby's health. There is no black-box label like that affixed to cans of infant formula or tucked into the corner of magazine advertisements, at least not yet. But that is the unambiguous message of a controversial government public health campaign encouraging new mothers to breast-feed for six months to protect their babies from colds, flu, ear infections, diarrhea and even obesity. In April, the World Health Organization, setting new international bench marks for children's growth, for the first time referred to breast-feeding as the biological norm.

"Just like it's risky to smoke during pregnancy, it's risky not to breast-feed after," said Suzanne Haynes, senior scientific adviser to the Office on Women's Health in the Department of Health and Human Services. "The whole notion of talking about risk is new in this field, but it's the only field of public health, except perhaps physical activity, where there is never talk about the risk."

A two-year national breast-feeding awareness campaign that culminated this spring ran television announcements showing a pregnant woman clutching her belly as she was thrown off a mechanical bull during ladies' night at a bar - and compared the behavior to failing to breast-feed. "You wouldn't take risks before your baby's born," the advertisement says. "Why start after?"

Senator Tom Harkin, Democrat of Iowa, has proposed requiring warning labels, on cans of infant formula and in advertisements, similar to the those on cigarettes. They would say that the Department of Health and Human services has determined that "breast-feeding is the ideal method of feeding and nurturing infants" or that "breast milk is more beneficial to infants than infant formula."

Child-rearing experts have long pointed to the benefits of breast-feeding. But critics say the new campaign has taken things too far and will make mothers who cannot breast-feed, or choose not to, feel guilty and inadequate. "I desperately wanted to breast-feed," said Karen Petrone, an associate professor of history at University of Kentucky in Lexington. When her two babies failed to gain weight and her pediatrician insisted that she supplement her breast milk with formula, Ms. Petrone said, "I felt so guilty." "I thought I was doing something wrong," she added. "Nobody ever told me that some women just can't produce enough milk."

Moreover, urging women to breast-feed exclusively is a tall order in a country where more than 60 percent of mothers of very young children work, federal law requires large companies to provide only 12 weeks' unpaid maternity leave and lactation leave is unheard of. Only a third of large companies provide a private, secure area where women can express breast milk during the workday, and only 7 percent offer on-site or near-site child care, according to a 2005 national study of employers by the nonprofit Families and Work Institute. "I'm concerned about the guilt that mothers will feel," said Ellen Galinsky, president of the center. "It's hard enough going back to work."

Public health leaders say the weight of the scientific evidence for breast-feeding has grown so overwhelming that it is appropriate to recast their message to make clear that it is risky not to breast-feed.

Ample scientific evidence supports the contention that breast-fed babies are less vulnerable to acute infectious diseases, including respiratory and gastrointestinal infections, experts say. Some studies also suggest that breast-fed babies are at lower risk for sudden infant death syndrome and serious chronic diseases later in life, including asthma, diabetes, leukemia and some forms of lymphoma, according to the American Academy of Pediatrics. Research on premature babies has even found that those given breast milk scored higher on I.Q. tests than those who were bottle-fed.

The goal of a government health initiative called Healthy People 2010 is to get half of all mothers to continue at least some breast-feeding until a baby is 6 months old. Though about 70 percent of new mothers start breast-feeding right after childbirth, just over a third are breast-feeding at 6 months and fewer than 20 percent are exclusively breast-feeding by that time, according to the 2004 National Immunization Survey. Breast-feeding increases with education, income and age; black women are less likely to breast-feed, while Hispanics have higher breast-feeding rates.

For women, breast-feeding can be an emotionally charged issue, and a very personal one. Even its most ardent supporters acknowledge that they have made sacrifices. "It's a whole lifestyle," said Kymberlie Stefanski, a 34-year-old mother of three from Villa Park, Ill., who has not been apart from her children except for one night when she gave birth. "My life revolves around my kids, basically." Ms. Stefanski quit working when her first child was born almost six years ago, nursed that child until she was 4 years old, and is nursing an infant now. She said she wanted to reduce the risk of breast cancer for herself and for her three daughters, referring to research indicating that extended breast-feeding may reduce the risk for both mother and daughters.

Scientists who study breast milk almost all speak of it in superlatives. Even the International Formula Council, a trade association, acknowledges that breast-feeding "offers specific child and maternal health benefits" and is the "preferred" method of infant feeding. The American Academy of Pediatrics states in its breast-feeding policy that human breast milk is "uniquely superior for infant feeding."

Dr. Haynes, of the Health and Human Services Department, said, "Our message is that breast milk is the gold standard, and anything less than that is inferior." Formula "is not equivalent," she went on, adding, "Formula is not the gold standard. It's so far from it, it's not even close."

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