The Department of Health and Human Services commissioned an advertising campaign to increase public awareness of the benefits of breast feeding. Breast feeding rates appear to be on the rise, but the United States still lags behind other developed nations. The campaign was to feature striking images that would highlight the potential health problems of not breast feeding infants, but infant formula makers objected. As a consequence, according to this report, the ads were watered down, compromising their effectiveness.
The milder campaign HHS eventually used had no discernible impact on the nation's breast-feeding rate, which lags behind the rate in many European countries.
Some senior HHS officials involved in the deliberations over the ad campaign defended the outcome, saying the final ads raised the profile of breast-feeding while following the scientific evidence available then -- which they say did not fully support the claims of the original ad campaign.
But other current and former HHS officials say the muting of the ads was not the only episode in which HHS missed a chance to try to raise the breast-feeding rate. In April, according to officials and documents, the department chose not to promote a comprehensive analysis by its own Agency for Healthcare Research and Quality (AHRQ) of multiple studies on breast-feeding, which generally found it was associated with fewer ear and gastrointestinal infections, as well as lower rates of diabetes, leukemia, obesity, asthma and sudden infant death syndrome.
The report did not assert a direct cause and effect, because doing so would require studies in which some women are told not to breast-feed their infants -- a request considered unethical, given the obvious health benefits of the practice.
The article describes how the industry sought to influence the ad campaign.
Two of the those involved were Clayton Yeutter, an agriculture secretary under President George H.W. Bush and a former chairman of the Republican National Committee, and Joseph A. Levitt, who four months earlier directed the Food and Drug Administration's Center for Food Safety and Applied Nutrition food safety center, which regulates infant formula. A spokesman for the International Formula Council said both were paid by a formula manufacturer to arrange meetings at HHS.
In a Feb. 17, 2004, letter to Thompson, Yeutter began "Dear Tommy" and explained that the council wished to meet with him because the draft ad campaign was inappropriately "implying that mothers who use infant formula are placing their babies at risk," and could give rise to class-action lawsuits.
Yeutter acknowledged that the ad agency "may well be correct" in asserting that a softer approach would garner less attention, but he said many women cannot breast-feed or choose not to for legitimate reasons, which may give them "guilty feelings." He asked, "Does the U.S. government really want to engage in an ad campaign that will magnify that guilt?" . . .
The formula companies also approached Carden Johnston, then president of the American Academy of Pediatrics. Afterward, Johnston wrote a letter to Thompson advising him that "we have some concerns about this negative approach and how it will be received by the general public."
The letter made a strong impression at HHS, former and current officials said. But it angered many of the medical group's members and the head of its section on breast-feeding, Lawrence M. Gartner, a Chicago physician. Gartner told Thompson in a letter that the 800 members of the breast-feeding section did not share Johnston's concerns and had not known of his letter.
More on Mother's Milk
We need to do everything we can to get mothers back to the natural way of feeding babies. Formula advertisment shouldn't be banned, because there are valid reasons why mothers who cannot breastfeed for one reason or another deserve equal access to a competitive market. If we really want to make a difference, we need to understand that today's world practically requires a two-income family (see all the recent discussion of "The Two-Income Trap") and that today's workplaces simply do not offer the facilities necessary for a breastfeeding mother to continue feeding her children while returning to work.
People as a whole need to demand equal treatment for young families, both for breastfeeding mothers and for young dads to assume an equal role in childrearing. I would like to think that this can accomplished without resorting to government intervention, but I despair of this ever coming to pass.
My wife stayed home for a year to breastfeed our daughter, and it nearly broke our finances, even though we live a relatively modest lifestyle. I wish we had been able to make it last longer, because the best research I've read has indicated that children should be breastfed until 2.5 years old for optimal effect, but it simply wasn't in the cards.
OTOH, my sister in law is pregnant now, and suffers from a debilitiating disease that requires her to be constantly medicated. She has stopped taking the medications while she is pregnant, but it will be extremely important for her to continue her meds after birth. As a result, she will not be able to breastfeed, due to the possible dangers to the child. Should she not have the right to have a free marketplace working to meet her needs? The most important means of maintaing a free market is making sure the consumer is informed as much as possible, and banning advertisment doesn't help, but we also must insist on truth in advertisment--I see nothing wrong with regulating in that area.
Did you miss WIC's response to this issue on the page liked by NatRev?
"Although some have questioned whether WIC provides a disincentive to breastfeeding by supplying free infant formula, the women most likely to participate in WIC, including mothers who are poor and have low education levels, are less likely to breastfeed their children in general."
And I just love the original article by Freddoso:
"Can't health magazines and women's magazines do a much better job, with a profit motive, of alerting women to the dangers of not breastfeeding?"
Hey, Freddumbass, it's that vaunted profit motive of yours that's being suborned here. Let's see, for a magazine publisher, who pays more money: a formula advertiser or a breastfeeding mother? If magazines had to survive on subscribers, they either go broke or only be read by the rich. Advertising is what keeps the vast majority of mass-market magazines afloat.
There is absolutely no doubt about the effectiveness of breastfeeding. For anyone who refutes this, I welcome you to find an alternative explanation for mammary glands. Education about breastfeeding cannot be left to the marketplace, because there is absolutely no incentive for the marketplace to advocate breastfeeding. This is simply one area where the free market doesn't work, and never will. The entire reason *why* we need to advocate breastfeeding over formula is because for over a hundred years the formula companies have done everything they could to suggest to and convince mothers that formula is *better* than breast milk. Now that we know the truth, we need to undo the damage.
the draft ad campaign was inappropriately "implying that mothers who use infant formula are placing their babies at risk," and could give rise to class-action lawsuits.
Can anyone here guarantee some Edwards type aggressive attorney won't sue, some judge will allow class action and some other judge/jury will award $100B? The negative effects of our legal system are so conveniently overlooked by attorneys.
I can just hear Edwards pleading the US government has said formula is inappropriate and yet these blood-sucking, money hungry, rich businesses are harming your children.
Yes, breast feeding is better, but government scare campaigns have failed miserably against drugs, smoking, and teenage sex. The fact that a milder campaign failed to increase breast feeding is evidence that ad campaigns waste taxpayer money, not evidence that a more ridiculously emotional campaign would work.
And in this case, many women are unable to breastfeed, and they don't need the Nanny State dumping on them. My wife breast fed one of our kids, but she was very disappointed to be unable to breast feed the other one for medical reasons. It was quite a surprise to discover how insensitive and mean many (not all) breastfeeding activists and lactation nurses were about the situation. Since then, I've talked to many other parents who gave up breast feeding quickly precisely because the people pushing them to breast feed were so over the top and unable to compromise!
As usual, the best thing the government can do is to leave families and their doctors alone to make their own decisions.
UK- As of 1st April 2007, all female employees are entitled to 52 weeks of maternity leave. 39 weeks of this leave is paid, with the first six weeks paid at 90% of full pay and the remainder at a fixed rate.
Sweden- All working parents are entitled to 16 months' paid leave per child, the cost being shared between employer and State. To encourage greater paternal involvement in child-rearing, a minimum of 3 months out of the 18 is required to be used by the "minority" parent, in practice usually the father
Bulgaria- Provides mothers with 45 days 100% paid sick leave prior the due date, 2 years paid leave, and 1 additional year of unpaid leave. The employer is obliged to restore the mother to the same position upon return to work. In addition, pregnant women and single mothers cannot be fired.
Canada- In 2000, parental leave was greatly expanded from 10 weeks to 35 weeks divided between the two parents, which can be expanded to a year. In Canada parental leave is paid.
Is it any coincidence that these countries have much higher rates of BFing moms?
Did you consider the fact that one of the reasons the women under WIC are more likely to use formula is because WIC gives them free formula?
Furthermore, since WIC is supplying the formula it knows the exact location of many of the women who are not breast feeding.
Don't you think it would be more effective for them to directly target an education program to these women who are not breast feeding????
There is a vast social and demographic difference between the US, UK, Bulgaria, Sweden, and Canada.
To find out the actual impact of the paid maternity leave one would have to account for these differences.
The fact that the UK has higher breast feeding rates even though the maternal leave policy did not go into effect until April of this year suggests that maternal leave is not the only factor contributing to the higher rates of breast feeding in the countries you mentioned.
Missed your earlier comment thanks for the information.
Given the information you provide it appears even though there is a targeted education campaign to a population that uses formula and would benefit from breast feeding, they still use formula instead of breast feeding.
That seems to support the idea that the advertising campaign people are talking about is not going to be effective.
So why are they spending the money on advertising instead of something that might be more effective?
My wife and I both believe in breastfeeding as the primary feeding method for infants. When my daughter was born, my wife for one reason or another wasn't producing any milk just yet. We had taken the breastfeeding classes, and read all the material, but we didn't realize at first the fact that athough our daughter was sucking for all she was worth, she wasn't getting anything.
The night we brought her home, it was terrible. She screamed and screamed, and we couldn't figure out how to comfort her. When I finally realized what the problem must be, we had no formula on hand, so I resorted to feeding her water through an eyedropper. This finally clamed her down, and my mother-in-law (who never breastfed, and could not advise my wife well) went to the 24 hour pharmacy to get formula. My daughter gulped it down.
The next day, we returned to the hospital to get advice, but all they did was essentially tell us that we were bad parents for giving our daughter formula, and were particularly pissed at me for having given her water! They wouldn't even listen to what we had to say, and treated us like we were idiots. Thank god *my* mother is a certified RN with a specialty in OB/GYN and she assured us that we did the right thing. Unfortunately, my mother couldn't be there in person because she suffers from MS.
Our daughter stayed on formula for about 1-2 weeks, after which my wife's milk came in in earnest.
As you can probably tell, I sympathize with the plight of women who are *unable* to breastfeed for some reason.
I'm sorry you had to deal with such jerks. Some practitioners don't want babies under six months having water because, they say, the babies' kidneys may not be able to handle it and all sorts of chemical balances will be thrown off. Others have never heard of this theory. Consult your pediatrician.
TJIT, the amount of formula most WIC programs provide don't fully supply a child's needs past six months or so. Mom ends up buying more and more formula retail. Of course by that time, it's too late to decide to breastfeed.
Here's a GAO report on how the formula companies market their product to undermine WIC promotion of breastfeeding:
http://www.gao.gov/new.items/d06282.pdf
For many women, pregnancy is difficult enough. After a while, you just want your body back.
Interestingly, the stats about breast-fed babies do not account for parental income, IQ, and level of education. The women who breast-feed usually earn more and are more educated than their peers; it is not surprising that their kids turn out better. Correlation does not equal causation, and all that.
A woman does not need to take extended maternity leave or waste time and energy pumping and freezing breast milk to give her baby the benefits of breast-feeding. The cheapest, easiest way to go is to breast-feed at home and have your child care provider give the baby formula. I breast-fed my first until he was a year old and the younger two until they were three--and were very articulate about saying, "I wanna suck" while riding in supermarket shopping carts. With each of them I went back to work a week after they were born.
This way of doing things is convenient and you never lose sleep if, like me, you just have the baby in bed with you at night. If more women realized that this was feasible, and convenient, more women would do it. Instead, breast-feeding advocates make such a fuss about the whole business that lots of women are completely put off or get so uptight about the whole thing that they fail and fewer babies get any breast-feeding at all.
Tales from the Nursery
The Crucial Health Stat You've Never Heard Of
The Crucial Health Stat You've Never Heard Of
But never mind, I'm sure you can find some corporation to blame for the rising levels of Peanut and Nut sensitivity...
Probably. I know that I was breast-fed, as were both of my sisters. I don't have a pictorial log of the events or an archived copy of the feeding shedule or anything like that, and would be mildly disturbed if I ever encountered such a thing, but it's not the sort of knowledge that kills.
Then again, I know seven nurses and have even had the misfortune of being at a table where three or four of them were present simultaneously and conversing about their job experiences, so there is very little knowledge that can kill me these days.
Put another way: It's like realizing that your parents had sex at some point, as did your grandparents, etc. Adults can handle the existence of that knowledge. Mature adults simply don't dwell on said knowledge, wherein lies the difference between "normal" and "psycho".
Well, since you seem to be asking a constitutional question, it seems clear to me that this constitutes spending for the general welfare, and I don't think that's a stretch at all. Public health is a legitimate issue of government concern. For the same reasons you believe breast-feeding is better for an individual baby, the government believes widespread breast-feeding is better for our society.
The deeper question is why government ought to get involved in a moral sense, because this does seem like another step towards the nanny state. It seems to me that breast-feeding represents a sort of market failure; it's harmful to the companies that sell formula, but there's no competitor to make a profit. Thus, there's no significant financial incentive for any private actor to do what the government is doing here, to encourage breast-feeding and to make the option available to those who might not utilize it otherwise. There's really not a good market solution here, and thus the government has an appropriate role.
I suppose the answer is that may become public health (in the opinion of some people) when the government is responsible for the health care of the individuals involved. But that raises all sorts of issues that are outside the scope of this discussion.
Here's another wrinkle -- if the government does have a role to play, why the FEDERAL government? I would be a lot less bothered to see this initiative coming from state or local authorities, although even then I would judge it harshly if the tone got too moralistic.
One of the most serious problems with capitalism is it permits time and level arbitrages of this sort -- when a profit today is exchanged for a loss tomorrow, or a small profit for an individual is exchanged for a loss to society, we usually have a way of representing the profit, but we often have no way of representing the loss.
A rational society would recognize this situation as a net loss and avoid it. To the extent our social current model does not accurately account for the situation -- it does not assign the loss in a way that enables it to weigh against the profit -- it is not completely rational.
One should be careful of ideologies; no-ones model completely describes what is going on out there.
The letter writer pointed out that cigarette smokers in her department took 5-10 10 minute breaks throughout the day for years, always on the clock, always paid.
Thought it was an interesting perspective.
A real nanny state would have a slew of government-paid wetnurses. But I digress, and I'm probably giving people ideas.
In truth, as another poster said above, there are modest benefits to breastfeeding. They are real, but it is also true that plenty of mothers give their babies formula and the babies turn out fine, while plenty of mothers breastfeed and see their babies get sick. If a mother decides to breastfeed, good for her. That's a great decision that needs to be supported. If a mother doesn't, people should calm down and not pretend that she is murdering her child.
And I am really uncomfortable with criticizing WIC. A lot of poor women desparately need to work and may not have very understanding and enlightened bosses when it comes to child care. Free formula probably makes a not insignificant number of people's lives much easier. (Indeed, middle class and wealthy people who advocate breastfeeding should really bear in mind that like many other choices one makes as a parent, this one is a lot easier for people with a certain amount of money.)