The Conversation on NYC's Hospital Breastfeeding Initiative
Twenty-eight hospitals in New York City have taken a commendable step to support mothers who choose to breastfeed by signing on to “Latch on NYC.” Through this voluntary citywide initiative, formula supplementation will no longer be provided to new mothers by default, and the promotion and distribution of infant formula will be limited. Formula is still available for mothers who choose to formula-feed and in cases where it is medically necessary.
While the evidence to support the benefits of breastfeeding is abundantly clear (leading health professionals from the American Academy of Pediatrics to the Surgeon General recommend that infants be exclusively breastfed for the first 6 months of life), women who want to breastfeed often face numerous barriers in the hospital setting. Strong hospital policies that actively support the choice to breastfeed give women the best chance to be successful in their breastfeeding goals and help shape a hospital environment that truly bolsters health.
In the news
The NYC initiative is increasingly being presented in the media as the latest example in a crusade of “nanny state” efforts to restrict individuals’ choices. “Sucking the choice out of parenting” and “The Nanny State vs. New Moms” exemplify the kinds of headlines that have been circulating, with statements going so far as to say the initiative “infantilizes women by telling them they are no longer adult enough to decide for themselves what is best for their families and themselves.”
“Should [a mother] choose to supplement with formula, she’ll now find New York City standing in her way,” states another piece, one of many articles to suggest “restrictive, pro-breast-milk programs” constrain women’s choices and hinder them from following through with their infant feeding goals. A recent Pediatrics study, however, highlights the flipside to this argument. Over half of the women surveyed during their pregnancy expressed their intention to breastfeed exclusively, yet less than one third of them met their breastfeeding goals. Women who did not receive formula in the hospital were 2.5 times more likely to meet their stated breastfeeding goals than those who did, offering strong support for hospitals’ efforts to curb aggressive formula marketing.
Why messaging and framing matters for health
Media stories that pit hospital policies against new mothers overlook the larger issue at play. The common refrain that hospital policies “will only make life more difficult for newborns and their moms” does not take into account the many factors that truly do make things difficult for new moms who want to breastfeed, like the lack of workplace support or broader social norms that stigmatize breastfeeding. While these barriers are equally important to address, actively supporting breastfeeding in hospitals plays a critical role in setting the tone for how breastfeeding is perceived outside of hospitals.
Hospital policies like the ones taking effect in New York City (along with over 140 others hospitals across the US) do not constrain women’s choices. And they don’t, as many articles falsely claim, deny any women access to formula supplementation if they ask for it or if their infant medically requires it. Rather, they provide a critical foundation to support and make possible women’s previously expressed desire to breastfeed—a desire that too often goes unrealized in the absence of these supports. “When it comes to creating policies that improve public health, such policies don't threaten choice; they simply influence the context for it,” Berkeley Media Studies Group stated in a recent blog post. “The question, then, becomes: What do we want that context to look like? Do we want our surroundings to work against us…Or do we want our surroundings to work in our favor?"
These recent news stories provide advocates with a unique opportunity to elevate the importance of policies and norms that support breastfeeding. This week, we’re providing you with talking points to help guide your response:
- Hospital policies and practices are one of the first influences on a woman’s decision to breastfeed. The first 24-72 hours of a child’s life—while the mother and baby are still in the hospital— is a critical window for initiating and practicing breastfeeding. Hospital practices such as a failure to provide skilled support, separating a new mother from her baby, delaying the first feeding, and providing formula supplementation can discourage mothers from continuing to breastfeed or carrying out their decision to breastfeed.
- Hospital policies that promote and support breastfeeding can reduce health inequities. Evidence shows that hospitals that have implemented model policies around infant feeding show higher rates of exclusive breastfeeding among all income levels and ethnicities. Such policies level the playing field, providing all babies and mothers a fair chance at gaining the protections provided by breastfeeding—no matter where the baby is born.
- Breastfeeding adds up. Illness and chronic disease related to poor nutrition and physical inactivity accounts for nearly 17% of our health care costs—that’s $168 million a year in medical costs alone. Breastfeeding is one of the most important preventive care measures for children’s health, protecting against infections and chronic disease, and helping to build healthy immune systems. In addition to the health boosts breastfeeding provides, there are significant economic benefits. If 90% of U.S. mothers exclusively breastfed for the first six months, the U.S. would save an estimated $13 billion annually in reduced medical costs.