On mandatory breastfeeding

Many people mocked supermodel Gisele Bundchen as a "boob" and a "twit" a couple of years ago when she said the law should require mothers to breastfeed for at least six months. It turns out Bundchen may just have been a little ahead of her time.

As of this summer, hospitals in New York City will no longer make formula available to new mothers and babies unless it is medically indicated, or promote its use in any way. "Latch On NYC" is an initiative of the city's mayor, Michael Bloomberg.

"Motherhood" by Mary Cassatt

Studies have been piling up in recent years that show that breast-fed babies  do better in a number of ways than bottle-fed babies. Still, fewer than one-third of babies are consuming only breast milk at 3 months, and nearly four-fifths of babies have stopped breastfeeding altogether before the recommended minimum of one year. 

And as Linda Lowen wrote recently on About.com,

Part of the problem is that we like our swag -- our goodie bags packed with toys and samples and coupons. Hospitals give these out as a matter of course, and as new moms we're eager for it.

The swag started with the formula companies. And they knew exactly what they were doing. They were hooking women at an emotional and vulnerable time, and from there they reeled us in.

Taking the free samples of formula away from new moms in hospitals protects them from the manufacturers who make it so easy to start a baby off on formula, rather than on the breast, Lowen wrote.

But even some breastfeeding proponents are protesting the new methods for giving breast-feeding a leg up in the nursery. Some women say mothers are already feeling the effects of Latch On NYC, which will go into effect Sept. 3.

New NYC mom Jacoba Urist wrote in a Wall Street Journal blog about her experience trying to have her baby fed with formula at the New York University Medical Center, where she had given birth, so she herself could sleep through the night. Nurses twice said they couldn't find any formula, and brought Urist her baby in the middle of the night to breastfeed, she wrote.

After Sept. 3, lack of cooperation, if such it was among those nurses, will turn to rules in NYC. "With each formula bottle a mother requests, she’ll get a lactation lecture about why she should use breast milk instead," Urist writes of Latch On NYC. She supports breastfeeding in general and does it herself, but thinks the new rules themselves will "prey on women in the days (sometimes hours) after they deliver a baby."

Kara Spak, a new mother and my former colleague at the Chicago Sun-Times, made an especially compelling case for leaving formula-feeding moms in peace, in a recent commentary about Latch On NYC in the Sun-Times.

Spak, who is perhaps best known nationally for winning more than $85,000 as a contestant on Jeopardy in 2010, wrote that she intended to breastfeed, but her baby wasn't thriving on breast milk. Ultimately, she had to choose between her baby's health and the breast-feeding ideal. She began feeding her new daughter formula, and continues to do so.

After that traumatic beginning, when Spak talked with her friends with babies, all of whom were committed breast-feeders, it turned out that all of them had had problems nursing, she said.

And that's the travesty here, or one of them, anyway. As Alissa Quart reported in her recent New York Times op-ed piece, "The Milk Wars,"

For most women, there is little institutional support for breast-feeding. According to the Bureau of Labor Statistics, only 11 percent of private-sector workers get paid family leave through their employers. Once mothers go back to work, there are few places where they can pump milk for later use.

Jane Brody's NYT column in response to Quart's piece, "The Ideal and the Real of Breastfeeding," gave readers a look at this longtime health writer's own rocky experience with nursing many years ago, plus a survey of studies and anecdotal evidence that makes it clear that, while breast might be best, it isn't for everyone.

On a more positive note, this year's "Big Latch-On," completed just this weekend, attracted 8,862 nursing babies (and their moms) in 23 countries, a new record.

And check out Birth Story's previous posts on breastfeeding.

Image: Motherhood by Mary Cassatt

We dream for our children

My children are 10 years apart in age, and one thing that has struck me since Maeve's birth almost 13 years ago is how much more complicated the world grows as they get older.

When children are small, you can see clearly how their perfect lives will roll out. You can see them graduating from Harvard — or perhaps Yale; you devote serious time to considering which would be better — going into law or medicine, gliding along until they finish up as President of the United States. Along the way, of course, there will be sports trophies, prom dresses, all the trimmings.

Reality sets in gradually. It turns out the kids have learning disabilities, or strange hair, or no interest in sports — whatever, and likely in multiples. Ten years or so after spinning all those perfect dreams, you might find yourself praying they'll finish high school. Or even, please, God, let them stay alive through high school.

When Maeve was in preschool, I remember sitting in a group listening to moms in the Harvard vs. Yale stage, while my mind was on the then-exotic sensation some teen-aged boys in Nora's vast social network had created by sending nude pictures of girls they had probably known since kindergarten out across the Internet. I remember thinking that perhaps I had seen some of those boys, and those girls, on swings in the park or at a library reading hour when they too were small.

What I mean to say is that many of the things that seem critical when children are little get put firmly in perspective as they grow.

Poking around Lisa Belkin's Motherlode blog on the New York Times website this week, I landed on a post called "A Breast-Feeding Guru Who Uses Formula," which attracted me because I have been writing about breast-feeding. Through Belkin, I discovered Katie Allison Granju and her mamapundit blog. (I know, where have I been?)

Granju is a writer and digital-media expert who has become an authority on breast-feeding. Nevertheless, she found with her fifth child, Georgia, now seven weeks old, that she was unable to breast-feed. "I did have colostrum for the first week or two, but I never got the full enchilada," she writes in a post on Babble.com.

She tried "pumping, herbs, supplemental nursing system, plenty of skin to skin with baby, nursing on demand, nipple shields," all to no avail.

She is "resigned" now to the fact that Georgia is a bottle-fed baby, and she does what she can to inject warmth and meaning into an experience she never expected a child of hers to have.

But Granju believes that a horrific recent event in her life has contributed to her inability to breast-feed.

"I suspect that the biggest factor in my inability to produce milk at the moment is that my oldest child died in my arms only a few weeks before G was born. God only knows what the shock of that experience did to my body and its normal functioning," she wrote.

The death of Granju's son Henry from a drug overdose is about as terrible as this world gets. We dream for our children but they live the lives we give them. My heart goes out to the Granjus.

The latest edition of doctors’ book on birth

Often, the annual meeting of a medical group produces a flurry of scientific papers, but the meeting of the American College of Obstetricians and Gynecologists seems more like, say, a bunch of writers  getting together. (I attended the 2009 meeting in Chicago.) As a cohort, OB-GYNs seem to want to find out about the newest approaches, tools and techniques they might put to use in their practices, and perhaps exchange some stories from the trenches as well.

Happy babyBut here's something new for consumers from ACOG, which held its annual meeting in San Francisco this week. The fifth edition of Your Pregnancy and Childbirth: Month to Month was unveiled, along with a new companion website,  www.yourpregnancyandchildbirth.com.

While there are many pregnancy books, this one is "unique in the extent of the medical detail that it covers about all aspects of pregnancy, yet it is designed as an easy-to-read, helpful reference for all of those questions that inevitably pop up," said Hal Lawrence, MD, The College's vice president of practice activities in a press release on the ACOG website.

The latest edition of the book has a new chapter that addresses obesity and eating disorders, another devoted to diabetes during pregnancy, and a third covering other chronic diseases like hypertension, heart disease, celiac disease, lupus, and physical and mental disabilities.

"The majority of women do not experience severe complications, but we felt it was important to give a thorough overview so women will know if something's wrong and when to call a doctor," Dr. Lawrence said.

Another new chapter covers feeding the baby, and includes advice on both breastfeeding and the use of formula.