Wednesday, July 08, 2009

Should mothers who use formula feel guilty?

Should mothers (and fathers) feel guilty for using formula rather than breastfeeding?

Plenty do - or feel they are expected to. Here's a comment someone has just posted anonymously on an earlier blog here:

Since all of you are clearly obsessed with the idea that formula feeding is bad, bad, bad - perhaps I should mention that for some mothers, it's the only alternative. My wife tried to breastfeed and in the end had to resort to bottle feeding. We didn't want to, and we didn't like it. But it was the only option we had. So for all you mums who sneer at the poor ignorant women formula-feeding their babies - good for you. We had no choice - and guess what? Our baby is a year old, healthy and a joy. So stick that in your narrow-minded obsessive pipe and smoke it.

I've also recently been contacted by a health worker who says she sees the ill health resulting from formula feeding - such as gastro-enteritis, ear infections - and raises the greater risk of diabetes and other long-term illnesses. She asks: " There seems to be an obsession about fear of "making Mums feel guilty" when it comes to breast feeding, but NOT with other health advice e.g. smoking and healthy eating and vacinnation advice etc. I don't know why this terror of Mums feeling guilty seems UNIQUE to breast feeding."

I stand by my often repeated - but as often ignored - comment that it is a mother's decision how she feeds her child and nobody should attempt to make her feel guilty about it.

I appreciate that some may disagree, but my view is that mothers have a right to accurate, independent information on infant feeding and the health implications of not breastfeeding. If a mother makes an informed decision not to breastfeed, then there are presumably reasons why other factors were judged to be of greater importance than breastfeeding. If she decided not to breastfeed because she was misinformed or misled by company propaganda which suggests formula and breastfeeding are equivalent, or did not have the support to overcome difficulties with breastfeeding, I'm not sure that it is either fair or productive to blame her for being failed by those responsible for regulating marketing practices and providing support.

Remember, in the UK, 90% of mothers who stopped breastfeeding before their child was 6 weeks old said they wanted to breastfeed for longer. The mother cited in the first quote, tried to breastfeed and wasn't able to make it work.

The ones who should feel guilty are those who have failed to implement and enforce the marketing standards that were adopted by the World Health Assembly in 1981 and Resolutions since which update and clarify them. In the UK, this means the drafters of the Infant Formula and Follow-on Formula Regulations which allow misleading advertising and labels to go onto the market. The ones who should feel guilty are the company executives who, as policy, seek to weaken legislation and systematically break the Code and Resolutions.

Those of us trying to promote and support breastfeeding need to do a better job of reaching mothers - it is not easy because the formula industry is far better resourced and uses dishonesty to undermine breastfeeding and suggest that formula feeding and breastfeeding are equivalent (or formula feeding is better - despite the legally required 'breast is best' message).

Rather than using guilt as a lever over mothers, I think a better approach is to understand the role of formula marketing and find better ways to communicate to mothers, particularly those who have had, or are having, a bad experience with breastfeeding. I do appreciate tireless efforts are being put into this already by many.

I do think all of us who are attempting to change formula-feeding cultures back into breastfeeding cultures - which exist or have been recovered in many countries - should redouble our efforts. Promoting the ONE MILLION CAMPAIGN is a good start: - also shaming Nestlé, the worst of the baby food companies by promoting the Nestlé boycott:

As a final thought, I think it is important that those who do use formula, for whatever reason, are also protected. Information should be accurate. Instructions should be correct. And formula should be cheaper - it has one of the highest mark-ups of any product. This is the aim of our safer formula campaign - see the site.


Rob A said...

"I didn't breastfeed because I couldn't" = "It's my fault." The behaviour is solely the mother's and only appears once she is a mother.

Smoking and unhealthy eating are pre-exising behaviours that aren't uniquely associated with becoming a mother, so if one doesn't feel guilty before parenthood, there's little to stop one changing behaviour when the baby arrives.

Vaccinations can easily be thought of as beyond one's own control, so there's little guilt in not having children vaccinated.

Those are my thoughts anyway!

Anonymous said...

I haven't go much time to reply to this right now. However, in my experience, the guilt felt by mother's who use/used formula seems to be an inadvertant outcome of finding out the truth about something they thought the knew about, but didn't....

Helen said...

Guilt is self induced. If you feel you made the right choices then no-one can make you feel guilty! If you however, were misled, misinformed or received no support then you should not feel guilty...instead you should be angry! You should join the fight to help normalise breastfeeding and to put formula back where it belongs - on the pharmacists shelf as a 4th rate substitute for breastmilk.

I would like to ask though why formula should be cheaper? I understand from the point of view of the massive profits it provides it's manufacturers but would this not also further encourage it's use? Instead it should perhaps be available on prescription only?

Mike Brady said...

Thanks for the comments so far!

In response to Helen above about the price of formula, I raised a similar question when colleagues in Italy were taking action over a cartel of formula companies that were fixing their prices to increase their profits. Price fixing is a particularly commonplace accusation against Nestlé across its business. See:

Is it a good thing if formula is more expensive, to highlight even more that breastfeeding is free? I think if you were a mother who had to use formula for whatever reason, you wouldn't think so - particularly if the extra is just to enrich company executives and shareholders.

The issue of whether formula should be on prescription is a separate one to cost. Formula should only be used on the advice of a health worker in any case and it can be viewed as a nutritional medicine. What do people think?

Helen said...

I do see your point on the price Mike. It's just a double edged sword. I detest the fact that formula companies are making huge profits to the detriment of babies however, I would be worried that if the price was lower it would encourage more people to use it.

Bast Spandangle said...

Lots of women are getting formula for free from the government with milk tokens so the issue of cost is only affecting people who have a middle income, not a low one. For lots of people, if they get it for free they think they might as well use it! Little is done to inform mothers who breastfeed that they can use the milk tokens to buy milk or vegetables for themselves. A few years ago I had to go to the DSS on many occasions when they kept changing my milk tokens to formula tokens. I had to tell them 'No, I'm STILL breastfeeding, I don't want formula'. Things are a bit better now as there are not separate tokens for different items anymore but a voucher with an amount of money on, but still, lots of mothers think that they are only for formula

Valerie W. McClain said...

Has anyone considered that this whole issue of not making formula feeding mothers guilty is part of a PR campaign brought to you by the infant formula industry?  A good public relations campaign is one in which the people never truly realize that they are being manipulated.  No one "makes" someone feel guilty unless you are as creative and clever as some of the great PR companies.  The idea that breastfeeding advocates/professional LCs are making mothers guilty is PR.  Great PR because we, breastfeeding advocates and professionals think this is a valid issue.  Guilt can be a great motivator but it can be a great excuse.  And it can be the infant formula industry's greatest theme song.  The only guilty party is the infant formula industry who spends big bucks to manipulate the media and make us believe that guilt is an issue.