Many new
parents think infant formula is
the next best thing to Mom, but nothing
could be further from the truth.
by Katie Allison Granju
When Tabitha Walrond's
7-week-old infant died of starvation last year, the fact that this young New York mother
had attempted to breast-feed her baby -albeit with obvious lack of success
- was widely
blamed for the complex and haunting tragedy. The national headlines regarding the Walrond
case were ongoing and sensational. "Nursed to Death" read one.
"Breast-feeding can kill?" inquired another.
During the same period, the similar death of the 6-week-old breast-fed baby of another
New York mother, Tatiana Cheeks, raised further breast-feeding concerns in the press and
with the public. This time one headline read "Nursing Death?" In 1995, a
widely-circulated Wall Street Journal article detailing dehydration in several
middle-class breast-fed babies whose mothers had experienced breast-feeding difficulties
led to a surge in phone calls to pediatricians and hospital hotlines across the country
from new parents worried that breast-feeding itself could somehow harm their infants.
Given this environment, many conscientious new parents may conclude that formula-feeding
represents a safer alternative to the potential "dangers" of breast-feeding. In
fact, nothing could be further from the truth.
In virtually all of the reported cases each year in which a breast-fed baby becomes
seriously ill as a result of her mother's feeding choice, the problem is actually one of not
breast-feeding -meaning that, as in the Walrond and Cheeks cases, some uninformed and
unsupported nursing mothers are not aware that they aren't effectively transferring milk
from their breasts to their babies. In sharp contrast, however, routine formula feeding
-even when done properly by parents -is itself a contributor to overall rates of
infant morbidity and mortality in the United States. This is because - despite what
manufacturers' advertising would have parents believe -today's commercial infant
formulas, while a marked improvement over the homemade concoctions of years past, still
represent a flawed and highly inferior imitation of our own, species-specific milk.
According to the American Academy of Pediatrics' most recent member survey, a majority
of baby doctors see slightly more formula-fed babies than breast-fed babies admitted to the hospital
for instances of malnutrition and failure to thrive. But this represents only the tip of
the iceberg when it comes to the differences in rates of morbidity and mortality between
formula-fed and breast-fed infants in this country. When the overall health of formula-fed
infants in the U.S. is compared to that of breast-fed infants -even after controlling
for variables such as parents' socioeconomic backgrounds - it becomes clear that
formula-fed babies are sicker, sick more often, and are more likely to die in infancy or
childhood. However, parents often lack access to this information, and in fact, are often
the recipients of misinformation, thus denied the ability to make truly informed choices
regarding how they will feed their babies. Although the phrase "breast-feeding is
best" is tossed around so liberally as to have been rendered almost meaningless, many
Americans are under the mistaken impression that today's commercial infant formulas are
nearly identical to human milk. And because of this, parents who routinely approach other
important infant health and safety issues in a thoughtful, deliberate way are largely
unaware that in epidemiological terms, the decision to formula-feed when breast-feeding is
an option places their child at demonstrably higher risk for a wide variety of ailments.
"Parents are not adequately informed regarding the real risks of artificial milks
[infant formula]," says Nancy Wight, MD, FAAP, IBCLC, and a neonatologist at
Children's Hospital in San Diego. She says that she considers it part of her job to
strongly encourage the parents of her patients to breast-feed. "Doctors never worry
about making parents feel guilty when we discuss childhood immunizations, car seats,
seatbelts, bicycle helmets or fencing around pools. I have an obligation to my patients to
give them correct information - not formula marketing slogans - and let them make the
choice."
Dr. Lawrence Gartner, MD, FAAP is a respected medical authority on infant feeding who
has played a role in drafting policy statements for the AAP regarding this issue. He
agrees that parents today aren't fully aware that the breast-or-bottle decision is more
than just another neutral lifestyle choice. "Compared to other equally important child
safety issues like car seat use or babies' sleep position, parents should understand that
the decision whether to breast- or bottle-feed ranks right up on top when it comes to
protecting babies. The AAP certainly puts it in that category."
In fact, the AAP explicitly
states that encouraging breast-feeding among parents is "as important to
preventive pediatric health care as promoting immunizations, car seat use, and proper
infant sleep position."
Katherine Dettwyler, Ph.D., associate professor of anthropology at Texas A&M
University and an internationally recognized expert on infant nutrition, agrees with
Gartner's assessment of the relative risks of "artificial feeding" for American
children. "I would rank the decision of how to feed your baby as the No. 1 infant
safety issue in this country," says Dettwyler.
Despite the widespread misperception that aggressive promotion of breast-feeding has
had a major impact on how we feed our babies, more than 70% of infants in the United
States are fed infant formula as their primary source of nutrition for most of their
critical first year of life. According to a recent
report in the Washington Post, although a federal survey in 1995 found that 58% of
American mothers start off breast-feeding their babies -- the same percentage as a decade
earlier - 20% fewer mothers today are still breast-feeding after three months.
While it is certainly true that many individual formula-fed infants will do "just
fine" (as will most unvaccinated individuals in the United States), the research
clearly indicates that, as a population, America's formula-fed babies are not
"fine" at all
Parents may reasonably ask why, with research demonstrating the many and serious
potential health hazards of routine bottle-feeding, do so many otherwise competent doctors
continue to take a neutral or even pro-formula stance with their patients? As pediatrician
and author Dr. Jay Gordon noted in the book "So That's What They're For:
Breastfeeding Basics," by Janet Tamaro-Natt: "This [infant feeding] seems to be
the one area where you can practice medicine in the 1990s -with 1960s know-how
- and
not get sued."
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