Breast Milk is a Formula for Success

Baby formula is big business as it is the primary source of food for most American babies during their first 6-12 months of life.

Due to the necessity of ensuring that our nation’s babies are eating safe and healthy food, infant formula is heavily monitored and regulated by the the U.S. Food and Drug Administration. Formula is also attracting a lot of attention from our nation’s public health  departments.

Though formula has proven to be generally safe, and has reared millions of babies; not everyone is in agreement that more formula is better. The Washington County Breastfeeding Coalition (WCBC) envisions “a community where breastfeeding is the norm and where families are supported and empowered to achieve their breastfeeding goals.”

WCBC is a refreshingly passionate alliance of men and women representing Allina Medical, Fairview Lakes, Grace Medical Supply,La Leche League, Lakeview Health, Stillwater Medical Group, Washington County Department of Public Health and Environment, Women, Infants and Children (WIC), and Woodwinds. WCBC is part of a growing movement seeking to educate the public that the benefits of breastfeeding outweigh the short-term conveniences of formula.

The Creation of a Milk Substitute: Baby Formula

The vast majority of babies were breastfed at the start of the twentieth century and many received supplemental food, often a mixture of cow’s milk, water, cream, and sugar or honey. This mixture became the subject of study by Dr. Thomas Morgan Rotch (1849-1914) as he created lab trials and studied babies’ reactions to the ingestion of various cow’s milk formulations

These results were introduced to the public as the “Percentage Method,” which marked the beginning of a move away from breastfeeding and toward manufactured milk products. Percentage, or “formula” feeding, grew in popularity as companies, in addition to the government, began marketing formula as a more scientifically pure and sanitary food source than mother’s milk. By the 1950’s, over half of all American babies were reared on formula and by the 1970’s, over 75% of American babies grew up on synthetic formulas.

At Issue: Climbing Obesity Rates and Resulting Chronic Diseases are Now a Major Public Health Concern

Clinical studies which draw a comparison between bottle-fed and breastfed babies demonstrate a huge advantage for the “breast is best” argument. The American Academy of Pediatrics recommends that infants be breastfed exclusively for the first six months of life, then breastfed and provided complementary foods up to a year or more.

In 2011, US Surgeon General, Dr. Regina Benjamin issued a Call to Action to Support Breastfeeding, which included a detailed account of the significant health benefits of breastfeeding for babies and their mothers. It also described a number of ways breastfeeding benefits overall public health:

“For nearly all infants, breastfeeding is the best source of infant nutrition and immunologic protection, and it provides remarkable health benefits to mothers as well. Babies who are breastfed are less likely to become overweight and obese.” - Dr. Benjamin, US Surgeon General

The Call to Action cites a number of disproportionately higher health risk factors for those babies that are bottle-fed versus those breastfed. For example, bottle-fed babies have: 250% more likely risk of being hospitalized for lower respiratory tract infections, 100% more likely risk of having acute ear infections, and 30% more likely to become an obese baby. Mothers who have not breastfed suffer as well- they have a 27% more likely risk of being diagnosed with ovarian cancer.

The Surgeon General’s Office also draws a direct connection between bottle-feeding and later-in-life chronic disease such as diabetes (60% more likely). The Call to Action also discusses the nation’s financial burdens that are associated with the short-term and long-term illnesses that arise as a result of bottle-feeding.  

The Minnesota Department of Health issued their own call to action, citing breastfeeding as a primary means of combating obesity and obesity-related illnesses. This has helped to spur the growth of groups like WCBC.

Fairview Lakes Lactation Consultant and WCBC member Sheila Humphrey, R.N., IBCLC, tirelessly advocates for both babies and mothers alike. She lights up a room when she gives her spiel: “Each mother’s milk is tailor-made for that particular baby in order to boost his/her immunological system. Breastfeeding sets the stage for that baby’s health path from infancy to adulthood, helping to prevent childhood cancers and later-in-life issues such as diabetes and high cholesterol.”

The Challenge: Balancing Motherhood and Employment

The spike in formula usage coincided with the post World War II movement of women into the workforce, and then again during the height of the feminist and women’s liberation movement. That is no mere coincidence; being a working mom is challenging to say the least.

Though the Family Medical Leave Act (FMLA) guidelines allows a new mother 12 weeks of protected leave from her job, a majority of women return to work 6 weeks after birth. These women often find it very difficult to continue with breastfeeding, due to challenges with finding places to pump and store milk, as well as encountering non supportive co-workers and employers. Coincidentally, the Center for Disease Control (CDC) 2006 National Immunization Study found that 80% of Minnesota infants are initially breastfed, yet only 16% are exclusively breastfed at six months of age.

WCBC has created a “Returning to Work” document, full of helpful tips such as: “Negotiate with your employer for break time.” and “Breastfed babies mean fewer sick days.” WCBC is also finalizing a comprehensive toolkit designed to provide clinics with resources and suggestions to help prepare women for breastfeeding and provide postpartum support.

WCBC discovered that physicians are very interested and ready to implement large-scale changes. “In addition to patient resources, they are asking for assistance with setting up lactation rooms and policies to support their own staff,“ explained Kim Ball, Washington County Senior Community Health Specialist.  “The medical administrators are saying, ‘we need to practice what we preach, and it starts here in our clinics.’” said Ball.

Public Health Means Systems Change: WCBC Members Set Big Goals

WCBC was established in 2010 with support from Statewide Health Improvement Program (SHIP) funds.  Their initial efforts were to: develop a lactation resource guide, offer professional breastfeeding training and support the local partners working on breastfeeding issues including the three hospital systems that initiated the Baby Friendly Hospital (BFHI) certification process.

Baby Friendly, USA supports those hospitals seeking a quality improvement program for their maternity services by providing policy and systems- change implementation guidelines. To ensure best practices in support of breastfeeding, BFHI requires hospitals to stop the practice of accepting free or reduced-cost formula—a bold move considering that gifts of formula have historically presented a huge cost-savings for hospitals.

“By accepting free formula you are, in a sense, part of the formula marketing and endorsement plan,” explained Jeanette Schwartz, Clinical Director for the Maternity Care Center at Woodwinds.

In addition to training staff for participation in BFHI, Woodwinds also used SHIP funds to start up an in-house donor-milk system as a bridge for babies in need of breast milk, but unable to receive milk from their own mothers.

“It’s not that we won’t offer formula, but under BFHI guidelines, we have clear priorities: breast feed first, use expressed milk second, utilize donor milk third, and if need be, use formula as a last effort,” said Schwartz. “We anticipate our families returning home feeling confident in their ability to continue with breastfeeding.”

Now the Washington County Breastfeeding Coalition (WCBC) focus is to create more breastfeeding supports within medical clinics.  Future endeavors may include community and work site supports for breastfeeding. Maggie Domski, WIC Breastfeeding Coordinator, is witness to the huge transformation in the way women feed their babies, “The WIC breastfeeding initiation rates have risen dramatically over the years and currently 80% of WIC moms initiate breastfeeding in Washington County.”

With the goal of helping families and communities to give their children the best start in life to become healthy and productive adults, WCBC is creating ripples of change in what may soon be a tidal wave.