by Jack Newman, MD, FRCPC
Most healthcare practitioners say they are supportive of breastfeeding. But many are supportive only when breastfeeding is going well, and some, not even then. As soon as breastfeeding, or anything in the life of the new mother is not perfect, too many advise weaning or supplementation. The following is a partial list of clues that help you judge whether the health professional is supportive of breastfeeding, at least supportive enough so that if there is trouble, s/he will make efforts to help you continue breastfeeding.
1. S/he gives you formula samples or formula company literature when you are pregnant, or after you have had the baby. These samples and literature are inducements to use the product, and their distribution is called marketing. There is no evidence that any particular formula is better or worse than any other for the normal baby. The literature, CD's or videos accompanying samples are a means of subtly (and not so subtly) undermining breastfeeding and glorifying formula.
If you do not believe this, ask yourself why the formula companies are using cutthroat tactics to make sure that your doctor or hospital gives out their literature and samples and not other companies'? Should you not also wonder why the health professional is not marketing breastfeeding?
2. S/he tells you that breastfeeding and bottle feeding are essentially the same. Most bottle-fed babies grow up healthy and secure and not all breastfed babies grow up healthy and secure. But this does not mean that breastfeeding and bottle feeding are essentially the same.
Infant formula is a rough copy of what we knew several years ago about breastmilk which is in itself only a rough approximation of something we are only beginning to get an inkling of and are constantly being surprised by. For example, we have known for many years that DHA and ARA were important to the baby's brain development, but it took years to get it into formulas. But it doesn't follow that the addition of these to formulas is doing what they are supposed to, as their absorption from formula is different from breastmilk.
The many differences have important health consequences. Many elements in breastmilk are not found in artificial baby milk (formula) even though we have known of their importance to the baby for several years -- for example, antibodies and cells for protection of the baby against infection, growth factors that help the immune system, the brain and other organs to mature.
And breastfeeding is not the same as bottle feeding; it is a whole different relationship. If you have been unable to breastfeed, that is unfortunate (though most times the problems could have been avoided), but to imply it is of no importance is patronizing and just plain wrong. A baby does not have to be breastfed to grow up happy, healthy and secure, but it does help.
3. S/he tells you that formula x is best. This usually means that s/he is listening too much to a particular formula representative. It may mean that her/his children tolerated this particular formula better than other formulas. It means that s/he has unsubstantiated prejudices.
4. S/he tells you that it is not necessary to feed the baby immediately after the birth since you are (will be) tired and the baby is often not interested anyhow. It isn't necessary, but it is often very helpful (See handouts Breastfeeding—Starting Out Right and Skin to Skin Contact). Babies can breastfeed while the mother is lying down or sleeping, though most mothers do not want to sleep at a moment such as this.
Babies do not always show an interest in feeding immediately, but this is not a reason to prevent them from having the opportunity. Many babies latch on in the hour or two after delivery, and this is the time that is most conducive to getting started well, but they can't do it if they are separated from their mothers. If you are getting the impression that the baby's getting weighed, eye drops and vitamin K injection have priority over establishing breastfeeding, you might wonder about someone's commitment to breastfeeding.