Bottled Up. Suzanne Barston
search box and voila—thousands of answers at your fingertips. Who needs a physician when there’s WebMD? Or friends when there are chat rooms?
The Internet hooks you from the start: women struggling to get pregnant find themselves lured by the siren song of TwoWeekWait.com, where they’ll be aided and abetted by others equally obsessed with having two lines pop up on a urinedrenched stick. Later, if you’re considering a home birth, you can hit up Mothering.com, where there are plenty of folks assuring you that this is indeed the safer, smarter option. On the message board I frequented while pregnant, women would post queries like “is this labor?” or “am I miscarrying?” prior to calling an actual MD. The danger in this, obviously, is that anyone with a keyboard can claim to be an expert; the World Wide Web has opened us up to a world of biased misinformation under the guise of “Web journalism.” The Internet is a physician, therapist, and best friend but also your worst enemy, a bad boyfriend who treats you like trash but then shows up with flowers and candy.
Google breastfeeding and you’ll find a minefield of information. In addition to articles supporting the vast superiority of breastmilk over formula, there is ample help for any nursing problem under the sun—breastfeeding after a reduction or implants; nursing your adopted child; even lactation for men (which, for the record, is indeed possible). But amidst the plethora of substantial, legitimate information, there is also a cacophony of foreboding, judgmental voices: “lactivist” blogs that compare formula feeding to child abuse; public message boards with calls to action—“I automatically feel sorry for the baby sitting in the cart in the formula aisle as their parent loads up on cans of the stuff. I feel like yelling ‘HOW CAN YOU DO THAT TO THE POOR CHILD!?’ ” says one poster on a Facebook breastfeeding group forum;3 diatribes from medical professionals and lactation consultants, using their professional credentials to validate staunch personal beliefs. Even a board dedicated to planning Disney World dream vacations devolves into a formula-versus-breastfeeding argument when a woman brings up the lack of nursing rooms in Frontierland.
When I first performed my own prenatal Internet search on infant feeding, I was surprised by the vitriol expressed in these lactivist websites toward formula feeders, but since the breast-feeders were in my prospective camp, I chose to ignore my sneaking suspicion that something was amiss. Plus, I admit that I possessed an embarrassingly classist view regarding formula. Better bonding, improved immunity, less chance of childhood obesity, higher IQ, reduced cancer risk—all this could be yours, simply by nursing. Knowing all this information was out there, I couldn’t believe there was anyone who didn’t breastfeed these days, other than uneducated teenage moms, those with uncompromising work situations, or those unfortunate women who were physically unable to do so (and according to what I had read on the La Leche League website, there were very few of these women out there—far fewer than the formula lobby and misinformed doctors would have us believe).
It was one thing if a legitimate medical reason, insensitive employer, or lack of education stopped a mom from nursing; but all things being equal, it seemed selfish not to breastfeed. I certainly didn’t think formula was poison; almost everyone I knew in my generation was formula fed, and we all survived. But as another poster on that Facebook forum lamented, if we had all been breastfed, “who knows how much better [we] could have been?”
In my former life, I was more than immune to peer pressure; rather, I would choose the “alternative” point of view just to differentiate myself. But when it came to motherhood, I was a simpering mess, just waiting for the cultural zeitgeist to sway me in a certain direction. Because when it came down to it, like Prissy in Gone with the Wind, I didn’t know much about birthing babies, and even less about raising them. If the smart, progressive moms were breastfeeding, then I would be breastfeeding too.
• • •
A few months before I gave birth, a package arrived at my door. It included a sample can of Similac formula and a ton of literature on breastfeeding.
My husband watched me open the package and raised his eyebrows when he saw its contents.
“Why did they send you that?” he asked. “We’re breastfeeding.”
It was a good question, with a rather convoluted answer. The International Code of Marketing Breastmilk Substitutes (known in lactivist circles as the “WHO Code”) prohibits formula companies from advertising in any conspicuous way: “There should be no advertising or other form of promotion to the general public of products within the scope of this Code,” proclaims article 5.1 of this policy, coauthored in 1981 by UNICEF and the World Health Organization (WHO).4
The creation of the WHO Code was inspired by events that caused the Nestlé company to begin to be associated with infant death rather than chocolaty goodness. The debacle began when Nestlé deployed “Mothercraft” nurses, dressed in white uniforms evocative of medical professionals, to assist new moms in the maternity wards of developing nations. The trouble was that these “Mothercraft nurses” were not nurses by any stretch of the imagination, and they liberally doled out formula along with infant-rearing advice.5 Mothers were encouraged to use formula under these false pretenses and sent home with free samples; their milk soon dried up, as did the formula freebies. Faced with limited financial resources and, in many cases, a contaminated water supply, babies were soon being fed with diluted bottles of disease-laced formula. This caused dehydration, malnutrition, and fatal cases of bacterial infections and gastroenteritis from the compromised water used to mix the formula; breastfeeding advocates claimed that up to ten million infant deaths could be attributed to the proliferation of infant formula use in developing nations. Physicians, religious leaders, and activists banded together to demand a boycott of Nestlé products worldwide and to encourage the promotion of breastfeeding as the safest and best form of infant feeding.6
The Nestlé controversy was integral to the resurgence of breastfeeding in Western societies, many of which had become primarily bottle-feeding cultures in recent decades. It not only revealed that formula companies were out for the bottom line and apparently had no concern for the infants they were claiming to nourish, but also led morally driven scientists and social activists to question the formula-accepting status quo. Within several years of the Nestlé disaster, WHO came out with its famous Code, an outpouring of studies suggesting the superiority of breastmilk hit the medical journals, and an international conference was convened to create the Innocenti Declaration,7 which could be considered the cornerstone of lactivism. Developed during a WHO/UNICEF policymakers’ meeting in the summer of 1990 (held at the appropriately named Spedale degli Innocenti in Florence, Italy), this declaration outlined the importance of global breastfeeding initiatives: “As a global goal for optimal maternal and child health and nutrition … all infants should be fed exclusively on breastmilk from birth to 4–6 months of age. … [T]his goal requires, in many countries, the reinforcement of a ‘breastfeeding culture’ and its vigorous defence against incursions of a ‘bottle-feeding culture’ … utilizing to the full the prestige and authority of acknowledged leaders of society in all walks of life.”8
The serious tone of the Innocenti conference reflected a belief—inspired by the Nestlé debacle—that formula feeding was legitimately dangerous. It didn’t really matter that what caused the deaths of so many third-world children was not the formula, specifically, but a slew of formula-handling-related problems (contaminated water, lack of resources); even in affluent Western cultures where these problems were practically nonexistent, people began viewing formula as a deadly substance. This mentality became more pervasive through the decades, gaining momentum through literature that frames risks in ways that the average person can easily misinterpret. For example, in her book The Politics of Breastfeeding, nutritionist and outspoken breastfeeding activist Gabrielle Palmer chastises the United States for its hypocrisy in claiming to defend the life and liberty of babies in a myriad of military conflicts, and then being unwilling to set “guidelines for the marketing of a product which could kill children.”9 The Los Angeles Breastfeeding Task Force website somberly states that “the practice of feeding babies infant formula … carries with it profound risks in modern, industrialized countries, as well as