Kimberly Seals Allers

    New York Magazine “Milk Culture” Column Gets it All Wrong; Undermines Women & Babies

    Posted December 10th, 2012 by

    Breastfeeding: No “culture” required

    As a woman born, raised and educated in New York City, I take any and all commentary, critiques, songs or even Haikus about my city, very seriously.

    And I admit, as a journalist with degrees from NYU and Columbia J-School (told you I was a New Yorker), I have an unusual predilection to facts. One might even call me “obsessed.” Please forgive me.

    But the recent New York Magazine, BroadMinded column, “Milk Culture: Rise of the Breast-feeding Obsessed,” penned by Alissa Quart (also a Columbia J-School alumna) is woefully, well, narrow-minded at best and shows a true lack of understanding of the infant feeding landscape for mothers in New York City and across America.

    As a maternal and infant health advocate, I am committed to making sure all voices are represented in the breastfeeding table talk and that the health of infants is not prostituted by the media for the next controversial cover or for a spot in the coveted “Most Commented” box.

    Over the past few months, I’ve watched with sheer bewilderment at the highly emotional response to New York City’s Latch On initiative, which seeks to monitor not ban infant formula distribution. While there’s been much ado about “choice”  and warnings of a “nanny state” infringing on women’s rights by allegedly removing feeding options, I’ve been shocked about how little most women know about the actual environment of the hospital where they deliver.

    While I applaud Ms. Quart for noting (albeit three-fourths of the way in) that breastfeeding is the healthiest food for infants the rest of her column is blatantly devoid of one critical component: actual facts. You know numbers, data or statistics. The kind typically used by journalists to support a premise.

    The other blatant omission is perspective. But I will start with the facts.

    Facts which can be obtained by visiting the state’s health department website (shout out to Women’s eNews for compiling this info).  A few clicks revealed some of New York City’s hospital data as reported by the hospitals themselves. At University Hospital of Brooklyn, in the Flatbush area, for example,  93.6 percent of the babies born there in 2010 were fed any breast milk at all– a high initiation rate. But the percentage of babies who were being breastfed yet supplemented with formula in those first few days was 96.1 percent.

    Spoiler Alert: Once you begin supplementing, you’re much more likely to reduce your own milk supply, which will increase your use of formula. And so on. Early supplementation is the surest and loudest death knell for a successful breastfeeding experience.

    Oh and New York State has the second highest supplementation rate in the nation. New Jersey is the worst state.

    Indeed, only 3.6 percent babies born at University Hospital are exclusively breastfed by the time of discharge.

    At New York Medical Center of Queens, 46.7 percent initiate breastfeeding, but the supplementation rate is 84.5 percent. Only 7.2 percent of babies born there were exclusively breastfed at discharge. I delivered my son at this hospital and experienced nurses repeatedly ignoring my feeding decision and suggesting formula at the slightest sign of common early breastfeeding challenges.

    Travel to Manhattan’s Upper East side, to the New York Presbyterian Hospital- Cornell Weill Center where 92.9 percent of babies were fed any breast milk, and the supplementation rate was 74 percent. The percentage of exclusively breastfed babies was 24.1 percent.

    These high initiation rates show that most women do want to breastfeed, but somehow, something happens early in their journey and they don’t continue. I’ll offer up the easy access and excessive promotion of formula by hospital staff as a starting point.

    As I travel the country in my breastfeeding advocacy and consulting work, too often I speak with some nurses who have the infant formula rep’s phone number on speed-dial or posted on the nursing station bulletin board. These reps use hospital policy loopholes to sponsor continuing education credits, conference expenses and more lunches than you can imagine for the maternity ward nursing staff.

    P.S. infant formula companies know that the hospital is ground zero for a mother’s feeding experience, that early supplementation is a breastfeeding “killer” and that the early days will likely shape the road ahead–which is why they spend billions marketing to hospitals and giving away free samples to mothers.

    Therefore, no mother can have true “choice” when some hospitals are making back- door deals with infant formula makers and determining maternity ward policy based on (not what’s best for mom or baby) what’s best for profits considering the handsome rebates the infant formula companies provide to hospitals in exchange for access to 100% of  its new mothers.

    Compare that with NYU Hospital Centers, one of New York City’s Baby Friendly hospitals, which only gives infant formula when medically directed. The initiation rate is 96 percent, the exclusive breastfeeding rate is 95 percent and the supplementation rate is 0.9 percent. Wow! It’s amazing what moms can successfully do, if its their choice, without any other influences.

    Later, Ms. Quart attempts to delve into the complicated space of race and class and the impact on breastfeeding. Very important. Yet, I find it confusing how she seeks to buttress a comment about a New York City initiative and speak to the barriers of low income women by…(Wait for it…) speaking to a Rockville, Maryland-based physician.

    Cue head scratching here.

    Yes, Rockville, Maryland—a suburb about 20 miles from Washington, D.C. where the median family income is $102, 544 and the median home price is $390,000.

    Quoting from her BroadMinded column:

    When I spoke to Suzanna Martin, a pediatric emergency physician who works at Shady Grove Adventist Hospital in Rockville, Maryland, she was critical of Latch On.

     ”Women arent stupid theyve got the information, said Martin. They know breast-feeding is better than formula. But Martin notes that not everyone can afford pumps, Those suckers are $300. And how easy is it for low-income woman to pump at work?

     And while Dr. Martin correctly mentions the price of pumps as a key barrier for low-income women, she fails to mention that most health insurance providers now cover the cost of a pump or that her own hospital rents high quality pumps for $75.00 per month. Her own hospital, Shady Grove Adventist, also offers a free breastfeeding “warm” line where mothers can get their questions answered by lactation consultants or visit the free weekly breastfeeding support group–the kind of group that was invaluable to me for help with navigating the back-to-work challenges.

    Also, the low-income women Dr. Martin cares so much about would likely qualify for WIC (Special Supplemental Program for Women, Infants and Children), where in New York City currently employs 210 breastfeeding peer counselors. Free pumps, internationally board certified lactation consultants and other support is also available.  All women can find great tips on making use of the federal law and Affordable HealthCare mandate which allows for pumping breaks at the United States Breastfeeding Committee website.

    And if she really wanted to speak to the plight of low-income women particularly as it relates to their breastfeeding experience, I would encourage Ms. Quart to skip Maryland suburbia and take a train ride over to Jamaica Hospital in my home borough of Queens.  Out of the nearly 5,000 births in 2010, 96.5% were initially breastfed but the actual number of exclusively breastfed babies at time of discharge was a whopping 2.

    One. Two.

    What’s most egregious, however, is Dr. Martin’s comment that “Women aren’t stupid,” as if the decision to breastfeed or not is a purely intellectual one, based on education or good ole’ common sense. How insulting and short-sighted. Overly simplistic comments like these ignore the more powerful influences of cultural nuances, a lack of multi-generational support, company policies and communities that are a virtual desert of  support mechanisms.

    Now for some perspective.

    By using the word “culture” repeatedly in her headline and body paragraphs, Ms. Quart seeks to define and stereotype mothers, as if being a breastfeeding proponent means you are akin to the Mayim Bialiks (with all due respect) of this world. Breastfeeding my baby does not mean I subscribe to any “natural” parenting, “attachment” parenting or any other parenting “culture,” league or clique–it simply means I want to give my baby the healthiest first food possible. Point blank. Period.

    I breastfed both of my children for at least one year each, while hiding my recyclables in black bags to avoid a fine and always carrying an overpriced (and probably not eco-friendly) designer diaper bag.  We slept with our baby in our bed before I knew of any “co-sleeping” parenting “strategy” because it just seemed easier to scoot over and pop it out for middle of the night feedings. And because my British-born but of West Indian parentage husband grew up poor, babies sleeping with their parents just seemed normal to him. Please don’t put me in the Bialik box. Or any other.

    Words like “obsessed” and “culture” are trigger words that fuel the so-called “mommy wars” and the “us vs. them” environment among parents that is already at fever pitch. Fanning these destructive flames, at a time when mothers need more support is irresponsible.

    In fact, it’s the media who are “obsessed” with mothers and breastfeeding. Women just want to make the best decision for their lives and their infants without the influence of corporate interests or media desperation. I implore all mothers to ignore attempts to alienate, define and divide us. And its high time that “not stupid” women like Ms. Quart stop being complicit in this tactic.

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    December 16, 2012 at 6:08 pm by Amy

    Moms-to-be; please take a prenatal breastfeeding class. And get the name/number of your local IBCLC; International Board Certified Lactation Consultant. Breastfeeding is best!


    December 12, 2012 at 10:31 pm by Sharon

    Let me just be the voice from the other side. I think breast feeding is great, woman should be able to breast feed on public, and work places should be more accomodating to nursing moms. However, let’s be careful not to judge bottle feeding moms- they didn’t all start b/c it was just more convenient or someone @ the hospital told them to. I had a baby that even after spending a lot of $ on a lactation consultant, wasn’t latching on. On top of that was serious post partum depression. Bottle feeding was really almost a necessity. I felt lime a failure. More than once, breast feeding moms made derogatory comments about me being a bad mom w/o even knowing my story. So please just remember not to judge moms who make different choices.


    Linda Reply:

    @Sharon, Nowhere in this article does Ms. Allers bash formula feeding moms. It’s time we help women whose breastfeeding experiences were negative are able to heal, not feel attacked and demeaned. You deserved better help than you got and for that I apologize on behalf of breastfeeding helpers.


    December 11, 2012 at 11:12 pm by priscilla

    great article!…please keep using your gift of writing to support moms and babies!


    December 11, 2012 at 6:07 pm by Lauren

    “as if the decision to breastfeed or not is a purely intellectual one”

    At my company* Holiday Party last night, I was asked by 3 different well-educated, well-heeled women (wives) if I am still breast-feeding my 3rd child who just turned 5 months old. Only one of them had breast-fed a child for 12 months and most of the response was that it was too inconvenient to continue breastfeeding. None of them were lacking resources for lactation consultants, breast-pumps or time. They each have three children and do not work outside of the home for financial need or career advancement.

    I simply can’t imagine their perspective as much as they have difficulty with mine.

    *I work full time outside of my home.


    December 11, 2012 at 10:39 am by Denise Bulpitt

    Beautifully written and informative article. As a hospital based IBCLC working in a Baby Friendly Hospital I tackle this every day. What people need to understand is that it IS about getting all the facts, making an informed decision AND most importantly getting the support you need to support your decision. I will be sharing your article with my Baby Friendly Hospital Committee today. Now that the Joint Commission has adopted Exclusive Breast Milk Feeding as a Perinatal Core Measure, hospitals will need to pay attention.


    Anita Reply:

    Thank you for your comment and for sharing the article!


    December 11, 2012 at 9:49 am by Shannon

    Love this! So many issues beautifully addressed and well-articulated. I’m a nurse and lactation consultant and in my hospital’s NICU yesterday, I had a doctor “worried” that the increasing numbers of women who want to breastfeed and the numbers of people available to support them would make other moms fearful of using formula at all. That “it’s perfectly fine to just give a baby a couple of bottles of formula per day in the first week while the mother is waiting for her milk to come in”…(this is a Neonatologist and his opinion seemed to be coming –obviously not from facts– rather his own parenting experience). And somewhere in there “breastfeeding Nazi” came out and I’m like, “Really?!! Nazi??!”- no words. I basically told him that hospital protocols and thinking will be very different in 10 years and I’ll wait for him on the winning side! Wonderful article- will print for work and thank you!


    Jennifer Reply:

    I swear Neonatologists are the worst when it comes to this issue. I think it may be because formula is so much more convenient to use in NICU. My daughter ended up in NICU when her blood sugar dropped to 4 (that’s right 4) 48 hours after birth. The hospital we were at is very progressive and pro-breastfeeding, until you end up in NICU. The Neonatologist seemed to have no concept of how the early stages of breastfeeding works and insisted that this happened due to deficient milk supply on my part. Luckily, everyone under the sun had seen me breastfeed the baby and I quickly mobilized my pediatrician and the hospital lactation consultant to get NICU to minimize the formula they were giving my baby. When we left the hospital, she still told me I needed to supplement and gave me a bunch of free samples, and I smiled and nodded and promptly went back to exclusive breastfeeding. It turns out my daughter has a rare genetic disorder related to her ability to process fatty acids and I’m pretty positive that my exclusive breastfeeding is the best thing I can be doing for her at this point. Had I not be incredibly informed and entirely vigilant on this issue, I’m sure I would have left the hospital formula feeding my baby, even though breastfeeding is the supposed overarching goal of this hospital.


    Anita Reply:

    Thank you Shannon, for sharing your comment and for taking this piece to work!


    December 11, 2012 at 12:02 am by Jeanette McCulloch

    Kimberly ~ Once again, spot on. Breastfeeding is about biological norms, not just an attachment parenting culture. Thanks for this great piece. And two? Really? After such a high initiation rate? So glad you are educating birth and breastfeeding professionals about what we need to do to support *all* moms.


    December 10, 2012 at 10:55 pm by Sarah

    Thank you. We need more journalists who are educated about breastfeeding! Extremely well written and important article.



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