“Breast milk is the gold standard for infant nutrition and the only necessary food for the first 6 months of an infant’s life. Infant formula is deficient and inferior to breast milk in meeting infants’ nutritional needs. The infant formula industry has contributed to low rates of breastfeeding through various methods of marketing and advertising infant formula.”
This is the first line of National Center for Biotechnology Information’s (NCIB) more recent studies, but this sentiment wasn’t always the case.
The benefits of breastfeeding that are obvious to us today, were once forgotten or never articulated:
- Breastfeeding protects babies from infections and illnesses that include diarrhea, ear infections and pneumonia.
- Breastfed babies are less likely to develop asthma and allergies, and it reduces the risk of sudden infant death syndrome (SIDS).
- Children who are breastfed for six months are less likely to become obese.
- Breastfeeding also offers mothers considerable postpartum and long-term health benefits, such as decreased risk of breast and ovarian cancers.
Of course, we know now that the benefits of breastfeeding go far beyond just the baby’s health; it has benefits for the mother and the relationship between the two, as well as economic ramifications that contribute to the family and society as a whole. Families who opt out of buying formula would save $1200 - $1500 the first year alone.
If breastfeeding is so good and so innate, why was it ever questioned?
Breastfeeding throughout history
Breastfeeding is so natural that it seems crazy that there could ever have been any second-guessing it.
Throughout history, most infants were breastfed until they were at least a year old. Alternatives to breast milk were homemade formulas which consisted of cow’s milk. But by the 1940s, the duration had dropped to about six months, after which babies transitioned to cow’s milk. Incidentally, although most infants were breastfed, it was also during the 40s that the overall rate of breastfeeding started to decline.
By the 50s, concentrated, commercially made formula hit the market and parents loved the convenience. And by the late 50s, breastfeeding had all but become a thing of the past. “According to a national mail-back survey conducted in 1958, only 30 percent of mother of young infants reported their babies were either completely or partially breastfed at one week of age.”
So by 1960, formula became available in readymade packages, which complimented the change in the household as more women ventured into the workforce. In fact, during the 70s, less than 25% of infants were breastfed at any point. American parents were giving babies formula for the first half-year before switching over to cow’s milk thereafter.
And then like most things, the research eventually caught up with what we already knew historically—that a mother’s breast milk, as nature intended, might have benefits that simply can’t be replicated in a lab.
In the 1980s, the US government enacted a national initiative for breastfeeding. The goal to have 75% of mothers at least breastfeeding while in the hospital and 35% still breastfeeding after the child was six months old.
Advertising in the 80s, however, affected how mothers (the consumers) viewed the option of breastfeeding versus the convenience of readymade formulas.
“Breast-feeding resurged to 54 percent in 1980, probably because of increasing awareness of the advantages of mother's milk and the activism of groups like La Leche League, whose insistence that nature's way is best appeals to a generation weaned on ecology."
When it came to lower income, urban families, maybe they—the US government, corporations, formula companies Gerber and Carnation, or all three parties—knew the advantages of breastfeeding and chose to keep this knowledge at bay. Or maybe it was a concerted effort to get these working class women out of hospital beds and back on the job.
In any case, inner city mothers were heavily targeted in advertising and thus slower to adapt to the national shifting back to breastfeeding.
WIC, Women Infants and Children, an organization that services low-income families, has historically provided formula, a product they must pay for but that is free to its clients, over educating these families about breastfeeding and promoting the economic benefits.
If breastfeeding is best, why is WIC providing formula? “Even though WIC is promoting breastfeeding, and does not have any explicit campaign to promote formula feeding, the knowledge that WIC provides free formula is likely to be an important factor in attracting clients to WIC. On that basis, it would not be surprising that WIC clients are more likely to choose formula than those outside the WIC program.”
They presume that breastfeeding rates in WIC clients are lower simply because breastfeeding is just less common in lower income communities. But this all goes back to education. If WIC is providing the formula, couldn’t they just as well provide the education?
“A [study] conducted by the New York City Department of Health revealed that 68 percent of the mothers who gave birth in all types of city hospitals  planned to use infant formula; the figure rose to 82 percent in municipal hospitals, where most of the maternity patients are lower-income women. Infant formula is popular with some low-income women because they see it as ‘a kind of status symbol,’ says Judith Gordon, formerly a researcher at the city's Bureau of Maternity Services, but doctors believe that a more significant contributing factor is the need for many of these women to return to work soon after giving birth, which makes formula the simplest feeding method.”
In 2011, the Surgeon General put out a Call to Action to Support Breastfeeding, which outlines steps that can be taken to remove some of the obstacles faced by women who want to breastfeed their babies.
Today, the breastfeeding appears to be mainstream again and going strong!
How many American women breastfeed their babies?
- Three out of four mothers (75%) in the U.S. start out breastfeeding, according to the Centers for Disease Control and Prevention’s 2010 Breastfeeding Report Card.
- At the end of six months, breastfeeding rates fall to 43%, and only 13% of babies are exclusively breastfed.
- Among African-American babies, the rates are significantly lower, 58% start out breastfeeding, and 28% breastfeed at six months, with 8% exclusively breastfed at six months.
- The Healthy People 2020 objectives for breastfeeding are: 82% ever breastfed, 61% at 6 months, and 34% at 1 year.
And the impact economically are noticeable. According to the Surgeon General:
- Families who follow optimal breastfeeding practices can save between $1,200–$1,500 in expenditures on infant formula in the first year alone.
- A study published last year in the journal Pediatrics estimated that if 90% of U.S. families followed guidelines to breastfeed exclusively for six months, the U.S. would annually save $13 billion from reduced medical and other costs.
- For both employers and employees, better infant health means fewer health insurance claims, less employee time off to care for sick children, and higher productivity.
- Mutual of Omaha found that health care costs for newborns are three times lower for babies whose mothers participate in the company’s employee maternity and lactation program.
Still, baby formula continues to be popular too. According to the United States Department of Agriculture, more than 80 percent of infants three to 11 months old in the United States are fed at least some infant formula. The volume of infant formula sold in the United States is approximately 28 billion ounces per year.
According to NCIB, “Public health programs should continue to promote breastfeeding initiation and increase support of breastfeeding continuation, especially among subgroups with the lowest rates (i.e.,Black, poor and young mothers; mothers with less than a high school education; and mothers residing in rural areas.”
But whether the baby is fed naturally by the mother or given formula is the mother’s choice, and one that she must make based on her personal situation, lifestyle, or values.
We encourage the continued education to families across the income spectrum so that