Dear all:

The reason why I am so grateful to Marcia Walker for keeping on top of the various different risks of formula feeding and to ILCA for routinely publishing policy statements on the hazards of formula feeding is that most health care practitioners never DO discuss the risks.  I have never had a parent tell me that health care practitioner explained to them that making up formula to the right concentration is risky business.  I have never had a parent tell me that another health care practitioner told them about the FDA warning about using powdered formula.  I have never had a parent tell me that another health care practitioner explained to them that soy formula is likely to be just as allergenic as cow's milk formula and may have other risks associated with the phytoestrogens.  I have never had a parent tell me that another health care practitioner told them about human donor milk.  I have never had a parent tell me that another health care practitioner told them how to feed their baby from an artificial device in ways that don't increase the risk of aspiration.  

The basic point is that we are better placed than many health care practitioners to talk frankly about those risks and help parents minimize some of those risks.  We certainly cannot eliminate all of those risks by the very nature of formula itself.  But why are we squeamish about openly discussing the risks of formula feeding in ways that help parents mitigate as many of those risks as are possible?  Do you really believe that the formula industry sponsored talks are really giving most health care practitioners good information about why lactose-free formula is a totally bizarre marketing gimmick?  Do you really think that the formula industry is disclosing the fact that DHA is genetically modified and that the minor differences they find between formulas have never really been compared to breastfeeding?   Do you really believe that the formula industry sponsored talks are even giving appropriate information about how to formula feed in ways that will mimic breastfeeding?  Who is that magical health care practitioner who will give parents full information to wend their way through the vast amounts of misinformation?  And I would say that even for someone relatively well informed it is a HUGE challenge to wend your way through it.

I recently looked at a pamphlet from one of the local hospitals.  Here is what it recommended for formula feeding:
2-3 oz, 8 times per day for 0 to 3 week old infants
3-5 oz, 5-7 times per day for 3 week old to 2 month old infants
5-7 oz, 4-6 times per day for 2-3 month old infants

Now, I know parents who will read this information and think they should do the same thing with breast milk.  When even formula fed infants should never be put on this plan.  How can we rationalize the absurdity of pouring 7 ounces down the throat of a 2-3 month old and feeding that baby only 4 times per day?  This is the most insane overstretching and overriding of normal hunger satiety cues that I can think of.  No wonder we have such a huge childhood obesity epidemic with this type of early training. 

We should be training all parents to feed their infants as normally as possible.  We are working with PROBLEMS that interfere with breastfeeding and we should be looking for SOLUTIONS that push parents in the direction of NORMAL infant feeding which is breastfeeding.  If we can turn around the current societal model which is "breastfeeding like artificial feeding"  into "artificially feeding like breastfeeding" when there are problems, aren't we taking things one step towards implanting the idea that breastfeeding is the normal way to feed?  

If breastfeeding were going beautifully and intuitively for everyone, we wouldn't really need to "know" (in an analytic way) about breastfeeding at all.  Since we have had a planet wide destruction of the normal infant feeding habits, we do need to "know" about breastfeeding and its woefully flawed competition.  How do you think the formula industry has managed to be so successful?  They study the lactation community all the time and capitalize on our messages by perverting them.  

Best, Susan Burger, MHS, PhD, IBCLC

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