Nikki Lee wrote:
Oh what a difficult thing it is to artificially feed a baby, between making
the formula correctly and being able to afford it.
http://www.newswise.com/articles/infants-at-risk-from-formula-stretching
Two-thirds of the families in the federal Special Supplemental Nutrition
Program for Women, Infants and Children (WIC) program - which provides
nutrition basics for low-income women with children - reported running out
of WIC-supplied formula toward the end of most months. Among food-insecure
families, 27 percent reported watering down formula or reducing feedings, a
practice that can have serious health consequences for babies' developing
brains, leading to cognitive, behavioral and psychological issues.
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Unfortunately, reports of this situation - of diluting artificial infant
feeds to make them "stretch" - goes back a long way and resurfaces from time
to time. It happened in similar populations in London in the 1880s-1890s,
over a hundred years ago, and in the West Indies in the 1960s. These would
not have been the only times and settings, just the ones I can think of
quickly. 
For instance, use of cheap substitutes such as cornflour or arrowroot
"flour", mixed with water, meant that - although the fluids looked "milky"
or "creamy" - they were calorie deficient and nutrient deficient and the
babies took large amounts and failed to thrive. Cheadle's lectures to
students of paediatrics at the Great Ormond Street Hospital in London in the
1880s are an interesting read. There was a huge number of commercial
preparations advertised in London for the feeding of infants in the
late-19th and early-20th centuries, but some families made do with the
above, and the babies ended up failing to thrive or with rickets. 
There was subsequently a campaign to encourage breastfeeding in Britain at
the turn of the 20th century, but mainly because so many would-be recruits
to the military didn't make the height limit after being artificially fed so
inadequately. It was, in fact, lowered to 5 ft 1 inch. The motivation was
imperial (foot soldiers for the Empire), rather than humanitarian. This has
been written about by a number of historians and so I shan't detail that
here.
Low-income mothers still, in some countries that I'm aware of, want to
bottle feed their babies with artificial milk, to "show they can afford it"
and to save face. Sort of a denial of being poor. Then, on returning home,
they can't afford to buy enough to feed their babies.
Any planning to counter the potential negative effects of supplementary food
programs on infant health - anywhere - needs to listen to the mothers'
concerns and meet them where they are at (emotions and beliefs), rather than
telling them what we think they should know. How can women with no
breastfeeding role models in their families or neighbourhoods believe that
something that doesn't cost money, doesn't come out of a can, and is
(mostly) invisible, is any good? Several generations since World War II have
grown up with consumerism (buying is good).
How can normal infant behaviour (e.g. frequently seeking the breast) be
understood by the mother and those around her as good, and not starvation?
In many, many cultures there are generations where this sort of belief has
been deeply entrenched - and Lactnetters will know the same beliefs or fears
are found among health care professionals, as well as among low-income
families.
There is also the "gift" interactions, with underlying feelings of
obligation to use a gift, whether in gift packs distributed in hospitals or
the access to supplements afterwards. Let's not forget the sense of
obligation to use pumps and products given at baby showers.
Knowing the local situation and what mothers "know" and feel - and what
their partners and mothers "know" - is always relevant. (Yes, I'm only
reiterating what many of you already know!)
On re-reading this, I realise it looks gloomy. It is not meant to be, but a
call for action in ways that address mothers' insecurities.

Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA 
Private Practice IBCLC
Cultural Historian of the History of Medicine,
Brisbane, Qld, Australia 
E: [log in to unmask] 
 

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