Dear Editor:  Your story entitled "In a reversal, bottle-feeding gets
a bad rap" (Life section, Dec.5/95), highlights the difficulties faced by
some bottle-feeding mothersin a changing social climate favoring
breastfeeding, but does little to explain the "breastfeeding pressure".
The sum total of breastfeeding benefits to
babies far exceeds those hinted at in your article.  Formula-fed babies
have twice as many ear infections as babies breastfed exclusively (i.e.
without added formula) for at least four months.  They are at increased
risk of gastroenteritis and more likely to be hospitalized and/or die
from dehydration resulting from it than breastfed babies.  In addition to
the increased risk of diabetes and colitis mentioned, they have a
demonstrated increased risk of allergy and asthma, sudden infant death
syndrome, lymphoma, and possibly multiple sclerosis and juvenile rheumatoid
arthritis.  Along with sub-optimal neurologic and oral development, and
possible psychological deprivation, these are compelling reasons to
recommend breastfeeding whenever possible on the basis of infant health
alone.
However, your article neglects the equally important risks to mothers
who do not breastfeed.  Their babies may "turn out allright", but they
themselves are at increased risk of hemorrhage after birth, as well as
weight gain, breast, ovarian and uterine cancers and possibly
osteoporosis.  Due to the increased risk of various illnesses in their
children, formula-feeding mothers have increased absenteeism from work,
not to mention the increased stress and financial burden of doctors'
bills and medications.  Nowhere does your article state the cost of one
year's supply of formula, which can range from $1200-1800, as high as
$2200 for the "hypoallergenic" formulas some babies end up on.
Criticizing any mother for her feeding choice, breast or bottle, is an
act of ignorance and insensitivity.  Mothers make their decisions based
on their own knowledge and life circumstances.  Some mothers truly cannot
breastfeed due to medical reasons, while others are bottle-feeding
because their breastfeeding was wittingly or unwittingly sabotaged by
ignorant health care providers or unsupportive relatives.  Some mothers
"bottle-feeding" in public are actually feeding their own expressed milk.
A mother who truly cannot breastfeed certainly need not feel guilty or a
failure.  A mother who could have breastfed but was misinformed or had
her breastfeeding mismanaged should feel anger rather than
guilt.
At a time when all available evidence points to a vast gap
between the two methods of infant feeding, the real guilt lies with
those who continue to sell American mothers the bill of goods
that "breast is a little better, but probably too difficult, inconvenient or
even risky".  This includes newspapers which highlight devastating "breastfeed
ing failure" cases due largely to mismanagement, without pointing out that
the needed formula could have been given by cup, spoon or a special
feeding tube at the breast, thereby preserving or restoring the milk
supply and ultimately allowing the baby and mother to reap the benefits
of breastfeeding.               Sincerely,
                                Alicia Dermer, MD, IBCLC
                                69 County Road 516,
                                Old Bridge, NJ 08857
                                (908)254-1515; Fax (908)651-0774
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