The illusion of choice, the free market, and your boobs

New York City Mayor Mike Bloomberg started an initiative called "Latch on New York" that is asking hospitals to take the formula samples off the bedside tables of new mothers and put them behind the nursing stations or in the drug cabinets so mothers have to ask for them. People are up in arms about this, crying that Mayor Mike is trying to prevent women from choosing and that he's creating a "nanny state."

No.

What he is doing is trying to even the playing field, so huge corporations that don't know or care about your health, your child's health, or any of the decision you make as a parent do not have the ability to pay to have access to your bedside table.

Does it make you angry that formula companies have paid to have the kind of access to you that no one but your chosen medical providers should have? That they have unfettered access to tell you things about your body that may be blatantly false? It makes me angry, but money buys your freedom. I'm surprised the formula companies haven't started striking deals in which women come out of labor and delivery with adhesive stickers (with the name of the formula) stuck across our breasts so the only way even to try to breastfeed is to peel off the stickers first.

Taking formula off your bedside table does nothing to change your ability to choose for yourself. If you are not handed a formula sample in the hospital there is NO EFFECT on your ability to give your child formula when you get down to the lobby, when you get home, a week later, six months later. None. If you are given formula in the hospital we know (based on formula company research) that women are less likely to breastfeed. This means that being given formula in the hospital narrows our choices. Not being given formula, no restriction on choice. Being given formula, restriction on choice.

If you truly care about a woman's right to choose what's best for her and her baby, you will take the financial pressure out of the equation, and eliminate any actions that impede free choice. Putting formula samples right next to the baby's head impedes free choice. Having to ask for formula (just like you have to ask for tylenol, or an extra chucks pad, or another container of orange juice) doesn't impede free choice. It doesn't change anything for women who cannot breastfeed--they can still get those formula samples easily by asking. It doesn't change anything for women who don't want to breastfeed--they can still get those formula samples easily by asking. It could change everything for women who want to breasfeed but don't have correct information or are experiencing problems they can overcome if they're given help, because they will be given EQUAL ACCESS to information that can help them breastfeed and formula samples. They ask for help or they ask for formula. Equal access. No privilege for formula.

I don't want the decisions I make about how to parent my children made by the highest bidder. Especially since the highest bidder doesn't care about me and only wants my money. (Let's not forget that those formula samples are worth about $1.50. A woman who chooses to feed formula based on those samples has just been signed on to spend hundreds or thousands of dollars on formula once she leaves the hospital. She is never informed of that. Is THAT free choice?)

I don't care how you feed your baby. But I want you to make a decision about it with all the information, all the support, and all the help you can get. Free choice. I do not want your choices narrowed by the huge financial incentives formula manufacturers pour into hospitals.

As usual, Mayor Mike has gone about his objectives in a ham-fisted way, barrelling in and offending people in an effort to protect consumers. Had I been mayor I'd have gone about it a different way, by requiring any formula company that wants to market directly to consumers in a vulnerable position to fund the salaries of three full-time lactation consultants for every 10 beds in a maternity ward so there is always an LC available to troubleshoot problems, along with providing training in breastfeeding once a year for every RN, LPN, and MD on the floor. Then, go ahead and put formula on the bedside table because there would be an LC right there, too.

But until there is an even playing field, ACTUAL FREE CHOICE WITH BOTH OPTIONS REPRESENTED EQUALLY, don't believe the hype.

 

(Special thanks to Dr. Aneel Karnani of the Ross School of Business at the University of Michigan for several discussions that informed the argument in this essay.)

 

UPDATE: Don't beliueve that having formula on the table affects your likelihood of breastfeeding? PhD in Parenting has a roundup of the research on it at the bottom of this post.