Lentis/Baby Formula

While breastfeeding is considered to be superior to baby formula, most mothers in the United States continue to feed their infants baby formula. Experts argue that breast milk provides newborns with the best nutrients for growth and development. However, baby formula offers much desired convenience for the modern-day woman. In order to analyze the controversy behind acceptable infant feeding, this article will begin with a brief history of the invention and development of baby formula. Next, both sides of the argument will be introduced and defended. Ultimately, the controversy surrounding baby formula demonstrates how perceptions of technological innovations can change drastically overtime according to cultural norms.

History
In ancient Mesopotamia, the upper class, who viewed breastfeeding as manual labor, used wet nurses to feed their own infants. Additionally, wealthy women shunned breastfeeding because it delays a woman's menstrual cycle, preventing her from becoming pregnant again. This practice of employing wet nurses continued throughout western Europe until the Enlightenment. At this time, scientists and philosophers began to advocate mothers breastfeeding their own children. For instance, Karl Linnaeus, who came up with the plant and animal classification system, grouped humans in the mammalia kingdom for their ability to lactate and thus urged women to feed their own children. However, this viewpoint did not take a strong hold among mothers and did not have a strong impact on the methods of infant nutrition.

The Industrial Revolution was the primary driving force for the development of alternative infant feeding methods. During this time, poorer women, who had previously been wet nurses, went to work in factories where they could make more money to provide for their family. Often they worked over twelve hour days and barely had enough time to breastfeed their own children let alone the upper class'. It became increasingly difficult for wealthy mothers to hire wet nurses, and so they began using homemade remedies to feed their newborn. These remedies included cow's milk, bread, and sugar wrapped in a cloth which the infant then sucked on.

In the 1860s, more nutritionally suitable commercial substitutes began to be developed. Henri Nestle, who's goal was to “prevent infant mortality due to malnutrition,” created the most successful substitute its kind. His formula, Farine Lactée Nestlé, comprised of cow’s milk, wheat flour, and sugar. The first infant to receive this formula had previously rejected his mother’s milk and other conventional substitutes. However, the infant drank Nestle's formula, saving his life. With this success, Nestle began to market the infant formula across Europe with the trademark bird’s nest for his family seal.

Arguments for Breastfeeding
There is a great deal of controversy over using baby formula or breastfeeding to feed newborns. Many health organizations, including the World Health Organization (WHO), the American Academy of Pediatrics (AAP), and the American Medical Association (AMA), support breastfeeding children to provide them with the nutrients for survival and growth. The United States national goal in 2000 was "75% of women should leave the hospital nursing their infants; 50% of women should continue to breastfeed their infants for the first six months of life and at least 25% should still be breastfeeding at one year postpartum". With this encouragement, the initiation of breastfeeding after birth drastically increased from 51.1 percent in 1990 to 77 percent in 2005. These health organizations recommend exclusively breastfeeding infants for the first 6 months of life. After this time period, the mother can begin introducing mashed food and other fluids, while continuing to breast feed their infants for up to two years after birth.

Benefits of Breastfeeding
Breast milk, unlike formula, has live cells and antibodies that help infants fight off infection before they develop their own immune system. A study conducted by the National Institutes of Health (NIH) showed that breastfed infants in neonatal intensive care were less likely to be re-hospitalized. These infants also scored higher on the Mental Development Index, 89.7 compared to 76.5. A study conducted in Brazil showed that infant mortality was significantly less in provinces where breastfeeding was the primary means of nourishing a new born.

Breastfeeding also has benefits for the mother. According to La Leche League International (LLLI), breastfeeding burns 200-500 calories a day, saves money, and provides bonding time with newborn infants. These benefits can encourage mothers to breastfeed newborns not just for their infant's health, but also for their own benefit. However, women who breastfeed must monitor their diet to provide their child with all the necessary nutrients.

According to LLLI breastfeeding also benefits society. Since breastfed infants are healthier than formula fed, "if 90 percent of families breastfed exclusively for 6 months, nearly 1,000 deaths among infants could be prevented." Additionally, healthier infants would also mean lower healthcare costs nationwide.

Baby Formula and the Modern-Day Woman
In a 2001 statement, the World Health Organization acknowledged breastfeeding as “an unequalled way of providing ideal food for the health, growth, and development of infants”. Additionally, this statement recommended that an infant should be exclusively breastfed for the first six months of life. WHO recognized that some women due to medical conditions are unable to breastfeed (e.g., the mother has HIV). In these rare cases, breast-milk substitutes are a suitable alternative. However, in 2007, the United States Center for Disease Control and Prevention’s Department of Health and Human Services issued a “Breastfeeding Report Card” which indicated that only 13.3% of mothers nationwide exclusively breastfeed their infants at 6 months old. If women know the benefits of breastfeeding both for the mother and for the infant, then why are so few women breastfeeding?

The Workplace
One of the main reasons why the modern-day woman uses baby formula instead of breast milk to feed her infant is because most mothers are working women. The United States is one of the few remaining developed countries that does not offer paid maternity leave. Under the Family and Medical Leave Act, the birth of a child allows mothers and fathers to take an unpaid, job-protected leave that lasts a maximum of twelve work weeks, or three months. However, this only applies to women who are working for companies with more than fifty employees. In contrast, the United Kingdom offers a partially paid thirty-nine week, approximately ten month, maternity leave. For the American woman, her income provides valuable resources for her family. Thus, taking twelve, unpaid weeks off of work would detrimentally effect the family’s funds. Because of the United States’ lack of an acceptable maternity leave, most mother’s feel pressured to return to work even before the end of their three month, unpaid maternity leave and resort to feeding their newborns baby formula.

Social Stigma
Another reason why mothers are feeding their newborns baby formula is because there is a social stigma against breastfeeding in public. The “sexualization” of the breast has caused most people to be uncomfortable with the sight of a bare breast of a mother who is nursing her child in public. In her essay, “The Sexualization of Breasts: The Impact on Breastfeeding”, Neilia Sherman asserts that breastfeeding ruins society’s “carefully preserved illusion that breasts are sex objects”. Pornography, television shows and racy advertisements have transformed the breast from a life-giving gland into a sex organ. Sherman concludes, “We tend to forget the indisputable truth: that they are merely mammary glands – fatty tissue with milk ducts designed to feed babies”. As a result, society has, in effect, deemed breastfeeding as inappropriate due to its sexual undertones; thus, most mothers, while in public, feed their babies formula.

For example, on a 2006 Delta Airlines flight from Vermont to New York, Emily Gillette, in the company of her husband, began to breastfeed her 22-month old daughter in the back of the plane. Although she was holding her shirt closed, a flight attendant who was uncomfortable with the situation approached her, attempted to hand her a blanket, and asked her to cover up. Offended, Emily refused to do so, claiming she had a right to breastfeed her child. At this, the flight attendant returned with a Delta Airlines ticket agent who then escorted the Gillettes off the plane. Commenting on the situation, Emily said, “No woman should ever be ashamed of breast-feeding. [I want] both airlines to create policies that protect a woman from being harassed for feeding her child on an airplane.” After the incident, Emily filed complaints against the airlines, stating that they violated state law.

Breastfeeding Advocacy and Legislation
In order to increase the prevalence of breastfeeding, several breast milk advocacy groups have arisen, such as La Leche League International and The National Alliance for Breastfeeding Advocacy (NABA). These groups have involved themselves in an array of activities from publishing literature to creating emotional support groups for moms. Most notably, they have instilled the mantra “Breast Is Best!” in the minds of expecting parents and doctors.

Additionally, due to the lobbying efforts of breastfeeding advocacy groups, several state laws have been passed. Florida was the first state to enact legislation regarding nursing mothers in 1994; however, as of 2010, forty-four states have passed laws concerning breastfeeding. For instance, Virginia Code § 18.2-387 exempts breastfeeding mothers from indecent exposure laws. Additionally, the Patient Protection and Affordable Care Act, signed in March 2010 by President Barack Obama, amended Section 7 of the Fair Labor Standards Act to require companies of fifty or more employees to provide “reasonable break time for an employee to express breast milk for her nursing child” as well as “a place, other than a bathroom…which may be used by an employee to express breast milk”. Some employers have embraced this law and even gone to the extent of even providing breast pumps as well as paid break time.

While legislation has been passed, the social stigma surrounding breastfeeding keeps it from increasing in prevalence because of a lack of knowledge about the legislation. For instance, while eating at a Johnny Rockets restaurant in Kentucky, Corday Piston stepped aside to breastfeed her six-month old daughter. Due to complaints from other customers, the manager asked Piston to either breastfeed her child in the restaurant’s bathroom or to move to a park bench. Piston refused and subsequently informed the manager of Kentucky legislature giving her the right to breastfeed in any public or private location. In response to the incident, she said, “What I would hope is that business owners realize it is the law and it's incredibly important to educate their employees”. Thus, in order for mothers to feel comfortable and unashamed of breastfeeding in public, breastfeeding legislation needs to be respected and enforced.

Conclusion
Baby formula was invented to prevent malnutrition in newborns. Nestle hoped to decrease infant mortality, believing that a mother's poor diet and poor living conditions contributed to infant death. While Nestle may have identified one of the key causes of infant mortality, his formula proved to be less nutritional than breast milk. It did not carry the live antibodies that a mother's breast milk provides her child. However, the use of baby formula continued. Baby formula transformed from a way to prevent infant death to a convenience for working mothers and a way to combat the social stigma of breastfeeding. Many technologies can transform in use over time and it is important to realize this change in philosophy. Societies need to understand the driving forces behind the technologies they are supporting.