Helping Themselves: Breastfeeding Advice Nestle-Style

by phdinparenting on November 4, 2009

This is a guest post by Erin, a breastfeeding counselor who teaches women how to succeed at breastfeeding. This post is a reflection of her opinion on Nestle’s breastfeeding advice. Read what follows and decide for yourself what the company’s true intentions are.

Why would the world’s largest infant formula company want to help mothers breastfeed? Huge spoiler ahead. Ready? They don’t. Yes, Nestle runs a glossy US website called the Start Healthy Stay Healthy Resource Center which claims that it gives expert advice about infant nutrition. Yes, the website’s informational section on breastfeeding is actually larger than the corresponding section on formula feeding. And yes, of course, some of the advice is accurate. It has to be. If they gave nothing but blatantly bogus information that would look pretty bad and a certain level of credibility is essential. Instead, the advice is misleading and manipulative in subtle ways. The “why” part should go without saying; if they can turn a mother who plans to breastfeed (as the majority do these days) into a mother who feeds her baby Good Start, they have just earned thousands of dollars. Switzerland is not in fact neutral.

Confident commitment before initiation is important to breastfeeding success. If a mother’s desire to nurse her baby, her trust in the process, or her confidence in her own abilities can be eroded then that is a win for Big Formula. Take a look at the pages that follow and you will see that those are precisely the types of subliminal messages (breastfeeding is difficult, painful, icky, and unnecessary) in Nestle’s breastfeeding information. I have provided screen captures after the links for readers outside the US who may not be able to access the website. (Clicking the photos again will make them large enough to read, by the way.)

  • Breastfeeding accessories (screen capture) This page is bound to get traffic since shopping for a new baby is perennially popular. According to Nestle, a nursing bra is “designed to let you inconspicuously open a cup to expose a breast for your baby.” That’s right– if you want to breastfeed you’re going to have to expose yourself to your child (who incidentally wants “easy access“) while trying to hide the fact. Pervert! Anyway so, oh yeah, you wanted something to put on your gift registry? How about some special (read: weird) nursing clothes. More “oversize shirts with buttons down the front” are going to sound awesome to women who have been stuck in maternity clothes for months.
  • Nutritious choices for breastfeeding moms (screen capture) Wait, what, you thought you were going to be able to eat? Make sure that pasta is “lightly sauced” and have some more vegetables with your vegetables. This reinforces the myth that a mother has to be really careful about what she eats while breastfeeding, which in turn makes nursing seem like an ideal that is probably unattainable for the average mother. Sure it’s a great idea for everyone to eat healthier, including nursing mothers, but this page is conspicuously lacking one important fact: what a mother eats usually has zero effect on the quality of her milk.
  • Breastfeeding problems and solutions (screen capture, screen capture) There is no mention of colostrum in the section titled “Understanding your lactating breasts.” From reading that someone might think that it could be up to 6 days before there is anything for the baby to eat. And how about the description of the milk coming in? Pain in the mother’s breasts and the baby having a hard time latching are emphasized. Then in case you missed the part about the pain they’ve got “chapped or tender nipples” next in bold. The information given on how to deal with that is flat-out wrong; “lanolin-free moisturizing balms” are not recommended and hydrogel patches are controversial. Next up is “inflamed milk ducts.” Huh? I think they mean “blocked ducts” there. If they were a bigger, richer, more powerful company maybe they could Google the proper term. Or, maybe “inflamed” sounds more painful. To “feed a baby right,” Nestle then tells you, it necessary to make sure your nipple is “covered almost completely by the baby’s mouth, with her tongue on the underside of your nipple.” Poorly written, details and phrasing chosen for creep-factor, and last but not least totally wrong. If your baby doesn’t have the entire nipple far back in her mouth, as well as a good portion of areola, you are going to have some serious pain as well as a baby who cannot get milk from your breasts. In closing, they advise that you should “pay attention to your milk supply” and that fatigue can reduce it. That’s okay though because no new mom is fatigued, right?
  • Solve breastfeeding dilemmas (screen capture, screen capture) You supposedly learned how to solve breastfeeding problems so now you can move on to the dilemmas. Nipple confusion, they say, happens because the bottle is “easier” for the baby and apparently can be avoided by not giving bottles “during the first week.” Then a few sentences later it says to wait three weeks. Oh hell, it sounds like one week is probaby good enough, right? The sooner the better since this breastfeeding stuff is so garbled and confusing. For latch on problems, make sure your baby is taking in “approximately one inch from the tip of your nipple.” Which is unlikely to be a deep enough latch and certainly won’t solve any existing problem.
  • When your baby loses interest in breastfeeding (screen capture) Even if your baby is only 3 months old, a nursing strike might mean that “she’s ready to give up nursing.” No, wrong answer, but it plays right into the hope that just a little bit of breastfeeding is enough (surely if baby herself is ready to stop there is no harm) and transforms normal occurences like temporary disinterest into pseudo-self weaning.
  • Why breastfeeding is best (screen capture) By this time maybe the resolve to breastfeed is beginning to waver. Why would anyone undertake such a confusing, embarassing, inconvenient sacrifice? Surely reading about why breastfeeding is “best” will affirm that choice. Well, it says here that breastmilk “contains the perfect balance of nutrients including DHA & ARA.” It is also “naturally gentle on baby’s developing digestive system.” Furthermore it “contains antibodies to help protect your baby from illness.” That sounds kind of good. But the language sort of rings a bell. Let’s check the description of Nestle Good Start Protect Plus. (screen capture, screen capture) This stuff has “complete nutrition,” “DHA & ARA for baby’s brain and eye development,” is “easy to digest” and it “supports baby’s healthy immune system.” Wow that’s almost exactly the same! (Except, of course, it isn’t. Not even close.)

Have you come to your senses yet, new mothers? If so, then it’s time to either start supplementing your breastmilk (screen shot) or you might want to just go ahead and transition to formula (screen shot). Nestle treats these two situations as different events even though they usually aren’t. There is no mention of milk supply dropping when supplements are introduced. Any doubts you might have about whether or not this is the right thing to do should be soothed by the assurance that formula could be a “nourishing, nurturing choice for your baby” as well as the helpful transitioning chart, where formula feedings are represented by cute little red hearts that multiply and breastfeedings are the faded blue dots getting nudged off the edge.

You may have noticed that in multiple places these marketing materials (we can stop playing along by calling them breastfeeding information) carry disclaimers. This is one crops up frequently: “Breastmilk is the ideal food for babies. Talk with your doctor about your feeding choices.” For an explanation of why “ideal” is a description of human milk that is ineffective in terms of breastfeeding promotion, check out this classic piece by Diane Weissinger called Watch Your Language. As for the second part about looking to your doctor for guidance, although many health organizations worldwide have very strongly worded recommendations to breastfeed, unfortunately doctors in America don’t necessarily recommend it to their patients. In fact, according to the American Academy of Pediatrics, “Obstacles to initiation and continuation of breastfeeding include…lack of encouragement and guidance from health care professionals.” The disclaimer is probably there at least in part for legal purposes; the company needs to avoid looking as if it is giving out medical advice. But really why wouldn’t Nestle spam this disclaimer all over the place anyway? It makes them look more honest and credible while risking little or nothing. Maybe even gaining.

There is, however, a disclaimer on the site that they probably benefit less from. Not coincidentally it is a little more difficult to find. After trumpeting all over the website that breastmilk has DHA and ARA but so does formula, they quietly admit in the fine print at the bottom of this page that “studies to date have not established brain and eye development like breastmilk based on the levels of DHA and ARA added to infant formula.” Surprisingly, US FDA regulations do not require novel ingredients like these new oils (which are chemically extracted from algae, by the way) to prove their usefulness before being added to an infant formula. If formula companies wanted to, they could throw some blue food coloring into their recipe. Why not. It’s a food product that has “GRAS” (generally recognized as safe) status according to the government. That might be a good idea actually; since human milk often has a slightly blue hue, this new and improved formula could then be marketed as “closer than ever to breastmilk.” If you think that’s way over the top, read this document from the California WIC Association about the lengths that formula manufacturers will go to increase their profits, and also this report from the Cornucopia Institute, a food safety watchdog group.

So, should Nestle revise the faux “breastfeeding advice” given on their website? Should they post links to La Leche League International instead? Or should they remove all mention of breastfeeding and just stick to formula? No. None of those options would be the ethically and morally correct course of action for the company to take. They should delete the entire website. All advertising or promotion of infant formula to the general public is forbidden by the International Code for the Marketing of Breastmilk Substitutes (Article 5.1) and furthermore marketing personnel are not permitted to seek contact of any kind with pregnant women or mothers of young children (Article 5.5.) Within the gigantic and blatant violation that is the “Start Healthy Stay Healthy Resource Center” are many more transgressions, such as idealizing artificial feeding (Article 4.2.) Essentially the company breaks every rule that it possibly can ands get away with it because in the United States there are no legal repercussions for doing it.

If any of this makes you angry, and you live in the US, take action. One quick and easy thing you can do is to file a complaint with the FTC online. Companies aren’t supposed to advertise in a way that is false and deceptive. If anyone comes away from that website thinking that any formula is similar to breastmilk then they have been misled. Each time the advertisement is seen it’s a separate violation, so go ahead and bookmark that page. The next thing you can do is to contact Congress. Tell your state Representatives and Senators that you want the Code put into law, in its entirety, so that companies are forced to start honoring it. You may also want to consider joining the Nestle boycott. Speaking to the company in the language they understand, in other words money, is probably the best hope outside legislation for creating change. Finally, perhaps the most important thing we can do is to spread the truth about infant feeding and to reach out and help other mothers whenever possible. Propaganda like we’ve just seen can only be taken seriously enough to do harm in a world where a motley mixture of myth, advertising copy and wishful thinking is routinely allowed to pass as fact.

Note from Annie (PhD in Parenting): If you are in Canada, you may wish to read up on Misleading Representations and Deceptive Marketing Practices and consider filing a complaint with the Competition Bureau.

Erin (@Artemnesia) is a breastfeeding counselor from central Massachusetts.  When she isn’t busy kissing boo-boos and nursing in public, she may be found playing no-limit Texas hold’em online. She isn’t a blogger yet, but is thinking of it…would you all give her some encouragement?

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{ 63 comments… read them below or add one }

1 Melissa November 5, 2009 at 12:06 am

Great post! I wish I had known then, what I know now, when I was struggling and trying to learn how to nurse my first baby. No wonder we had so many issues, all of the advice I was receiving and the language used, was leading me down the path towards formula! Luckily I had some awesome on-line support and a crazy drive to piss off my grossed out family members, and was able to successfully nurse my baby. Not for 3 months, 6 months or one year, but to go on to nurse while I was pregnant, and then tandem nurse, over 3 years now!! Take that formula companies!

And, I can’t believe you’re not a blogger! I think you have a LOT to say:) I look forward to more posts by you.

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2 Amber November 5, 2009 at 1:03 am

You must start a blog, Erin! I would totally visit. :)

I haven’t seen this website before (and I can’t view it directly being outside the US), but I have seen similar materials from various formula companies. They’re all sort of the same – mostly accurate, with just enough subtle messaging thrown in to make breastfeeding sound unpleasant or embarrassing. I sincerely hope that mothers who actually want to breastfeed exclusively seek out information from a source other than a formula company, which so clearly has a conflict of interest here.

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3 Jess November 5, 2009 at 1:34 am

As a multi-year breastfeeding mom, I was already waaaaaay on board. But now I’m just riled up. Seriously, who do they think they are!?! Well put. Please blog.

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4 Shauna November 5, 2009 at 1:55 am

Very well written, and researched. The magnitude of the deception is flabbergasting. I woudn’t have picked up on some of the more clever fabrications. Thanks for making me take a much needed closer look. Oh and you MUST blog more.

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5 katieh November 5, 2009 at 5:27 am

Thank you for writing this.

Particular to my own experiences, I had midwives who didn’t correct the mis-information about ‘nipple confusion’ that I had, and let my husband and I feed our son with a 5ml syringe from about 3 days old, because he was having a hard time latching on and repeatedly fell asleep at the breast. so i pumped (every two hours – night and day – as directed) and my husband fed our son 5ml at a time.

luckily after a few visits by different community midwives who couldn’t help, we went to the breastfeeding clinic at our local hospital – which happed to by run by sally inch and chloe fisher – i didn’t realise that i was meeting two massively important women with regards to breastfeeding, but i know now!

they weren’t surprised that i had been given the information that i had, and i will never forget chloe telling me about a letter she had published (which i hunted down) in a medical journal called ‘nipple confusion, who is confused?’

and now here i am, over a year later, still happily, and gratefully breastfeeding my son.

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6 Lara November 5, 2009 at 7:30 am

I just picked up a leaflet at my dr’s surgery with breastfeeding info from Nestle. This one mentions the diet thing, and also alcohol – of course you can’t touch the stuff if you’re breastfeeding!

Now to confront the doctor and get it removed!

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7 Naomi November 5, 2009 at 8:22 am

Please blog Erin so I can link to you!

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8 Shelly November 5, 2009 at 9:41 am

Love it!!

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9 Bettina November 5, 2009 at 9:43 am

Bravo! Well done! Should be required reading for all expecting mothers. :-)

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10 Summer November 5, 2009 at 10:31 am

LOVE THIS!!! Thank you so much for tearing their “help” apart piece by piece!

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11 Eilat November 5, 2009 at 11:58 am

This is infuriating, but not surprising. And is apparently pervasive as it reminds me of an encounter I had with an online retailer recently while trying to purchase bottles for my pumped milk that my daughter will drink while I am at work. It was a website called “babyearth.com”. I was so upset by the same kind of language all over their website that I wrote a complaint letter to them. I never heard back, but this seems like an appropriate forum to re-post:

To whom it may concern,

I am writing to express to you my deep disappointment with statements made on your website. I have a shopping cart full of products but after reading some statements on some of your pages I will now go somewhere else to buy these items.

I found your site via Google shopper, looking for a SwaddleMe blanket for my baby girl. I was pleased to see a website that seemed supportive of natural parenting products — in line with my own philosophy of living — and decided to continue shopping.

However, I was taken aback when I read on your link to “Check out more info on Breast Pumps & Accessories” that “Breast pumping can be exhausting and frustrating for women who are not prepared for the commitment it takes to regularly pump and provide nutrition for your baby via a machine.” As a mom who pumped for her son for 10 months 3 years ago (and am about to go back to work and do the same for my daughter), I believe this could be stated in a more positive way. Nowhere do you mention the benefits of breastfeeding or why a woman might choose to pump for her baby. This overly harsh admonition not to mention ridicule (“No one wants to feel like a dairy farm”) is out of line. Mothers who choose to pump milk for their babies could use support, not just warnings. How about some positive statements about the benefits of breastfeeding and the value of this great commitment? How about encouraging women that it is worth it? You might even sell some pumps along the way.

But it was the statement in your link to “Check out more info on Nursing” that really took the cake! “If you’ve made the choice to breastfeed, you’ll find that Nursing can be stressful and inconvenient, but only if you let it.” Really? So what you are telling new mothers is that their choice to breastfeed is trivial, a huge pain, and if they don’t succeed at it, it must be their fault. Bravo! You have succeeded in one sentence to offend both moms who are breastfeeding happily AND those who had difficulties and gave up. It is not surprising, I suppose, that you endorse the choice to bottlefeed (BPA free — of course! — “keep your little one safe”) so strongly (“Baby bottles are an essential for any new parent”).

It only got worse when I found you selling “No More Milk Tea Bags”. How very inappropriate (downright cynical!) to sell a tea to dry up mom’s milk in the *nursing* section!

It is clear from these examples, that your web site, despite its commitment to all things “natural,” holds a hostile view of breastfeeding. This is understandable from a business perspective, but highly disingenuous given your stated “commitment to making baby’s world as healthy, happy and safe as possible.” If you were truly “interested in raising [your] children in a wholesome all natural household,” you would present a more positive view of breastfeeding (or at least not be openly hostile to it!).

I hope the loss of my business will mean something to you. I urge you to educate yourselves about the health and emotional benefits of breastfeeding and change the tone of your website.

Sincerely,
Dr. Eilat xxxxx

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12 Holli November 5, 2009 at 3:17 pm

Omg, those comments about breastfeeding and pumping are awful!

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13 @Artemnesia (Erin) November 5, 2009 at 5:43 pm

So fantastic that you took the time to make the complaint. I truly believe that attitudes like that can be insidiously catchy and just as damaging as outright misinformation. Why not frame pumping as something awesome you can do for your baby during a separation? Making a mother feel crappy about pumping isn’t going to help sell pumping accessories that’s for sure.

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14 Andrea November 5, 2009 at 12:49 pm

Terrific post!

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15 space07 November 5, 2009 at 1:15 pm

Wow great article! I have read a lot of information on breastfeeding that you have written, but this is a very informative and consise call to action. I am so happy that people are realizing that breastfeeding is more than one option when it comes to feeding your child, it is the biological norm!!

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16 geekymummy November 5, 2009 at 1:28 pm

Gosh, the feeding on the road thing is the most nuts, implying that you have to carefully transport chilled breastmilk with you, when um, hello, you have your breasts with you at all times, easy peasy! The convenience of breastfeeding on the go is one of its greatest benefits to a mum, I was quite disappointed when I had to start carting cheerios and pureed carrot with me everywhere! Thanks for the post.

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17 Emma November 5, 2009 at 1:35 pm

Fab post – please keep blogging!

Will bookmark this for my breastfeeding counsellor assignments :-)

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18 Holli November 5, 2009 at 3:14 pm

This is infuriating! Thank you for all the time and energy you put into this post. I will definitely be following your links to file a complaint about the site…I totally agree that it should all be deleted. I am constantly surprised how many people don’t realize that formula should not be marketed to pregnant women…or at all for that matter.

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19 Jessica November 5, 2009 at 3:15 pm

I only got as far as the “feeding on the road” screen shot before I had to comment! I have actually seen moms who normally breastfeed, feed their baby a bottle of expressed milk at a get together. I never understood it. Maybe they have been reading Nestle’s website too much. Feeding on the road with a bf infant is the easiest thing in the world. You have the right food, at the right temperature, ready to go! What’s so hard about that???

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20 mjb November 5, 2009 at 3:24 pm

Great post! But if “marketing personnel are not permitted to seek contact of any kind with pregnant women or mothers of young children” how is Similac able to give moms a giant totebag of formula and coupons in the hospital?

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21 @Artemnesia (Erin) November 5, 2009 at 5:28 pm

Nestle isn’t the only company who violates the Code. They are, however, the largest and probably the worst offenders. This PDF lists all the companies and shows the ways in which they break and bend the rules:

http://www.ibfan.org/art/298-9.pdf

(The first page is supposed to be upside down as it is a flyer.)

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22 errn November 5, 2009 at 4:57 pm

Great post. Your wealth of information is amazing. So proud of you :)

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23 @Artemnesia (Erin) November 5, 2009 at 5:36 pm

Thank you all very much for the positive feedback! :)

I do think there is a lot to be gained from looking at the strategies the formula companies use to try to influence mothers to bottle-feed. Identify the underlying messages is a first step toward countering them.

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24 Aly November 5, 2009 at 5:45 pm

I would follow you and could get you many more followers if you started a blog.You have a real flair forit and it would be a shame if you didn’t carry on.I’m retweeting the link to this post as everyone should get to read it.A truly fantastic read.

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25 Jill November 5, 2009 at 6:36 pm

I kept going back and reading the self-weaning statement about 3 to 6 month olds. That is garbage.

That just reminded me of the special black backpack I got four years ago when I left the hospital… you know that one. There was a booklet in there called ‘Breastfeeding: The First Two Months.” The illustration and font were total knock-offs of the Nursing Mother’s Companion and the content about breastfeeding and pumping was actually quite good for a new mom who was already intending to breastfeed without supplementation. I’m sure there was “formula is freedom!” verbiage that I ignored because it didn’t apply.

It didn’t dawn on me until about a year later that the title was a subversive suggestion that breastfeeding would last… two months.

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26 Andrea November 6, 2009 at 11:44 am

Yes, garbage, it makes no biological sense for a 3 to 6 month old to “self-wean”! Human babies have been around a lot longer than formula…

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27 Rachel November 5, 2009 at 6:49 pm

In case it hasn’t been said before, don’t think, just blog! (Oh, wait, it has!)

I echo the frustration and anger expressed in previous comments. I am not surprised, though, which is sad. I really wish that this country would get its priorities straight–in other words, some things are more important than profit. Such as, oh I don’t know, the health and well-being of our children.

I did notice that on the feeding on the road page it said “Ready-to-feed formula is ideal for no-mess feedings on the go.” Um, actually I thought breastfeeding was the ideal no-mess no-fuss option, didn’t you? No bottles, no coolers, no tabs, spills, no waste. Not to mention the best nutrition I can give my child.

I hear my friends spouting back a lot of the misconceptions that are prevelant in our society, and it just drives me crazy. How in the world to I counter all the advertising, doctors’ (mis)advice, and years of misconceptions without sounding like I’m lecturing? A woman shouldn’t have to go do research on her own (hopefully NOT on the Nestle site!) in order to learn the truth about feeding her baby. I mean, I thought I was well-informed before I had J. I had read up on breastfeeding, I had talked to a lactation consultant, I thought I was pretty knowledgable. And yet I am *still* learning basic things about breastfeeding. Someone less determined (and probably less interested) than I am would just read this or hear their doctor’s words and go with that.

Anyway, I’m a bit off topic now. Thank you for sharing this information.

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28 Lauren @ Hobo Mama November 5, 2009 at 9:25 pm

Oh, my, oh, my! I started skimming this before taking a closer look because the first thing to catch my eye was “a nursing bra is ‘designed to let you inconspicuously open a cup to expose a breast for your baby.’” I seriously thought this was something Nestle had written in a different language and then had badly translated back into English. Could the writing be more awkward and off-putting?

Thanks for taking the time to ridicule this. :) It was begging to be done.

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29 Pixie November 5, 2009 at 9:51 pm

Art, I love you! Your information has always been utter gold and gave me so much faith in my ability to make the best milk for my baby girl. It’s inspiring to see your passion continuing, working so hard to support so many other women in breastfeeding, giving their children the right food.
I’ve got a photo I’m going to have to email to you ;) You’ll love it.

Keep doing what you’re doing. I’ve missed seeing you around but it’s so good to know you’re still fighting to get good truths out there and expose the misconceptions and deceptions around formula.
~Pixie

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30 That Danielle November 5, 2009 at 10:05 pm

FABULOUS dissection! Thank you Erin and Annie!

I wonder who goes to a formula company for breastfeeding information in the first place? How are people finding them? Are they buying Google Adsense keywords like breastfeeding and pregnancy? How do they do on SEO?

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31 phdinparenting November 6, 2009 at 3:48 pm

Yes – they do buy up those keywords. I wrote a post called Sabotage with very specific examples of this deception.

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32 Erin November 5, 2009 at 10:10 pm

Great article, Erin!
Thanks for bringing to light these horrendous and transparent business practices. I wish more people knew that Nestle was in such strong violation of the code. Thanks for posting the links to the FTC website. I’m also a fan of contacting our congressmen so you’ve given me another reason to do so. The (mis)information they give on the site is absurd. Unfortunately, there are many women who have not be exposed to the resources they need to nurse successfully to their goal or until their child chooses to wean. (Which coincidentally doesn’t usually happen at 3 months.)

Which brings me to…
Gotta go nurse my 2 month old- according to Nestle, she’ll be losing interest soon and, well, that means it may be time to stop. Oh, wait, didn’t they say I should just pump and feed her breastmilk via a bottle. (Because that doesn’t take any time or effort at all!) But ya know, if it’s close enough to breast milk and she’s getting bottle nutrition anyways, maybe it wouldn’t hurt to go ahead and feed her some Crap Start a couple of times. Or most of the time. Hell, might as well go ahead and “transition.”

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33 Apsara November 5, 2009 at 11:48 pm

Very informative and well-written analysis. Thanks for your post!

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34 MZ November 6, 2009 at 3:29 am

Thanks for that last paragraph in particular! I am definitely going to file a complaint now. I get so upset when I hear my friends talk about supplementing from the get-go (I am the only one of the 6 of us pregnant at the same time who didn’t) because their doctors told them it wouldn’t affect their supply, or because they read that was the way to go, but never know what to say to avoid coming off holier-than-thou. I’m going to post the link here to my FB page so that everyone can come and read what you’ve written because you said it so well! And yes, definitely blog!

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35 Olivia November 6, 2009 at 11:16 am

Facsinating breakdown. I was especially intrigued by the “Watch your Language” link. I had never realized how they way breastfeeding language was constructed against bottle feeding being considered the norm. And that bit about a 3 month old self-weaning is incredulous! Only in a culture of formula feeding is it even possible to conceive of a 3 month old self-weaning.

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36 Sasha November 6, 2009 at 12:28 pm

I think you missed one blatant “subliminal message” in the breastfeeding accessories section

CHAFING AND BACTERIAL GROWTH…. mmmm really makes me want to breastfeed now!!

ugg

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37 natalieushka November 6, 2009 at 1:11 pm

While I cannot fault your analysis in terms of its soundness in fact about breastfeeding, I think you don’t give enough credit to moms. Certainly I have never considered the exposure of my breasts, for example, to be an inconvenience sufficient to avoid breastfeeding. My son is 11 weeks old and I have been BFing him in public since day 4. All of the new moms that I know (there are many of us in my close friend group) are educated, intelligent women who do their research before making decisions. We all read Dr. Newman’s book while we were pregnant, scoured kellymom and LLLI.org, and otherwise prepared ourselves for the reality of BFing in order to give our babies the absolute best possible start in life. We have hired lactation consultants, attended weekly BFing clinics, hounded our moms and aunts for advice, and shared our knowledge with each other. We are not so naive as to be swayed by what is clearly and unabashedly a marketing exercise. I think you do women a disservice by assuming we are all so uncommitted to BFing that we will be deceived into giving our babies formula. If you want to be a feminist, the first thing you need to do is believe in the ability of women to make their own informed choices.

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38 That Danielle November 6, 2009 at 2:26 pm

You/we are very fortunate to be highly educated and resourceful but we are in the minority in this country. Neither Annie nor Erin think moms are naive but most people are highly influenced by advertising and their peers who tell them that “formula is fine.” You don’t have to be young+poor+uneducated to “fall for” the marketing of formula companies.

In fact, middle class educated moms are the ones making the decision to never breastfeed or wean before 3 months because they receive misinformation by the people who are supposed to be looking out for them- their mothers, mothers-in-law, medical professionals who say they’re supportive of breastfeeding, etc. They are the ones being set up to fail from day 1 by well-meaning but baby-unfriendly hospital procedures.

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39 natalieushka November 6, 2009 at 2:46 pm

Fair enough and I am grateful for the fact that my hospital and doctor actively supported me. I think the place where you live is also a big factor. My SIL lives in a very conservative city in Canada and her plan is to wean at 3 months. I am hoping to talk her out of it.

So I guess the question is how we change this. Is complaining about Nestle going to do it? I’m not sure about that. I think the real change is going to come from the ground level – in hospitals and public health clinics and doctors’ offices.

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40 That Danielle November 6, 2009 at 2:54 pm

It’s a multi-tiered process.

Pressuring companies like Nestle to obey the International Code for the Marketing of Breastmilk Substitutes is a start. Who do you think sends samples and propaganda to doctors, nurses, hospitals? Formula bags given to new moms at hospitals have been shown to majorly derail breastfeeding so getting on formula companies’ cases to obey the International Code and discontinue this practice as well as pressuring the medical community not to accept them and become UNICEF Certified Baby-Friendly are two major ways we can help moms get off to the best possible start with breastfeeding.

Baby-Friendly hospitals not only do not give out formula gift bags to new moms, they must also purchase the formula used in the hospital therefore cutting out formula companies’ aggressive marketing via “free” samples.

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41 phdinparenting November 6, 2009 at 3:43 pm

@natalieushka: I understand what you are saying and as an educated, Internet proficient, well-read and well-connected, upper middle class professional, I also did my own research. However, I know plenty of other people in a similar demographic who were more than easily convinced by bad breastfeeding advice that came from their pediatricians, mothers, friends, nurses, etc. Bad advice comes in many forms and unfortunately this information from Nestle’s website is just one of many such examples.

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42 natalieushka November 6, 2009 at 1:17 pm

I should add that my friends and I are fortunate to hold privileged positions in society; we are all professional women, slightly older moms, middle to upper class, and we live in a liberal area of Canada where the local hospital strictly adheres to the WHO and Lamaze guidelines and medical professionals involved in maternity care almost without exception are incredibly supportive of breastfeeding. I realize that if we were young, poor, uneducated, got our advice from medical professionals from the “old guard”, or had to fight for basic things like the right to immediate skin-to-skin contact with our babies and exclusive BFing in hospital, then we would be more likely to fall for the marketing ploys you have so thoroughly debunked in your very good and informative article.

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43 mjb November 6, 2009 at 2:59 pm

I second that don’t have to be an unwashed yokel to fall prey to bad information. I was told *by nurses in the hospital* after I had my daughter, “if you want to breastfeed, you don’t have to do it all the time, you can give them formula too sometimes” and “don’t let her spend more than 10 minutes on a side or it will make your breasts sag.”

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44 That Danielle November 6, 2009 at 3:03 pm

That is so wrong it’s unethical. I know now that nurses can be some of the most uninformed medical professionals a new mom will come into contact with but at the time, I would have listened to any dumb piece of advice they might have given me because they’re medical professionals, right? They MUST know what they’re talking about! They deal with babies all of the time!

(Even the LACTATION COUNSELOR at the hospital told me some cockamamie advice like the need to wash my nipples before and after every feeding. WHAT????)

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45 phdinparenting November 6, 2009 at 3:45 pm

I also got bad advice at the hospital. The nurse suggested giving my son, who wouldn’t latch, just a bit of formula so that he would “know what it feels like to have a full tummy”. When I asked to see the lactation consultant, she said “I am a lactation consultant”. Turns out she wasn’t THE lactation consultant. Maybe she had done some training on lactation, but she wasn’t one of the hospitals designated lactation consultants who have their IBCLC certification.

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46 phdinparenting November 6, 2009 at 3:50 pm

I just added a note in the post with info on how to report misleading advertising in Canada.

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47 toyfoto November 6, 2009 at 5:32 pm

It’s hard enough to get the right information for your breastfeeding situation from the experts, I think the last place I would go for advice would be a formula manufacturer. It’s akin to getting smoking cessation information from tobacco companies.

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48 coffeewithjulie November 7, 2009 at 9:32 am

I want to let you know that I appreciate the intelligent, thought-provoking posts that I find here on your blog.

My experience, however, on the infant-feeding front seems radically different than that experienced by most of the commentators. Rather than receive pressure to feed my son with formula, I felt extremely strong pressure to feed my son by breastfeeding (during pregnancy, in hospital and socially at playgroups, etc.). While it would not have been impossible for me to breastfeed, my husband and I made a considered, educated decision to feed our son with formula when he was born last June.

As one example: I was alienated by the nursing staff at the hospital because of my decision — in words and actions. Despite having had a c-section and having lost a significant amount of blood, I received absolutely no help whatsoever to feed my son, even during the first hours after surgery, because of my choice to formula-feed (other women received help lifting their babies to their breasts, ensuring that baby was receiving adequate nutrition, and general feeding support). [I should note that this was in Australia, not Canada or the United States.]

All this is to say that I think the days of “pro-formula” are well over. I believe that the “breast is best” message has been heard and embraced loud and clear now, thanks to the passionate campaigning of women who have the best interests of babies and mothers at heart (not profits from sales).

I believe, like one of your other commentors, that women can identify that they should not consult a formula company for breast-feeding advice (just as one does not consult a tobacco company for quitting advice). But if someone does slip through the cracks, there are lactation consultants present in the hospitals to counter-act this messaging.

Naturally, this doesn’t excuse a formula company for manipulative strategies such as the “Start Healthy Stay Health Resource Centre.” It really crosses an ethical line and I will join with the others in raising my voice against it.

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49 phdinparenting November 7, 2009 at 2:54 pm

@coffeewithjulie: I agree that the “Breast is Best” message is very strong. I think the problem is that it is understood, yet not fully supported. Women are told to breastfeed, yet there are so many societal barriers to breastfeeding. Many women who want to breastfeed end up turning to formula and then feeling like a failure. We need to break down those barriers so that women who want to breastfeed are able to do so successfully and do not receive messages from formula companies, health professionals, family members, friends, the media, their employer and colleagues, and the public at large that undermine their ability to breastfeed.

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50 LeahGG November 7, 2009 at 2:34 pm

I have to agree with Julie. I got so many “Breast Only” messages that when I had a post partum hemorrhage and had a lactation consultant come in and even with motillium and fenugreek still was only producing less than one-half ounce every two hours, (and the baby refused to latch) I felt like an utter failure. People repeatedly asked if I was nursing and when I (stupidly) responded that I couldn’t, they’d lecture me on how I was ruining my baby’s life. It was the most miserable experience I can imagine.

Somehow the breast-bottle war needs to stop leaving so many mothers as casualties.

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51 phdinparenting November 7, 2009 at 3:00 pm

@LeahGG: I agree. It isn’t right to blame mothers. We should be attacking the things that prevent women from being able to breastfeed. Not attacking the women who cannot breastfeed.

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52 Kathy November 7, 2009 at 9:01 pm

Well, it’s Nestle, after all. Unethical practices around formula are kind of their stock in trade, no?

I would add, as another Australian, that the breast is best message is reinforced loud & clear throughout our health system, and hospitals generally offer good and accurate support to getting bf established. So much so that unfortunately I must agree with Julie and Leah above that mothers who are not bf get ostracised and stigmatised by nursing staff, which I think is also wong.

I had my husband bring in a tin of formula and some bottles for my poor roommate when I gave birth to my youngest -she’d had an emergency c-section, had intended to bf but it wasn’t working AT ALL and she was expressing zero – nothing whatsoever – and her baby was screeeeeaming day and night. Nurses just pointblank refused to get her any bottles, and her own partner was away, no family support. She was in sobs, begging them to help her feed her bub and they wouldn’t. It made me VERY cross. I even expressed a syringeful for her baby for one feed to get some colostrum into her (I had plenty, supply was never my problem) but obviously that wasn’t a sustainable solution.

I have fed all three of my daughters and the public hospital I gave birth in (via caesarian, all three times) really helped me get started feeding and helped me over the humps of poor latch (firstborn) and deep breast thrush (secondborn). My firstborn breastfed until 16 months of age and self-weaned during my pregnancy; my secondborn weaned at 23 months, and number 3 girl is still feeding several times daily at 9 months. Only one of my children has ever had any formula, and that was the firstborn, who had 1 bottle a day 3 days a week from 9 to 15 months when I returned to work part-time. In hindsight, I wish I had not even done that; I was only away 7-8 hours on those three days, and I could have pumped a cup of my milk for her and she would’ve been fine with food and water otherwise. But hey!

I guess what I find puzzling in Australia is, given the ostensibly good support for bf, our bf rates are pretty low past 3 months. The norm seems to be for most women to have a go, but for people to wean to formula very quickly for a whole bunch of reasons. Maybe the social / marketing messages have a part to play here – I’m not sure.

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53 geek anachronism November 8, 2009 at 3:11 am

There’s a lot of social pressure too – in my mother’s group (all first babies and between 3.5 to 5 months) I am the only one exclusively breastfeeding. Two formula fed from the start, the other five ‘transitioned’ because of everything from growth spurt issues to nipple trauma to pressure from other people. So you can imagine how wonderful it is for me, being the youngest, the only one exclusively breastfeeding, the only one co-sleeping and the only one who isn’t talking about upgrading my house/car/pram. The last meeting turned into a formula ad at one point – it’s so much easier apparently. And the little ones only throw up four times an hour and are a little constipated when you get the right brand.

I’m lucky – I’m highly educated, pretty damn ornery and not much for socialising. I also have a lot of support for breastfeeding from my family. If I didn’t and my only touchstones for children my age were the women in my mother’s group? I’d have thought the four month growth spurt meant my daughter was starving. I would have assumed that the drop in what I was expressing meant she wasn’t getting enough. I would have believed that I need to give her bottles of water now it’s getting hot. I would have believed that weaning would mean my breasts would stay perky and big (even though they’re already big and saggy). I would have believed that weaning would be better for my health. I would have believed that weaning would mean I could go out. I would have believed that weaning would stop the mastitis. Because these are women like me, right? They know what they’re talking about, they lived it, right?

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54 coffeewithjulie November 8, 2009 at 3:45 pm

Kathy – Thanks for sharing your experience in Australia. I have birthed one baby in Canada and one in Australia. Overall, I found that my public health care experience in Australia was excellent — the use of mid-wives as standard practice, the at-home support, the baby wellness clinics in every neighbourhood, and the availability of specialists as needed.

However, during the post-delivery days in hospital, some improvements seem necessary. Although we wouldn’t want the public system to encourage formula use, it seems inhumane — just plain cruel — not to help someone like your roommate. I only got through because I had a proactive, assertive husband who insisted that the nursing staff show him how to properly sterilize a bottle, make formula and store it safely. When I was able to get out of bed, he then taught me how to do it. My roommate in
in the Australian hospital was a heavy smoker, and again, although we don’t want to have a public hospital encouraging smoking, it seems some kind of reality check is necessary because people do smoke. When she would leave to go and have a cigarette, she needed to go down 3 floors and across the street, so it was not a quick process. Yet, there is no nursery and the nurses will not watch your baby so you can have a smoke So, what did she do? Well, she left an underweight new-born baby on her own periodically throughout the day and night.

On the flip side, I exclusively nursed my daughter after her birth in a Canadian hospital and was sent home with a bag full of “goodies” that included the standard fare of diaper coupons and whatnot but also promotional materials for formula. I don’t think public institutions should be giving out these “goody bags” at all — regardless of contents. I would be annoyed if my child’s public school sent home corporate crap too. These are public institutions, they should not be passively assisting in corporate campaigning.

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55 phdinparenting November 8, 2009 at 9:35 pm

@coffeewithjulie: Was your goodie bag from the hospital? Or from an organization operating in the hospital? I got a goodie bag in the hospital too, but I think it was from the Welcome Wagon.

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56 natalieushka November 8, 2009 at 4:08 pm

Julie, that is so interesting. I had my son at the (public, obviously) hospital here in Victoria, BC, which is an accredited Baby Friendly hospital. There was zero discussion of formula, even when he was not latching properly and a touch dehydrated (the nurse showed me how to manually express and feed it to him with a finger, to get him enough calories so that we could keep working on BFing). It is clear to me from this discussion that the variation in practice among hospitals and care providers is a real point of potential change if we’re going to encourage and support breastfeeding.

In my town, there is more embarrassment and shame in buying formula than there is in showing your breasts in public to feed your baby. I have been using a mixture of pumped breastmilk and formula to supplement for a few weeks now and every time I buy formula at the grocery store I feel like I almost have to hide it with my other purchases just in case I run into someone I know. And that is a shame.

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57 coffeewithjulie November 8, 2009 at 10:39 pm

natalieushka — I don’t know if it was real or imagined, but I admit that I did feel like I was being judged when I fed my baby with formula out in public. I agree that with you that it would have been much easier to nurse in public (although this type of social judgement changes after a baby looks over a certain age).

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58 coffeewithjulie November 8, 2009 at 10:28 pm

phdinparenting – Hmmm … good question. It was seven years ago and I just can’t remember who actually gave us that “goody bag.” I don’t know why Welcome Wagon folks should be allowed access to women in the hospital though — they’re a business, just like any other. Why should they get priviledged access to hospital patients? (From the Welcome Wagon website: “Serving the advertising needs of reputable businesses that can assist people with the changes they are experiencing.”)

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59 phdinparenting November 8, 2009 at 10:32 pm

@coffeewithjulie: Not sure how they get access. But I know that my goodie bag was from them and that it did contain samples and coupons from formula companies.

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60 coffeewithjulie November 8, 2009 at 10:49 pm

I think it’s wrong, and downright unethical that they get access. Imagine a company getting access to your children in school and giving them “goodie bags” of Coke coupons, samples of Cheerios, and free stickers with Lego logos on them. We’d be outraged (well, okay, I would at least). Not necessarily by the product in and of itself, but the priviledged access in a public institution. It’s not that I’m against advertising, PR, marketing — I’m all for it actually — but not in my hospital room, uninvited.

Hmmm … my friend just had a baby in an Ottawa-area hospital. I’m going to find out if these goodie bags are still the norm (and what’s inside).

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61 phdinparenting November 8, 2009 at 11:07 pm

@coffeewithjulie: I agree that it is outrageous. I did ask someone recently to tell me if she got a visit from the Welcome Wagon and a goodie bag and she said no. I also didn’t get one with my second child (born in 2007), although I did with my first (born in 2004).

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62 coffeewithjulie November 29, 2009 at 6:14 pm

BTW – I did send an email inquiry to Welcome Wagon asking if they visit new mothers in hospitals. Never got a response.

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63 I'm a Full Time Mummy February 20, 2010 at 12:47 pm

Thanks for posting this! I am so glad to find this site. Hope you don’t mind if I share this out on my blog so that my bloggy friends can read about this too!

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