Abstract
Even in the field of breastfeeding medicine, some ask, “What is the big deal if a company markets bottles and nipples, as long as it is not formula? Some breastfeeding mothers have to use those things in order to keep breastfeeding!” Although I agree that sometimes mothers do need to use artificial teats and bottles to feed their babies, I would argue that most do not. In this day and age when many women do not reach their breastfeeding goals and start pumping and/or supplementing with formula unnecessarily (i.e., without a medical indication), the direct-to-consumer marketing of nipples and bottles undermines breastfeeding.
In the latest Academy of Breastfeeding Medicine Clinical Protocol #37, Physiologic Infant Care: Coping with Night-Time Breastfeeding, the evidence surrounding physiologic feeding is presented. Mothers and babies are wired to breastfeed. In an ideal world, there would be few to no barriers to this physiologic process proceeding. Mothers would have all of the supports they need to establish and maintain breastfeeding. There would be universal paid maternity leave. Mothers would have built-in help caring for themselves, their babies, and their older children, either within their own family or in the “village” or community in which they live. In this way, there would be little to no need for artificial nipples, bottles, and pumps unless they were medically needed.
In many locations in modern society, mothers do find it necessary to have these products available to continue breastfeeding. Does this make it acceptable to market them directly to families, and “sell” them as necessary items? Or, is there the need to appeal to a higher moral code? If the problem is that mothers do not have what they need to breastfeed, should we work to fix that core, societal problem, or should we allow corporations to profit from their need to be away from their infants by supplying “bandaids.”
Shouldn't we instead be advocating for the supports that make breastfeeding easier, more do-able, more attainable? Do we need bottles and breast pumps and ways to artificially feed babies, or should we be enacting legislation and creating policies and interventions that enable and empower mothers to physiologically feed their babies? And for those that need extra equipment or supplies, can't we just have them? Do they have to be marketed to those who do not need it, especially when they mislead mothers into thinking they do?
As an organization, the Academy of Breastfeeding Medicine is committed to the notion that breastfeeding is a human right. Breastfeeding is physiologic feeding, and rather than promoting “other” ways of feeding because breastfeeding has been suboptimally supported or made harder by modern day forces, we believe that more can be done to help this biological process survive and thrive. We all have a moral obligation to not just patch holes, but rather to fix the underlying problems that are making it harder for mothers to breastfeed. We will not partner with industry that violates the World Health Organization Code of Marketing of Artificial Breast Milk (or Breastfeeding) Substitutes.