If formula was made to be available only by prescription then breastfeeding rates would increase and the formula industry would “shrink like an unmilked breast“. That’s according to Erik Assadourian, who wrote an article in the Guardian  arguing that

He is calling for ‘a global treaty’ to ‘phase out’ this ‘unneeded product’, modelled on the treaty used to ban tobacco (yes tobacco…)

Assadourian is Transforming Cultures project director at the Worldwatch Institute and as part of this new ‘treaty’ he calls for a ban of formula advertising and product placement and puts forward the idea to:

Assadourian is assuming that the decision not to breastfeed or to mix feed or switch to formula, is a simple one. That it is one affected by the fact that there are shelves of formula in the supermarket easily available for us to go and buy. The truth is a bit more complex than that.

‘Breast is best’ but let’s clarify

Assadourian shares a compelling projection to show just how important breastfeeding is:

Even today, the WHO finds that if all of the world’s children were exclusively breastfed for the first six months of life, as opposed to just the current 35%, 1.5 million fewer children under the age of five would die each year.

This quote is correct and is made by Dr Elizabeth Mason of the WHO. However this projection about infant deaths refers mostly to infants in developing countries and the risk of malnutrition and infection that they face if they are not breastfed.

Factors such as inappropriate milk substitutes, unsanitary bottles, and unclean water, all pose a serious risk to infant health. It can be a significant health benefit to newborns in developing countries for their mothers to breastfeed and breastfeed exclusively.

Save the Children makes a similar projection but states things more clearly:

Save the Children estimates that 830,000 infant deaths in developing countries could be prevented if every baby were given breast milk, and only breast milk, in the first hour.

It’s worth noting that Assadourian shared this ‘projection of infant deaths’ in his article for the Guardian.com which has readers mainly in developed countries. 60% of readers are in the UK and US alone and their infants do not face the same level of risk if their babies are not breastfed.

The comparison between the benefits of formula milk and breast milk in young babies of developed countries is a very different one. And this is an important distinction to make when discussing the benefits of breastfeeding.

Assadourian also refers to studies done comparing breastfeeding and formula feeding in developed countries. These studies associate breastfed infants with lower incidences of a number of diseases later in life. Although the studies do mention that there is no causal link between the two, they provide evidence that for babies breast is indeed best.

But even with this in mind, is this whole picture when it comes to breastfeeding?

A woman’s choice

Breastfeeding involves a big commitment from mothers, and from their bodies.

20% of mums in the UK choose not to breastfeed. Should they not be allowed to make this choice for themselves and for their bodies?

After all, it’s their bodies and their babies.

Breastfeeding is natural but that doesn’t mean that it’s easy

80% of UK mothers (a vast majority) choose to breastfeed when their babies are born.

The figures reveal that this number tails off significantly after 2 weeks. A trend which implies that many mums do struggle to breastfeed.

In fact a recent study found that more than three quarters of mothers struggled to breastfeed. That’s an awful lot of women who have tried and suffered to get it right.

A few of the many common problems mothers face are:

• Problems getting baby to latch
• Recurrent mastitis
• Tongue-tie in babies which can lead to feeding difficulties
• Postnatal depression or struggles with other conditions
• Low milk production sometimes due to tiredness and stress

The fact is, it does not go seamlessly for the majority of mothers.

For the mums that try to breastfeed but encounter problems, they are then faced with an entirely different issue. That of feeling miserable and ‘like a failure’. And yet so many feel an ‘unrealistic pressure’ to battle on.

Assadourian is not suggesting that formula should be banned altogether but by suggesting it could be made prescription only, formula would be much harder to get hold of.

For new mothers, having to go and ask a professional doctor for a prescription, is likely to increase the feelings of shame and judgement that they are often already feeling if they have to use formula.

Is breastmilk ‘available on demand’?

Even when mums find breastfeeding easy, they can still face challenges along the way. Different mothers produce different milk of different amounts and different quantities.

And the amount of milk they produce doesn’t stay constant, it changes from time to time. Certain things can affect milk supply such as exhaustion, stress, bereavement following the loss of a loved one, diet and lifestyle choices as well as medications.

If a mum goes through bereavement, for example, her milk supply can stop completely. If mums notice their milk supply dwindling is her baby supposed to go without sufficient food for a few days, while she sorts out a prescription?

How many babies would suffer more severe and direct threats to their health if they were to be left with insufficient food for a period of time before formula could be provided?

Babies need to be fed

Even now, with formula freely available, some babies go hungry because they are not getting the milk they need. If they become severely dehydrated they can even die.

Like in the tragic case of Landon Johnson who died  just days after birth from a cardiac arrest caused by dehydration. His heartbroken mum, Jillian,  spoke out to make other mums aware of the dangers. She believes that if she had fed her son just one bottle he might be alive today.

The doctors told her to:

Believing that this was normal, and that she must breastfeed exclusively she carried on trying to breastfeed.

Speaking to The Washington Post , Jillian’s message is clear:

Is breastfeeding really ‘free’?

Assadourian goes on to state that breast milk is

free and available to nearly all mothers (and breast milk donations or prescription-formula available to the small percentage of those that cannot produce milk).

If mums formula feed, he says,

He’s right, of course. Mum’s bodies do make breast milk. They don’t have to pay for this to happen. But that does not mean that it’s ‘free.’

A viral tweet just last week (January 2019) challenges this idea that breast milk is free. History professor Kera Lovell tweeted:

Her tweet was liked by almost 14,000 people and was met with a flurry of replies. Mums were blown away with just how many hours the average mother spends breastfeeding and how it is only free if we don’t put any value on this time.

Battling on at the cost of mums’ mental health

Steph, 31, from Leeds, describes feeling ‘trapped’ by her experience of trying to persevere and breast feed her son, when she was struggling. She says:

For the many mums, like Steph who struggle, formula is not an ‘unneeded product’ and using it only as a ‘last resort’ takes its toll on their mental well being.

At the end of the day what should matter most is not whether mums breast or bottle feed ,but that all new mums have a choice to do what is right for them and for their babies – with support and solidarity rather than anything that leaves them with a feeling of shame or stigma.