When it comes to breastfeeding, The Lancet infantilizes mothers

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I just finished reading The Lancet’s new editorial on breastfeeding with its recommendation to ban all formula advertising. I have some advice for the editors:

Stop infantilizing women and mind your own business!

The piece, No ifs, no buts, no follow-on milk, is a masterpiece of elitist nonsense.

Trust women to make their OWN decisions.

…[T]he International Code of Marketing of Breast-Milk Substitutes was drafted in 1981 amid widespread concern about the advertising and promotion of infant formula, particularly in settings where mothers lacked access to the clean drinking water and sterilisation equipment needed to safely prepare formula milk. The Code prohibits direct advertising of breastmilk substitutes to mothers, claims that formula milk provides health benefits, and gifts or free supplies to health-care workers and facilities…

Strikingly, it is high-income countries (including the USA, Australia, and much of western Europe) … that have the fewest legal protections—and some of the lowest breastfeeding rates, particularly beyond 6 months…

And the consequences of that are … nothing, zip, zero, nada. Many of these countries have the lowest infant mortality rates in the world and there is ZERO EVIDENCE that even a single term baby has ever been harmed by formula feeding.

You’d never know that to read the hysterical pronouncements of The Lancet:

From tobacco, to sugar, to formula milk, the most vulnerable suffer when commercial interests collide with public health. Robust advertising regulation—covering all milk products for children up to 3 years, and banning social media promotion—is the next step to protect them.

That is pure bombast.

Tobacco kills millions around the world each year. Sugar doesn’t kill anyone and infant formula does not harm term babies. Why put them in the same category? Because condemning infant formula (and sugar) is a contemporary cultural conceit based on the firmly held belief that the less privileged should adopt the preoccupations of their betters.

Privileged, Western, white women are preoccupied with producing children who look perfect on paper, racking up achievements that position them to compete in a modern economy. They are obsessed with the idea that breastfeeding produces superior children despite a lack of scientific evidence that it provides significant benefits. They have made breastfeeding into a form of virtue signaling.

What is virtue signaling?

Virtue signaling is the popular modern habit of indicating that one has virtue merely by expressing disgust or favor for certain political ideas, cultural happenings, or even the weather…

Celebrities who publicly express panic about the environment without knowing much about science are virtue signaling. So are those who seize on current events to publicize their supposedly virtuous feelings …

Breastfeeding selfies are a form of virtue signaling, equally beloved of celebrities and ordinary women. “Normalizing breastfeeding” is a form of virtue signaling, as well as decrying formula feeding. Advocating bans on formula advertising and formula gifts are yet another form of virtue signaling that benefits no one except those signaling their virtue.

The Lancet is signaling its virtue in advocating a ban of advertising and formula gifts in industrialized despite a complete lack of evidence that either practice has any impact on breastfeeding rates in those countries. But that’s not the worst aspect of such bans. The worst part is that they treat women like idiots who must, for their own good, be manipulated by their betters.

Banning ads and gifts rests on ugly assumptions

1. The ugly assumption that women are morons. Despite decades of incessant blathering about the purported benefits of breastfeeding, women who can’t or choose not to breastfeed are imagined as unaware of the benefits.

2. The ugly assumption that women are silly creatures easily manipulated by industry. The editors of The Lancet imagine that women aren’t smart enough to form and maintain their own philosophies on parenting. They are so flighty that a packet of powder will entice them away from plans to breastfeed.

3. The ugly assumption that women are incapable of protecting themselves and their babies from evil corporations and need their betters to do it for them.

Given that the benefits of breastfeeding in industrialized countries are trivial, the editors have no business dictating to women how they should use their breasts. Given that women are intelligent, there is no need for endless hectoring in an effort to force them to breastfeed. Given that women are capable of protecting themselves from industry, there is no reason to infantilize them by banning formula advertising and gifts.

My advice to the editors of the Lancet (and to the breastfeeding industry itself) is simple:

Keep your virtue signaling to yourself, mind your own business and trust women to make their OWN decisions not the decisions that you prefer.

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  • Was also surprised by the lack of research to try to unearth WHY women aren’t breastfeeding. Damning of advertising and the rise of the Baby Friendly hospital initiative are based on some pretty huge assumptions but I have yet to see any evidence that we understand what drives breastfeeding adoption or duration.

    • Squillo

      Exactly. An advertising ban and many of the tenets of the BFHI only address one possible cause of lower bf rates–availability of an alternative. Those measures seem pretty drastic considering that bf “failure” seems to be multifactorial.

    • Dr Kitty

      Breastfeeding rates where I am are low.
      Largely because some women just don’t want to.
      Young single mums, in particular, who were usually formula fed themselves, enjoy the greater freedom of formula feeding.
      If you formula feed you can leave baby with granny or aunties and go out with your friends much more easily, unencumbered by a breast pump.

      Of course, how socially acceptable is it for these women to report that the reason they don’t want to breast feed is because they’d rather be having a few drinks in the club, or going to the cinema, or doing a bit of shopping with their friends?

  • Sue

    Coming from a country where direct marketing of pharmaceuticals to the general public is not allowed, it seems utterly bizarre to me that drugs could be marketed but formula could not. Utterly bizarre.

    • The Computer Ate My Nym

      I agree. Direct to consumer marketing of prescription drugs is evil and stupid. Apparently, however, it makes money for drug companies so they keep doing it.

      And while we’re discussing improving public health by eliminating deceptive advertising, how about making it illegal to advertise supplements that have not been proven either effective or safe? Not to mention eliminating the loophole that allows them to be sold without being tested for safety and efficacy, but that’s a different rant.

  • Megan

    If advertising is this powerful, the Lancet had better stop running ads for medications in their journals. They wouldn’t want to appear to be influencing physician prescribing behavior, would they?

    • Wombat

      Considering some of the scandals over the Lancet/Elsevier more specifically (and who they’ve semi-credibly been accused of being in bed with), it’s arguable that they actually do :c

  • StephanieA

    On the topic of breastfeeding, I have to complete this 20 hour breastfeeding ‘education’ course for work. It is so unbelievably ridiculous. I’m reading through the course material and there’s nonsense about how epidurals can hurt breastfeeding and how formula pretty much causes cancer, obesity, stupidity, etc. I then look at the references- one of them is freaking MOTHERING.COM. No joke. This is a course that is required by a hospital, shouldn’t it be scientifically based?? I can’t wait for the course evaluation.

    • Wombat

      Oooo, I know you probably don’t want to (and totally understand and support why) but this is a case where I wish naming and shaming were less dangerous to individuals :c People deserve to know when the hospital they’re trusting is.. well, that.

      Thinking back I wonder about some of the places and people I’ve trusted with me at my most vulnerable, and it’s a little scary.

    • L&DLaura

      I JUST did this. You could probably hear my eyes roll. That is, if you could hear them over me cursing the BFHI.

      • StephanieA

        Was it the step2education course? While reading it I had to keep reminding myself that my boys are not going to be fat, cancerous diabetics. Well, if they are, its not because I formula fed them. That course was awful.

        • L&DLaura

          Yes. It was awful.

  • An Actual Attorney

    I’m not very articulate today, so excuse the rambling.
    There’s a parallel here with the folks who argue that handing out condoms makes people have sex. They claim it’s better to not distribute or educate about condoms and to instead promote abstinence.
    In both cases, the proponents of “see no evil” ignore science, are really motivated by morality, and don’t say it out loud, but clearly don’t care if the “immoral” are injured or killed.

    • Wombat

      Yuppp. Catching up on some of the (admittedly old) coverage of Obama’s SxSW ‘diaper initiative’ it was really spelled out clear as day: “Diapers being expensive (and people being poor) isn’t the government’s problem” > “Don’t have kids if you can’t afford them” > “The government needs to restrict access and funding for contraception due to (usually religious) morals – if they’re expensive as a result, it isn’t the government’s problem”.

      At least pick a lane for your sanctimony, people :/

  • RNMeg

    I have a cabinet in my kitchen stuffed full of formula samples and one can we bought prior to my son’s birth. Despite this, I’ve been able to breastfeed him 98% of the time (only giving formula when I need a break and don’t happen to have any pumped milk on hand). It’s almost as if I’m an autonomous, individual, intelligent woman who can make decisions for her infant’s nutrition without anyone else’s input!

    • J.B.

      As recent events in several states make clear, all wimminz are weak, fragile and apparently incapable of making our own decisions.

  • Mattie

    Not exactly the point of the article (which I agree with) but I often wonder why some products are advertised at all, some things surely ‘sell themselves’? Things that spring to mind are toilet paper and soap but sure there are others. Would companies not make more money by not bothering to advertise?

    • demodocus

      Maybe, but there’s a lot of competition in the tp, soap, and chocolate markets. The stuff in general sells itself, but Hershey wants you to buy *theirs* and not Nestle, Giardelli, or Godiva

      • BeatriceC

        And they want you to buy their higher profit margin products. Why would they want you to buy the bulk stuff that doesn’t turn a lot of profit when they could get you to buy the fancy holiday themed stuff that takes them very little more money to produce but they can jack up the prices a few hundred percent? Advertising at it’s finest.

      • Mattie

        Yeh, I dunno? I guess I just go to the shop and buy either what is cheapest (toilet paper and soap for example) or what looks good on the day, rarely swayed by ads for that stuff. Makeup yes, some food things if they’re new, but not really essential things

        • AnnaPDE

          I did that too, until I discovered the wonderful feeling of actually soft tp. Now I shop for the nice soft brands, and that’s what the advertising is trying to tell me: Kleenex is softest! No, Quilton! No, Sorbent!

          • Mattie

            Haha fair, I do think on the whole in the UK our tp seems to be pretty good quality, even store brand is pretty soft and fairly thick lol you have to spend really small amounts and get the absolute cheapest to get the horrible thin stuff. However, don’t all brands try and say they’re good/soft/whatever in ads, so then you still have to choose what you want to get at the store lol

      • Wombat

        Most people have some of their highest brand loyalty for two ‘spheres’ of products: Luxury and Personal Care (including things like laundry soap).

        Companies don’t just accept that and be happy to have the likely never leaving market share they do, instead they’d rather pour money into it in hopes of stealing one of the competitor’s loyal customers and having them forever too.
        And sadly it works/makes financial sense (at least when you have high profits, virtual oligopoly, and a glut of cash flow) or they wouldn’t all be doing it.

        It’s kinda like Lewis Black’s bit about Pepsi and Coke, and kind of like a sad race for total domination when that’s never ever a realistic outcome. Capitalism!

  • Kelly

    Me too. I have started to use the store pick up too so that I don’t spend as much at Sam’s.

  • BeatriceC

    One of my life goals is to walk out of Target having spent less than $100.

  • Stephanie Rotherham

    Somewhat OT: what’s really irritating me lately is in some adverts for formula (in the UK, at least), mostly follow on formulas (apatamil/cow and gate), in little text at the bottom of the screen is ‘breastfeeding is best’, or similar rhetoric. Wtf? Companies can’t even promote formula without implicitly stating their product is inferior? I have a feeling there was a law passed somewhere or something.

    • Heidi

      It’s in the States, too. In fact, I got booklets from Enfamil and Similac that are mostly dedicated on how to breastfeed. No real instruction on how to properly formula feed! It’s infuriating.

      I didn’t know starting out that I was supposed to use distilled or boiled water. Nothing bad happened. We have good water and a full term baby so the chances of something bad happening as a result of unboiled tap water are probably very minute but why wasn’t this in a booklet?!

      • Mattie

        I totally agree, especially as some people use bottled water as they worry tap is not of a good enough quality, but bottled water often has huge amounts of minerals in it that are bad for infants

        • Irène Delse

          I don’t know about other countries but here (in France), brands of bottled water that meet the criteria for infant nutrition carry a baby bottle logo on the side. Manufacturers are obviously glad to advertise the fact.

          • Mattie

            That’s really cool!!! I’ve never seen that here (UK) but then we don’t have issues with our tap water, and if France is anything like Italy then we drink significantly less bottled water here haha

          • Irène Delse

            Yeah, lots of people really love bottled water. Tap water is generally very good, though, but it seems to be a tradition.

      • StephanieA

        We use nursery water because we have well water. If we had city water I wouldn’t have a problem using tap, but I don’t want to risk it. Even boiled our water leaves a white, chalky residue on the bottles.

        • J.B.

          White and chalky sounds like its from hardness and shouldn’t have a health impact. If you’re on a private well it’s probably good generally to test for coliform occasionally.

        • Mattie

          white and chalky sounds like limescale, we have super hard water (from the tap) and boiling doesn’t get rid of it, it’s not harmful but if you want to reduce it you can use a filter jug and then boil the filtered water (it also stops limescale build up on kettles lol)

        • Heidi

          I use straight tap water if we are at someone else’s house. I do boil my water because at home it has to be filtered for the Baby Brezza. I figure since we don’t wash the pitcher too often, bacteria could be there that could possibly not be so great for an infant. Our pediatrician handbook said to boil water though and when I read that the first time, I was like, “OOOHHHH NOOOO, I’ve been playing Russian roulette with my baby. Why didn’t the hospital tell me this?!” But then other sources that I trust to be legit say tap water is perfectly fine, too.

      • J.B.

        Dasani, aquafina and the like are purified tap water with a minor amount of minerals put back in (because ultra pure not so good for taste.) Water from public water systems gets tested frequently and I would have no concerns about using it.

        • Wombat

          I swear Dasani (I know in part because it’s probably my least favorite water so I was curious) used to say Municipal Source, but lately – checking rather infrequently – I haven’t seen it. I’m guessing some legislation expired somewhere :c

          Sadly Dasani is not only tap water but in large part Atlanta tap water (due to the locations of bottling plants) which even Atlanta’s citizens generally regard as an acquired taste. You’re at worst importing someone else’s slightly lesser (the regulations really leave very little room for that, but there is some) water and at best importing perfectly good water that you’re just not used to, lol.

          Could be worse though, they could start a Dasani plant in Lubbock TX /shudder

          • J.B.

            I should clarify that I have no concerns about using the tap water directly, and that I generally don’t see the point on spending extra money on bottled.

          • Wombat

            Oh me too (bottled is a convenience/out and about thing for me almost-if-not always). I was just commenting on the idea that many people don’t know that/Dasani in particular since I know it used to be labeled and I personally dislike the taste of it. Legitimately sorry if it came off otherwise :c

            My concerns with Atlanta, Lubbock, or anywhere wouldn’t be quality but taste.

      • Mrs.Katt the Cat

        Boiled or bottled? Huh. I’ve been using tap water that had been through a Brita and a Zero filter. Who knew being a bit of a water snob would have benefits for TheMiniKatt

        • Heidi

          Ours gets run through the Brita pitcher now because we use a Baby Brezza. If not, it could get mineral build up. I boil the water in a tea kettle and let it cool down not because I’m afraid of the germs in the water out of the tap, but since we don’t wash our Brita everyday, I figure it’s best to give it a boil.

        • BeatriceC

          I’m the opposite. The only time I have ever boiled water is when my area was under a state and county issued boil water alert for everybody in the aftermath of hurricanes or severe thunderstorms which caused flooding. I don’t use filtered or bottled water either.

          • Mrs.Katt the Cat

            I don’t boil, but I have always been picky about the taste of water especially at home. As a child i would only drink water from the upstairs hall bathroom sink, no ice. Now I double filter at home and am more accepting out in public than I used to be.
            I am in love with the Zero filter, it came with a meter that measures overall PPM ‘impurities ‘.
            I bring water when I visit my Mom, her water tastes like iron to me and I have trouble swallowing it.

          • BeatriceC

            MrC is more like you. He uses purified, bottled water in everything. He flat out refuses to use tap water. I can taste the difference but I don’t care enough. The exception of corse is when the risk of waterborne disease is high because of a natural disaster. I used to live in the Miami area, Homestead, to be exact, and hurricanes happen. So I have boiled water, but only for that reason.

          • Mrs.Katt the Cat

            I have never been in a true disaster area. Va can get the rough end of a grounded hurricane but it is not the same as coastal damage. During the worst storms I was lucky to live on the same section of the power grid as some wealthy politically connected neighborhoods. It seemed like the whole state was struggling to get power back and we had one day of inconvenience.
            We came from farm folk and were always ready to self sustain for a month if needed.

          • BeatriceC

            Hurricane Andrew was my Senior year of high school. I didn’t stick around long, as I went to a boarding school, but the week I was there was absolute misery. Utilities weren’t fully restored even when I came home for Christmas that year, and my parents’ house was nowhere close to being rebuilt completely. At that point they had power because my father worked second and third jobs in the construction industry when he was young and had skills to do work himself, plus the money to drive out of state with a flat bed trailer and purchase supplies, so he was able to get it half way put back together and get a generator running to power critical items like the refrigerator and stove. It was the following summer before the area was even a semblance of normal. There have been other storms, but after Andrew, a couple days or weeks of no power seems more like an inconvenience than anything else.

          • Mrs.Katt the Cat

            I remember Andrew. My Father took us to the coast too see some damage and a flooded river so we would have a sense of the loss that could happen. I found a silver ring with a turquoise line in it, I would wear it sometime and feel grateful that I hadn’t experienced the losses of the previous owner.
            I don’t think anyone can accurately imagine something like that. You either experience it or you don’t.
            This reminds me that my car needs baby updates to the emergency kit.

          • BeatriceC

            It was one of those things where nothing except being in the middle of it could describe what it was really like. Close up pictures showed the absolute destruction, but didn’t give any clue as to the scale of the disaster. Ariel photos showed the scale, but not the magnitude. And certain things you take for granted you don’t even realize until they’re suddenly gone. Like toilets. People think about things like food, water and shelter, but not the little things. Homestead was practically wiped off the map. To this day you can still see the scars. It’s something that no person should ever have to live through, yet so many people do every year somewhere on earth. I always remember my post-Andrew experience when I donate to disaster relief funds. I was lucky. I come from a wealthy family who was able to rebuild quickly and in a country that has an infrastructure for disaster relief. So many people in the world aren’t so lucky.

          • Mrs.Katt the Cat

            I believe it.
            I think that a memoir of yours would be a riviting read, and I enjoy your honesty and wit.

          • Charybdis

            Yeah, people immediately think about things like food, water, shelter, etc, but it is the little everyday things that get overlooked . Stuff like a toothbrush and hairbrush, ponytail holders, your purse, deodorant, hell, even pens and paper so you can start filling out forms, jotting down information, etc.

            Tornado Alley person here: we have had the widest tornado in American history (2.6 miles wide), the fastest wind speed ever recorded (318 mph) and baseball/softball/grapefruit sized hail storms as well.

            Also lived through a hurricane that made it inland as far as Auburn, Alabama. I prefer the tornadoes, as they are over faster. Not that I “prefer” them per se, but they are over way faster than a hurricane.

          • Bombshellrisa

            One of my friends lost her home and everything in it to a tornado in Alabama. She was at her elderly mom’s house in the storm shelter there. Her mother suffered the loss of…..a huge branch of a tree on the front yard and one door from a shed. Unpredictable things. She had the basics for a survival kit, what she didn’t have was the stuff like you mention

          • Charybdis

            I’ve always been picky about my water as well. If I’m drinking water, I’ll do bottled water because tap water tastes off to me. Water filtered through a Brita filter tastes “slick” to me, like it has a teeny bit of baking soda added into it.

            However, water straight from the garden hose is wonderful, it tastes of summer and childhood. My favorite is water from a drinking fountain: cold and with a slight metallic tang to it.

          • Mrs.Katt the Cat

            Huzzah. Water afficinato unite!

        • J.B.

          Just change the filter religiously please 🙂

          • An Actual Attorney

            Just curious, why? Do I want to know?

          • Azuran

            well…..Filter will catch all the bad things. So if you don’t clean them once in a while they slowly accumulate filth and bacteria can grow in them, contaminating the water that goes through.

          • J.B.

            Activated carbon filters tend to accumulate biofilm and both those and resin filters can release contaminants back in the water when they’re used up.

          • Charybdis

            Probably not. Biofilm, bacteria and I’ve seen a couple with algae. 🙁

          • An Actual Attorney

            That makes sense and isn’t as bad as I feared. Thanks.

      • Chant de la Mer

        I never used boiled or filtered water for bottles unless I was traveling. We have well water, but we get it tested every year and I just never really thought it was a big deal. We did use only the RTF until 3 months though, and switched to powered after that and maybe that’s why I wasn’t worried about the water? I don’t recall really, but I know that my BIL and his wife use bottled water for every single bottle and it irritated me for unknown reasons. I mean, I live in an area where there actually is concern about water and there is no city water, which is why we need the yearly water testing, and they live in a very modern city with very high standards and still think they need expensive bottle water because their precious baby might get something impure from the tap? I know, it’s very judgy of me and there’s probably more to it than I know plus it is recommended to use the bottle water so I’m just being an ass.

        But still, I have seen the problems from lack of clean water with formula use. I have done the formula safety education. I have had that conversation about how important is to mix formula exactly as directed and not over dilute it. I have talked to parents on how to keep bottles clean without running water. So I get a little frustrated at the privilege of people with abundant clean water available in their homes that still feel they need to buy bottled water for “safety”.

        • Mrs.Katt the Cat

          Oddly, I remember reading somewhere that bottled water is actually less regulated for purity and safety than tap. At least in the USA

          • J.B.

            Municipal drinking water is regulated by EPA and bottled water by FDA. I’m not familiar with the FDA requirements, but bottled water that doesn’t have residual disinfectant can have bacterial growth in it.

      • Mariana

        Here in Brazil they write that on the can of formula, with little pictures showing you (with text underneath) how to prepare the formula (and that you have to boil the water and the bottles). They even have a small guide of how much formula to prepare for each age (newborn, 3 to 5 months, etc), how many scoops per ml in the bottle, and how many bottles to offer in a day. The formula for 6+ months even takes into account that the kid will be eating solids and adjusts the amount of milk.

        The can says that it should only be used under medical advice (like all medication in the country), and they don’t advertise to consumers either (only over the counter drugs can be advertised to consumers.

        • guest

          Those sound like good instructions, but it’s FOOD! It’s not an OTC or behind the counter drug, it’s food for babies.

          • Mariana

            I agree with you. I was just saying that this is the way it’s done here. And some doctors will write you a prescription for formula… and some health insurance policies will reiburse some of it (the very good private ones).

    • Charybdis

      They do that here in the States as well. Every formula container has the phrase “Breastfeeding is best for your baby”, or “Breast is Best” or similar on it. The number you can call if you have questions/a problem with the formula connects you to a Lactation Consultant.

      • CSN0116

        Really?! I thought Enfamil, for instance, has their own feeding hotline, formula-feeding specific. Hmmmm!

        And they have to put that on the can due to an “International Breast Milk Substitute Marketing Code” that has been around for decades and dates back to the Nestle scandal of the 1980’s. But it’s fucking insulting. What if American women demanded its removal from packaging in the US?

        But as I always say: Formula. The only product that tells you right on its label that you should be using another product instead, yet continues to sell in droves. 😛

    • Rach

      It’s all linked to the WHO International Code of Marketing of Breast-milk Substitutes:

      Member countries can use the above as the basis for their national legislation or regulation of formula adverts. There is a list of member countries below:

      I know I posted something about Australia’s legislation on advertising of formula a few posts back, and that is based on the WHO Code. If you look up your country’s legislation, you might find it is based on this code which requires the companies to state that breastmilk is best yadda yadda yadda.

      • Rach

        Sorry, my links didn’t share for some reason. If you search for it, you’ll be able to find it easily.

  • carovee

    OK. Now I am super pissed. Lancet has a series of articles on breastfeeding none of which address actual impediments* like working, pain, working, low milk supply, working, or personal preference. I see a lot of blah blah global health blah, but not a lot of actual evidence*.

    *I admit I skimmed pretty quickly

  • carovee

    Wow. I can’t imagine anybody recommending that we limit advertising of products aimed at men because the ads are just too seductive. The Lancet needs to get its act together before they completely ruin their reputation.

    • Gatita

      Nobody talks about natural erections. “Your penis was designed to get hard!” Instead, cialis and viagra are covered by insurance and men use them without a hint of guilt or shame.

      • BeatriceC

        Slight misconception here. ED drugs aren’t usually covered by insurance, and they’re not all that cheap. There’s a generic for Viagra, but not the others, so it can get pretty expensive pretty fast.

        • fiftyfifty1

          Where I live, ED drugs are covered as long as a man has a medical reason for his ED like diabetes or heart disease etc. They are not covered for so-called psychogenic impotence.

          • BeatriceC

            We have to pay out of pocket. All the pharmacists I talked to said that US insurers as a rule do not, with the glaring exception of the state and federal employee policies. Congress men seem to think it’s important to be able to get their own dick’s hard, but don’t care about anybody else. Quite frankly, I’m okay with ED drugs being covered. The improvement in our sex life made a lot of depression issues MrC was having go away.

          • Gatita

            ED is a legit medical issue! Just because it involves sex doesn’t mean insurance companies should get away with not covering it.

          • BeatriceC

            And it has a cascading effect on the rest of a man’s health, and quite frankly, his partner’s happiness as well. Of course at the moment we have different issues, but a year ago it made a huge impact for both of us. He is much happier and much healthier all around when we weren’t dealing with the frustration of age related issues (he’s 62, it happens). I’m happier for the same reason. We had work arounds, but they just weren’t as good. And in the end, it’s still a body part that’s not working properly, therefore it’s a medical issue.

          • mabelcruet

            Same where I am-men can get it on prescription but I think they are only allowed a limited number a month (I think its 2). It’s disgraceful-your doctor is rationing your sexy times!

            (tongue in cheek, obviously)

          • Dr Kitty

            NHS- 1/ week (or daily Vardenafil).
            Diabetes, prostate Ca, spinal cord injury, MS, renal failure, Parkinson’s, severe psychological distress and a few other issues.

            You can, of course get your GP to prescribe a PDE5I privately, again, 1/week.

          • BeatriceC

            That brings up (pardon the pun) a whole host of other issues. We would be miserable if we were limited to once a week. I guess it’s better than nothing, but failure to cover a medication designed to correct a malfunctioning body part just isn’t okay. The absolute greatest benefit I’ve seen in the psychological effects. MrC was depressed enough that he was on antidepressants. Part of that had to do with his body failing him and not being able to participate fully in previously pleasurable activities. Fix the body part, fix that part of the depression. It’s that simple.

        • Wombat

          That’s why Cialis sought additional indication approval.

          Obviously BPH is a real issue and Cialis for it is effective (although more effective than other therapy seems to be a matter of who you ask). I have 0 issue with men being able to essentially ‘kill 2 birds with 1 stone’, but it is still kind of a skeevy marketing move to skirt private insurance (and especially Medicare) into a corner on it. Especially private insurance, where by many plans standards you can be nearly asymptomatic on the BPH side and yet it’s still covered like a (expensive/top tier) maintenance med :/

          Edit: And honestly, more treatment of ED is also fine with me (my issue is far far more with Eli Lilly), but other similar issues would need to be treated similarly (like women’s sexual dysfunction). As it is, even with hoops to jump through, it’s an outlier.

  • Gatita

    This is totally OT but it just struck me today that the “natural” rhetoric is especially harmful to black women. In the context of our culture, natural Africans have all kinds of ugly racialized connotations. If we posit natural as an ideal state for the upper class, that imposes a huge barrier for African Americans achieving economic and class parity. It’s a form of cultural apartheid and it’s gross in the extreme.

    That’s not even getting into the horrifying history of black slaves wet nursing their owners’ children. No wonder breastfeeding rates are low among black women.

    • CSN0116

      There is a black woman in my city who is a pastor and has run a soup kitchen (she calls it a community café) using her church’s own garden for years now. She has devoted herself to trying to improve the health of her community with nutrition. I adore her and the students in my classes will do a ton of outreach volunteering with her organization.

      Recently she has taken to starting a “Mother’s Café” because, “black women need to breast feed.” When you read her literature and talk to her it’s really twisted – it’s like she feels that if black women breast fed their babies the moms and children will experience less inequality in life. As if nursing will fix the poverty, institutionalized racism, violence… it’s bizarre. So she brings in these very vulnerable and poor black women via the soup kitchen and harps and harps about how they should breast feed their babies. Mind you, many do not even have stable housing, or are struggling with some very large social problems, but they need to breast feed to make it all go away!

      • Azuran

        I’d guess it’s a need to try something. One individual mother cannot magically change her economic and social status very easily (especially with you have a newborn baby) She cannot change society as a whole and prevent her kids from suffering racism, poverty or violence.
        The only thing she has (some) control over is probably BF. With everyone around you telling you that breast is best and that BF children are better, it makes sense that those women feel like the only thing they can do to give their child a better chance is breastfeeding.

        • CSN0116

          Yes, but using this logic (and I agree), imagine the level of guilt multiplied if they fail?!

          • Gatita

            The guilt sucks but ironically poor children are the ones who benefit the most from breastfeeding (presuming it can be done without compromising the mother’s ability to, you know, earn a living). They suffer from the weanling’s dilemma too and since they have poor access to healthcare, more incidences of diarrhea and ear infections might be more harmful to them. But yeah, haranguing them won’t remove the barriers that make it difficult/impossible to BF.

          • CSN0116

            I consulted with an allergist/immunologist once who told me about something she called “white suburban mom syndrome.” In short, she explained that poorer, urban-dwelling, minority children get sick less (with the common viruses and such) and experience fewer allergies than their affluent, suburban-dwelling, white counterparts. She stated that it’s a phenomenon directly related to suburban moms’ over use of sterilization and limiting germ contact. I wonder if she was full of shit? Have you ever heard of this?

          • FormerPhysicist

            I’ve heard of it, but I wonder how much is provider bias. How is the researcher measuring illness? If it’s in doctor visits, the study is crap. As a white suburban mom with good insurance and enough time, I take my kids to the doctor for things I know I would ignore if I wasn’t so privileged.

          • CSN0116

            I know. She never elaborated. FWIW she was an Indian woman talking to me, a White woman, about Black and Hispanic children LOL. It was a fascinating discussion and she was adamant that it was in her experience. She eluded to scientific fact, but of course I didn’t get any.

            You really should have been there. She was a hoot 😉

          • Inmara

            That’s the “hygiene hypothesis” which promotes the idea that lack of exposure to dirt and germs increases risk to become allergic. IIRC, it’s far from proven, but there might be some grain of truth, just hard to tease out from population data.

          • swbarnes2

            Yes, but the germs matter. Dirt, dog hair, I think, those are good. Cockroach detritus is bad and is associated with more asthma, not less.

          • Inmara

            This study says that what matters is most probably livestock or other exposures in rural areas, not household pets http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069066/

          • Gatita

            She’s full of shit. Poor kids suffer from environmental racism. Their homes and schools are more likely to be next to freeways and factories, they are more likely to live in older buildings with mold and lead paint, plus cockroach detritus makes asthma worse. As a result asthma rates are sky high among poor kids along with pneumonia and upper respiratory illnesses.

          • Dr Kitty

            In the UK at least there is also a perverse incentive to undertreat asthma.
            If you have an asthmatic kid who requires frequent hospitalisations, you may be eligible for higher benefits than if your kid has well controlled asthma.

            There are some people who look at £60 a week as a price worth paying and withhold their child’s inhalers as a result.

            I can prescribe medication. I can’t make people give to their kids. 🙁

          • Gatita
          • moto_librarian

            Jesus. That’s fucking awful. I’m a severe asthmatic. There’s no way I can imagine purposefully undertreating a child.

          • BeatriceC

            Holy shit. I’m appalled. I can’t even begin to wrap my mind around withholding treatment from a kid just for a few extra pounds a week.

          • Erin

            Before I quit work my job used to involve home visits to vulnerable families in temporary accommodation which was a mix of Council owned properties and privately owned properties leased to the Homeless Service by their landlords. On telling my Line Manager I was pregnant, I was told I could no longer visit a couple of flats because of the health risk to me and the baby…oddly enough no one seemed to care about the health risk to the babies and pregnant women we put up in those flats.

            Mushrooms growing through carpets, dead pigeons stuck on balconies, insect infestations, giant mould blots, lifts used as urinals by both dogs and humans, stairwells full of needles.

            Thought I was seeing things the first time I saw a “mushroom” carpet. It squelched.

            Fixing it wasn’t deemed a priority though which led to all sorts of situations like children being admitted to hospital. Not to mention the poor woman who spent a night on her kitchen table after seeing a family of rats running about. You’ve finally found the courage to leave your abusive rat of a husband and you wind up with a different sort of rat keeping you up at night. Horrific.

          • An Actual Attorney

            That’s deplorable. Should be criminal.

          • Gatita

            Oh God, that’s awful. People have no idea what it really means to be poor.

          • swbarnes2

            My Mom (I went to private school) said that she met other moms who were so pleased with their pediatrician, who specialized in allergies. My Mom’s take (which could very well be wrong) was that these moms were not “Thank goodness that my kid’s serious symptoms are being treated well” But “I’m so glad my special snowflake has a doctor who specializes in special snowflakes.” So maybe that’s what this pediatrician is seeing.

          • Angharad

            I wonder if affluent, suburban-dwelling parents are just more likely to take their children to the doctor for relatively mild symptoms? My daughter developed allergies as a tiny infant, and her symptoms were on the border between what I would consider “wait and see” and “get to a doctor” (constant runny nose, lots and lots of spitting up that didn’t seem to bother her too much, and a body rash that I was pretty sure was just eczema since I have eczema). I can see a family without a lot of time or money to spend at the doctor’s office deciding that the baby’s life is not in danger, so they just don’t end up diagnosed with allergies/viruses/etc.

            Personally, I grew up in a poor family, and the only times I remember any of us going to the doctor beyond check-ups were when there were broken bones, inability to breathe, extremely high fever with convulsions, injuries requiring stitches, or vomiting blood. We got sick plenty, my parents just didn’t take us to the doctor unless they felt it was urgent.

  • Allie

    The Lancet article series is about implementation of BFHI in the Democratic Republic of the Congo.
    For a Congelese newborn, the superiority of breastfeeding over formula milk isn’s up for discussion: either mom will breastfeed, or she’ll give unsuitable substitutes made up with contaminated water. In which case baby stands a pretty good chance of dying.
    The people writing these articles are so rabid in their campaign against formula advertising because they see this harsh reality every day. Every mom choosing formula over breastmilk is pretty much sentencing her child to an infancy filled with disease and death.
    I blame the Lancet editors for refusing to make a difference between the DRC and the US or Europe. The realities of mothers and infants in New Jersey vs those in Kinshasa are so far apart they may as well live on different planets. Ham-fistedly ramming the BFHI down the throats of mothers in developed coutries or demonising what is essentially a safe and healthy product in a first-world environment will not save a single Congolese baby’s life.

    • An Actual Attorney

      That makes more sense when they talk about a ban on advertising milk products before 3 years old. I was trying to figure out how you stop advertising cheese and yogurt. Makes more sense int he DRC.

    • Irène Delse

      The recommendations make a in the DRC, indeed. Lack of access to clean water is a game killer when it comes to formula. But it’s irresponsible of the Lancet to act as if bullying the women who do have easy access to clean water will save babies, on Africa or elsewhere.

      By the way, even in the developing world, I wonder if there’s been a study on the actual efficacy of banning formula advertising, as compared to grassroots initiatives to educate women and local health providers. Nothing is perfect, after all, and while we all know the evils of formula in countries with a poor infrastructure and high rates of poverty, those countries also have a sometimes sizable middle and upper class who do have access to clean water and enough money to purchase enough formula to feed a growing baby.

      • CSN0116

        When PMTCT programs include the provision of safe infant formula, the cost is not only very comparable to what they pay for more frequent ARV treatments which must be coupled with exclusive breastfeeding, but the HIV-free survival rate is actually higher. The programs distribute the powder milk, education, home follow-ups, bottles, and a stovetop cooking device to sterilize water – all for nearly the same price as increased ARV+breastfeeding. When these things are provided, the risk of death by improper formula feeding is practically eliminated.

        I fucking hate the WHO.

        http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0054180

        • Irène Delse

          What a surprise. An international organisation prioritises a one-size-fits-all approach that, coincidentally or not, is not the most likely to enhance women’s autonomy.

        • Sarah

          Wow

    • Gatita

      Something else that doesn’t apply to Western women (at least not to the same extent) is the weanling’s dilemma. Babies are weaned to nutrition poor foods and foods that aren’t refrigerated. To keep those babies healthy it’s best to breastfeed them as long as possible.

      • CSN0116

        Is this why Brooke says I should breast feed for four years? Nothing like falsely applying global recommendations on developed, privileged populations!

    • Angharad

      Breastfeed your baby, there are dying babies in Africa!

      Apologies for the dark humor, but that’s what it reminds me of.

  • CSN0116

    I’ve heard this! But I’ve never had a Sam’s Club near me, so Target it has always been :/

    • Heidi

      If you buy 3 tubs of Target online, you get a $10 giftcard. If you buy 6, you get a $20 giftcard. I have the Redcard, which is just a debit card and it saves 5% on top of that. Shipping will be totally free. I looked at the Sam’s Club prices, and it’s about the same with the discounts plus no membership required if that’s not your thing. We don’t shop there ourselves.

      • CSN0116

        Yes! I buy in bulk numbers and use my Red Card (I have the one linked to my checking account) too. Occasionally, I receive coupons in addition to that.

        I read a report once, by an economist, on why name brand costs so much. And it’s because the federal government buys over 50% of all infant formula in the US for WIC. And only name brand companies can get government contracts. Well, the government pays quite a bit less per unit than the Avergae Joe, therefore the cost gets passed on to Average Joe who is having to purchse it (without WIC).

        • Heidi

          I also wondered if the name brands invest more in research? I know if you need a really specialized formula like Nutramigen or EleCare, generic doesn’t offer an equivalent. I assume, but it could be a wrong assumption, that generic makers like Perrigo, use the name brand research and recipe without having to do it themselves.

          • CSN0116

            I have wondered the same. However, according to this ridiculously long report by said economist – no. It’s straight-up WIC-related buck passing. What it costs Enfamil per reconstituted ounce, versus what they charge for it is SICK.

          • Heidi

            Doesn’t surprise me. I had to go to the ER twice a few years back for a bad but delayed reaction to sulfa (had finished my dose a few days prior to reaction so I couldn’t just quit taking it and hope for the best). Although it was serious, the treatments were cheap – benadryl and steroids. I got billed THOUSANDS of dollars and insurance only paid what they thought was fair, which was a few hundred bucks. I really got the impression that I was subsidizing people who don’t have the means to pay anything.

  • SporkParade

    You forgot the part where a ban on advertising prevents families who need formula from making an informed choice on which one to use. Now, the fact is that there isn’t really a difference between brands in terms of nutritional content, but but people are still entitled to have their arbitrary preferences.

  • Gatita

    Privileged, Western, white women are preoccupied with producing children who look perfect on paper, racking up achievements that position them to compete in a modern economy.

    An important point to make is that many such women feel their privilege is in peril. If they don’t give their children every single advantage they risk falling out of their privileged status and down the economic ladder. So the stakes are very high. In their minds anyway.

    • guest

      My privilege is totally in peril (the class/economic aspects of it). You are exactly right.

  • guest

    Also, all advertising is not created equal. There are manipulative ads, that try to create a feeling of need or desire where none existed before, and there are ads that use logical persuasion, which involves presenting facts about the product which are often very helpful – particularly for new products (for instance, an ad about how DHA is now added to formula, since that wasn’t always the case).

    There’s a lot of research on how ads work and I am not as up on it as I should be, but the “BAN ALL FORMULA ADS” is either lazy or overkill. Either no one wants to do the work of setting appropriate guidelines for formula ads, or they just want to exterminate formula with fire in any way possible. Parents who use formula deserve informative advertising about the different kinds available, but should be protected from misleading ads that could potentially attempt to convince parents they need to use formula when they don’t (I haven’t seen any such ad, but without regulation it certainly could happen).

    • Irène Delse

      Yes, this! Even if all women who could breastfeed did, there’s always going to be some with insufficient supply or even no milk at all, and some babies who are allergic to human milk. My mother told me that had my little brother be born 10 years before, they would not have been able to keep him alive because he needed a special all-vegetable formula.

  • guest

    I hate all breastfeeding pressure, but I really hate these established organizations who view stopping at six months or even one year as deficient. It’s like even when you’re successful at breastfeeding, you still aren’t good enough. And exactly what is the benefit of breastmilk after 6 months? After one year? If it works for you, do it – this is not about denigrating extending breastfeeding (which often is unfairly called disgusting and bad for toddlers), but come on. We can’t be done at 6 months and not be counted as “failure” statistics?

    • J.B.

      I know. Because I breastfed to around a year with both kids but didn’t go to two years I wasn’t committed. Should have gone straight to formula I guess they were ruined!

      • guest

        I might’ve tried to stick it out for a full year, but when they moved the goalposts to two years, I said fuck this. I’m done. (I wasn’t jazzed about pumping at work to begin with, and my maternity leave was ending.) We made it to seven months breastfeeding, and then I gave them one bottle of frozen breastmilk a day until eight or nine months (formula for the rest of the bottles).

  • KBCme

    I hate the formula advertising gambit. They always imply that “If you really love your child, you’ll pay assloads of money for our brand name stuff.” I used formula, but I used the store brand stuff (Target brand). It was like half the price of the Enfamil/Similac stuff but just as good. My kids did just fine on it. The notion that women aren’t smart enough to see beyond the advertising is paternalistic at best.

    • CSN0116

      I’m all Target’s Up and Up. I’d puke if I had to pay nearly double for Enfamil/Similac. No way. Even though… wait for it …my babies get Enfamil inpatient because that’s who my hospital contracts with. Shocking that I abstain!

      • Gatita

        Costco formula is also half the cost of brand names.

        • Kelly

          I use Sam’s Club!

        • An Actual Attorney

          I went to Costco last week, and they didn’t have any store brand formula. It was all enfamil/siliac. 🙁

        • Young CC Prof

          I didn’t like Costco because of the consistency. (I don’t actually remember what I disliked about it.) We used CVS Advantage and stocked up when it went on sale, the price usually worked out to about $2.50 for a day’s supply (1 quart.)

          Except when he was a newborn, then he got the much more expensive high-calorie stuff, but it was needed.

  • LaMont

    I think that all food advertising should be banned, then. After all, a breastfeeding mother might eat some of that food which would then be passed down to her baby through the breastmilk! Only food that you grow yourself is immune to the commercialism of this fallen world!!

    • Mishimoo

      And then only if you’re growing organic non-gmo heirloom open-pollinated seeds using the bio-dynamic method and non-fluoridated water.

  • CSN0116

    OT: A sign hanging in the hospital room of a non BFHI hospital with a well baby nursery. BFF just had a beautiful baby girl via repeat cesarean this morning and is EFF. She is being treated beautifully and has a whole bin of formula in her caddy. No resistance whatsoever from staff. She was in recovery with a first time mom, mere minutes post cesarean, “failing” at breastfeeding and hysterical, so they gave her a nipple shield. How sad that moms think they need to be feeding, or even latching a baby, while barely even stitched up!

  • Jennifer

    This makes me want to leave public health (I’m an epidemiologist). Correlation doesn’t necessarily equal causation. That is basic science. The only randomized study I know (probit) found extremely modest results. You really want to reduce health disparities in kids, try poverty reduction programs. Breastfeeding is such a ridiculous thing to waste public health dollars on.

    • Kelly

      It is so short sited. They are telling those in poverty that they need to breastfeed your child but once they wean, good luck on feeding them. Sure, that won’t affect their schooling and behavior at all.

      • Angharad

        Just breastfeed forever! It’s perfect nutrition for six-year-olds.

  • Tori

    I’d strongly believed ‘breast is best’ as I’d been told that ever since I can remember, as well as ‘everyone can breastfeed’. It wasn’t until a diagnosis of IGT, low supply and tears in my OBs office that he told me reliable research for benefits of breastfeeding compared to formula done safely in an industrialised country wasn’t there. He’d also warned me prior to the birth that I might have to supplement but I didn’t really understand at the time, because I’d previously been told differently and that true low supply was very rare. I was upset when we started supplementing – on the advice of a very good LC I might add – because of the push that ‘breast is best’. In hindsight I’m very glad we stepped in early before things got too bad. I wish it was more widely stated that breast isn’t always best! Particularly if exclusive breastfeeding means starving your child. Thank goodness for my OBs wise advice and a sensible LC – they saved my child from harm and looked after me.