Conservative rhetoric masquerading as breastfeeding advocacy

A recent commentary in the National Review titled, “Fire the government wet nurse,” reads, at first blush, like breastfeeding advocacy. Author Julie Gunlock starts out by saying, “Breast milk is magic,” citing benefits for fighting infection and improving maternal health.

But then Gunlock takes aim at the WIC program, arguing that this safety net for poor families “encourages poor women to skip breastfeeding altogether and instead turn to formula for their children’s nutrition needs.” Gunlock notes that only one third of WIC mothers breastfeed for 6 months, and the program accounts for more than half of formula sales in the US. WIC, she argues, is yet another entitlement program that is hurting the very people it is supposed to help.

It’s a tidy argument – that safety net programs cause poverty, rather than help those who are most in need. The only problem is that it’s not true.

First, consider that WIC is the largest public breastfeeding support program in the United States. All WIC participants are encouraged to breastfeed, unless medically contraindicated, and WIC breastfeeding peer counselors work tirelessly to provide around-the-clock support. WIC recently revised its food package to provide extra food for nursing mothers to meet the caloric needs of breastfeeding. A growing number of local WIC offices provide free pumps for mothers returning to work.

Notably, Gunlock makes no mention of these programs in her commentary. Instead, she proposes a quick fix – “fire the government wet nurse” – in a not-so-subtle reference to “suckling at the teat of big government.” It’s rhetorically effective, but it has nothing to do with enabling mothers and infants to breastfeed.

Ideally, breastfeeding would be the cultural norm, and our society would provide paid maternity leave, affordable child care for older siblings, and adequate support to establish and sustain lactation. Instead, we live in a culture saturated with formula promotion by an industry that spends millions selling the idea that formula is just as good as breast milk.

Other nations have solved this problem by implementing the WHO Code of Marketing of Breastmilk Substitutes, which bans advertising of infant formula. In the US, we not only allow formula promotion – we struggle to convince health care providers not to participate in formula marketing campaigns.

Paid maternity leave is rare, and public assistance programs require mothers to return to work or lose benefits. Indeed, one analysis found without welfare reform in the 1990s, breastfeeding rates at 6 months would be 5.5% higher.

Gunlock doesn’t advocate for regulation of formula marketing, paid leave or maternity benefits for families receiving public assistance – instead, she implies that poor women formula-feed because they are lazy. She writes, “Because these WIC mothers know that they have access to free formula, there’s an obvious incentive for them to go ahead and use it rather than bothering to breastfeeding — which can be more time-consuming that bottle feeding. “

Gunlock contrasts these mothers with her personal experience: “I breastfed all three of my children, and while it wasn’t always easy, it was free and I knew my kids were getting the best food possible — the food I was designed to provide them.”

By framing the discussion in terms of “Good mothers breastfeed, bad mothers don’t,” Gunlock is fueling the mommy wars, instead of support strategies that enable mothers and infants to make an informed decision and achieve their own feeding goals. And the worst part is that, by touting breastfeeding as “magic,” she’s masquerading as a breastfeeding advocate.

I look forward to the day that WIC spends the overwhelming majority of its infant nutrition budget on breastfeeding protection and support, using formula for the rare-but-real cases where mothers are unable to produce enough milk to feed their babies. But “firing the government wet nurse” is not the way to get there. Cutting nutrition funding for the 22% of American children who live in poverty will instead send more women and children to bed hungry, while depriving at-risk mothers of critically important breastfeeding education and peer support.

Alison Stuebe is an ABM member and a maternal-fetal medicine physician at the University of North Carolina in Chapel Hill.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.