making formula prescription only?

[Mama_Meme]

Hi there!

A group of moms (myself included) were talking the other day about immunizations and how we could increase immunity without having immunizations. Of course, breastfeeding was mentioned and we talked a lot about there potentially being less need for immunization if breastfeeding was done by the vast majority of mothers.

One of the ideas, for promoting breastfeeding, above formula, was to create a proposal for a bill that would change formula from being something you could by at any old grocery/drug store to something that was given as a prescription, by a doctor, who recommended it because breastfeeding was either not possible for mother or baby. We all realised that there are special cases where formula needs to be used (even though it would be great if milk banks were more prevalent!), so we didn't want to present something that would take that options away from mothers who really need it, but we thought it might create the mentality that it was only for special situations (like morphine, say) and not for the general public.

I decided to post here to see what other lactivists think about this idea. Is it too extreme? Is it stomping on rights? do you think it might work?

Any ideas on this subject would be wonderfully accepted.

thank you!

[1littlebit]

i think i would need to know what your definition of need is before i comment do you mind elaborating?

[honeybunch2k8]

Well, I imagine it can and does work in places where breastfeeding is the norm, but I don't think it would work here. IMO for that to even begin to work we'd need things like much longer maternity leave with pay, education campaigns, etc. But hey that's just my opinion I dont know if that's right.

[rhiandmoi]

I don't think it promotes breastfeeding so much as it forces a mom who is possibly already feeling bad enough about the situation to justify going to formula. Also what if the doctor disagrees with her assessment that it's not working for her?

[BugMacGee]

In our NICU, it has to be ordered by the neonatologist. I don't know how I feel about making it totally perscription only for everyone.

[woodchick]

I'm no expert, but this idea has been suggested before and I remember many being against it. The idea was put out that if formula was not regurlarly available mothers may turn to homemade formula and early introduction of solids- especially poor, working moms who may not have the support for pumping.

[Ruthla]

I think this would be a REALLY bad idea, for a number of reasons:

1) A lot of babies might be given whole milk before they're ready, if the parents couldn't get a prescription for formula (or the dr didn't prescribe enough.) Although this could be mitigated by possibility #3 below.

2) Lots of new moms would get prescriptions for formula 'just in case BF doesn't work out" and then they'll think "I have this Rx for formula, I must need it" and that's going to be a much more powerful message than they currently get from formula samples and such.

3) If "infant formula" is regulated and Rx only, then the same companies will start marketing more "toddler formulas", possibly some with identical ingredients to the infant formulations. So parents would learn that many "toddler formulas" are perfectly safe for infants, which could do one of two things:
a) Completely undermine the whole prospect of trying to regulate formula
b) cause more confusion between different toddler formulas, with some infants being fed innapropriate formulas that are NOT adequate for infants.

[Mama_Meme]

WOW! thanks for the input! I am glad that I put this message up. I'll try to address all the replies in one post.

I totally agree that people who couldn't get prescriptions/people who couldn't afford to and that would lead to early intro to solids. Never thought of that one. I live in Canada, so health care is not costly to receive, so a doctor's visit wouldn't necessarily be something that would leave poorer mothers in a bad situation.

I also agree that there would definitely need to be longer maternity leaves with pay(which I think need to be happening anyways) and support for pumping options.

As far as the "need" for formula: (and these are just ideas, i'm not sure if these are all situations that necessitate formula)
- mastectomies and other situations where the mommas breasts don't/can't produce milk and donor milk isn't available
- situations of low milk supply where baby isn't growing at all and needs supplementation (i have a friend who was very anti-formula who had this situation happen)
- cases of illnesses in mother where breastfeeding won't work (such as cancer, where chemotherapy is necessary)

With a wide spread education initiative, maybe it would work? and public health care? Right now in Canada, doctors are now taught to encourage mothers to breastfeed instead of just offering the formula option to any mom that comes in having a hard time bf'ing. all the education and information put out by health canada is stating that bfing is the best option. i wonder how we can reach more people with this education, or have the education have more impact.

thanks for your input!!


Well, it was just an idea. I'll report back to my mom's group with the information, and we'll keep brainstorming ways to promote breastfeeding and reduce dependency on formula.

[Viola]

Originally Posted by Mama_Meme

I decided to post here to see what other lactivists think about this idea. Is it too extreme? Is it stomping on rights?

That's pretty much how I feel. I'm a lactivist, but I'm pro-choice on this issue.

[AllyRae]

What about the people with no health insurance or prescription coverage? Would WIC still cover their formula? Would the cost of formula quadruple like every other medication does once it becomes prescription only? What about people who absolutely can not pump enough at work because of work conditions and not biological things?

I don't know. I like having the choice. I like the fact that when my adopted daughter couldn't breastfeed after a week, I could get her food--had we been in the US and formula was prescription only, we would have had to wait a week for an appointment (and who would make this determination--the child's doctor because it's her eating or my doctor because it's my breasts?) Then go through testing and wait for results. Then get the prescription. Then find a pharmacy that's nearby that carries what I need. And by that time, I have a very hungry child that was not able to breastfeed. And she's screaming and inconsolable and if I don't know better, I go to the store and feed her whole milk or pediasure, or whatever I can get into her to calm her down.

I don't like it. People are always going to choose or have circumstances where they can't breastfeed. All I can do is do what's best for my children and help others out who need help. But I'm not all keen on making life horrible for those that couldn't breastfeed.

[1littlebit]

so lets say it is prescription and doctors will only write prescriptions for mothers who NEED it so noones getting formula just incase. who would decide what warrants needing formula? what about mothers who are on medications that are not indicated for breastfeeding? what if they tried to switch to medication that is safe during bfing and it didnt work at all? psychiatric meds are trial and error and you have have to find one that works if that safe meds dont work then what do you do? what about women who were sexually abused? would an aversion to bfing because of sexual abuse be a reason? what if she never told anyone or atleast never told a health care provider.. would she have to tell them or would she just have to deal with it and bf? what if someone decides that not a good reason? who would write these prescriptions? how drastically would women be expected to change their diets in order to deal with food sensetivites? and how long would they require breastfeeding? b/c they would have to require for atleast a little while to ensure children are not getting solids or whole milk to soon. though i will say that if formula is prescription and lower income mothers got bfing established i doubt they would be tripping over themselves trying to spend money on solids an whole milk. i think a lot of times getting started is the hardest part.

[FullMetalMom]

Bad, bad, bad idea. Very bad and frankly, totally out of line to think that mom's shouldn't be able to make the choice themselves. Taking away women's choices is not supportive. Yikes.

[Amylcd]

Originally Posted by FullMetalMom

Bad, bad, bad idea. Very bad and frankly, totally out of line to think that mom's shouldn't be able to make the choice themselves. Taking away women's choices is not supportive. Yikes.

I totally agree. It's a horrible idea.

[Momily]

In that case, my DS would have been a pretty clear case of "needing" formula -- there would have been no question that we'd be on that list.

DS was on a "prescription" type formula (actually not a true prescription formula, but one that could only be ordered through a medical supply company and that was paid for by my insurance company). It was something of a nightmare -- they'd deliver the wrong formula, or deliver it to the wrong house, or they'd deliver half as much as we needed etc . . . Every month there was stress over whether I'd be able to feed my child.

Our experience with prescriptions was similar -- we'd go to get them, the pharmacy would be out, they'd transfer it somewhere else and I'd take the bus across town, wait a couple of hours and find out that they didn't have it. I missed a huge amount of work running to different pharmacies and picking up prescriptions at doctors offices.

I think this system would result in more women choosing inferior homemade formulas, or switching their babies to cows milk, or diluting the formula with too much water.

[rhiandmoi]

Originally Posted by Viola

That's pretty much how I feel. I'm a lactivist, but I'm pro-choice on this issue.

Love that

I think women should be able to say "I don't want to BF" and have that be acceptable. I think lactivism should be about helping more women want to BF instead of making it their only choice.

[AtomicOcean]

While I agree that the choice should be there, I also think that not breastfeeding is a health issue that should be discussed with a doctor.

Maybe they need to make access to formula the same as access to the morning after pill here - you have to talk to the pharmacist before getting it and all the pros and cons are discussed. There would be no need to go into the woman's medical issues, if she didn't want to (although I still think that needs to be taken into account)

[NewMama2007]

I think that that would lead to babies being fed inappropriate things, like regular cow's milk or what my mom had...Pet milk w/ Caro syrup. And what about the mom that has to return to work and can't pump enough? Is she just out of luck?

When it comes down to it, bfdg is a choice...and if a woman doesn't want to, she won't. As sad as that is...if a woman doesn't have access to formula, she would feed her baby something else if she doesn't want to bfd.

And it is a choice! Don't forget that.

[PatioGardener]

Originally Posted by NewMama2007

When it comes down to it, bfdg is a choice...and if a woman doesn't want to, she won't. As sad as that is...if a woman doesn't have access to formula, she would feed her baby something else if she doesn't want to bfd.

And it is a choice! Don't forget that.

I wish it wasn't a choice. I wish it was a decision that mothers make with full information and support. Sadly right now it is often seen as a choice between two almost equal things- with breastmilk being 'best' - but formula being 'good enough'.

Rather than formula being prescrition only, I would like to see formula companies and hospitals and health care providers conform to the WHO code for marketing of breastmilk substitutes. If you take the formula marketing out of the picture, women have a better chance of receiving full information and making an informed decision.

[stik]

A lot of low-income moms have to go back to work much sooner than they would like to, and employers do not always offer anything like enough support to allow a woman to pump milk for her newborn. Even in Canada where healthcare is socialized, going to the doctor for a formula prescription takes time that a mom may not have.

(And if she does have it, honestly, it would be more beneficial to her and her newborn if they stayed home and bonded - which might allow them a little time to breastfeed even if the mom can't do that full time - than if they dragged themselves off to the doctor's office to sit in a germy waiting room for a formula prescription.)

The choices women face when feeding are not only breastmilk and formula. There's breastmilk, commercially-produced formula, cows' milk, home-made formula, and complete crap people concoct out of whatever is cheap and liquid enough to flow from a baby bottle. Keeping commercially-produced formula readily available helps cut down on the number of people who find themselves seriously contemplating complete crap.

[Blu Razzberri]

I didn't really have a chance to read the other replies, but I did skim through them. There's some good stuff.

I also (if it hasn't been said yet); believe it would just become yet another over-prescribed drug. Nothing would change, really. Women who don't want to BF would make excuses and their doc would write them the prescription happily, while pocketing the money to do so. Then there's the fee's (in the US anyways) you'd have to pay to the doctor just to visit, consult, and GET the 'script.

Also, would you need a prescription for every can? I don't formula feed so I'm not sure, but... don't babies go through like two cans a week? That's a whole lot of fee's on top of the fee's to get the prescription. This may deter a small number of people; but really it just creates a whole different problem. To the rich, it wouldn't matter, but to the mom who can't otherwise breastfeed (perhaps she had a lumpectomy or her breasts were removed for cancer or something) and she was barely able to afford formula in the first place; adding doctors fee's on top of that would mean what for her child? She finds an alternative (possibly far less suitable), or the child dies.

I think the change has to come from the way society looks at it. People need to stop viewing formula as a 'choice'. The only way that's going to happen, is if people become aware of the consequences and downfalls of formula; which gets lost more and more with each generation.

Honestly, the "breastmilk is good" campaign fails, because people think "ok, breastmilk is good...so is formula". They also think it's easier for some reason. I think there needs to be heavy "formula is bad, because..." campaigns that explain in simple terms the difference between formula and breastmilk, and why it's hard on babies.

GAH! I'm thinking myself crazy about it. Must stop writing.