Latch On NYC—What’s All The Fuss?

by Heidi Green
August 02, 2012

The headlines are alarming: “NYC Hospitals’ Baby Formula Plan Rankles Mommy Bloggers.” “Bloomberg’s Breast-Feeding Nudge—or Shove.” And (perhaps my favorite title ever), “Mayor Bloomberg, ‘keep your hands out of our bras!’”

The charges are astonishing: Locking up formula is akin to keeping a drug addict away from the hospital’s supply of morphine. It’s going to make for “screaming, hungry infant[s]” in “understaffed hospital[s].” Government is “put[ting] its hands down [women’s] shirts to monitor and mandate” how they feed their baby, and “messing with a delicate bond … between a mother and her baby.”

Getting beyond the drama, to the heart of Mayor Bloomberg’s directive, can be a real challenge.

What’s all the fuss?
This isn’t the first time New York City Mayor Michael Bloomberg has been mired in controversy over issues related to infant health. In 2005, Bloomberg launched the Take Good Care of Your Baby campaign, a citywide safety campaign designed to reduce the risk of SIDS. The campaign was expanded in 2007 to include efforts to increase breastfeeding rates among NYC mothers by discouraging the distribution of free formula by local hospitals.

This latest initiative, Latch On NYC builds on prior efforts by urging hospitals to voluntarily:

• Enforce a statewide hospital regulation to not supplement breastfeeding infants with formula unless medically indicated and documented on the infant’s medical chart
• Limit access to infant formula by hospital staff
• Discontinue the distribution of promotional or free infant formula
• Prohibit the display and distribution of infant formula advertising or promotional materials

While touted as Bloomberg’s personal initiative, Latch On NYC has received the endorsement of several leading NY health organizations, including New York State Department of Health, Greater New York Hospital Association, Academy of Family Physicians—New York County Chapter, American Academy of Pediatrics—New York State (District II), and Society for Adolescent Health and Medicine—New York State Chapter.

To date, more than two dozen hospitals and health systems have voluntarily committed to follow the guidelines laid out in the Latch On NYC initiative.

Latch on, latch off
Opponents of the Latch On initiative believe it to be a case of government overreaching its authority. A mother’s feeding of her infant is her choice, they say, and women shouldn’t be “forced” to breastfeed the babies they have birthed. It will make women who are unable to breastfeed (or who choose not to breastfeed) feel shame and guilt. One blogger for the NY Times characterized the effort as “an attack on parents and babies in the midst of what can be a difficult choice and a difficult time.”

If there has been an attack, Latch On supporters counter, it has been the long-standing attack on breastfeeding that has been going on in hospitals and birthing centers for decades. The Latch On campaign, they argue, is necessary to put an end to infant formula marketing in hospitals and ensure that babies and mothers have postpartum support to establish breastfeeding.

Fear of the policies causing hardship for mothers and babies are unfounded, according to one doula/lactation consultant working in a hospital with Latch On-type policies. Mothers who “don’t want to breastfeed … don’t.” But those who do won’t have to worry about nurses “sneak[ing] formula behind [their] back”—as some well-meaning maternity nurses sometimes do—since it would have to be documented on the chart.

Although Latch On opponents have claimed mothers who choose to formula feed will be subject to lectures from hospital staff, this is not borne out by the initiative. Any formula given to the baby in hospital will need to be documented—the same way that anything given the baby would need to be charted. The hospital staff will need to indicate why the baby is receiving formula, whether it is medically indicated or the parent’s choice. But this documentation is not atypical for hospital charting. In fact, it is in accord with practices set forth by the Joint Commission, the hospital accreditation authority, and New York state’s own hospital regulations. It is not surprising that hospital staff should need to document the reason for giving formula now; rather, it’s surprising that they haven’t had to document the reason before.

In addition, concerns about limitations to access of formula (often described as it being “locked down”) are overstated. Formula will be no more “locked down” for mothers post-Latch On than it was pre-Latch On. Prior to this initiative, a mother who chose to formula-feed her infant had to call the nurse and ask for a bottle to be brought to her. Under this initiative, a mother who chooses to formula-feed her infant has to call the nurse and ask that a bottle be brought to her. If there is a “lock”—and Mayor Bloomberg’s deputy press secretary has said that there need not be—it is behind the scenes. It is accessible by nursing staff, and only ensures that they discuss feeding decisions with parents and document those choices deliberately, rather than dole out formula as a matter of course.

The less-dramatic aspects of Latch On call for the removal of infant formula promotional materials from hospitals. Instead, the campaign is developing a series of posters for display in hospitals and public areas such as subways, touting the important health benefits of breastfeeding.

“Human breast milk is best for babies and mothers,” New York Health Commissioner Thomas Farley noted at the announcement of Latch On in May, “With this initiative the New York City health community is joining together to support mothers who choose to breastfeed.”

Mothers who choose to formula-feed their babies and mothers who need to supplement their babies with formula can do so. But those NYC mothers who want to breastfeed, who are struggling with breastfeeding, or who require help with breastfeeding, might finally find it easier to get the help, support, and assistance they need and deserve.