July 13, 2006 -- Do you cringe when you see a woman breast-feeding in public? Or do you pass judgment when you see a woman buy milk formula for her newborn? Americans have mixed visceral reactions to breast-feeding, and a recent breast-feeding ad campaign has brought those reactions to a roiling boil.
The U.S. government spent $2 million on an ad campaign to promote breast-feeding. One of the ads shows a pregnant woman logrolling; another shows her riding a mechanical bull. Both ads ask: "You wouldn't take this kind of risk with your baby, so then why would you take the risk by not breast-feeding?"
America has one of the lowest breast-feeding rates of any industrialized country. That could be due, in part, to how uneasy Americans get when it comes to seeing a woman nursing in public.
"Whenever I see a mother breast-feed in public, I always go over and say to her, what a wonderful mom you are," said Amy Spangler, a lactation consultant who was an adviser on breast-feeding ad campaign.
Spangler, along with scientists, doctors and even the baby formula industry, all agree the breast is best. Studies show giving babies breast milk significantly reduces the number of infectious diseases they suffer.
"We teach immunizations, we teach car safety, we teach mothers to use bicycle helmets, but we don't teach anything to mothers about breast-feeding," said Spangler. "Yet it's an integral part of what we really should be doing as part of the healthy lifestyle."
But critics of the campaign say it should have focused on the health benefits of breast milk rather than on the risk of not breast-feeding. Some women who chose to use baby formula said the negative framing of the ad campaign touched a nerve in them.
Jen Spitzer, a mother who used formula, not breast milk, said the ad made her angry because it was too black and white. "I think it would make someone who can't breast-feed or somebody who chose not to breast-feed feel guilty because it's saying that you are putting your child at risk if you choose to formula feed," said Spitzer.
According to Spangler, that's not at all what the campaign intended. "It's not that we were equating that. It [the ad campaign] was simply very humorous framing of a very sensitive topic," said Spangler. "Any kind of a message using a risk-based focus is always a difficult arena to venture into and it's always controversial."
Recipe for Disaster
Dr. Myron Peterson of the Cato Institute, a private research foundation, disagrees. "It's basically negative advertising and it's designed to frighten people," he said. "One of the worst things you can do is to force or coerce or cause a woman to breast-feed when she really doesn't want to because that's a recipe for disaster."
Spitzer knows that recipe for disaster all too well. "If you're frustrated and you're stressed, the baby's goin' to feel it and sense it as well. I was so much happier bottle-feeding. And I saw a difference in my child," said Spitzer.
Peterson said women shouldn't feel bad about not breast-feeding. "I just don't think it's correct to say a woman who chooses not to breast-feed is in that category of negative behavior." Peterson said the focus should really be on taking steps to make breast-feeding easier, such as making changes in the workplace.
Spitzer agreed. "I think it's irresponsible of the government to put a commercial on and say this is what you must do and then not assist individuals to do it."
Advocates of breast-feeding agree that much more needs to be done to encourage companies to make it easier on nursing mothers. Sixty percent of mothers with small children are in the work force. Companies are only required to give 12 weeks of maternity leave, and just a third provide rooms for moms to nurse or pump in.
Can Mothers Ever Win
Spangler said it's the mothers' responsibility to initiate changes at the workplace to make breast-feeding easier for them. "You need to go to your employer early in your pregnancy. You need to say to them, 'Let's talk about what kind of accommodation we can make so that I don't have to trade off breast-feeding my child for continuing to provide you with the work services that you're accustomed to receiving."
But just how easy is it for women to talk to their employers about breast-feeding? Spangler said she hears from mothers every day who speak to their employers about this issue.
Public Tolerance to Breast-Feeding
Critics said that although the government ad campaign succeeds in promoting breast-feeding, it fails to address the negative reactions many nursing mothers receive when they breast-feed in public.
Melissa Lader, a mother who wanted to breast-feed but couldn't, said, "If they were to have an ad of a woman actually breast-feeding, I think there would have been a lot of uproar in a different way, saying why are you showing that publicly?"
After all, this is a country that came to a standstill when Janet Jackson's breast was exposed for a second on national television. Is it any wonder nursing women are experiencing a lot of hostility or discomfort when they nurse their babies and expose their breast in a public place?
Spangler cited new legislation on breast-feeding that has passed in some states that gives a mother the right to breast-feed wherever she has the right to be. "Now that the law is in place, we're challenging those mothers. Please, come out of the closet, come out of the bathroom, come out of the back room, and feel comfortable breast-feeding your babies."
Supporters of the government advertising campaign said it was designed simply to raise awareness, to encourage women to buck the national trend and start breast-feeding.
"We need to be clear about this -- that any amount of breast milk a baby gets is a gift," said Alison Walsh, a mother who chose to breast-feed. But Spitzer, who decided not to breast-feed, said that type of thinking makes her feel guilty. "Sitting next to you, being the person that bottle feeds, I almost feel as if you're saying I didn't give any gifts to my child."
Despite their differences, there is one thing all women agree on: that the government's ad campaign put the proverbial cart before the horse. A lot of laws and attitudes still need to change if breast-feeding is to make significant headway in the United States.