Mary hurries out of her car. She is late for the lunch that she has called all her friends together for. As she gets seated all her friends sit quietly. Mary is so busy trying to get situated that see doesn’t realize all eyes are on her. Finely Amy pipes up “Well what is the big news?” Mary grins, “Well Mark and I are… having a baby!” The whole table jumps with excitement.

Chatter continues as the women discuss the joy of buying baby clothes and all the work Mary has to look forward to. About half way through their meal Ann pops of a question, “You are going to breastfeed, Right?” Before Mary has a chance to answer Amy fires back, “All my kids were formula fed and nothing is wrong with them, honey it is your choice. Personally I wasn’t comfortable with a kid hanging off my boob.”

Mary sat quiet for a second, “Well, to be honest, I haven’t thought about it. There is a choice to make in feeding my baby? What are the differences? How much will this cost? Who do I talk to?”

“Calm down, it is not a decision you have to make now. I’ll set you up with my lactation consultant. She will tell you all about it.” Ann whispers to her. “No, talk with your doctor. Lactation consultants are biased and she will try and force you in to breastfeeding,” Amy states. Mary sits back and watches her two dear friends bicker about what is a better choice, formula or breast milk. After ten minutes, Mary looks at her watch. It is 1 pm. She has to be in for her OB appointment, with her family doctor, in 20 minutes. “Sorry gals, I’ve got to run. I was great having lunch. Maybe next time you two won’t fight so much,” Mary smiles and Ann and Amy embarrassingly smile back. “Alright hun, well congratulations on the baby.” Mary gives Ann and Amy a hug then bolts out the door.

Sitting in the physician’s office, Mary is thinking about this choice that women put in front of her. How big of a decision is this? Her name is called and she steps into the hall way toward the “check in station”. The nurse checks her blood pressure weight and time of last menstrual cycle. All looks good; the nurse leads her toward her room.

Shortly after she get comfortable in the room (well as comfortable as she can get) the doctor knocks on the door. “Well hello Mary how are you feeling today?” Reaching for the fetal heart monitor, he motions Mary to lay back. Lifting up her shirt Doc squirts the cold gel onto her stomach. He presses the receptor onto her skin. After a couple of seconds, a strong rapid heartbeat comes through. “Every thing sounds great. Your blood pressure and weight are looking fine. Do you have any questions for me?”

“Well, I do have a question for you. When I went to see some friends today they were asking me whether I was going to bottle of breastfed. I’m not sure. What do you think?”

“Breast milk is better for the baby. Nevertheless, it is whatever makes you more comfortable. Formula has come along way. When you get closer to your due date, I will give you some samples of brand X. Do you have any other questions?”

“Um… No. Thanks (I think)” The physician pats her on the back and leaves the room. Mary sits on the bed even more confused then she was before. If breastfeeding were best, why would my doctor offer samples of formula? That doesn’t make since to Mary. She walks down the hallway back to the front desk to pay her bill.

Arriving at home, Mary is greeted at the door by her husband, “How was the doctor's appointment?” He had just arrived home seconds before her. He is covered form head to toe in dirt and grease. “Next time I hope we are not working on such a messy project so I can come along. How did your friends take our news?”

“It had really been a strange day. Ann and Amy wanted to know if I was going to breast feed or bottle feed. They were arguing over which one was better. I asked the doctor what he thought. All he told me was that breastfeeding was better but he would give me a sample of formula when the due date is closer. I’m so confused.”

“Well we have the internet. Why don’t you do a little research? Whatever you decide I am behind you one hundred percent. If you decide to breast-feed, my parents might throw a fit. Mom says that it is a body fluid, so that makes it unclean. Me, I don’t know. You were breast fed… right?”

“Ya, I was. I have never really though about it. I was so worried about getting pregnant, how to feed the baby never entered my mind.” Mary sits on the couch, arms folded, head down. Mark moves closer to her and wraps his arms around her. “It will all be ok. Don’t let this stress you out. We still have six months before out baby is born. Plenty of time to figure it out. Why don’t you go do some research and I’ll start dinner. I’m making steak, your favorite.”

“That is really sweet of you but I really don’t think that would settle very well. Can we have spaghetti instead, with very little sauce?” Mark smiles and gives her a kiss on the forehead. “Sure, if you think that you can eat that, I’ll make it.’

Mary sits down to her computer. Pulling up the search engine, she types “breast milk vs. formula.” An array of website titles pops on her screen. Mary scrolled through the page reading the different title and their descriptions. The title “Infant Formulas versus Breast Milk” caught her eye. The first thing she saw was a quote from one of the articles reference material, “Infant formulas have a difficult gap to fill. They must mimic breast milk as closely as possible. Yet it is difficult to produce a formula equal in all respects to breast milk, because its exact chemical composition is not yet known.” (Pray). This took her by surprise. With all the technology we have they still don’t know all the things that are in breast milk.

She continues reading to find that formula does not adequately meet all the nutrition needs for most babies. As she continues reading there is a disclaimer box that breaks the text.

Breast milk is ideally suited for the average infant, delivering all needed nutrients. It is a species-specific liquid containing unique substances such as living cells (e.g., macrophages), hormones, antibodies, active enzymes (which promote gut maturation, facilitate digestion and stimulate passage of meconium) and other proteins (e.g., immunoglobulins such as IgA) that cannot be artificially supplied to the infant.5 Breast milk composition varies on a diurnal basis, and its fat content changes according to the time of the feeding episode ("fore" milk versus "hind" milk).3 Early milk (colostrum) contains proportionally greater amounts of protein and minerals and less fat than mature milk. These ratios reverse as the infant ages. (Pray)

Mary can’t believe what she is seeing. Going back to the main search page she looks for another source of information.

Arriving at a different website the title scared her “The Deadly Influence of Formula in America.” It said that the original propose of formula was not for women or families to choose a feeding method but a resource for women that couldn’t nurse there babies circumstances such as premature babies (before the breast pump of today) or mothers who died. It again stated that formula doesn’t meet all of a babies nutritional need, but adding that is “leaves their immune system failing”. The article then points out infant formula doubles the risk of infant death in the US (a developed country with quality health care). Continuing it discusses the different reasons why infants die. After explaining each one Mary sees a table. The table calculates the actual deaths (for infants in 1999) the relative risk (of each cause of death) for breast fed and formula fed children. What Mary saw next amazed her. If all children in the US were breastfed (from birth to 12 months) 9,335 lives would have been saved! Even more intriguing was that studies show that infants that are supplemented (receiving both breast milk and formula) have illness and death rates closer to babies that are strictly formula fed. (Palmer)

The article was filed with so much information Mary could not stop reading. She noticed a headline “And Beyond the First Year”. Studies show that the child still gets great benefits from breast milk into the second and third year. The Netherlands did a study showing “a strong correlation between the extent of breastfeeding and the number of illnesses in children.”(Palmer) Mary stops to ponder, “Not only does this affect my child’s health but it also affects us economically. If we formula fed that could mean more doctor visits, and costs of formula, bottles, nipples, and who know what else. Then I have to worry about making the bottles. Are they the right tempterature? The type of formula to use… All that seems like more work.”

Mary continued reading the article. As she approached the end, this statement caught her eye.

Pediatricians spend much time frightening parents with something like a 1 in 100,000 combined risk from vaccine-preventable diseases when parents question the utility and safety of vaccines. “Would you want to risk the life of your child?” they demand. Yet these very same professionals offer formula samples with the other hand – when the magnitude of health risks associated with the use of formula is 500 times greater. (Palmer)

She remembered back to when her physician told her that he would give her a formula sample. “Why would he do that? “ She wondered. Mary went back to searching. She typed “Physical knowledge of breastfeeding" into the search engine. Up came a very short but shocking article.

The University of North Carolina did a study to find out just know much physicians know about breastfeeding. They randomly sent out questioners to a total 5,035 doctors (hospital residents, pediatrics, OB/GYN and family physicians). When reviewing the results “less than 50% of residents chose appropriate clinical management for a breast-fed jaundiced infant or a breast abscess.” (Freed) The numbers shocked Mary. Could it be that her physician didn’t explain the differences better because he wasn’t sure on all the details. Mary was pleased to see that 90% endorsed breastfeeding. However, only half said the they were effective breastfeeding counselors (Freed). Mary gathered her information and headed into the kitchen.

Mark joins Mary at the table. Together they go thought all the information that Mary had found. “Well dear what do you think?” asks Mark under the glow of the chandler light. “There is no option. I’m breastfeeding this baby. I don’t understand how a mother could possible say that it is a choice to breastfeed or not. Sure there are many people have survived on formula. However, it can never give our child what I can. Formula should be reserved for medical necessity only. Well, I guess I answered my own questions from this afternoon.”

“What questions are those? “

“Well, when I was listening to Ann and Amy bicker I freaked out.”

“You never… I mean why dear?” Mark tries to hide a smile

“What are the differences between breast milk and formula? There are so many. The biggest one is that my milk will be custom made for our child. What will it cost? It could cost out child’s life. Finally, whom do I talk to? I think I’ll call Ann and get the name and number of her lactation consultant."

Works Cited

Freed, G. L.; Clark, S. J.; Sorenson, J.; Lohr, J. A.; Cefalo, R.; Curtis, P. “National assessment of physicians' breast-feeding knowledge, attitudes, training, and experience.” The Journal of the America Medical Association 273.6 (1995) 13 April. 2008 http://jama.ama-assn.org/cgi/content/abstract/273/6/472

Palmer, Linda Folden PH.D. “The Deadly Influence of Formula in America.” Natural
Family Online. 4 December 2003. 2 April 2008
http://www.naturalfamilyonline.com/articles/312-formula-report.htm

Pray, Steven W. PH.D., RPh. “Infant Formulas Versus Breast Milk.” U.S. Pharmacist. 2 April. 2008 http://www.uspharmacist.com/oldformat.asp?url=newlook/files/cons/acf2f78.htm