B.C.’s Fraser Health questioned over tone of ‘breastfeeding contract’

For new parents, there are fewer issues more pressing or emotionally charged than how to feed their child.

To breastfeed or not to breastfeed, that is the question often posed to new mothers, and one that can become moot in the case of exceptional circumstances, medical hurdles or legitimate personal aversions.

But there is a distinct stigma directed at those who do not breastfeed, and a Vancouver hospital recently – though perhaps unintentionally – has piled onto that bandwagon.

British Columbia’s Fraser Health released what appears to be a breastfeeding contract, which urges new mothers to indicate to hospitals in writing whether they intend to breastfeed once they return home with their child.

The document has been referred to some as a "breastfeeding contract." And while mothers are given three options on the sheet, being asked to indicate whether she will breastfeed, use formula or implement a feeding system using both options, the wording strongly implies there is a correct answer.

Under the breastfeeding options, it reads:

The other options include less positive remarks, including warnings that the woman's breasts will become hard and sore, that formula feeding increases health risks in the child and that it can be expensive.

The document is referred to as a "prenatal decision-making tool," though the first line of the document states simply, "Breastfeeding is the normal way to feed your baby."

The matter has sparked significant debate. Today's Parent, a popular site for both new and experienced parents, recently wrote about the "contract" and the steps one mother took to hide her stash of "emergency formula" from a judgemental lactation consultant.

"As if responsibility for a tiny, new human isn’t terrifying enough, I can only imagine how new moms struggling with breastfeeding must feel when signing the Infant Feeding Declaration," wrote Jennifer Pinarski.

Raina Delisle wrote on iVillage.ca about how another mother's plan to avoid baby formula as if it were Ebola was quickly decimated by reality, and how she was made to feel like an inadequate mother and woman.

Sidney Harper, a 30-year public health nurse with Fraser Health, has written a blog post in response, stating that the "ultimate objective" of the prenatal decision-making tool was to help women set and reach their own feeding goals.

"This is not a declaration or contract as some people have reported," she wrote.

"Like a birthing plan, the feeding plan can change day-to-day, depending on your circumstances. We know that 95% of women want to breastfeed; and we do what we can to help them do this. We also know that some mothers, for various reasons, choose to use formula, and our role is to provide as accurate information as possible so they can make informed decisions."

Not that anyone is arguing the point, but studies have backed up the health benefits of breastfeeding.

The World Health Organization promotes breastfeeding to ensure healthy growth. Fraser Health says children who are not breastfed are more likely to suffer from diarrhea and vomiting, colds and chest infections, diabetes, some cancers and obesity. The Public Health Agency of Canada says breast milk makes your baby smarter, and also builds a special relationship between mother and child.

But for the majority of parents, it is not a question of whether they want to breastfeed. It is a question of whether they can. Sometimes babies refuse to latch. Sometimes mothers simply can't provide the necessary milk or live reasonable lives that don't allow them to be home to feed 24-7. In other cases, modern families are comprised in a way that does not include an eligible provider of breast milk.

It is in such instances when the public shaming campaign that calls for breast milk-only diets becomes offensive, and unhelpful.

Parents and expecting parents know what is at stake in the early days of a new life. They are feeling the pressures of the breastfeeding movement, the SIDS scaremongers, the environmentalist union, the working-mother naysayers and the "keep you kids at home" cabal.

The last thing they need is to be told they are failing as a parent, and a human, if they don't get the right amount of breast milk into their baby during the first days of life.

Harper, the Fraser Health nurse, insists that is not what the prenatal decision-making tool is about.

"Infant feeding is an emotionally charged topic in our culture. Our job is to inform women with accurate information, let them make their decision and then support them to achieve their own feeding goals; all the while supporting the long-term health and well-being of both mother and baby," she writes.

There are 100 ways to raise a child, and all of them are wrong in the eyes of someone. Advice and guidance is very welcome from medical professionals such as those at Fraser Health. But sometimes providing support should be top of that list. When parents leave the hospital feeling like they've already failed, something isn't quite right.

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